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

Contents
CONTENTS
Page
Preamble 6
Introduction and terms of reference 7
Chapter 1 Narrative of key dates and events 11
Chapter 2 Evaluation of the health care and treatment of Louisa Ovington –
medical, psychological input and addictions services 67
Chapter 3 Outline of mental illness and personality disorder 85
Chapter 4 The Care Programme Approach (CPA) and how it was applied 88
Chapter 5 Involvement with police and probation, including outline of MAPPA 99
Chapter 6 Risk assessment and management 114
Chapter 7 The provision of mental health services for Louisa Ovington –
service configuration, service modernisation, policies and procedures 118
Chapter 8 The use of the Mental Health Act and compliance with the Code
of Practice 127
Chapter 9 Conclusions and recommendations: 132
i. CPA/Care coordination 133
ii. Risk assessment 138
iii. Public protection – MAPPA 139
iv. Organisational structure 140
v. Clinical issues 142
vi Interface between police, probation and the mental health and
social care services 149
vii. Policies and procedures 151
viii. Records 151
List of recommendations 154
List of abbreviations 160
Bibliography 161
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