Conrad Colson

1st July 2023 

Dear Madam 

Thank you for sending a copy of the Prevention of Future Deaths report dated 26 May 2023 
following the inquest into the death of Conrad Colson. 

We would like to reiterate our condolences to Conrad’s family and friends.  The 
investigation process has provided a valuable learning experience for our organisation and 
we are grateful for the opportunity to improve our processes. 

We have noted the concerns raised by you and have considered these within the 
organisation. Our response to these concerns is set out below. 

•  We have updated our ‘BDD policy’ so that all new patients presenting to the clinic are 
formally screened for BDD using the validated, and published COPS questionnaire. The 
COPS score is then clearly documented in a dedicated page of the patient’s electronic 
medical notes. Further that if there is a COPS score of 30 or more, or if there are any 
clinical concerns of BDD, that this information is shared with the GP (subject to patient 
consent). Please find attached updated BDD policy with edits in red font. 

•  We have also updated the policy to ensure that clinical assessment of BDD incorporates 
communications sent by patients to clinic, for example patient concerns over cosmesis, 
treatment results or impact on well-being.  Please find attached updated BDD policy 
with edits in red font. 

•  We have ensured that the BDD policy is embedded by: 

o  Delivering in-depth, mandatory training on the revised BDD policy to all our team. 

Training was carried out on 14th June 2023. 

o  Commencing a daily team brief at the beginning of each day, where all patients to be 
seen are discussed amongst clinicians and patient coordinators. There is a focus on 
highlighting all new patients that are to undergo the formal BDD screen. During this 

Dr Tatiana Aesthetic Dermatology Clinic | 2 Devonshire Place | London W1G 6HJ 
www.drtatiana.co.uk | +44 7718219145 

 
 
 
 
 
   
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 o 

meeting, any patient concerns raised by patients, in person or via email/telephone 
are discussed, and it is checked that these communications have been uploaded into 
the medical notes. This will help ensure clinicians consider concerns raised by 
patients during their upcoming consultations and incorporate these concerns into 
their decision making processes. Discussion summaries and outcomes are recorded. 
This is outlined in our updated ‘patient journey policy’ (edits in red font). 
Initiating an annual audit to ensure that the updated BDD policy is being followed. 
This audit will assess whether: a) patients are being screened appropriately b) 
whether documentation is adequate c) for patients where there are clinical concerns 
of BDD, that they are managed appropriately, and relevant information is being 
shared with GPs/other relevant healthcare professionals. The findings of the audit 
will be presented during our weekly team meeting and any areas of improvement 
will be highlighted and relevant action taken. The first audit will be carried out in 3 
months (September 2023) 

•  Clinicians have been reminded to ensure that documentation is full including making use 

of the free text options in the electronic records. This includes all 
assessments/discussions regarding BDD and patient concerns. This will also include 
ensuring that communications from patients where concerns are raised are discussed 
with the patient in a clinical setting, where appropriate, and documented in the 
electronic records. We will carry out an annual audit of patient consultations. Please find 
attached the updated ‘patient journey policy’ with edits in red font. 

•  We have now updated our ‘patient journey policy’ so that all communications where 
patients raise concerns are uploaded into the electronic medical notes. Further that 
these communications are highlighted to the responsible clinician within 24 hours and 
patients receive a response within 24 hours. Clinicians must document in the notes how 
these concerns have been considered and addressed. Please find attached the updated 
‘patient journey policy’ with edits in red font. 

•  We have updated our ‘patient journey policy’ to provide clear guidance on when to 
share/request patient clinical information to/from GPs or other relevant healthcare 

Dr Tatiana Aesthetic Dermatology Clinic | 2 Devonshire Place | London W1G 6HJ 
www.drtatiana.co.uk | +44 7718219145 

 
 
 
 
 
   
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 professionals. We have also specified that communication with patient GPs or other 
healthcare professionals should be in writing and that an electronic copy of 
correspondence must be kept in the patient’s electronic records. Please find attached 
the updated ‘patient journey policy’ with edits in red font. 

•  All our clinical team have received training on the revised policies, and we will ensure 

that our team receive refresher training on at least an annual basis. 

We hope that this provides reassurance to you of the steps taken by the Dr Tatiana 
Aesthetic Dermatology Clinic and the steps taken by way of continuous improvement. 

Yours faithfully 

Dr Tatiana Aesthetic Dermatology Clinic | 2 Devonshire Place | London W1G 6HJ 
www.drtatiana.co.uk | +44 7718219145

Office Ref: 1208 

Action Plan Title:  D150069 

Action Plan Owner : 

Target Date: 01/12/2023 

Safely NELFT Action Plan: 12/06/2023 

Priority: High  

Service/Team: Mental Health Services 

Business Unit:  Waltham Forest 

Directorate:  Waltham Forest 

Start Date 

Source:  Complaints 
Serious Incident  X     Medicines Management  
External Inspection 

     Clinical Audit 

  Dashboard 

   Other x Regulation 28  

    External Inspection 

 Infection Control 

     Internal Inspection 
     H&S 

     QPS 

     Internal Audit 
     Serious Case Review 

     Safeguarding 

     Safety Thermometer 

Concerns of the Coroner:  

1.  Joint working (information sharing): A concern arose at the Inquest hearing in relation to the absence of liaison between the highly specialist 

services of the CADAT team and the stepdown services provided by NELFT. There was a lack of full information sharing around risk and joint risk 
assessment/risk management planning on discharge.  

2.  Risk management: Both mental health services were aware that Conrad was accessing aesthetic dermatology treatment. There was a concern that 
neither service adequately highlighted the risks of accessing such treatment to Conrad or attempted to share information with the skin clinic. The 
inquest heard that patients with BDD should be fully informed of the risks of seeking aesthetic dermatology treatment and wherever possible, clinics 
who are providing treatment should be made aware of the BDD diagnosis.  

3.  Training: The Inquest heard that there is a need for training to be provided to step-down service teams in relation to the diagnosis of BDD and the 

risks associated with it.  

Concern raised by 
the Coroner 

Act
ion 
no. 

Action (short 
form) 

Action  
(long form) 

By Whom 

By   When 

Regulation 28 action plan  

 
 
 
    
     
 
 
 
 
 
 •  Joint working protocol to be developed between the CADAT 
team and the stepdown services provided by NELFT. This 
should highlight the need for full information sharing around risk 
and joint risk/management planning and discharge. 
•  The joint working protocol to be shared with all staff and 

discussed in team business meetings. 

31 /09/2023 

Assistant 
director 

31/09/2023 

Joint working 
(information 
sharing): A concern 
arose at the Inquest 
hearing in relation to 
the absence of liaison 
between the highly 
specialist services of 
the CADAT team and 
the stepdown services 
provided by NELFT. 
There was a lack of 
full information 
sharing around risk 
and joint risk 
assessment/risk 
management planning 
on discharge.  

1) 

Improve working 
relationship 
between the 
highly specialised 
services of the 
CADAT team and 
the stepdown 
services provided 
by NELFT. This 
should include 
the need for full 
information 
sharing around 
risk and joint 
risk/management 
planning and 
discharge 

Regulation 28 action plan  

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Assistant 
Director 

31/08/2023 

05/07/2023 

Assistant 
Director 

30/09/2024 

2)  Learning event to 

be arranged on 
BDD for all staff 

Short Term 

•  Learning event to be arranged on this case with specific reference 
on BDD and the importance of working with partner agencies. 

•  Learning  event  on  completing  risk  assessments  arranged  for 
05/07/2023.  This  learning  event  will  cover  updating  risk,  the 
parameters to consider when completing a risk assessment and 
when to update a risk assessment. 

Long Term 

•  The Trust is planning to undertake a Quality Improvement Project 
on understanding why there are gaps in risk assessment and risk 
management  processes  (a  couple  of  examples  of  reoccurring 
themes),  particularly when  there  are  poor  outcomes associated 
with care provided. The project will focus on working with users 
of  service,  clinical  and  operational  teams,  as  well  as  senior 
leadership  and  other  identified  key  stakeholders  to  understand 
the  structural,  process  and  cultural  factors  which  contribute  to 
poor  outcomes  and  use 
improvement  methodology  and 
framework  to  address  the  areas  which  can  result  in  process 
changes  to  improve  outcomes.  It  may  be  that  a  break  through 
series  collaborative  methodology  could  be  used  across  various 
teams  at  NELFT.  This  approach  could  potentially  standardise 
variation  through  testing  a  change  package  which  includes 
evidence  based  approaches  to  ensure  care  provision  meets 
those standards and teams have a realistic chance of providing 
the care that is required to avoid future untoward outcomes. There 
is also a workstream which is leading on the development of risk 
implementation  of  robust  risk 
formulation 
assessment  and  risk  management  process  to  improve  patient 
safety and move away from the current risk stratification model. 

to  ensure 

the 

Risk management: 
Both mental health 
services were aware 
that Conrad was 
accessing aesthetic 
dermatology 
treatment. There was 
a concern that neither 
service adequately 
highlighted the risks 
of accessing such 
treatment to Conrad 
or attempted to share 
information with the 
skin clinic. The 
inquest heard that 
patients with BDD 
should be fully 
informed of the risks 
of seeking aesthetic 
dermatology 
treatment and 
wherever possible, 
clinics who are 
providing treatment 
should be made 
aware of the BDD 
diagnosis.  

Regulation 28 action plan  

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 3)  Body Dysmorphic 
(BDD) training to 
be offered to all 
staff 

Training: The Inquest 
heard that there is a 
need for training to be 
provided to step-down 
service teams in 
relation to the 
diagnosis of BDD and 
the risks associated 
with it.  

•  Training department to arrange training on BDD for all staff this 

01/12/2023 

to be in conjunction with SLAM who offer training in this 
specialised area. 

Head of 
Learning 
services 

Regulation 28 action plan

Nadia Persaud 
The Coroner’s Court,  
Queens Road,  
Walthamstow 
 E17 8QP 

Dear Coroner, 

National Medical Director  
NHS England  
Wellington House 
133-155 Waterloo Road  
London 
SE1 8UG 

18 July 2023 

Re: Regulation 28 Report to Prevent Future Deaths – Conrad Richard James 
Colson who died on 2 March 2022.  

Thank you for your Report to Prevent Future Deaths (hereafter “Report”) dated 26 May 
2023  concerning  the  death  of  Conrad  Richard  James  Colson  on  2  March  2022.  In 
advance of responding to the specific concerns raised in your Report, I would like to 
express  my  deep  condolences to  Conrad’s family  and  loved  ones.  NHS England is 
keen to assure the family and the coroner that the concerns raised about Conrad’s 
care have been listened to and reflected upon. 

NHS England’s Highly Specialised Severe Obsessive-Compulsive Disorder and 
Body Dysmorphic Disorder Service 

The NHS England Highly Specialised Severe Obsessive-Compulsive Disorder (OCD) 
and  Body  Dysmorphic  Disorder  (BDD)  Service  (Adults  and  Adolescents)  (hereafter 
“Service”)  is  resourced  and  commissioned  via  the  provision/service  specification 
C09/S(HSS)/a 
(Publication  Date:  2012/2013):  https://www.england.nhs.uk/wp-
content/uploads/2018/08/Severe-obsessive-compulsive-disorder-and-body-
dysmorphic-disorder-service-adult-and-adolescent.pdf. 

The Service is a national service and treats patients with severe BDD who have failed 
to  respond  to  evidence-based  treatment  in  locality-based  and  regional  centres 
according to need. It comprises five integrated centres based at the following Trusts; 
South  London  and  Maudsley  NHS  Foundation  Trust  (SLAM)  adults,  SLAM  children 
and adolescents, Hertfordshire Partnership NHS Foundation Trust (HPFT), the Priory 
Hospital North London and South West London and St George’s Mental Health NHS 
Trust (SWLSTG). Each centre is led by a consultant psychiatrist and a multidisciplinary 
team  specialising  in  the  treatment  of  BDD,  and  each  centre  specialises  in  different 
aspects  of  care  –  some  offer  inpatient  care,  others  residential,  home-based  or 
outpatient-based care. The Service covers children, adolescents, and adults with no 
upper age limit. 

Referral pathways into the service emanate from secondary or tertiary care.  Patients 
are ordinarily referred to the Service by a senior member of their local mental health 
team.  They  are  expected  to  have  a  care  coordinator  and  consultant  psychiatrist 

                                                                                                                       
 
 
 
 
 
 
  
 
 
 
 
 
 
 
   
 actively involved for managing their overall psychiatric care and associated risks at the 
time of referral and during the waiting phase. The care coordinator and consultant are 
expected to remain involved throughout the care under the service, who liaise closely 
with them throughout care planning and discharge. 

The  national  Service  operates  a  monthly  case  allocation  meeting  at  which  new 
referrals  are  allocated  to  the  centre  that  best  meets  their  clinical  need.  Following 
referral,  the  patient  is  assessed,  and  a  decision  made  as  to  whether  the  service  is 
clinically appropriate. If they are accepted, there may be a further wait before treatment 
starts.  Waiting  times  for  assessment  and  for  treatment  vary  across  the  service, 
depending on the centre and the kind of treatment provided. For example, inpatient 
care  usually  has  a  longer  waiting  time  than  outpatient-based  care  and  cognitive 
behaviour therapy has a longer waiting time than pharmacotherapy. 

Current waiting times for assessment range from 1-4 months (SLAM adults, HPFT, 
Priory  Hospital,  SWLSTG  inpatient  care)  to  around  7  months  (SLAM  child  and 
adolescents), measured from the date of referral. Waiting times for treatment range 
from  1-6  months  (HPFT  outpatient  or  home-based  care,  Priory  H  outpatient  care, 
SLAM outpatient care, SWLSTG inpatient care) to around 16 months (SLAM child and 
adolescents service, SWLSTG home based care) from referral. Waiting times are kept 
under regular review and, where possible, patients are allocated to the centre where 
the waiting time is the shortest e.g., for home-based care. 

While there has recently been a perceived increase in the overall number of referrals 
to  the  NHS  England  Highly  Specialised  Severe  OCD/BDD  Service  for  children  and 
adolescents at SLAM, a similar pattern of increased BDD referrals has not so far been 
seen in the adult Service, but it may simply be a matter of time before the perceived 
increased occurrence in younger people filters through to adult mental health services, 
highlighting a probable need to consider building greater capacity for treating BDD at 
primary and secondary mental healthcare levels, which we will continue to monitor. 

The  clinicians  in  the  NHS  England  Highly  Specialised  Severe  OCD/BDD  Service 
consider this issue highly important because BDD is common, estimated at 0.5-3.2% 
in  the  general  population,  1.3-5.8%  in  student  cohorts,  4.9-  21.1%  in  general 
dermatology cohorts, and 2.9- 57% in cosmetic surgery cohorts.  It is also a dangerous 
condition with a markedly high suicide rate; 0.3% per annum prospectively end their 
life and about 25% have made a past attempt on their life, and it can be very difficult 
to treat. The Service therefore engages in education and training activities for relevant 
healthcare professionals and aspires to expand these education and training activities 
as well as the future development of regional specialist centres, to disseminate best 
practice more widely, conditional on additional resourcing.  

Aesthetic and cosmetic treatment risks and BDD 

Regarding your concern that patients with BDD should be fully informed of the risks of 
seeking aesthetic dermatology treatment and that, wherever possible clinics who are 
providing  treatments  should  be  made  aware  of  the  BDD  diagnosis,  there  is  clear 
guidelines from the National Institute for Healthcare Guidance (NICE) on this issue. 
The guidelines (NICE Clinical guideline [CG31]) include the following paragraphs:  

 2.6.5.4  For  people  known  to  be  at  higher  risk  of  BDD  (such  individuals  with 
symptoms of depression, social phobia, alcohol or substance misuse, OCD or 
an  eating  disorder),  or  for  people  with mild disfigurements  or  blemishes  who 
are seeking a cosmetic or dermatological procedure, healthcare professionals 
should routinely consider and explore the possibility of BDD.  

2.6.5.6 People with suspected or diagnosed BDD seeking cosmetic surgery or 
dermatological treatment should be assessed by a mental health professional 
with specific expertise in the management of BDD. 

2.6.5.9  Specialist  mental  health  professionals  in  BDD  should  work  in 
partnership  with  cosmetic  surgeons  and  dermatologists  to  ensure  that  an 
agreed screening system is in place to accurately identify people with BDD and 
that agreed referral criteria have been established. They should help provide 
training  opportunities  for  cosmetic  surgeons  and  dermatologists  to  aid  in  the 
recognition of BDD. [GPP] 

10.3.1.3 Specialist OCD/BDD teams should collaborate with people with OCD 
or  BDD  and  their  families  or  carers  to  provide  training  for  all  mental  health 
professionals, cosmetic surgeons and dermatology professionals. [GPP] 

There  can  however  be  barriers  to  implementation  of  the  NICE  guidance,  where 
patients do not consent for private providers and their mental health professionals to 
disclose information to each other.  

NHS England’s existing national Clinical Reference Group (CRG) for OCD & BDD is 
intending to convene with relevant wider stakeholders in light of the concerns raised 
in  your  Report.  This  will  include  consideration  at  a  national  level  of  the  issues  of 
patients with BDD who access aesthetic dermatology treatments.  

Other concerns 

In  terms  of  the  matters  of  concern  specific  to  Conrad,  NHS  England  are  unable  to 
comment  on  the  absence  of  liaison  between  the  Centre  for  Anxiety  Disorders  and 
Trauma (CADAT) team at SLAM and the stepdown services provided by North East 
London  NHS  Foundation  Trust  (NEFLT),  nor  the  adequacy  of  communication, 
information sharing between the two Trusts or the training of staff employed by NELFT, 
who are the appropriate organisations to respond  to your concerns. NHS England has 
however  been  sighted  on  NELFT’s  Serious  Incident  Report  into  the  matters 
surrounding  Conrad’s  death  and  note  that  there  have  been  learnings  and 
recommendations  made,  including  improvements  to  information  sharing.  We  have 
also asked to be sighted on the response to you Report from both NEFLT and SLAM 
and will consider these carefully.  

I would also like to provide further assurances on national NHS England work taking 
place around the Reports to Prevent Future Deaths. All reports received are discussed 
by  the  Regulation  28  Working  Group,  comprising  Regional  Medical  Directors,  and 
other clinical and quality colleagues from across the regions. This ensures that key 

 
 
 
 
 
 
 
 
 learnings and insights around preventable deaths are shared across the NHS at both 
a national and regional level and helps us pay close attention to any emerging trends 
that may require further review and action. 

Thank you for bringing these important patient safety issues to my attention and please 
do not hesitate to contact me should you need any further information. 

Yours sincerely, 

National Medical Director

Psychological Medicine & Older Adults (PMOA) 
South London and Maudsley  
NHS Foundation Trust (SLaM) 
1st Floor Reay House 
Lambeth Hospital Site 
108 Landor Road 
LONDON | SW9 9NU 

Date: 20.07.2023 

PRIVATE & CONFIDENTIAL 

Ms Nadia Persaud 
Walthamstow  
Coroners Court 
Queens Road, Walthamstow 
London. E17 8QP 

Dear Ms. Persaud 

Regulation 28 Report Response arising from the inquest into the death of Conrad Colson 

Thank  you  for  your  Regulation  28  Report  dated  26  May  2023  setting  out  your  concerns  to  be 
addressed. I would like to begin by expressing my deepest condolences to the family and friends of 
Mr Colson.  

Following the conclusion of the inquest on 18 May 2023, you requested an update on the matters 
outlined below. The concerns you raised in your Regulation 28 Report in respect of South London 
and Maudsley NHS Foundation Trust (‘the Trust’) were as follows: 

1.  ‘A  concern  arose  at  the  Inquest  hearing  in  relation  to  the  absence  of  liaison  between  the 
highly specialist services of the CADAT team and the stepdown services provided by NELFT. 
There  was  a  lack  of  full  information  sharing  around  risk  and  joint  risk  assessment/risk 
management planning on discharge’;  

2.  ‘Both mental health services were aware that Conrad was accessing aesthetic dermatology 
treatment.  There  was  a  concern  that  neither  service  adequately  highlighted  the  risks  of 
accessing such treatment to Conrad or attempted to share information with the skin clinic. 
The  inquest  heard  that  patients  with  BDD  should  be  fully  informed  of  the  risks  of  seeking 
aesthetic dermatology treatment and wherever possible, clinics who are providing treatment 
should be made aware of the BDD diagnosis’; and 

3.  ‘The Inquest heard that there is a need for training to be provided to step-down service teams 

in relation to the diagnosis of BDD and the risks associated with it’. 

The Centre for Anxiety Disorders and Trauma (‘CADAT’) has updated its discharge policy (enclosed 
with this letter), to explicitly state the expectations of liaison between local teams and CADAT. The 
updates to this policy confront the issues faced in Conrad’s case. The updated policy was circulated 
to all team members at CADAT and was discussed in the clinic’s team meeting on 1 June 2023. This 

Our ref:  WEB143633 CADAT 

Page 1 of 2 

 
 
 
 
  
     
    
 
 
 
 
 
 
 
  
 
 
 
 policy is also in line with that of the Trust’s Anxiety Disorders Residential Unit. The updated policy 
was reviewed and ratified by the PMOA Leadership Team on 12 July 2023. The policy will again be 
discussed and shared in CADAT’s business meeting on 3 August 2023. 

The updated CADAT discharge policy also includes how staff are expected to communicate with 
skin clinics regarding patients seeking aesthetic dermatological/cosmetic treatment which includes 
seeking consent from the patient to liaise with local services/GP, and if this is refused how to manage 
the situation. 

It would not be possible for the CADAT to provide training on BDD to all referring services nationwide 
due to the logistics and capacity within the clinic itself. The CADAT clinic is in the process of offering 
training on BDD to local services. In addition, the CADAT has agreed to provide more support to 
local services who have referred patients. The CADAT will now include a detailed one page BDD 
information  guide  (enclosed  with  this  letter)  prepared  by  Professor  David  Veale,  Consultant 
Psychiatrist  in  Cognitive  Behaviour  Therapy  at  the  CADAT,  to  referring  services  in  their 
communication following referral. 

The PMOA Leadership Team has reviewed the response by North East London NHS Foundation 
Trust (‘NELFT’) to your Regulation 28 Report which it received on 17 July 2023. Following receipt of 
this document, the CADAT has been in communication with NELFT with regard to recommendations 
1 and 3 of its Action Plan (which were contained in its response provided to you) to ascertain how 
best the CADAT can assist NELFT going forward in implementing the recommendations it has made.    

Please do let me know if you have any additional queries. 

Yours sincerely, 

PMOA Deputy Director  

1.  Enclosed: CADAT Draft Discharge Policy 
2.  Enclosed: Body Dysmorphic Disorder (BDD) Information 

CADAT - Discharge 
Policy.pdf

BDD Information.pdf

Our ref:  WEB143633 CADAT 

Page 2 of 2