Cornwall Partnership NHS Foundation Trust
NHS Trust
Action Taken
AI-generated response summary
• The Trust introduced a 24-hour response telephone line and appointed a Senior Operational Lead and six Band 7 Clinical Leads to the Initial Response Service. • The Single Point of Access Manager ensured staff access to the Operational Policy and Triage Guidelines. • The Single Point of Access Manager commenced a review of the assessment team Operational Policy and triage process, and a Task and Finish group is expected to commence to develop a training package and a standardised triage tool.
View full response
Dear Mr Cox
Darrell Francis Sharples, deceased Prevention of Future Deaths
As outlined at the inquest Cornwall Partnership NHS Foundation Trust has introduced a 24 hour response telephone line and is in the process of developing a single point of access for people presenting with mental distress, which we are calling an Initial Response Service.
We have worked across the whole health system to develop the model for this service which is due to be launched in the coming months. The service brings together voluntary and third sector organisations, the Improving Access to Psychological Therapy Service (Outlook South West) and the secondary care mental health services such as the Community Mental Health Teams into one place, for anyone wishing to refer themselves or anybody else for help.
The aim is to provide an immediate response in a way that will enable us to identify quickly a person’s needs and to ensure that an introduction or referral is made to the appropriate organisation or service.
A Senior Operational Lead has been appointed to the Initial Response Service. This role includes oversight of the Home Treatment Team; Crisis Hub and the 24 hour response telephone line, Mental Health Connect. In addition, six Band 7 Clinical Leads have also been appointed (equivalent seniority to ward Leaders and Clinical Nurse Specialists) to provide 24 hour clinical support to the service.
A dedicated Manager for the Single Point of Access within the integrated Community Mental Health Teams has also been appointed to manage the triage assessors across the county in addition to the development of processes and protocols for referral management. Previously the assessment teams were managed separately by the respective community mental health team mangers. The change in management structure provides additional governance and consistency to the assessment teams.
Nurse triage assessors within the Single Point of Access teams are senior clinicians of Band 6 grading. Core competencies for nurses working at this level requires consolidation of specialist knowledge and skills in mental health practice, demonstrating a depth of knowledge, understanding and competence that supports evidenced, informed, complex, autonomous and independent decision
Page 2
making. There will be occasions when Band 5 Clinicians will need to triage referrals in their capacity as duty desk clinician. This too is within the scope of competencies for a Registered Nurse, using their core professional qualification and training to conduct assessments in line with the Nursing Midwifery’s code and standards. A senior Clinician is available to the Band 5 Clinician should they require any support in guidance in complex situations.
All new members of staff are required to attend a corporate welcome day induction and each member of staff, including bank and agency staff, are required to complete statutory training depending on their role.
The Single Point of Access Manager has taken immediate action to ensure anyone performing this role within the Community Mental Health Teams has access to the Operational Policy and Triage Guidelines.
A Task and Finish group, consisting of the Initial Response Service Manager, Community Mental Health Team Clinical Lead, Associate Director for Mental Health and Learning Disabilities Nursing, Suicide Prevention Lead and involving Quality Leads from both Community Mental Health and Inpatient services; representation from Crisis Services including the Psychiatric Liaison Service with support from our governance team, is expected to commence later this month. The group will review and redesign how assessments are conducted and will include ongoing work around developing a standardised triage tool covering all adult mental health services, based on the UK Mental Health Triage Scale, as well as developing a training package for anyone performing a triage and assessment role within the Community Mental Health Team to ensure they are familiar with the assessment guidance and relevant policies and that there is a robust system in place to ensure this is the case. The Single Point of Access Manager has already commenced work with the Quality Lead for Community Based Mental Health services in reviewing the assessment team Operational Policy and triage process.
I hope that the above provides assurance in respect of the areas of concern identified in your report to prevent future deaths. On behalf of the Trust I would like to extend my sincere condolences to Mrs Sharples and to Mr Sharples’ family.
Darrell Francis Sharples, deceased Prevention of Future Deaths
As outlined at the inquest Cornwall Partnership NHS Foundation Trust has introduced a 24 hour response telephone line and is in the process of developing a single point of access for people presenting with mental distress, which we are calling an Initial Response Service.
We have worked across the whole health system to develop the model for this service which is due to be launched in the coming months. The service brings together voluntary and third sector organisations, the Improving Access to Psychological Therapy Service (Outlook South West) and the secondary care mental health services such as the Community Mental Health Teams into one place, for anyone wishing to refer themselves or anybody else for help.
The aim is to provide an immediate response in a way that will enable us to identify quickly a person’s needs and to ensure that an introduction or referral is made to the appropriate organisation or service.
A Senior Operational Lead has been appointed to the Initial Response Service. This role includes oversight of the Home Treatment Team; Crisis Hub and the 24 hour response telephone line, Mental Health Connect. In addition, six Band 7 Clinical Leads have also been appointed (equivalent seniority to ward Leaders and Clinical Nurse Specialists) to provide 24 hour clinical support to the service.
A dedicated Manager for the Single Point of Access within the integrated Community Mental Health Teams has also been appointed to manage the triage assessors across the county in addition to the development of processes and protocols for referral management. Previously the assessment teams were managed separately by the respective community mental health team mangers. The change in management structure provides additional governance and consistency to the assessment teams.
Nurse triage assessors within the Single Point of Access teams are senior clinicians of Band 6 grading. Core competencies for nurses working at this level requires consolidation of specialist knowledge and skills in mental health practice, demonstrating a depth of knowledge, understanding and competence that supports evidenced, informed, complex, autonomous and independent decision
Page 2
making. There will be occasions when Band 5 Clinicians will need to triage referrals in their capacity as duty desk clinician. This too is within the scope of competencies for a Registered Nurse, using their core professional qualification and training to conduct assessments in line with the Nursing Midwifery’s code and standards. A senior Clinician is available to the Band 5 Clinician should they require any support in guidance in complex situations.
All new members of staff are required to attend a corporate welcome day induction and each member of staff, including bank and agency staff, are required to complete statutory training depending on their role.
The Single Point of Access Manager has taken immediate action to ensure anyone performing this role within the Community Mental Health Teams has access to the Operational Policy and Triage Guidelines.
A Task and Finish group, consisting of the Initial Response Service Manager, Community Mental Health Team Clinical Lead, Associate Director for Mental Health and Learning Disabilities Nursing, Suicide Prevention Lead and involving Quality Leads from both Community Mental Health and Inpatient services; representation from Crisis Services including the Psychiatric Liaison Service with support from our governance team, is expected to commence later this month. The group will review and redesign how assessments are conducted and will include ongoing work around developing a standardised triage tool covering all adult mental health services, based on the UK Mental Health Triage Scale, as well as developing a training package for anyone performing a triage and assessment role within the Community Mental Health Team to ensure they are familiar with the assessment guidance and relevant policies and that there is a robust system in place to ensure this is the case. The Single Point of Access Manager has already commenced work with the Quality Lead for Community Based Mental Health services in reviewing the assessment team Operational Policy and triage process.
I hope that the above provides assurance in respect of the areas of concern identified in your report to prevent future deaths. On behalf of the Trust I would like to extend my sincere condolences to Mrs Sharples and to Mr Sharples’ family.