We utilise several mechanisms to ensure that lessons are learned. These include learning from incidents, feedback including complaints and compliments, surveys, audit and announced and unannounced visits.
As a result of this, guidance has been produced within Mental Health Services for Older People for staff visiting properties in the community which appear to be unoccupied. Adult Mental Health is also adopting the procedure.
Guidance has also been produced to inform staff regarding what information they can and cannot share with family members if the patient has not given consent for his/her treatment to be discussed with them. Guidance will clarify that we are able to accept information and are able to disclose generalised information to carers.
Specific concerns raised around the death of an outpatient highlighted the need to introduce a risk rating for community patients. Once identified high-risk patients with them will be subject to a daily review and handover. Concern was also raised with regard to clinicians maintaining separate process notes and communication between in and outpatient teams. All recommendations were accepted and Adult Mental Health services are producing an action plan. It has been agreed that the action plan will be shared across the Division for wider learning.
Publication of Independent Investigation Report into the Care and Treatment of Mr N in Derbyshire
Findings of an independent investigation into the circumstances surrounding the care and treatment of Mr N have been published.
Mr N was released from prison whilst detainable, but no suitable bed could be found. Mr N approached a policeman saying he was hearing voices telling him to kill people. The policeman took him to the local Emergency Department where he spent two days waiting for a bed. He was transferred to an Enhanced Care Ward and placed in seclusion, before his transfer into higher secure services after a couple of weeks.
This was a near miss and investigated due to the potential for learning across the NHS.
If you would like to leave feedback about any of our services, you can do so here: http://feedback.nottinghamshirehealthcare.nhs.uk/
This Well-Led review is an important assessment for the Trust, not only because trusts are expected to advise NHSI of any material governance concerns that have arisen from the review and the action plan in response to those concerns, but more importantly because it provides the opportunity for the public to fully understand the strengths and weaknesses of our current governance arrangements and how we implement recommended actions at an appropriate pace.
On being established as an NHS Foundation Trust from 1 March 2015, the Trust has been required to comply with the conditions as set out in the NHS Provider Licence. The Licence, which replaced the former Terms of Authorisation for Foundation Trusts, is the main tool used by NHSI to regulate providers of NHS services.
NHSI may take action against an NHS Foundation Trust if the organisation is in breach of its Licence conditions. It is therefore important that the Trust is assured of its compliance, is able to evidence and where weaknesses in compliance are identified that these are appropriately addressed.
A paper outlining the Trust’s compliance with the NHS Provider Licence was submitted to, and approved by the Board of Directors on 25 May 2017 (as part of the Performance Report). Please see the following documents in relation to the Trust’s compliance with the Provider Licence:
There is a requirement for relevant public sector organisations to publish information in relation to trade union facility time.
The Trade Union (Facility Time Publication Requirements) Regulations 2017 (“the Facility Time Regulations”) came into force on 1 April 2017 requiring relevant public sector employers to publish specified information on an annual basis covering the 12 month period beginning with 1 April.
The relevant period covers the period April 2020 – March 2021. The schedule of tables (Schedule2) shows the information the Trust is required to publish: Facility Time return 2021.pdf [pdf] 55KB
Trade Union (Facility Time Publication Requirements) Regulations 2017 - Archive