Responses

Dear FOI Team,

I am writing to request the following recorded information under the Freedom of Information Act 2000.

Clinical Audit 24-142, “Audit of Access to Psychological Interventions for People with Psychosis and Bipolar Disorder among the West Gloucestershire Recovery Service Caseload”, recorded a planned re-audit date of October 2026.

Please provide:

1. Confirmation of whether the planned October 2026 re-audit has commenced or been completed.
2. If completed, a copy of the re-audit report, including findings, recommendations and any associated action plan.
3. If commenced but not yet completed, any existing recorded timetable or planned completion date.
4. If the re-audit has been postponed or cancelled, any existing recorded decision, reason or revised timetable.

I am not requesting the creation of new information. Where no relevant recorded information is presently held, please confirm this.

Electronic copies by email would be appreciated.

Kind regards

Good Afternoon,

Under the Freedom of Information Act 2000, I am requesting information relating to adult Level 1 and Level 2 mental health inpatient rehabilitation placements commissioned or funded by your Integrated Care Board (ICB). For the purposes of this request, “spot purchased” means an individually commissioned placement purchased on a named-patient basis and funded outside of any block contract, bed retainer arrangement or other fixed-capacity agreement.

Please provide the information for:
• Financial Year 2025/26 (1 April 2025 to 31 March 2026)
• Financial Year 2026/27 year to date (1 April 2026 to the date of your response)

Please include information separately for:
• The total number of male placements into Level 1 mental health rehabilitation inpatient beds and the total number of bed days
• The total number of female placements into Level 1 mental health rehabilitation inpatient beds and the total number of bed days
• The total number of male placements into Level 2 mental health rehabilitation inpatient beds and the total number of bed days
• The total number of female placements into Level 2 mental health rehabilitation inpatient beds and the total number of bed days
• Please also indicate the split between NHS provider placements/bed days and independent sector placements/bed days

Where possible, please complete the table below.

Level 1 and Level 2 rehabilitation services should be defined in accordance with NHS England’s Commissioner Guidance for Adult Mental Health Rehabilitation Inpatient Services.

Financial Year Patient Group Rehabilitation Level Number of NHS Spot-Purchased Placements Number of NHS Bed Days Number of Independent Sector Spot-Purchased Placements Independent Sector Bed Days
2025/26 Male Level 1
2025/26 Male Level 2
2025/26 Female Level 1
2025/26 Female Level 2
2026/27 (YTD) Male Level 1
2026/27 (YTD) Male Level 2
2026/27 (YTD) Female Level 1
2026/27 (YTD) Female Level 2

Kind Regards,

FREEDOM OF INFORMATION ACT 2000 REQUEST
COGNITIVE BEHAVIOURAL THERAPY FOR PSYCHOSIS (CBTp)
INDIVIDUALISATION, OUTCOME MONITORING AND RESPONSE TO TREATMENT FAILURE

Please provide the following recorded information held by the Trust concerning psychological interventions provided to adults with psychosis or schizophrenia.

This request is concerned particularly with Cognitive Behavioural Therapy for psychosis (CBTp) but where the Trust’s relevant policies or governance arrangements apply more generally to psychological interventions for psychosis, please provide those documents.

The period for questions 2-4 below is 1 January 2022 to the date of this request.

1 Policies, Procedures and Clinical Guidance

Please provide the current version of any policy, procedure, clinical pathway, protocol, guidance, standard operating procedure or equivalent recorded document setting out:

a) how the individual patient’s goals, preferences, needs and treatment priorities are identified and
incorporated into the psychological intervention.
b) how the effectiveness or clinical benefit of the psychological intervention is assessed for the
individual patient.
c) which outcome measures, assessment tools or other measures are expected to be used before,
during and/or following treatment.
d) how service-user satisfaction, helpfulness, acceptability or experience of the intervention is
assessed or recorded.
e) how the intended course or “dose” of CBTp is determined and recorded, including the number of
sessions planned and how compliance with the relevant CBTp model or core components is
assured.
f) how non-initiation following referral or offer, disengagement, early discontinuation or non-completion
is assessed and recorded, including the reasons for this and whether the suitability, accessibility or
acceptability of the intervention is considered.
g) whether barriers to engagement or effective participation are expected to be assessed including,
where relevant, cognitive or communication difficulties, sleep disturbance, distress or arousal,
medication adverse effects, physical health problems or practical/social barriers.
h) what clinical review or action is expected where the intervention has not produced the intended
benefit, including whether the diagnosis, clinical formulation, treatment plan, barriers to participation
or treatment approach should be reconsidered.
I) how alternative or adapted psychological approaches are considered where CBTp is ineffective,
unsuitable or unacceptable to the patient or cannot be completed.
j) how psychological interventions are adapted where an individual has relevant neurodevelopmental,
cognitive or communication needs.

2 Audit, evaluation and quality assurance

Please provide copies of any audits, evaluations, quality-improvement reviews, assurance reports or
equivalent recorded assessments undertaken during the period specified above which examined any of the following:

* whether CBTp or other psychological interventions achieved intended clinical outcomes
* compliance with requirements to monitor outcomes routinely and systematically
* service-user satisfaction, helpfulness or acceptability
* referral, offer, commencement, completion or non-completion of psychological interventions
* reasons for non-initiation, disengagement, early discontinuation or non-completion
* the number of CBTp sessions planned compared with the number actually attended or delivered
* whether CBTp was planned and delivered in accordance with relevant NICE recommendations
including the recommended course of at least 16 planned individual CBT sessions
* adherence to the intended CBTp model or its required/core components
– 2 –

* individualisation or personalisation of psychological treatment
* barriers affecting engagement or participation
* action taken following inadequate response to psychological treatment.

3 Aggregate management and outcome information

Please provide any existing aggregate report, dashboard, dataset summary or other recorded management information held by the Trust showing, for CBTp for psychosis:

a) numbers or proportions referred for CBTp
b) numbers or proportions offered CBTp
c) numbers or proportions commencing CBTp including where held, the numbers attending at least one
session
d) numbers or proportions for whom a course of at least 16 sessions was planned
e) the number of sessions actually attended or delivered, where this is already held in aggregate form,
including any existing mean, median, range or equivalent summary
f) numbers or proportions completing the planned course or any locally defined adequate course
g) numbers or proportions not commencing, disengaging early or not completing treatment
h) recorded reasons or reason categories for non-initiation, disengagement or non-completion
I) recorded clinical outcome or outcome measure results
j) any aggregate service-user satisfaction.

4 Governance oversight

Please provide copies of any reports, papers, presentations, relevant minute sections or action plans presented during the period specified above to the Trust Board or a Trust-level governance, quality, clinical effectiveness, psychological therapies or equivalent committee concerning:

* effectiveness or clinical outcome of CBTp or other psychological interventions for psychosis
* access to, engagement with or completion of CBTp
* the difference between psychological treatment being offered and treatment actually being
commenced or received
* patient experience, satisfaction or acceptability
* treatment non-response, non-initiation, disengagement or non-completion
* deficiencies in outcome measurement or recording of treatment/dose sessions received
* compliance with relevant NICE recommendations concerning the delivery, monitoring and review of
psychological interventions for psychosis
* competence, training or supervision of staff delivering CBTp
* action taken to improve the effectiveness, individualisation, accessibility or monitoring of those
interventions.

Scope

This request does not seek:

* patient-identifiable information
* examination of individual clinical records
* creation of new statistics, calculations or analyses
* explanations, opinions or clinical judgements that are not already recorded.

Where one document answers more than one part of this request, please provide the document only once and identify the questions to which it relates.

Where a relevant document contains substantial material unrelated to this request, provision of the relevant section or extract is sufficient.

Where no recorded information is held for a particular part, please state that explicitly. Electronic copies by email would be appreciated.

Dear Freedom of Information Team,

I am writing to make a request under the Freedom of Information Act 2000. Please provide the following information relating to your Trust’s ADHD and Autism Spectrum Disorder (ASD/ASC) diagnostic, assessment, medication titration and related neurodevelopmental services.

1. Service Provision
For each locality or service area covered by your Trust, please confirm whether your Trust provides each of the following services:
•Adult ADHD assessments
•Adult ADHD medication initiation or titration
•Adult ASD/ASC assessments
•CYP ADHD assessments
•CYP ADHD medication initiation, titration or physical monitoring
•CYP ASD/ASC assessments
•Neurodevelopmental triage or screening services, where separate from full diagnostic assessment
If any of the above services are not provided by your Trust in a particular locality, please state which organisation is responsible for providing or commissioning that service.

2. Service Locations and Pathways
For each service listed in Section 1, please provide all:
•Clinic, hub or service names
•Towns/city’s and postal addresses
•Functional team email addresses
•Team telephone numbers

3. Use of External Providers
Please confirm whether your Trust currently uses external providers for any of the following:
•Adult ADHD assessments
•Adult ADHD medication initiation or titration
•Adult ASD/ASC assessments
•CYP ADHD assessments
•CYP ADHD medication initiation, titration or physical monitoring
•CYP ASD/ASC assessments

If yes, please provide:
•Supplier name
•Service provided
•Locality or pathway covered
•Whether the model is insourcing, outsourcing, subcontracting, framework call-off, direct award or another arrangement
•Contract start date
•Contract end date or review date
•Procurement route, such as framework, open tender, direct award or other
•Estimated annual contract value, if available

4. Future Commissioning and Pathway Review

Please confirm:

•Whether your Trust expects to procure additional ADHD or ASD/ASC assessment capacity within the next 24 months
•Whether your Trust is reviewing or redesigning its ADHD or ASD/ASC diagnostic pathways
•Whether your Trust plans to expand, reduce or change its use of external providers

5. Key Contacts

Please provide the name, job title, NHS email address and telephone number, where applicable and publicly available, or a generic team email address and duty/team telephone number, for the following roles:
•Head of Neurodevelopmental Services
•Head of Adult Mental Health Services
•Head of Mental Health Adult Services responsible for ADHD or ASD/ASC pathways
•Head of CYP Mental Health Services
•Head of Mental Health CYP/CAMHS
•Head of CAMHS or CYP Neurodevelopmental Services
•Head of Pathways or Head of Integrated Care Pathways responsible for ADHD or ASD/ASC pathways
•Adult ADHD Service Lead
•Adult ASD/ASC Service Lead
•CAMHS ADHD Service Lead
•CAMHS ASD/ASC Service Lead
•CYP ADHD Service Lead
•CYP ASD/ASC Service Lead
•Operational Manager responsible for Neurodevelopmental Services
•Operational Manager responsible for Adult ADHD or ASD/ASC services
•Operational Manager responsible for CAMHS or CYP ADHD or ASD/ASC services
•General Manager responsible for Neurodevelopmental Services
•Director of Operations responsible for these service lines
•Clinical Director overseeing these service lines
•Procurement Lead for Mental Health Services
•Procurement Lead for Community Services
•Procurement Lead for Neurodevelopmental Services, if applicable
•Any equivalent, differently named or additional contact roles responsible for ADHD, ASD/ASC, neurodevelopmental pathways, service operations or procurement where the role titles above do not match the Trust’s structure

I would be grateful if you could provide this information electronically, preferably in Microsoft Word or Excel format.

Thank you for your time and assistance with this request.

One question: In your provider system, which role owns continuity when established adult ADHD treatment ends without an accepted receiving prescriber, what bridge or escalation mechanism applies, and what record would evidence the decision?

A one-paragraph answer naming the role, mechanism and record would be enough. If this inbox is not the right route, please identify the correct published contact rather than treating this as a request for out-of-area care.

Kind regards,

Dear Freedom of Information Team,
I am writing to request information under the Freedom of Information Act 2000 regarding Care Reviews undertaken by Gloucestershire Health and Care NHS Foundation Trust.
I would be grateful if you could provide the following information in an anonymised form, with no patient-identifiable information:
1. How many Care Reviews are currently open?

2. For all currently open Care Reviews, how long have they been open? If individual figures cannot be provided, please provide this using the following bands:

o Under 6 months
o 6–12 months
o 12–18 months
o 18–24 months
o Over 24 months

3. Of the currently open Care Reviews, how many relate to a patient’s death by suspected suicide?

4. Of those relating to suspected suicide, how many have been open for:

o More than 6 months
o More than 12 months
o 18 months or longer

5. For all Care Reviews completed during the last three years, what was:

o The average time between the patient’s death and formal completion of the Care Review
o The longest time between the patient’s death and formal completion

6. For Care Reviews relating to suspected suicide that were completed during the last three years, what was:

o The average time between the patient’s death and formal completion
o The longest time between the patient’s death and formal completion

7. During the last three years, how many Care Reviews took 18 months or longer from the date of death to formal completion?

8. What is the Trust’s current target or expected timescale for completing a Care Review following a patient’s death?

9. Of the Care Reviews currently open, how many have exceeded the Trust’s expected or target completion timescale?

10. Where Care Reviews have remained open beyond 12 or 18 months, what information does the Trust hold regarding the reasons for these delays? For example, whether delays have been attributed to staffing or capacity, complexity of the review, availability of staff or witnesses, or other factors.
I am requesting statistical and anonymised information only and am not seeking any information that could identify individual patients, families or staff members.
If any part of this request is considered exempt or cannot be answered as worded, I would be grateful if you could provide the information that can be disclosed and explain which exemption is being relied upon for any information withheld.
Yours faithfully,