Document name: Clinical Management of Service Users with Dual Diagnosis (mental health and substance use) Document type
Partnership working and information sharing
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- 9. Learning from Incidents
- 10 Training
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| Partnership working and information sharing
8.2.1 Underpinning safe and effective care delivery is robust documentation and information sharing with all partners involved in care/treatment provision. Given the range of agencies likely to be involved sharing information in a timely manner is essential. 8.2.2 RIO provides a system that facilitates information sharing across teams in the Trust including Barnsley BDU from 2013. 8.2.3 It is good practice to obtain written consent before information is disclosed. Most service users will provide consent if they understand the importance of information sharing in promoting good care delivery. 8.2.4 Careful consideration of what information is passed on to which organisations is required. Information is shared on a ‘need to know’ basis. A minimum requirement would usually be information about the nature of mental health and substance use problems and an assessment of risk. It is good practice to discuss with service users what information will be shared and in what format this will be. Often service users can share in the preparation of such information. 8.2.5 Some service users pose significant risks to others. Staff have a responsibility to share such information with other services involved in their care in line with the Multi agency Information Sharing Policy/Confidentiality Policy. 8.2.6 In some circumstances it will be necessary to break confidentiality. This decision should be made by the multi-disciplinary team, including the team leader and consultant psychiatrist. The rationale for the breach should be discussed with the Caldicott Guardian who can provide further advice. The service user should be made aware of actions being taken unless there are clear reasons for not doing so. The reasons for breaking confidentiality, and, if the service user is not being informed, the reasons for this, should be documented. Where children are involved the welfare of the child is paramount and concerns can be shared without consent if necessary in line with Safeguarding Children Procedures. Where a person has been assessed as lacking capacity to make a decision regarding consent to sharing information, a decision should be made using section 4 of the Mental Capacity Act to determine if sharing information is in the person’s best interests. This will include consultation with others who are interested in the person’s welfare. 8.2.7 During treatment (when consent has been given), as a minimum, external ‘agencies’ (including carers) should be invited to CPA meetings and given copies of care plans. However, it is good practice to maintain regular dialogue with all parties involved in care delivery. Partner agencies should always be informed of significant changes in the service users’ circumstances. 9. Learning from Incidents 9.1 All incidents related to substance use should be reported in line with the Incident Reporting and Management Policy and Procedures. A record should be made in the risk event history. The incident reporting system (DATIX) captures incidents where substance use is a focus and has the potential to highlight those where substance use has been a contributory factor to other incidents (eg intoxication with alcohol contributing to violence).Findings from the reports should be reviewed at least annually. 9.2 Patient safety communications relating to risks associated with substances (eg contaminated heroin supplies) must be circulated across the whole Trust via the Chief Pharmacist/Accountable Officer for controlled drugs to the Dual Diagnosis and Substance Misuse Advisory Group to cascade through services so that all service users who are using substances and their family and carers can be alerted. Such information originates from a variety of sources (eg police, local substance misuse services, Drug and Alcohol Action Teams). A summary of the information should be posted in waiting areas and on wards. All staff should pass on details to service users and carers who may be directly at risk. 9.3 When Serious Untoward Incidents have a substance use component dual diagnosis leads should be consulted as part of the investigation and review process to ensure that dual diagnosis perspectives are fully considered as substance use, particularly alcohol, can be a significant factor in suicides (With reference to the Investigations Policy). 10 Training In line with the Trust’s training needs analysis (TNA), any staff members identified as requiring dual diagnosis training will undertake the e-learning Dual Diagnosis module as a one off event. It is the individual staff member’s responsibility supported by their team manager to maintain and update their skills and knowledge base as appropriate. Trust staff with a specific remit in their job description will be expected to undertake individual study leave with an appropriate external provider. This could include modules from Leeds Addiction Unit. Information regarding further courses can be sought from the Dual Diagnosis and Substance Misuse Advisory Group. (Contact details for Wakefield: sean.mcdaid@swyt.nhs.uk; Kirklees: Svyet.finch2@swyt.nhs.uk; Calderdale: adam.barrett@swyt.nhs.uk; Barnsley: Alison.hill@swyt.nhs.uk ) Standards'>11 Policy standards Policy Standards Key:
MH mental health SM substance misuse DD dual diagnosis
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