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Dear Mrs Speers,
 
Thank you for your further emails of 6 and 14 October to the Department of Health about West London Mental Health Trust (WLMHT) and suicide prevention.  I have again been asked to reply, and I apologise for the delay in doing so.
 
In your email of 6 October in response to my previous reply, you ask about the employment of the former Chief Executive of WLMHT by NHS London.  I should explain that employment decisions are solely matters for the NHS organisations concerned, and as such, the Department of Health could not comment on any employment decisions made by NHS London.  If you believe that this specific appointment represents a conflict of interest, I would recommend that you raise your concern with NHS London directly.
 
Likewise, it is for individual SHAs to determine when and how to publish reports of investigations into untoward incidents.  Whilst the Department of Health does take an interest in such reports, it would not be appropriate to intervene in either the investigation or reporting process.
 
The same email also raises a concern that low and medium secure hospitals have no regulator.  I can assure you that this is not the case and the Care Quality Commission (CQC) is the regulator for all mental health services.  However, you will appreciate that high secure services require specific monitoring criteria and therefore require special consideration, as stated in my previous reply.  In addition, as the regulator of health services, it is for the CQC to measure that Trusts are providing an appropriate level of service for the populations they serve.
  

With regard to the Healthcare Commission's assessment process, as you are aware the Healthcare Commission was completely independent of the Department of Health and as such, the Department cannot comment on its inspection procedure.  As the CQC has taken over the responsibilities of the Healthcare Commission, you may wish to contact it directly with any concerns about the involvement of PPIFs and the previous rating system. 
  

Finally in this email, you mentioned the PHSO’s decision to not investigate your son’s case any further.  Whilst I appreciate your concern about this issue, it is important that the Ombudsman is able to investigate complaints free from political or Departmental interference or bias and, as such, she is completely independent of the NHS and Government and the Department cannot comment on her decisions.  Also, I am afraid that the Ombudsman’s decision cannot be appealed against.  However, her decisions (like the decisions of other public authorities) are open to judicial review.  This involves making an application to the court.  I would suggest that you seek legal advice on how to do this.
  

In your emails of 6 and 14 October you asked for further information about suicide reduction plans and the withdrawal of the suicide indicators.  With regard to the Healthcare Commission’s ‘reluctance’ in agreeing to withdraw the indicator, as I have indicated previously, the Commission was independent of the Department and so I am unable to comment on its opinion about the withdrawal. Again, you may wish to seek the views of the CQC about this issue.
  

With regard to the general policy on suicide reduction, I am aware that previous correspondence from Louis Appleby and me has outlined the work the Department is conducting in this area, including the National Suicide Prevention Strategy for England.  As you will be aware, the strategy aims to support the target to reduce the death rate from suicide and undetermined injury by at least a fifth by the year 2010.  The latest available data is for the three year period 2005/6/7, which shows a rate of 7.9 deaths per 100,000 population.  This is an all time low and represents a reduction of ten per cent from the 1995/6/7 figures.
 
The suicide prevention strategy recognises that the factors associated with suicide are many and varied, which is why the Department developed a broad strategic approach to suicide prevention.  The strategy is available on the National Mental Health Development Unit’s (NMHDU’s) website (www.nmhdu.org.uk) by entering ‘suicide prevention’ into the search bar.
  

I am afraid that I am unable to provide specific details of the plans to achieve the target to reduce suicides, as these have been drawn up by individual SHAs, in conjunction with their PCTs, according to the specific local conditions and needs, and vary across the country.  It is for SHAs and PCT to determine locally how the plans will be implemented and monitored.
  

You may also be aware that the National Service Framework for Mental Health made it a requirement for all local services to develop a local system for suicide audit to learn lessons from suicides and take necessary action.  The Department published a toolkit, Suicide audit in Primary Care Trust localities, in October 2006 to support them in this task. 
  

I hope this reply is helpful.
 

Yours sincerely,
 

Dominic Ward
Customer Service Centre
Department of Health