Independent investigation: Freya Emson(3 mnths), NE London (2000)

Issue an anti-discriminatory code of practice binding on NHS employers

Produce, rapidly, a protocol for doctor-to-doctor consultations.

Existing guidance from the Royal College of Psychiatrists is followed to ensure comprehensive provision of perinatal mental health services (in many areas costed plans already exist which are not expensive – but the will and the commitment are lacking).

The Department of Health through the National Institute For Mental Health England and Strategic Health Authorities and the National Care Standards Agency through the agency of Local Authority Social Services Area Child Protection Committees, should ensure that mental health services to patients with children are child sensitive and ‘child protection proofed’. Ensuring that National Service Frameworks for Mental Health and Children are implemented in these two respects should meet this requirement.

Resource staff in these departments to take appropriate responsibility for the care and support of staff and act as a supportive interface between their clinical needs and their employers.

Support this by a programme of compulsory anti-stigma training for all senior clinical staff and senior managers to be fully introduced by the end of 2004.

Make recommendations on the nature and structure of services for doctors with physical or psychological illnesses.

The National Specialist Commissioning Group at the Department of Health rapidly produce guidance on the commissioning of perinatal mental health services.

Area Child Protection Committees should issue guidance to their local mental health services, provide training for their staff and should ensure that services are adequately resourced to fulfil this function comprehensively.

Recognise through appropriate expertise that 50% of the disabilities in employees are psychological and psychiatric in nature (Appendix 7.4) and some of those employees are in very mobile posts.

The Chief Medical Officer should lead a group involving the General Medical Council (GMC), British Medical Association (BMA), Academy of Royal Colleges, the Institute of Health Service Management and the NHS Confederation to address this issue.

Work on the maternal mental health section of the National Service Framework for Children’s Services is not further delayed by the internal reorganisation of the Department of Health.

Mental Health Trusts should not wait for their local Area Child Protection Committees but should make proposals for ‘child protection proofing’ their services with Social Services Departments immediately.

The Department of Health should examine whether there are advantages to Occupational Health Services being provided across the NHS by Primary Care Trusts.

The Royal College of Psychiatrists continues to have a particular role and responsibility to eliminate stigma towards mental illness within its membership and should take the appropriate action.

The National Institute For Mental Health England and the National Institute for Clinical Excellence take responsibility for ensuring all disciplines involved in the post-natal care of mothers with a history of mental illness are up to date with advice on good practice.

The Modernisation Agency needs to train managers to supervise and support staff with psychological and psychiatric needs and help to create a climate through codes of practice and staff training in which employees with a range of needs can seek support without fear of the consequences of stigma.