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recurance

John Haines

16 Nov 2017 · Coroner Lisa Hashmi · Manchester (North)

This report repeats 2 earlier warnings, and was raised again 2 times later. See the linked reports.

The coroner's concerns

  1. 1. lack of access to qualified psychologist for mental health in-patients

    “During the course of the evidence it became apparent that mental health in-patients still do not have access to therapy from a qualified Psychologist, despite the fact that this has been raised in previous Regulation 28 PFD Forms. Notably, all clinicians were of the professional view that psychological therapy was critical to treatment, alongside psychiatric care.”
  2. 2. lack of access to qualified psychologist while under Home Treatment Team care

    “Similarly, patients cannot access a qualified Psychologist whilst under the care of the Home Treatment Team (HTT') etc. The only way for patients to get access to a Psychologist is through referral to 'Healthy Minds'. Health Minds cannot provide access where the patient remains under the care of the HTT etc.”
  3. 3. long waiting times for Healthy Minds access

    “Timely access to Healthy Minds is also hindered by long waiting times.”

Linked reports

Repeats an earlier warningJanette Insley16 Dec 2014 · 2 years 11 months earlier
Identical hazardConfidence 0.95 · high

Earlier report

“staff were unable to make any such referral for inpatients due to lack of i) availability of suitably qualified practitioners and ii) resources.”
Original on judiciary.uk ↗

This report

“patients cannot access a qualified Psychologist whilst under the care of the Home Treatment Team (HTT') etc.”
Full chain: Lack of access to qualified psychologist during home treatment team care
Repeats an earlier warningThomas Green16 Feb 2017 · 9 months earlier
Closely relatedConfidence 0.80 · moderate

Earlier report

“When a referral was made this was made to Healthy Minds. The Court heard evidence how this was not a case which was suitable for Healthy Minds as it was complex and involved potentially complex PTSD.”
Original on judiciary.uk ↗

This report

“Similarly, patients cannot access a qualified Psychologist whilst under the care of the Home Treatment Team (HTT') etc. The only way for patients to get access to a Psychologist is through referral to 'Healthy Minds'. Health Minds cannot provide access where the patient remains under the care of the HTT etc.”
Full chain: Inappropriate referral to Healthy Minds for complex PTSD
Raised again laterStephen Kennedy7 Feb 2019 · 1 year 3 months later
Closely relatedConfidence 0.90 · high

This report

“During the course of the evidence it became apparent that mental health in-patients still do not have access to therapy from a qualified Psychologist, despite the fact that this has been raised in previous Regulation 28 PFD Forms.”

Later report

“The inquest heard that whilst he was under the care of the home treatment team there was no access to psychology services.”
Original on judiciary.uk ↗
Full chain: Lack of psychological therapy for emotional unstable personality disorder
Raised again laterRobin Ward18 Oct 2024 · 6 years 11 months later
Closely relatedConfidence 0.90 · high

This report

“Timely access to Healthy Minds is also hindered by long waiting times.”

Later report

“Another particular problem identified was the long waiting times for psychological assessment.”
Original on judiciary.uk ↗
Full chain: Long waiting times for psychological assessment

Responses

2017-0402-Response-by-Heywood-Middleton-and-Rochdale-CCG.pdf ↗· Bury

Stated action · May 2017

“The CCG commissioned a new Primary Care Mental Health Pathway during 2016/17, which mobilised in May 2017. The model has been developed to respond to the local population needs, preparing service users to access therapy in order to optimise recovery performance. The service is subject to robust a performance dependent payment framework which provides assurance of performance delivery.”
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Source: Prevention of Future Deaths reports and responses published by the Courts and Tribunals Judiciary at judiciary.uk. Crown copyright, used under the Open Government Licence v3.0. Data updated 26 Oct 2026.

A link shows that a similar concern was raised again, not why. It is not a finding about any organisation or person. Methodology and responsible use · Report an error