Patient Engagement & At Risk to Self or Others

Reference: 24-25492

Date response sent: 04/03/2025

Details of enquiry

1. Do you have a policy for when a service user is not engaging? If so, please can you attach to the FOI response.

For the 12 months between January 2021 to January 2022:

2. How many service users classed as being a “sufficient risk to self or others” were admitted into your care between January 2021 – January 2022?
3. How many of those service users classed as being a “sufficient risk to self or others” were referred to your service from police?
4. Of those service users classed as being a “sufficient risk to self or others” how many were classed as DNA or non-engagement service users?
5. Of those service users classed as being a “sufficient risk to self or others” how many were discharged?
6. Of those service users classed as being a “sufficient risk to self or others” and also classed as DNA or non-engagement service users:

a. How many were referred back to their GP after missing 1 appointment?

b. How many were referred back to their GP without a Care Co-Ordination review meeting?

c. How many were referred for a further assessment under the Mental Health Act 1983?

d. How many have not had contact with your trust either directly or via their GP?

For the 12 months between January 2022 to January 2023:

7. How many service users classed as being a “sufficient risk to self or others” were admitted into your care between January 2021 – January 2022?
8. How many of those service users classed as being a “sufficient risk to self or others” were referred to your service from police?
9. Of those service users classed as being a “sufficient risk to self or others” how many were classed as DNA or non-engagement service users?
10. Of those service users classed as being a “sufficient risk to self or others” how many were discharged?
11. Of those service users classed as being a “sufficient risk to self or others” and also classed as DNA or non-engagement service users:

a. How many were referred back to their GP after missing 1 appointment?

b. How many were referred back to their GP without a Care Co-Ordination review meeting?

c. How many were referred for a further assessment under the Mental Health Act 1983?

d. How many have not had contact with your trust either directly or via their GP?

For the 12 months between January 2023 to January 2024:

12. How many service users classed as being a “sufficient risk to self or others” were admitted into your care between January 2021 – January 2022?
13. How many of those service users classed as being a “sufficient risk to self or others” were referred to your service from police?
14. Of those service users classed as being a “sufficient risk to self or others” how many were classed as DNA or non-engagement service users?
15. Of those service users classed as being a “sufficient risk to self or others” how many were discharged?
16. Of those service users classed as being a “sufficient risk to self or others” and also classed as DNA or non-engagement service users:

a. How many were referred back to their GP after missing 1 appointment?

b. How many were referred back to their GP without a Care Co-Ordination review meeting?

c. How many were referred for a further assessment under the Mental Health Act 1983?

d. How many have not had contact with your trust either directly or via their GP?

Response sent

Explanatory note:

It is relevant to your understanding of our responses below, that the following points are taken into account.

a. The Tavistock and Portman NHS Foundation Trust is neither a hospital nor an acute Trust. It is a small specialist outpatient and mental health Trust, with a focus on training and education.

We provide outpatient, and mainly psychological services via talking therapies.

We do not provide acute services, nor inpatient patient services, nor detention facilities, and do not have an A&E department.

b. We have taken the term “admitted” to mean admission into inpatient services, because we do not provide a walk-in service and only provide outpatient services for accepted referrals holding a pre-booked appointment.

c. We have taken the term “sufficient risk to self or others” to mean that the patient would be at risk of significant harm to themselves or others.  Of note, our risk assessment process does not include the term “sufficient risk to self or others.”

1. Do you have a policy for when a service user is not engaging? If so, please can you attach to the FOI response.

The Trust has the following clinical policies in place.

safeguarding-adults-at-risk Policy

safeguarding-children-policy

Managing DNA Procedure (in date but on intranet only)

[see attachment]

For the 12 months between January 2021 to January 2022:

2. How many service users classed as being a “sufficient risk to self or others” were admitted into your care between January 2021 – January 2022?

Our Trust provides services for outpatients only, so we would not necessarily be the recommended pathway for such patients.  We do not have detention facilities, and we do not section patients under the Mental Health Act.  For a full list of the services we provide, please visit our website at: Services – Tavistock and Portman

The service users you describe above would, most likely, be assessed and accepted for treatment by an acute mental health Trust which would, post assessment either admit to an inpatient ward or commence a course of treatment.

3. How many of those service users classed as being a “sufficient risk to self or others” were referred to your service from police?

Please see our response to Q2 and the explanatory note A above, that we do not have detention nor inpatient facilities..

4. Of those service users classed as being a “sufficient risk to self or others” how many were classed as DNA or non-engagement service users?

Not applicable – see above responses

5. Of those service users classed as being a “sufficient risk to self or others” how many were discharged?

Not applicable, as a specialist outpatient service we do not see patients in acute need, nor classify patients as being at sufficient risk to self or others as (eg to commit harm)

We provide outpatient services only.

6. Of those service users classed as being a “sufficient risk to self or others” and also classed as DNA or non-engagement service users:

Please see our answers to Q1 and Q2, related to our DNA procedure.  This governs the steps we take when patients DNA which are different to those described below in your questions a to d.

i. How many were referred back to their GP after missing 1 appointment?

ii. How many were referred back to their GP without a Care Co-Ordination review meeting?

iii. How many were referred for a further assessment under the Mental Health Act 1983?

iv. How many have not had contact with your trust either directly or via their GP?

7. For the 12 months between January 2022 to January 2023:

Please refer to our responses 1-6 above

8. For the 12 months between January 2023 to January 2024:

Please refer to our responses 1-6 above