Barnet review

The benefits of repatriating patients to their Locality Ward where possible is fully acknowledged. However repeated transfers can have a negative impact on a patient’s continuity of care. This case has highlighted the need for Bed Management Teams to make every effort to minimize these transfers as much as possible.

There was a delay of 13 days before the Bristol note were uploaded onto RiO. It was the responsibility of the Bed Management Team to upload this information. It should be reinforced to the Bed Management Team that information received from other providers must be uploaded immediately.

Decisions to discharge patients should not be made unless all reasonable efforts have been made to obtain information relevant to the decision particularly if patients have been moved/transferred on more than one occasion.

The need for clinical staff to speak separately to relatives and carers whenever possible in order to assess their needs more fully, must be reinforced.

Risk of harm to others should be carefully considered if there is a pre-occupation with a relationship ending, particularly if the patient has suicidal ideation. This should be reinforced in domestic abuse training offered to all staff.

BEHMHT to explore with Respect the potential for basing a domestic abuse worker who understands mental health issues and perpetrator interventions within the Trust. The profile is for an expert for identification, risk assessment and advising on certain cases. Loosely based on what has become known as the Hackney Model, the worker would not have a caseload but would focus on increasing the knowledge and skills on working with domestic abuse perpetrators among Trust staff.

Review existing training and awareness raising materials in LB Barnet to ensure that all forms of abuse are given an equal profile, that coercive control is properly understood, and that the absence of physical violence is not interpreted as the abuse being less serious or non-existent.

IRIS has already been rolled out to some GP practices in LB Barnet. It is recommended that those surgeries be advanced to the next stage, namely IRIS +. This is an extension of the original in that it incorporates training about, and a referral pathway for: ▪ male victims/survivors and perpetrators ▪ female perpetrators (as well as victims/survivors) ▪ children exposed to domestic violence and abuse

At the next iteration of the VAWG strategy, include training and awareness raising work in workplaces so that employers and colleagues know how to safely respond.

All local VAWG strategies should include support for specialist agencies on the basis that the cultural understanding they offer and their linking with local communities means that they are able to meet the need of service users more swiftly and effectively than mainstream services.

Develop a domestic abuse policy for LB Barnet.