Norfolk and Suffolk NHS Foundation Trust

“NSFT has asked all clinicians that receive referrals into services to identify those where treatments have been recommended by non-NSFT clinicians in order to offer an assessment prior to signposting elsewhere on the basis that: - there may be an alternative treatment available within NSFT services that is appropriate and could be offered, based on NSFT clinical assessment; and/or - if NSFT clinicians agree that a treatment not available within standard services is required and individual”

“The SARP would like to explore the opportunities for a joined-up review process as part of this ongoing piece of work. An update regarding the proposal for a domestic homicide review is expected in September.”

“Norfolk and Suffolk NHS Foundation Trust has said in its response to you that it has asked all its clinicians that receive referrals into mental health services to identify those where treatments have been recommended by clinicians from outside the Trust in order to offer an assessment prior to any decision being made on the most appropriate way forward”

“The Trust has recently been reviewing and updating their Clinical Risk Assessment and Management Policy. This Policy is currently progressing through Trust internal governance processes and is due to be published end of June 2024, with a Policy implementation plan to be progressed during July/August 2024.”

“The ward has improved their processes which now ensures the nurse in charge is identified and roles allocated to the shift team members. To achieve this, the daily allocation form has been reviewed which clearly identifies the nurse in charge. In addition, the Matron oversees the off duty rota and delegates nurse- in-charge duties each shift. This is monitored by the Clinical Team Leader and Modern Matron. [name redacted] to this aspect the trust is formulating a seminar on shift co-ordination and”

“1: In order to prevent delays accessing care when a service user presents with complex co-morbid mental health conditions the following process has been developed. The care coordinator will ask other teams to joint work and/or provide consultation to ensure all relevant expertise is promptly accessed. Input from another team will be prioritised according to risk and not held on a waiting list if there is an urgent need. Any concerns regarding capacity and access to care will be escalated to the”

“The plan for the new Personality Disorder Service involves eight elements: 1. Clinically-led personality disorder leadership team supporting a change in culture and clinical practice at a senior level modelling consistency, accountability and leadership.”

“2. Improved access and assessment that involves a needs-based screening process which works alongside diagnostic criteria to ensure people access the part of the pathway which will deliver the most benefit and prevent unnecessary admissions to hospital.”

“3. Specialist personality disorder therapy teams comprising nurses, psychologists, psychiatrists, occupational therapists and social workers within local teams, delivering targeted interventions to those with the most complex needs and providing advice & consultation to their colleagues and the wider system.”

“4. A breadth of training ranging from Knowledge and Understanding Framework (KUF) training for all staff, through to full Dialectical Behaviour Therapy training for the specialist teams.”

“5. 72 hour inpatient protocol providing purposeful, formulation-driven, recovery-focused care packages concentrated on self-regulation and discharge.”

“6. Needs-based interventions involving a framework of delivery that works with diagnosis to enable better management of people with personality disorder in standard community and inpatient pathways.”

“Through service user involvement, we are co-producing as much of our patient-facing information about our pathways and interventions as possible. We have”

“The trust continues to roll out a comprehensive training programme for NSFT staff in relation to PD/CEN. The main training for staff is our Knowledge and Understanding Framework, which is entirely co-produced and co-delivered. We also have a two-day dialectical behaviour therapy (DBT) skills course which any member of staff can attend.”

“STORM training includes specific training on safety planning, and our Dialog+ care planning tool is used to collaboratively create a safety plan for every adult and working age adult under our care. Our Youth teams have formed their own safety planning documentation which is co-produced with our young service users.”

“We are currently developing a specific offer for older adults with complex emotional need, supported by specific training.”

“We are currently reviewing our personality disorders and complex emotional need (PD/CEN) strategy for release in April 2024 after service user and carer consultation.”

“We are recruiting to one specialist post to provide for people with these comorbidities in South and West Norfolk, and we have set up a working group in psychology to guide us as to evidence and Trust HQ: County Hall, Martineau Lane, Norwich, NR1 2DH Web: www.nsft.nhs.uk - 3 - best practice in relation to modifying our therapeutic offer.”

“Daily visits from the mental health team”

“The Trust obtains assurance of this improvement through means such as audit and its quality and safety reviews”

“The report doesn't identify at which stage of care a request for a mental health act assessment may have been appropriate”

“The team's current working process is to allocate an individual staff member to each service user; they have some additional responsibilities to ensure the care package is comprehensive and includes all other agencies”

“Thinking of this wider partner network and the requirement for close working, our suicide prevention lead has hosted two events bringing together non-statutory and statutory agencies, service users and Trust services in order to open channels of communication and raise awareness what each other provides”

“The Trust is taking the following actions which are anticipated to assist in bringing consistent and sustained improvement. All clinical services have been instructed to review their working practice in respect of record keeping and communication with partner agencies. Responsibility for this rests with the operational managers who will provide assurance of the actions taken to drive improvement.”

“the Trust will be using [the deceased]'s case in the provision of learning via our. patient safety newsletter and- through the range of practice * education teams and staff receive. Linked to this, under the leadership of the Medical Director, the Trust is commencing a programme of work to examine the barriers to using 'clinical curiosity' and develop the skills and frameworks for staff to ensure this critical aspect of care is consistently applied”

“The Trust recognises the impact this has for service users, families, carers and staff. The clinical team involved in the case (Central Norfolk Long Term Treatment Team) currently has one band 5 vacancy which is being recruited to.”

“The Trust will make an assessment of the medications prescribed upon discharge and this consideration will continue across the Trust.”

“The service user will be given the phone number for the duty worker so if they experience change in their circumstance before attending their appointment they can speak to someone.”