DOZENS of recommendations have been made following a review into the care and treatment of a mentally ill Barrow man who went on to kill his father.

A Joint Domestic Homicide Review and independent mental health homicide investigation in South Cumbria made a number of findings and recommendations in light of the death of John MacMillan.

Mr MacMillan was fatally stabbed by his son Jonathan on June 18, 2019 in Provincial Street, Barrow – five days after he was erroneously released from a mental health unit in Maidstone, Kent.

The review – commissioned by NHS England – made 26 recommendations pertaining to the action taken by various bodies involved in Jonathan’s treatment and care.

At the time of the incident, the Cumbria Partnership NHS Foundation Trust (CPFT) provided mental health services in South Cumbria, which is referred to as the Trust in the review.

The recommendations have been summarised as follows:

 

NHS Morecambe Bay CCG

The CCG must:

  • explore whether there are systems available to assess the safety of family members and informal care providers who are supporting patients with mental health issues in the community and advise GP practices accordingly.
  • ensure risk assessments are updated at expected intervals and communicated to other agencies.

Cumbria Partnership NHS Foundation Trust (CPFT)

The Trust must ensure:

  • that risk to families is considered as part of risk assessment and management and must incorporate the understanding of potential risk of harm to parents into risk assessment training, policy and procedures.
  • that there is clear guidance to be followed for the care of patients who present as sexually disinhibited, which adheres to national guidance on same sex accommodation.
  • the use of Section 17 leave is supported by robust risk assessment and clear care plans that are agreed by the multidisciplinary team (MDT) and families as appropriate.
  • that families and carers are appropriately involved in care planning and risk assessment and recognise that supportive families may also be at risk of harm, and that comprehensive assessments and supportive plans are developed.
  • that serious incident investigations are carried out at the appropriate levels, within expected timescales and that they provide evidence of action plan implementation.

The Mail: Cygnet Hospital, Maidstone.jpgCygnet Hospital, Maidstone.jpg (Image: Newsquest)

Cygnet Health Care

Cygnet Health Care must ensure:

  • that the risks identified by local services are clearly visible in any risk assessment completed by Bearsted Ward, and that when risks are identified they are recorded and mitigation plans developed.
  • that serious incident investigations are carried out at the appropriate levels, within expected timescales and that they meet expected NHS England national standards.
  • policies should clearly demonstrate the sign off and governance process and must demonstrate and provide assurance to commissioners that their admission, discharge and Care Programme Approach (CPA) policies are adhered to.

NHS England

NHS England should share learning identified about parricide (the killing of a parent or relative) with the Home Office and with the First Tier Tribunal (Mental Health) and risk to family members, and how sensitive third-party information is managed.