Simon Sankey
27 Dec 2013 · Coroner Alan Walsh · Manchester (West)
The coroner's concerns
1. inadequate referral categorisation by untrained staff
“The categorisation and allocation as between Emergency, Urgent and Routine referrals is done by an Administration Assistant who is not qualified nor trained to carry out such duties”
2. lack of review of referral urgency
“There is no review of the hard copy file, the referral form or the entry on the electronic patient record to enable a review of the category of urgency assessed by the Administration Assistant”
3. failure to follow up non-contact referrals
“When a service user is not contacted or when an attempt to contact has failed the hard copy file is put into a file tray to be picked up whenever by another Senior Nurse [name redacted]. There is no system of reviewing the none contact referrals within an appropriate and reasonable time”
4. ineffective resource coordination for unpredictable referral volume
“The evidence at the Inquest revealed in effective management of the Team to co-ordinate and allocate resources to deal with an unpredictable number of referrals each day”
5. insufficient staffing for high referral volume
“The staffing levels on each shift, particularly having regard to a large and unpredictable volume of referrals each day”
6. ineffective team management and resource allocation
“The ineffective management of the team as a whole and in particular Senior Nurse [name redacted] to co-ordinate and allocate resources to deal with the large volume of referrals within the appropriate time period”
Responses
2013-0361-Response-by-5-Boroughs-Partnership.pdf ↗· 5 Boroughs Partnership NHS Foundation Trust
Stated action · maximum of 30 minutes of receipt
“not an administrator who categorises referrals. A system is in place whereby administration staff place referrals in an appropriate tray based on the referral priority provided by the referrer, who is usually a general practitioner. Where no priority has been identified by the referrer this is now brought to the immediate attention of the senior nurse practitioner on duty who will review the referral and assign the appropriate clinical priority within a maximum of 30 minutes of receipt. The”