18. Miss I complains about the Trust’s rejection of six referrals for her to access secondary mental health care. She says she accessed talking therapies but felt this was no longer working and she needed an assessment with a psychologist/psychiatrist. She says the Trust should not have made decisions without seeing her in person.
19. The Trust declined the referrals on the basis that primary care is the most appropriate form of support for Miss I.
20. When we complete a primary investigation, we look at whether there are signs an organisation has got something wrong. We do this by comparing what should have happened with what did happen. We have done this and, we have not seen any indications that something has gone wrong in the care and treatment the Trust gave Miss I.
21. Referrals to the Trust are considered by its single point of access (SPA). The Trust’s Core Pathway Operational Policy says ‘the SPA is an integrated team that undertakes screening, triage and an initial assessment of routine and urgent referrals. Following an initial assessment, the service user will either be:
• transferred to the intensive home-based treatment team (IHBTT) for a crisis assessment • treated within the Core or Enhanced pathway • signposted to other external partners • discharged from secondary mental health services’.
22. The SoP says, ‘referrals will be accepted for people who have mental health issues with additional physical health and social care needs that impact on their mental health’.
23. Miss I was referred to the Trust’s SPA six times between February 2021 and April 2024.
24. The role of the SPA is to decide if there is a need for secondary mental health services after an initial assessment. This can include a discussion with the referrer (in this case Miss I’s GP) and any services involved (in this case the talking therapies service).
25. NHS Talking Therapies is a programme for anxiety and depression. This was developed to improve the delivery of, and access to psychological therapies for depression and anxiety disorders. Miss I was continuing to receive therapy with the talking therapies service.
26. The Trust discussed Miss I’s referrals in its MDTs, and with the talking therapies service. The Trust decided the talking therapies service was the correct pathway for Miss I given her symptoms of anxiety and depression.
27. The Trust did not identify any risks that would warrant an assessment by secondary mental health services. The Trust, therefore, declined the referrals on the basis that primary care was the most appropriate form of support for Miss I.
28. Our adviser said the talking therapies service was the appropriate pathway for Miss I given the reasons for the referrals – her anxiety and depression.
29. Miss I did not present with any additional physical health or social care needs. The Trust assessed the referrals in line with its SoP.
30. We have seen no indication Miss I received the wrong care from the Trust. Miss I’s referrals were assessed properly each time. We have therefore, seen no indications of failings in the Trust’s management of Miss I’s referrals and care. The Trust correctly followed its SoP in the management of Miss I’s referrals. Following a review of each referral, the clinical team agreed that Miss I’s needs were best treated in a primary care psychological pathway via the talking therapies service.
31. We recognise the frustration Miss I experienced in not being able to access secondary mental health care and get a diagnosis for her symptoms. We acknowledge the length of time this has taken and the distress this has caused.
32. We are grateful to Miss I for bringing her concerns to our attention. We know this has been an incredibly frustrating time for her.