Ernest Smith
14 Dec 2017 · Coroner Anna Crawford · Surrey
The coroner's concerns
1. lack of GP correspondence review system
“The system for considering correspondence received from GPs, including requests for medication reviews, appears to remain the same as the system which was in place at the time of Mr [name redacted] death and which failed to identify request for a medical review on 7 March 2016”
2. lack of GP update system for non-medical team care
“There are a number of CMHRS service users who, like Mr [name redacted], are not under the CMHRS medical team, but whose care is led by other members of the multi-disciplinary team, including clinical psychologists and care co-ordinators”
Responses
2017-0459-Response-by-Surrey-NHS-Trust.pdf ↗· Surrey and Borders Partnership NHS Foundation Trust
Stated action
“The action plan is going to be monitored and followed up at the monthly Adult Mental Health Directorate Quality Assurance Group meeting”