Investigations / Service Reviews
Undertaking service reviews and serious incident reviews in both private and NHS teams either as the independent investigator or as part of a team working in Independent Homicide investigations HSG (97/24). Themes have included:-
- Bullying and Harassment
- Clinical errors and communication errors
- Poor documentation and safeguarding concerns
- Each investigation utilises root cause analysis theory and an understanding of human factors to provide a balanced, proportionate report for the client
- Recommendations follow the S.M.A.R.T process and are designed to progress the service within a “ no blame “ framework
- Close liaison with the client and teams involved with regular updates provided
- Provision of training and aftercare to embed long term improvements
Clients have included
- St. Andrews Health Care
- Dorset Healthcare University NHS Foundation Trust
- Avon and Wiltshire Mental Health Partnership NHS Trust
- West London Mental Health Trust
- North East London NHS Foundation Trust
- Barnet, Enfield and Haringey Mental Health Trust
- Cambridge and Peterborough Mental health Trust
- Cygnet Health Care
- Christchurch Group
- Maidstone and Tunbridge Wells NHS Trust
- Arden and Worcestershire CSU