Recurance · prevention of future deaths reports
Pre-inquest brief
The earlier warning
Adrian Jennings · 19 Apr 2018 · Alison Mutch, Manchester (South)
“The inquest heard evidence that the Mental Health Trust had not introduced one IT system across the Trust, which impacted on information sharing between professionals involved in his care;”
judiciary.uk/prevention-of-future-death-reports/adrian-jennings
What was promised
Stated action 1 · response to Adrian Jennings (19 Apr 2018) · stated timescale: next two to three and a half years
“we recognise that there are challenges across the service in enabling secure record sharing and there are a number of steps being taken, fed by NHS England.”
Stated action 2 · response to Adrian Jennings (19 Apr 2018) · stated timescale: 2015
“We revised the Code of Practice in 2015 and set out guiding principles to ' hups://www.gov.uk/government/publications/code-of-practice-mental-health-act-1983 improve the care for patients.”
judiciary.uk/…/2018-0111-Response-by-Department-of-Health.pdf
Stated action 3 · response to Adrian Jennings (19 Apr 2018) · stated timescale: process of investing
“The Tameside and Glossop Strategic Commissioning Board has recognised the need to develop and expand mental health support and is in the process of investing in additional services”
judiciary.uk/…/2018-0111-Response-by-Tameside-Glossop-CCG.pdf
5 further stated actions are listed on the full chain page.
What recurred
- 22 Nov 2018 · Matthew Craven · Alison Mutch · Closely related · confidence 0.90 (high)
- 23 Apr 2020 · Gordon Fenton · Adrian Farrow
- 21 Jul 2023 · Corinne Haslam · Chris Morris · Closely related · confidence 0.90 (high)
The clearest link, quoted from both reports:
Earlier · Gordon Fenton · 23 Apr 2020
“There does not appear to be a reliable and consistent method of sharing medical records and information between the two Trusts.”
Later · Corinne Haslam · 21 Jul 2023
“It is a matter of concern that Mental Health Trusts and Acute Trusts operate different (apparently incompatible) electronic records systems.”
What happened next
No web check of the stated actions has been published for this chain.