Source · Investigations in the NHS

Independent investigation: Sue Goswell, West Chiltington, Sussex (2007)

South East Incident 23 Dec 2007 Subject Sue Goswell

Mentally ill man fatally stabbed wife then kills himself, a week after leaving psychiatric hospital. Many previous warnings. MH history – released from Psych hospital despite warnings from daughter

Acceptance status

Per recommendation

No Response Published

Total recommendations

About this data

Acceptance status tracks whether the trust accepted or responded to each recommendation.

Independent health investigation reports and reviews commissioned by government or NHS England.

About this investigation

Source & metadata

Independent investigation report. Recommendations and any published response are extracted below.

Recommendations

4 total

Recommendation

The Trust will ensure that all clinical policies and procedures are amended to instruct clinicians of the importance of providing a differential diagnosis where indicated as clinically appropriate. These amendments will also include instructions as to the importance of providing … Read more

Recommendation

The Trust will conduct an audit of its risk assessment processes within six months of the publication of this report to determine:  the compliance of all clinicians in the completion of risk assessments for every service user;  the … Read more

Recommendation

The Trust will conduct an audit to ascertain the effectiveness of its new arrangements. These audits should be conducted within six months of the publication of this report and be developed in collaboration with commissioners. The Trust should:  audit … Read more

Recommendation

The Trust should audit all new processes for effectiveness within six months of the publication of this report. The audit should ensure that Trust personnel attend MARAC meetings on a regular basis and should also serve to review how many … Read more