Lousia Ovington independent investigation report ... - NHS North East

professional who had seen her within the past 24 hours’. The social worker then
rang Staff Grade Psychiatrist 1 (the apparent care coordinator at this time) who
told her to ring the GP again and ask him to make the referral to either the CRT
or the CMHT. 100
v. On 5 October 2004, a referral to the forensic services was apparently agreed at a
meeting between Social Worker 7 (the then care coordinator) and Staff Grade
Psychiatrist 1. This was not done. Staff Grade Psychiatrist 1 told the panel that it
should have been done by the care coordinator, whereas the panel was later told
by Consultant 9 that he would have expected the referral to be made by a
doctor.
The panel felt that these examples revealed two things, first a general ignorance
amongst mental health professionals and staff about referral /access procedures
which, if it remains the case, needs to be addressed urgently and secondly an
undue rigidity within some of the services about their own referral criteria. While
it may be justifiable to decline to accept a person to the service because the
person does not meet the criteria for that service, it is less justifiable to decline to
accept a referral from a professional who is requesting that the service assess the
patient simply because it is the wrong sort of professional making (or trying to
make) the referral.
• Recommendation 22. Trusts should ensure that all mental health
professionals and staff across the various services are clear about who
can make referrals to any other branches of the services, including
psychiatrists, psychology, forensic, CMHT services, CRT, AOT 101 etc. and
what the mechanism for referral is.
• Recommendation 23. Trusts should disseminate across the services the
criteria established by each branch of the service for acceptance into and
exclusion from that service.
h) Disengagement and discharge from services
CHAPTER 9 – CONCLUSIONS AND RECOMMENDATIONS
‘Engagement’- the patient’s active and willing involvement with the mental
health services is a major component in the successful management of mentally
disordered patients in the community. However with a complex individual
such as Louisa Ovington, whose mental health issues were not easily defined,
presented variably, were complicated by substance abuse and resulted in serious
behavioural problems, engagement is not straightforward. The panel was
concerned to note that there were several occasions when Louisa Ovington was
discharged from services. On some occasions this was as a result of failure to
attend appointments, notably in the summer of 2004, by Staff Grade Psychiatrist
100 Chapter 1 paragraph 127 and see subsequent comment.
101 Assertive Outreach Team
147