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Deaths and Suicides on MH Waiting List 2018/19 to 2023/24

Reference: 24-25091

Date response sent: 31/05/2024

Details of enquiry

  1. The number of people on your Trusts waiting list for issues relating to mental health who died before receiving treatment broken down by each of the financial years a) 2018/19, b) 2019/20, c) 2020/21, d) 2021/22, e) 2022/23, f) 2023/24
  2. The number of people aged 18 and under on your Trusts waiting list for issues relating to mental health who died before receiving treatment broken down by each of the financial years a) 2018/19, b) 2019/20, c) 2020/21, d) 2021/22, e) 2022/23, f) 2023/24
  3. The number of people on your Trusts waiting list for issues relating to mental health who died of what was recorded as suicide before receiving treatment broken down by each of the financial years a) 2018/19, b) 2019/20, c) 2020/21, d) 2021/22, e) 2022/23, f) 2023/24
  4. The number of people aged 18 and under on your Trusts waiting list for issues relating to mental health who died of what was recorded as suicide before receiving treatment broken down by each of the financial years a) 2018/19, b) 2019/20, c) 2020/21, d) 2021/22, e) 2022/23, f) 2023/24

Response sent

Prior to 2022 we used to report mortality data by department within the Quality Reports section of the papers for the Board of Directors Meetings.

Since 2022, the Trust has changed its presentation of mortality data, and no longer splits its mortality data by department, waiting list, active patients, or any other parameters (see point 1. below for more on this point).  This is to prevent the possibility of individuals being identified through triangulation of data, due to the relatively low number of service users who may be referenced.

We routinely answer FOI requests for mortality data, (suicide, death by natural causes, death from other causes) by pointing applicants to data that is periodically published and publicly available both in the public domain, and on our website, such as the Annual Reports and Quality accounts, the quarterly Board Meeting papers, and the FOI disclosure log, which may be reached via the links below,  covering patient mortality data across all departments since 2014. These may be reached via the following links:

a. Tavistock and Portman Annual Report & Accounts

b. Tavistock and Portman Quality Accounts    where produced as a separate document

c. Tavistock and Portman Board meetings and board papers on the pages listed below.

d. Tavistock and Portman Freedom of Information Disclosure Log

We have engaged exemption under section 21 of the Freedom of Information Act 2000 (FOIA), whereby, we are not required to provide information in response to a request if it is already reasonably accessible to you.

The most effective way to search any documents on our website would be to conduct word searches within the document using key words for your questions such as “death” “suicide” “serious” (as in serious incident), and such a search can be conducted simply by clicking within the website document, pressing CTRL+F and entering your key word (if more than one key word is being searched then enter these between quotation marks), and then view the results one by one.  This would cut out the need, to read each document in its entirely to seek the requested data.

In order to be helpful to you, we have conducted this search, and the results we found are as listed below, under points 2.i to 2.iv. Please note that these results cover patient mortalities Trust-wide, and is not confined to just the GIC.

The rationale for this approach is:

a. The Trust now follows guidance from the Office of National Statistics (ONS) on disclosure control to protect confidentiality within death statistics, and the Trust will not report mortality numbers by service, due to risks of identification of the low number of service users referenced.

Practical examples of where this has been applied elsewhere are:

  • National Confidentiality Inquiry in Suicide and Safety in Mental Health
  • Ministry of Defence Suicides in the UK regular armed forces: Annual summary and trends over time 1 January 1984 to 31 December 2020
  • Any statistics that are under five will only be referenced as <5

b. The Trust now complies with “The revised guidance on reporting suicide and severe self-harm to NRLS for all providers except those providing specialist mental health services” issued by the National Patients Safety Agency  (2012).

    • Other providers would meet their responsibilities by ensuring they pass on any information that indicates suicide or self-harm to the relevant specialist mental health trust so they can report it

c. This means that, retrospectively, the Trust’s mortality data can change over time.

    • Due to the nature of its services, the Trust may generally only hold mortality data provided to it, and it may take up to 2/3 years for it to be validated and/or made available to us.
    • A patient’s death may be unrelated to Trust service provision, and due to other causes, eg cancer, natural causes,

d. This means that when the coroner contacts the Trust and states that ‘Action Should be Taken’, the Trust will respond within the required framework

More Data will be Available:  Intended for Future Publication: 

The Trust may hold information on more recent cases which will be published soon, in line with their publication schedules, and withheld from disclosure, for now, under s22 of FOIA 2000 it is intended for future publication.

 

Under section 22 of FOIA 2000, the Trust is not obliged to provide information intended for future publication, subject to the outcome of a public interest test, which weighs up whether the public interest in disclosing the information now, outweighs the public interest in withholding it until its publication date. (NB: Public interest is defined here as for the public good, and not what is of interest to the public, nor the private interests of the requester.)

We have considered whether the public interest in maintaining the exemption is greater than the public interest in disclosing any incremental information now and in response to your request.  We have concluded that it is reasonable to withhold any additional information until it is made publicly available for the following reasons:

 

Arguments in favour of disclosure:

  • Immediate disclosure of most recent mortality data would provide increased transparency via early release of data without incurring delays until formal publication schedules, albeit that deaths by department are no longer provided by the Trust
  • Disclosure upon request, of Trust mortality data, would be consistent with the Trust’s intentions to proactively release data on such matters, which are of a wider public interest.

 

Arguments in favour of maintaining the exemption

  • to avoid the possibility of any requestor gaining advantage in obtaining the requested data in advance of its release to general publication
  • It is in the public interest that the Trust’s quality assurance process is able to conclude before making mortality information available to the public, to ensure confidence and accuracy.
  • It is in the public interest to ensure that any new mortality data can be accessed simultaneously by the general public rather than piecemeal by disclosure to a small number of applicants under FOIA.
  • We fully intend to continue to publish more information, as and when we receive new mortality data, in our next and future board and/or quality reports, as well as the FOI, enabling applicants to search these in the manner described earlier and via the links provided above.

The publicly available mortality data, reported on a Trust-wide basis is on our website covering all departments is as follows:

i. Annual Report and Accounts

2018/19 Page 127-128, Page 130

ii. Quality Accounts – where produced as separate documents

Quality Accounts Financial year 2020/21 Page 19-20

Quality Accounts Financial year 2021/22 Page 16-19

Quality Accounts Financial year 2022/23 Page 17, Page 19-20

iii. Board of Directors Meeting Papers

BoD 23/05/2017 Page 58 and Page 67

BoD 28/11/2017 Page 203 and 214

BoD 26/09/2017 Page 164 and 173

Note: From 2018, the BoD meetings went down from a meeting per month, except August, to just the months of May, July, September, November, January & March. The January 2019 meeting was moved to February.

 

BoD 30/01/2018 Page 6

BoD 27/03/2018 Page 137

BoD 24/07/2018 Page 143-144 and Page 204

BoD 27/11/2018 Page 142 and 162

BoD 12/02/2019 Page 154

BoD 26/03/2019 Page 309-310

BoD 28/05/111 Page 111

BoD 30/07/2019 Page 6 and Page 110 and Page 158

BoD 24/09/2019 Page 117

BoD 26/11/2019 Page 141 and 319

BoD 28/01/2019 Page 98

BoD 31/03/2020 Page 187 and Page 5

BoD 19/05/2020 Page 52

BoD 28/07/2020 Page 74 and Page 88

BoD 29/09/2020 Page 7

BoD 24/11/2020 Page 81 and 168

BoD 26/01/2021 Page 107

BoD 21/03/2021 Page 85-86 and Page 90 and Page 95

BoD 18/05/2021 Page 10 and Page 109 and Page 116

BoD 28/09/2021 Page 8

BoD 30/11/2021 Page 110

BoD 25/01/2022 Page 37 and Page 160-161 and Page 177

BoD 29/03/2022 Page P105 (explanation that Q3 reported death were cumulative over longer period)

BoD 29/03/2024 No new deaths data

BoD 26/07/22 Page 25

BoD 27/09/2022 Page 7

BoD 19/04/2023 Page 50 and Page 59 and Page 62

BoD 21/02/2024 Page 64-65

BoD 09/05/2024  Page 20

iv. Freedom of Information Disclosure Log

23-24509 Waiting List Deaths 2023 and of which waited 18+ weeks

22-23123-ADHD-Wtg-Diagnosis-Rejects-Deaths

22-23131-Unexpected-Deaths-2018-22

22-23267-Inpatient-Suicides-CAMHS-Deaths16-17to21-22

23-24140-Suicides-Waiting-Times-2018-23

23-24509 Waiting List Deaths 2023 and 18+weeks waited

18-19256_Deaths_in_Service_since_2012_of_Nursing_Staff

18-19416_Death__Serious_Incidents_of_Patients_with_Learning_Disabilities

20-21022_Types_Numbers_of_SIs_Reported_2017-18__18-19__19-20

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