Poor health and social care integration
Lack of a fundamental shift towards collaborative, integrated system-wide change in health and social care.
70 items
1 source
15 inquiries
Strongest theme matches
Mixed across source types and ranked by classifier confidence plus text match strength.
Inquiry recommendation
85match
R101 - Whole-system commissioning with cross-agency risk assessment
Planning and commissioning services for people with learning disabilities and autistic people should be done as a single process across the whole system (including primary care, housing, benefits and independent and third sector providers of services). There must be a risk assessment that assesses how the impact of change in one part of the system impacts on another...
Matched on
terms: care, health, social
Inquiry recommendation
73match
R10 - Access to allied health professionals
It is critical for the wellbeing of people with learning disabilities and autistic people that they are well supported by, and have access to, AHPs including psychologists, speech and language therapists (SALTs), occupational therapists (OTs), podiatrists and dieticians. These AHPs need to be well integrated into daily life in service users’ homes and their recommendations, including positive behaviour...
Matched on
terms: care, health
Inquiry recommendation
72match
F235 - Joint proceedings
The Professional Standards Authority for Health and Social Care (PSA) (formerly the Council for Healthcare Regulatory Excellence), together with the regulators under its supervision, should seek to devise procedures for dealing consistently and in the public interest with cases arising out of the same event or series of events but involving professionals regulated by more than one body....
Matched on
terms: care, health, social
Inquiry recommendation
65match
11 - Reconstitute the Hospital Management Committee
The present members of the Hospital Management Committee should be invited to resign and the Committee reconstituted. In view of the pressing need to reorganise services at Whittingham, a small committee of about eight should be set up pending the establishment of an Area Health Board covering the Preston area. There is a need both for fresh blood...
Matched on
terms: health, social
Inquiry recommendation
65match
78 - Mutual understanding between authorities
Where a child is placed outside the area of the child’s own local authority the Social Work Departments of the two areas should have a clear mutual understanding of the roles and responsibilities of those involved in the care of the child (17.8).
Matched on
terms: care, social
Inquiry recommendation
62match
26 - Recruit social workers with local authorities
A strong group of social workers should be recruited in association with the Local Authority Social Service Departments of Preston County Borough and Lancashire County and services built up along the lines set out in Chapter 7.
Matched on
terms: social
Inquiry recommendation
62match
15 - Schools to link with Social Work Departments
The discovery of sexual abuse is not the monopoly of any agency. In particular, schools should establish close links with their local Social Work Departments. Teachers should be designated to be trained in the recognition of child sexual abuse and the roles of the various professionals who may be involved (15.34-35).
Matched on
terms: social
Inquiry recommendation
60match
53 - Timing of first review of assessment
The first review of the initial assessment should take place within one week of the initial assessment, and should take place in every case. It should be a multi-disciplinary review, with representatives from the prisoner’s wing, healthcare and the team responsible for implementing the establishment’s violence reduction strategy all contributing to it. The documents set out in paragraph...
Matched on
terms: care, health
Inquiry recommendation
59match
191 - Accessible social workers
Social workers should be readily accessible and available to the particular community which they serve and know and be known by it (19.28).
Matched on
terms: social
Inquiry recommendation
59match
20 - Independent professional advice for Social Work Departments
Social Work Departments should have recourse to independent professional advice in all appropriate cases in addition to the carrying out of any necessary medical examinations. A list of persons suitably skilled and experienced in providing such advice should be available to all Social Work Departments. It may also be appropriate to have recourse to advice from a child...
Matched on
terms: social
Inquiry recommendation
53match
17 - Professional Executive and therapeutic teams
The Group Secretary, the Chairman of the Medical Executive Committee and the Chief Nursing Officer, with other appropriate professional heads, should constitute a Professional Executive with delegated authority for day-to-day management of the hospital. They should maintain close liaison with the local authority Departments of Social Services. Similar co-ordination at other levels should be achieved by setting up...
Matched on
terms: social
Inquiry recommendation
53match
9 - Factors for the Board's reorganisation programme
The Board’s programme of reorganising mental illness services should emphasise factors which seem to us not to have been adequately recognised and are essential to the implementation of their policy: (i) the need to provide day places as well as beds in new district general hospital departments, (ii) the need for effective liaison with those responsible for supporting...
Matched on
terms: social
Inquiry recommendation
53match
162 - Consult before abandoning a case
Where a Reporter requires to consider the abandonment of a case which has been passed to the Sheriff for proof he should consult the Social Work Department before finally deciding to do so (18.50).
Matched on
terms: social
Inquiry recommendation
53match
13 - Designated senior coordinator in multiple abuse
At least in cases of suspected multiple sexual abuse a senior member of the staffs of the Police and Social Work Department should be designated to co-ordinate their joint work (15.32).
Matched on
terms: social
Inquiry recommendation
53match
F234 - Cooperation with the Care Quality Commission
Both the General Medical Council and Nursing and Midwifery Council must develop closer working relationships with the Care Quality Commission – in many cases there should be joint working to minimise the time taken to resolve issues and maximise the protection afforded to the public.
Matched on
terms: care
Inquiry recommendation
52match
194 - Orkney Islands Council and the community
Orkney Islands Council should take active steps towards improving the relationship between themselves and in particular their Social Work Department and the local community (19.33).
Matched on
terms: social
Inquiry recommendation
51match
SP53 - GMMH and Alder Hey joint SMART audit
At the local level, Greater Manchester Mental Health NHS Foundation Trust and Alder Hey Children’s NHS Foundation Trust should by no later than 13 October 2026 carry out and report on a joint audit to ensure that for cases involving both Trusts, the action points from multi agency meetings, healthcare meetings, discharge plans and management plans after risk...
Matched on
terms: care, health
Inquiry recommendation
48match
180 - Joint training with other agencies
Joint training should be undertaken between the social work profession and other agencies including in particular the police (19.15).
Matched on
terms: social
Inquiry recommendation
48match
164 - Police duty to inform Reporter
In all cases where a police constable has reasonable cause to believe that a child may be in need of compulsory measures of care he should be under a statutory duty to pass that information to the Reporter (18.52).
Matched on
terms: care
Inquiry recommendation
45match
25 - Single psychology department
Psychologists employed at the hospital should form one department and their work should be integrated into the therapeutic programme as a whole.
Matched on
classifier match
Inquiry recommendation
45match
7 - Multi-disciplinary advisory panel for the Board
In the light of our findings we consider that the Board have suffered from a lack of advice from the field. The Board should establish a multi-disciplinary advisory panel containing comprehensive professional representation from the field to advise them on current problems in developing psychiatric services in the Manchester Region.
Matched on
classifier match
Inquiry recommendation
45match
R94 - Continuing community support provision
There will be a continuing need, which must be met, for new and ongoing community-based support for young people and adults with learning disabilities and autistic people whose families become unable to cope full time. This means there is a continuing need for a range of types of provision and well-coordinated support services in addition to the usual...
Matched on
classifier match
Inquiry recommendation
44match
RHI-18 - Inter-Governmental Framework
More generally, we recommend a Northern Ireland government-wide framework for information exchange and, where appropriate, co-operation between the Northern Ireland Civil Service, Whitehall Departments and (where relevant) Departments of other devolved Governments and of the Government of the Republic of Ireland.
Matched on
classifier match
Inquiry recommendation
44match
27 - Co-ordinate occupational services
All occupational services, including industrial therapy, should be effectively co-ordinated under the aegis of a professional Resocialisation Group. They should be expanded, with the emphasis on industrial therapy, to provide activities for all patients who can make use of them.
Matched on
terms: social
Inquiry recommendation
44match
20 - Nurse training in co-ordination with Sharoe Green
Training for student and pupil nurses and experience of trained staff should be arranged in co-ordination with Sharoe Green and the new Preston hospital facilities to give adequate variety in all types of patient care.
Matched on
terms: care
Inquiry recommendation
44match
16 - Medical Executive Committee
The senior medical staff with clinical sessions at the hospital, together with representatives of other medical staff, should constitute a Medical Executive Committee, electing a Chairman whose appointment should be subject to yearly renewal. The Chief Nursing Officer and other professional heads, including the local Directors of Social Services, would no doubt be invited to attend as appropriate....
Matched on
terms: social
Inquiry recommendation
44match
156 - Reporter's independence in discussions
In any informal discussion between the Social Work Department and the Reporter his independence of action must be recognised and respected (18.39-41).
Matched on
terms: social
Inquiry recommendation
44match
IHRD-49 - Multi-Trust Mortality Meeting Engagement
Where the care and treatment under review at a mortality meeting involves more than one hospital or Trust, video conferencing facilities should be provided and relevant professionals from all relevant organisations should, in so far as is practicable, engage with the meeting.
Matched on
terms: care
Inquiry recommendation
41match
19 - Co-ordinated psychiatric nursing division
The Chief Nursing Officer should become head of a co-ordinated psychiatric nursing division, including Ribchester, Sharoe Green and the future hospital department at Preston. The current reorganisation of nursing staff on Salmon Report lines should continue within this framework.
Matched on
classifier match
Inquiry recommendation
41match
15 - Liaison with the Preston Group
The new Hospital Management Committee should maintain close liaison with the Preston Group to co-ordinate policy, particularly in relation to the admission unit at Sharoe Green and to plan a new service based on general hospitals at Preston and Chorley.
Matched on
classifier match
Inquiry recommendation
41match
6 - Co-operation between the Board and local authorities
We note the absence of local authority facilities in the Whittingham catchment area and consider that the Department should take steps to promote closer co-operation between the Regional Hospital Board and the local authorities concerned in planning the development of services for the area.
Matched on
classifier match
Inquiry recommendation
41match
1 - Guidance on long-stay elderly patients in the transition
The Department are, we understand, about to issue guidance on the problems of transition from mental illness services based on specialist psychiatric hospitals such as Whittingham to those based on units in general hospitals. Further thought and advice are urgently needed on provision that will have to be made for elderly long-stay patients who cannot be permanently accommodated...
Matched on
classifier match
Inquiry recommendation
41match
161 - Local guidelines on information to Reporter
It should be clearly stated in all local guidelines in what form if any information requires to be given to the Reporter (18.48-49).
Matched on
classifier match
Inquiry recommendation
41match
119 - Agreed strategy for joint interviews
Where agencies are to undertake joint interviews, there should be an agreed strategy both for the course of interviews and for the resolution of disputes and for the assessment of the ongoing work both by managers and interviewers (17.59).
Matched on
classifier match
Inquiry recommendation
41match
31 - National guidance on inter-area co-operation
The national guidance should include guidance on the principles to be followed where authorities or agencies of different areas require to co-operate in dealing with complex cases of child abuse together with other particular matters suggested in the main Report (15.64-65) and a new title should be given to the national guidance (15.66).
Matched on
classifier match
Inquiry recommendation
41match
30 - Co-operative preparation of national guidance
The national guidance should be prepared with the co-operation of all agencies and disciplines engaged in work in the field of child abuse and be available as guidance for all of them (15.61). It should include guidance on all forms of sexual abuse including multiple abuse (15.62), and should recognise the difference between operational and managerial guidance in...
Matched on
classifier match
Inquiry recommendation
41match
21 - Cooperation between two local authorities
Where two separate local authorities become involved in the investigation of a case of suspected multiple sexual abuse which extends over both their areas the heads of the respective agencies involved should make special arrangements to ensure complete co-operation (15.47).
Matched on
classifier match
Inquiry recommendation
41match
14 - Joint training and joint guidelines
To assist in practical co-operation both agencies should engage in joint training and should prepare joint guidelines (15.33).
Matched on
classifier match
Inquiry recommendation
41match
12 - Agencies share information in joint approach
In a joint approach while investigation of a case is properly a matter for the police each agency should share fully with each other the whole information relevant to their particular responsibilities (15.30-31).
Matched on
classifier match
Inquiry recommendation
38match
163 - Reporter and Procurator Fiscal to consult
The Reporter and the Procurator Fiscal should consult together to avoid conflict between the courses of action to be taken and they should also be invited to attend case conferences where appropriate (18.51).
Matched on
classifier match
Inquiry recommendation
38match
19 - Early inter-disciplinary meeting and parental involvement
In any case of child sexual abuse an inter-disciplinary meeting should be held at the earliest stage (15.39). Parents should usually be informed from the outset that the suspicion exists and that the matter is being investigated. Their co-operation should be sought (15.40-41). Consideration should be given to making enquiries of adults rather than of the children (15.42)...
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classifier match
Inquiry recommendation
36match
157 - Reporters not to investigate
It is not recommended that Reporters should undertake an investigative function before matters are brought formally to their attention (18.43).
Matched on
classifier match
Inquiry recommendation
36match
136 - SWSG to prepare interviewing guidelines
As part of the national guidance already recommended SWSG should undertake the preparation of guidelines for the investigative interviewing of children in consultation with representatives of all the agencies and professions who may be involved in that work (17.78).
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classifier match
Inquiry recommendation
36match
134 - Review before departing from interview plan
Any departure from the purpose or number of interviews should only be made after a full review of the situation and the agreement of all agencies (17.76).
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classifier match
Inquiry recommendation
36match
128 - Planned supervision of joint interviews
Where interviews are being undertaken jointly, supervision should be planned on an occasional but regular joint basis (17.70).
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classifier match
Inquiry recommendation
36match
16 - Awareness for school administrative bodies
The administrative bodies of all schools should be helped to develop an awareness of the problems involved in child sexual abuse and the roles of the various agencies engaged in dealing with it (15.36).
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classifier match
Inquiry recommendation
32match
29 - Split the inner catchment area into districts
The inner catchment area of Whittingham Hospital coincides with that of the Preston Group. This should be split into defined districts, each with the responsibility of a single multi-disciplinary therapeutic team.
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classifier match
Inquiry recommendation
32match
117 - Channels from interviewers to case managers
Clear communication channels should be set up from interviewers to case managers (17.57).
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classifier match
Inquiry recommendation
32match
18 - Joint MoJ/DfE policy for children in custody
The Chair and Panel recommend that the Ministry of Justice and the Department for Education share policy responsibility for managing and safeguarding children in custodial institutions. This is to ensure that standards applied in relation to children in custody are jointly focussed on discipline and securing child welfare.
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classifier match
Inquiry recommendation
32match
R91 - Higher-funded resettlement team for complex needs
There needs to be a recognition that those service users in Northern Ireland yet to be resettled (if there are any by the time of publication of this report) will require a higher level of funding due to their needs and behaviour that challenges. A highly qualified team must be formed to progress their resettlement. An example of...
Matched on
classifier match