Central and North West London NHS Foundation Trust

“We have revised our approach to ensure that referrals are accepted even when patients are not yet medically cleared. This enables earlier engagement, risk planning, and support. A key performance indicator for the HLT is timely response to referrals. In the past six months, over 95% of ED referrals have been responded to within one hour.”

“We are issuing additional guidance around managing risk of suicide in those with a diagnosis of Personality Disorder (or more commonly now known as Complex Emotional Needs) reminding staff to consider the need for assessment by a Consultant [name redacted].”

“We have shared learning on this with the team and are updating our policies accordingly.”

“We are part of interagency Suicide Prevention group for Kensington, Chelsea and Westminster. In addition, we recently held a Learning session entitled - Suicide Prevention Part 1: Understanding Suicide. We are also piloting a new way of caring for service users in South Westminster ("Open Dialogue") with the overall goal to enter into discussion and communication with different sources to ensure increased participation in the safety and treatment of the service user”

“We are reviewing our guidance on this and will ensure staff are clear on action to be taken.”

“We are reminding staff of the need for consistent and adequate communication amongst professionals involved in treatment.”

“In November 2022, the Trust updated its resuscitation training to the Nationally accredited RCUK Level 3 Resuscitation training also known as Immediate Life Support (ILS). It is a course where to be successful the participants need to successfully demonstrate the skills required to resuscitate a patient. Providing assurance to both the individual and the Trust. All participants are involved in multiple resuscitation simulations, all of which have been developed from incidents that have occurred”

“The Trust began using SystmOne as its electronic clinical system in February 2019. As staff transitioned to the new electronic clinical record system they were learning about the operation and functionality of the system, and this also involved use of templates within the system and recording of information. It is fair to say that in March 2019 St Charles Mental Health Unit was at the start of the process of using SystmOne. Three and a half years later staff are now proficient in its use. This has”

“The Trust should give serious consideration to developing a guide to all staff on when to refer cases to healthcare. This should be achievable without being either over-prescriptive or over-restrictive.”

“psychiatric reports. Work to review the procedures for obtaining and providing psychiatric reports is already underway, recognising the particular gap in relation to provision of reports for the purposes of fitness to plead. Following your letter to , Chief Executive HMCTS, I can confirm that in July 2017 HMCTS and the Judicial Office re- issued existing guidance from 2010 on this process, with the caveat that it is recognised that some information may be out of date. The Senior Presiding Judge has”

“The ACCT document is currently being redesigned with a view to its nationwide re- introduction in early 2018. As part of this redesign, we will consider your suggestion that a summary sheet of ACCT observations and conversations be included”

“learning bulletin (ACCT - Case Reviews, CAREMAPs and Levels of Conversations and Observations) was issued to all prisons in July this year. The bulletin reminded staff that ACCT review meetings must be multidisciplinary and must take place within the specified timescales. It further stated that that where any individual involved in the prisoner's management cannot attend the review, they must submit written contributions”

“The PSI also states that unconvicted prisoners, such as [the deceased], must be allowed more frequent visits, and that establishments with a large number of unconvicted prisoners will require a more flexible system to enable rebooking of cancelled visits.”

“Our service specification 'Manage the Custodial and Post Release Periods' is clear that all individuals in custody must have a resettlement plan and that the offender manager must ensure that external agencies are notified of a prisoner's release. All prisons are expected to adhere to this specification, but I know that it is not fully in place across the estate, and we are currently implementing a new model of offender management in custody.”

“We have had a discussion with HMPPS who have agreed to provide a response regarding the procedure for cancelling visits.”

“Procedures that any requests for reports are communicated to the Consultant as soon as they are received; this includes instructions from the Court, defence solicitors, Crown Prosecution Service and/or any other relevant external agencies including Probation Services.”

“CNWL Offender Care has developed its own bespoke training for the management of harm and suicide in prison environments. This training forms part of our mandatory training list and is retaken annually by all staff. Across Offender Care, we are currently 94% compliant with this requirement.”

“CNWL Offender Care has produced prison specific guidance highlighting these requirements which has been disseminated to all prison sites regarding expectations around CPA management, for comment. We expect this to be formally ratified as a new policy by 1 October 2017.”

“A new discharge policy -”

“prescriber is responsible for ensuring the ongoing monitorin effectiveness of medication, including side effects (GPs and CNWL Psychiatrists/ NMP). This is supported through: e In-line with community equivalence the GP would continue with repeat prescribing but would ensure the treatment plan assures them that the patient is in receipt of the appropriate level of supervision via primary care services. However, should the GP have any concerns around ongoing monitoring or psychological”

“From January 2016, CNWL has increased the number of experienced Mental Health trained nursing staff into the First Night Centre.”

“The reviews will evaluate existing procedures which relate to all aspects of safer custody including suicide prevention and self-harm management and violence reduction. The reviews will look to explore the following issues; = Early days in custody - Transfer from court/ reception timings, reception interview and assessment, first night interview and induction package, healthcare screening and mental health referrals; = Assessment, Care in Custody and Teamwork - compliance and delivery, quality”