Maureen Campbell-Scott

Dear Ms Persaud RE: Regulation 28 in the case of MC-S, NELFT and Fullwell Cross Medical Centre refer to the Regulation 28 dated 28th March 2018 in relation to the sad death of Maureen Campbell-Scott. Please note that NELFT have been liaising with colleagues from both, Fullwell Cross Medical Centre and Redbridge CCG in regards to the action plan to address the issues raised in the Regulation 28 report: We have made progress in regards to completion of the actions and there remain only two actions yet to be completed by NELFT alone: have attached the latest version of the action plan for your information: understand thatl Fullwell Cross Practice Manager, has also returned the action plan to you to evidence progress, which NELFT are grateful for: We understand that he has made a note on the action plan regarding there yet to be an agreement between Primary Care colleagues and NELFT Psychiatrists in regards to prescribing of medication changes and titration of drugs. We have had two meetings with the Fullwell Cross Practice and believe that we had agreed a process regarding the prescribing of medication to our shared patients. It was only on Tuesday of this week that we were informed that the practice had some late reservations about this specific aspect of the joint action plan: As such we are reconvening a meeting with Primary Care Colleagues to discuss the position further and agree a way forward. We understand that Fullwell Cross Medical Centre are now of the view that NELFT should undertake the prescribing whereas our clinicians advise this is not practical for a number of reason, these broadly the following: Risks to patient safety. The GP has the overview of the entire patient's medication. If the mental health medication is prescribed in isolation there is a significant patient safety risk: Medications may have interactions and contraindication that we as potential prescribers may be unaware ofas we do not have an overview: to advanced frailty of many of the patients, cannot get their own prescription or do not have family members who are able to do it for them. NELFT do not have arrangements with community pharmacists to ensure medication is provided: Many patients under the Older Adult Mental Health Team do not have capacity; therefore prescribing via FP1O is not feasible: Many of our patients use compliance aids like dosett box/blister packs therefore the medication needs to be organised via the GP. NELFT are unable to facilitate this via local pharmacists Many of our patients are in care homes, nursing homes and sheltered accommodation who will not accept a prescription via the FP1O, as this would need to be filled by a community pharmacist. Chair: Joe Fielder Chief executive: John Brouder E disability confident

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We have already agreed to provide personal contact details of NELFT Consultant's to GPs for additional support and this action is already in place to allow GP's to access advice regarding the management of people who have mental health problems: NELFT attended a very successful event with all Redbridge GP's last week, where our staff did a series of table presentation to the GP'. The theme was around mental health services and the crisis care pathway: We believe this will aid our future joint working with GP's within the borough: The event was coordinated by who is the BHR CCG Lead GP for Mental Health: At the event he briefed GP' s regarding future communication methods that all communication will move to being electronic in line with the action plan in relation to this regulation 28. apologise for the slight delay in forwarding the action plan, but as stated above this was due to the concerns raised by the practice: You may be assured that as an organisation NELFT and our officers will not leave the matter here, but continue to do all that we can to ensure that the gap in responsibility is closed.