Wiltshire review

Primary and secondary health services in Wiltshire to work together to produce a referral template that is quick and easy to electronically complete at the GP surgery, whilst transferring all relevant clinical and social information to the secondary care service

For all involved organisations to review internal cultures to embed the spirit of organisational participation in future Domestic Homicide Reviews, improving information sharing to reassure families that organisations are supporting the Review process with transparency, integrity and fairness.

Ensure that there is a system in place for: Routinely screening information that is sent to the team by referrers

Ensuring that a record is made to indicate that this screening process has taken place, and to alert clinicians to new information, for example by recording its existence in the progress notes.

Ensure that a paper copy of information sent to either team by referrers is filed in the ‘blue folder’ and that this folder is handed over to any team which subsequently takes over the care of the service user

Ensure that a person’s veteran status is highlighted in the Ex-British Armed Forces Indicator, under additional personal information, on RIO.

Ensure that Team Members are familiar with the Veteran’s Service website, so that they can suggest service users access it when appropriate

Ensure that ageless services/teams are provided with appropriate training in the needs of both adults of working age and older adults with functional illnesses

Review the staffing of the PCLS service to ensure that there are adequate numbers of substantive clinical and administrative staff

Liaise with primary care services to review the process for sharing information at the point of referral to ensure that: Key information is highlighted and unnecessary information is not provided (as this may breach the patient’s confidentiality and may make significant information harder to identify)

Review the process for obtaining paper records in the light of the feedback that this process has ‘slowed down’ since the advent of RIO and that teams are, therefore, less inclined to seek these out.

Review whether the ‘Working with Military Veterans’ training should be made available again.

GPs should be reminded re the risk of prescribing amitriptyline when there is a risk of overdose.

Patients who have previously overdosed should be searched for on the clinical system and a screen note added to their notes to act as a reminder prompt for the GPs when consulting with these patients.

Administration team should follow all standard operating procedures, a reminder to this effect and review of the “Fax out” standard operating procedure.

consideration should be given to improving communication from the Intensive Team/ AWP back to the GP regarding their involvement with patients.