Scott Taylor

Minister of State for Health (Secondary Care) 

39 Victoria Street 
London 
SW1H 0EU 

HM Assistant Coroner, James Thompson   
Gateshead & South Tyneside 

 21 August 2026 

Dear James Thompson, 

Thank you for the Regulation 28 report of 6 July 2026 about the death of Scott Alan Taylor. 
I am replying as Minister of State for Health.       

Firstly, I would like to say how saddened I was to read of the circumstances of Mr Taylor’s 
death, and I offer my sincere condolences to his family and loved ones. The circumstances 
your report describes are concerning and I am grateful to you for bringing these matters to 
my attention.  

The report raises concerns about the availability of specialist tertiary care for the treatment 
of obsessive-compulsive disorder (OCD).  

Responsibility for the commissioning of specialist tertiary care for the treatment of OCD 
sits with Integrated Care Boards (ICBs) which are overseen by NHS England.   

In considering your report and the concerns raised, officials within the Department of 
Health and Social Care have made enquiries with NHS England and concluded that NHS 
England is therefore best placed to provide a response. I am advised that NHS England 
will provide you with a full and comprehensive response on the concerns you have raised.  

I would like to assure you that we recognise that it is unacceptable that some people are 
waiting to receive the mental health care they need. We are determined to change that so 
that people can be confident in accessing high-quality mental health support when and 
where they need it.  

We know that long waits are being driven by increasing demand to a system in desperate 
need of change. We are already responding by delivering new, innovative models of care 
in the community, and are piloting six community-based adult mental health centres to 
bring together community, crisis and inpatient care. We are also providing more NHS 
Talking Therapies, investing in mental health emergency departments and giving patients 
better access to 24/7 support directly through the NHS App. Through our upcoming mental 
health strategy, we will put more emphasis on early intervention and recovery to support 
people to live well and thrive. 

 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
  
  
 
  
 I hope this response is helpful 

Yours sincerely,  

MINISTER OF STATE FOR HEALTH

Mr James Thompson 
Assistant Coroner for Gateshead & South Tyneside 
Coroner’s Service 
Town Hall and Civic Offices 
Westoe Road 
South Shields 
Tyne and Wear  
NE33 2RL 

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

17th August 2026  

Dear Mr Thompson, 

Re: Regulation 28 Report to Prevent Future Deaths – Scott Alan Taylor who 
died on 12th May 2023.  

Thank you for your Report to Prevent Future Deaths (hereafter “Report”) dated 6th July 
2026  concerning  the  death  of  Scott  Alan  Taylor  on  12th  May  2023.  In  advance  of 
responding to the specific concerns raised in your Report, I would like to express my 
deep  condolences  to  Mr  Taylor’s  family  and  loved  ones.  NHS  England  is  keen  to 
assure the family and yourself that the concerns raised about Mr Taylor’s care have 
been listened to and reflected upon.   

Your Report raises concern about the  lack of specialist tertiary centres for treatment-
resistant Obsessive Compulsive Disorder (OCD) in the United Kingdom. The centres 
that are available are located in London and the South East, making it more difficult 
for those living in other parts of the country to access treatment.  

The  NHS  England  Highly  Specialised  Service  for  Severe  Obsessive-Compulsive 
Disorder  (OCD)  and  Body  Dysmorphic  Disorder  (BDD)  caters  to  both  adults  and 
adolescents  suffering  from  these  debilitating  conditions.  This  service  provides 
intensive, evidence-based treatments to patients with severe forms of OCD and BDD 
who have not responded to previous treatments in their local and regional healthcare 
settings.  The  National  Service  is  only  deemed  to  be  applicable  to  those  who  have 
reached  Step  6  severity  in  the  NICE  clinical  guidelines  CG31  requiring  intensive 
treatment and inpatient services. 

The  service  is  delivered  across  five  integrated  centres,  within  three  separate  NHS 
Trusts  and  in  the  private  sector  (the  Priory  Hospital  North  London),  providing  a 
comprehensive  treatment  pathway  for  the  most  complex  cases.  NHS  England  has 
commissioned 36 inpatient beds nationally across these five specialist centres, most 
of which are adult services. 

The five national specialist centres for the NHS England Highly Specialised Severe 
OCD/BDD Service are: 

1. 

South London and Maudsley NHS Foundation Trust (SLAM) – Adult Service 

                                                                                                                       
 
 
 
 
 
 
  
 
 
 2. 

3. 

4. 
5. 

South  London  and  Maudsley  NHS  Foundation  Trust  (SLAM)  –  Child  and 
Adolescent Service 
Hertfordshire Partnership University NHS Foundation Trust (HPFT) – Adult 
Service 
The Priory Hospital North London – Adult Service 
South West London and St George's Mental Health NHS Trust (SWLSTG) 
– Adult Service 

These centres provide a range of services including out-patient treatment, intensive 
out-patient and home-based treatment including intensive liaison with local community 
mental health teams and telephone monitoring, residential unit treatment and inpatient 
treatment (for patients who require 24-hour nursing care). The centres are designed 
to  cater  to  the  needs  of  both  adults  and  adolescents  with  severe  OCD  and  BDD. 
However, it is important to note that the national centre services require collaboration 
and ongoing active specialised intervention with the local mental health services, care 
co-ordinators, general practitioners and other multi-disciplinary teams already involved 
with the patients who are referred. 

Commissioning and Service Model 

The  national  service  operates  in  line  with  NICE  guidelines,  which  recommend  a 
stepped care model of mental health intervention for OCD and BDD, where treatment 
intensity  is  gradually  increased  based  on  patient  needs  and  treatment  history.  This 
model  ensures  that  patients  with  the  most  treatment  refractory  forms  of  these 
disorders are referred to the national service after exhausting appropriate treatments 
in lower tiers of care. 

Key service provisions include: 

• 

• 

• 

Inpatient, residential, home-based, and outpatient services: tailored to meet 
the  needs  of  both  adults  and  adolescents  across  various  levels  of  care 
intensity. The service currently offers 36 inpatient beds nationally, ensuring 
access to intensive care for the most severely affected patients. 
Multidisciplinary teams: led by consultant psychiatrists, these teams provide 
specialised  interventions,  including  Cognitive  Behavioural  Therapy  (CBT) 
and  pharmacotherapy,  augmented,  when  necessary,  by  antipsychotic  or 
dopamine blocking medications. 
National  referral  pathway:  patients  referred  to  the  service  are  required  to 
have  ongoing  care  from  their  locality’s  mental  health  teams,  ensuring 
continuity of care before, during, and after treatment in the national service. 
Referral pathways into the service typically come from secondary or tertiary 
care,  and  patients  are  referred  by  senior  members  of  their  local  mental 
health  team.  Referrals  must  include  active  involvement  from the patient’s 
care  coordinator  and  consultant  psychiatrist,  who  manage  the  patient’s 
overall psychiatric care and associated risks during the referral and waiting 
phases. Ongoing coordination with local mental health teams is critical for 
ensuring continuity of care throughout the treatment journey. The national 
service  leads  from  each  service  centre  hold  monthly  case  allocation 
meetings where new referrals are reviewed and assigned to the centre that 

 
 best meets the patient’s clinical needs. Once a patient is accepted, there 
may  be  a  waiting  period  before  treatment  begins,  and  waiting  times  for 
assessment  and  treatment  vary depending  on  the  centre  and  the  type  of 
care required. 

Geographic Distribution and Capacity 

It is correct to note that all five specialist centres are concentrated in the South East 
region, with four of them located in London. This distribution is not a deliberate policy 
choice but reflects the availability of providers with the necessary expertise to deliver 
this  highly  specialised  care.  While  this  concentration  allows  for  the  delivery  of  high 
quality, evidence-based treatment from recognised centres of excellence, it may pose 
challenges in terms of access for patients located in other regions of England. This 
geographic concentration underscores the importance of ongoing collaboration with 
local  mental  health  services  to  manage  care  coordination  and  ensure  equitable 
access. 

Additionally,  due  to  the  highly  specialised  nature  of  the  National  OCD  and  BDD 
service,  it  is  not  feasible  for  this  service  to  have  specialist  centres  in  every  region 
across  the  United  Kingdom,  or  for  the  specialised  care  to  be  delivered  in  more 
generalised healthcare settings. This is true for most specialist services in the NHS 
e.g. specialist cancer treatment centres, neurosurgery and ophthalmology, where the 
concentration of expertise and resources is necessary to provide the highest quality 
care. Patients are referred to these specialist centres from all over the UK to access 
the expert treatment they require. 

For  the  national  specialist  OCD/BDD  services,  there  is  no  separate  commissioning 
provision  within  the  service  specification  for  providers  or  NHS  England  to  routinely 
fund patients’ travel to access treatment. 

As with other NHS services where patients may need to travel outside their local area 
to access specialist care, responsibility for travel costs does not automatically sit with 
the  commissioning  service.  There  are,  however,  established  NHS  arrangements 
through  which  eligible  patients  may  receive  support.  This  includes  the  Healthcare 
Travel Costs Scheme for patients who meet the relevant eligibility criteria, and NHS-
funded patient transport services where an individual has a qualifying medical need 
for  transport.  Providers  should  therefore  ensure  that  patients  are  appropriately 
signposted  to  the  relevant  arrangements  and  supported  to  understand  what 
assistance may be available to them. 

Given the highly specialist nature of OCD/BDD services, it is recognised that some 
patients  will  necessarily  need  to  travel  significant  distances  to  access  nationally 
commissioned expertise. Providers should take this into account when planning care 
and,  where  clinically  appropriate  and  consistent  with  the  commissioned  model, 
consider how elements of assessment, follow-up or ongoing care can be delivered in 
ways  that  minimise  unnecessary  travel.  This  does  not,  however,  create  a  general 
entitlement to NHS-funded travel or transfer responsibility for routine travel costs to 
the specialist service. 

 
 I  would  also  like  to  provide  further  assurances  on  the  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 events, such as the sad death of  Mr 
Taylor, are shared across the NHS at both a national and regional level and helps us 
to  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   
NHS England