Rebecca Henry

we From Nadine Dorries MP

D e partm ent Parliamentary Under Secretary of State for Mental Health,

Suicide Prevention and Patient Safety
of Health &
Social Care 39 Victoria Street

London
SW1H OEU

Your Ref: JSP/HK/R-Henry 020 7210 4850
Our Ref: PFD-1187214

Professor John Pollard

HM Assistant Coroner, Manchester West
HM Coroner's Court

Paderborn House

Howell Croft North

Bolton BL! 1QY

Thank you for your correspondence of 1 August to Matt Hancock about the death of
Ms Rebecca Louise Henry. I am replying as Minister with responsibility for Mental
Health and I am grateful for the additional time in which to do so.

2.\ October 2019

Firstly, I would like to say how sorry I was to read of the particular circumstances of
Ms Henry’s death. I can appreciate how devastating this must be for her family and
loved ones and offer my most heartfelt condolences to them.

I note that in this case the Greater Manchester Mental Health NHS Foundation Trust
fully accepted your findings and acknowledged that the standard of care provided to
Ms Henry fell short of what she should have received. I very much welcome the
steps taken by the Trust to put this right and reduce the chance of this situation from
happening again, including by putting staff through new risk assessment training and
providing them with new advice on how to deal with similar situations.

Your report raises concerns about patient confidentiality and how this can impact on
communication between mental health professionals and family and carers where
information sharing might help inform decision making about an individual’s care.

I am aware that a number of families bereaved by suicide have encountered issues
around confidentiality in their interactions with healthcare services. This includes
concerns that healthcare practitioners can seem reluctant to listen to information or
insights from families and friends, or to give them information about a loved one’s

risk of suicide. Prevention of future deaths reports issued by coroners following
inquests into suicides share similarities with these concerns and therefore those you
have raised in your report.

The Suicide Prevention Strategy for England', published in 2012, placed a new
emphasis on providing better support to those bereaved or affected by suicide. As
part of this, the Department of Health worked with a range of professional bodies to
agree a consensus view on confidentiality and suicide prevention. /nformation
sharing and suicide prevention: Consensus statement”, was published in 2014,
alongside the first annual report of the suicide prevention strategy. The statement
includes the following passage:

We strongly support working closely with families. Obtaining information
Jrom and listening to the concerns of families are key factors in determining
risk. We recognise however that some people do not wish to share information
about themselves or their care. Practitioners should therefore discuss with
people how they wish information to be shared, and with whom. Wherever
possible, this should include what should happen if there is serious concern
over suicide risk.

The consensus statement does not change a practitioner’s current legal duties of
confidentiality in respect of the people they are caring for, nor does the statement
replace the professional guidance available to practitioners. However, the statement
is designed to promote greater sharing of information within the context of the
relevant law, and to clarify that disclosure is a matter of professional judgement for
an individual practitioner.

You question in your report whether a review of the legal duties around patient
confidentiality should take place. As you may be aware, in October 2017, the
Government announced plans for an independent review of mental health legislation
and practice. As a first step towards this, Professor Sir Simon Wessely was asked to
chair a full and independent review of the Mental Health Act. ‘Modernising the
Mental Health Act: Increasing choice, reducing compulsion’, the report of the
review, was published in December 2018 and made 154 recommendations.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/271792/Consensus_st
atement_on_information sharing.pdf

) https:// www.gov.uk/government/publications/modernising-the-mental-health-act-final-report-from-the-independent-
review

The review did not look at confidentiality and information sharing specifically.
However, it did look at the role of families and carers and made a number of
recommendations, including moving from the Nearest Relative provision to
Nominated Person.

At present, a patient’s Nearest Relative has certain powers to protect the rights of the
patient, but the patient has no say over who fulfils this role. Allowing the patient to
choose their Nominated Person will give people more choice and autonomy about the
people involved in their care. The Government has already accepted this
recommendation.

In addition, the review recommended that patients should have greater rights to
choose to disclose confidential information to additional trusted friends and relatives,
including through the Nominated Person nomination process or advance choice
documents, and for the Nominated Person to have the right to be consulted on care
plans. The review considered that this would ensure more meaningful involvement
and also help staff to share information without worrying about potential breaches to
patient confidentiality, especially where the patient lacks capacity to make relevant
decisions when they are in hospital.

We intend to publish a White Paper by the end of the year, which will set out the
Government’s response, in full, to the independent review of the Mental Health Act,
and pave the way for new legislation to be brought forward when Parliamentary time
allows.

As Miss Henry was not detained under the Mental Health Act, the provisions in the
Act and the changes we are considering, would not have applied in this case.
However, I hope it reassures you that we are taking steps to address some of the
concerns which have been highlighted by this case.

Thank you for bringing these concerns to my attention.

Neb ae

NADINE DORRIES