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Bereaved left in limbo by serious incident report delays, says mother of man who took his own life.


The mother of a man who took his own life has said bereaved families are left "in limbo" by a mental health trust's delays in providing serious incident reports.

Local health officials have raised concerns about extended delays in Cambridgeshire and Peterborough NHS Foundation Trust's (CPFT) reports.

Maria Nowshadi, whose son James died in 2020, said they should be done quickly "so there's answers for families."

Chief nurse at Cambridgeshire and Peterborough's Clinical Commissioning Group (CCG), Carol Anderson, said there were "concerns around serious incident processes and reporting" at CPFT.

A CCG spokeswoman added they had agreed an extension with CPFT "for the completion of serious incident reports due to additional pressures because of the pandemic and staff redeployment.

"Our overall concern is the timeliness of serious incident reporting, so that we can ensure that learning is put in place as soon as possible."

Ms Nowshadi's son James, from Cambridge, took his own life in April 2020 while under the care of CPFT. At his inquest in 2021, a coroner criticised CPFT's serious incident report into his death, calling it "not credible."

Ms Nowshadi, who works as a nurse, said: "These investigations should happen in a timely, quick manner so there's answers for families, but also in case there's any learning to be had to make sure there's no further deaths in the same way, because of any errors within the system."

She said when the original date the report was due to be completed passed, she reached the stage where she was looking at the mailbox every day and told a patient liaison officer: "You all know about the last three months of my son's life and I've got no information. He was living with me but I didn't know about his mental health problems, so that's something I really need access to."

She said that another reason she wanted to see the report related to getting legal representation for the inquest.

She said: "You have to have had the serious incident report because the solicitors can't take you on until they've seen whether there's a case for them to take on or not."

When asked how delays may affect families, she said: "I think it leaves people in limbo. It leaves them not knowing what's going on."

She said she had spoken to CPFT and believed plans were in place to provide better patient liaison.

A spokesman for CPFT said: "We treat the investigations of all incidents with the upmost seriousness.

"Even with the ongoing pressures caused by the response to the Covid pandemic, we have added an additional dedicated resource to help aid our processes, and we are committed to improving the quality of reports, including working closely with family members to address their concerns, to ensure all lessons are learned and patient care is improved."