We are writing to provide a clear and supportive reminder of VHG’s risk and safeguarding processes.

These processes are in place to ensure you feel supported by our Network Clinical Assurance Team. We value your autonomy and clinical expertise as independent practitioners while also recognising our shared clinical responsibility and duty of care. Our team’s processes, advice and guidance are there to support you in providing safe and consistent care for clients, and we never want our network providers to feel they have to manage complex or high-risk cases in isolation. The team also must ensure all work remains aligned with contractual requirements across our 50+ partner organisations, as well as key national and professional body standards and frameworks.

We therefore kindly request that you read and digest the below reminders of process and expectations to ensure that we can make timely, safe and ethical decisions about clients’ care together.

Our Risk and Safeguarding Refresher online training may also be helpful as a reminder of our processes and expectations around risk and safeguarding.

Risk Process Reminder

As shared in previous communications, any risk or safeguarding concerns must be submitted via a ticket or email with “Risk Review” in the subject line, or “Urgent Risk Review” if you have had to deal with an immediate risk or serious safety concern. This ensures your request is automatically allocated to the Risk Team for timely review.  Routine clinical queries submitted through MPB, or sent outside of this process, may take up to five working days for a response. Using the correct route helps us avoid delays in providing guidance and ensures clients receive the right support at the right time.

Mandatory Reporting Requirements

To ensure clinical oversight, uphold internal policies and maintain client safety, you must inform VHG via the above risk process if any of the following occur:

• A client makes a suicide attempt while in therapy, including between referral/assessment and initial appointment
• A self-harm incident requiring treatment beyond a GP visit
• A client is actively being supported by another mental health service (e.g: crisis team, CMHT)
• A client becomes an inpatient in a mental health facility, either voluntary or detained under the Mental Health Act
• Any safeguarding concern, including but not limited to, children, risk to/from others, abuse disclosures or concerns about capacity
• Diagnosed and/or active eating disorders

Recommended Reporting

We also encourage you to discuss the following presentations with us so we can support clinical decision making, appropriate service involvement and ensure contract suitability. We have additional screening tools available to help assess severity and guide next steps:

• Disordered eating presentations
• Suspected symptoms of psychosis or mania/hypomania
• Complex presentations that would benefit from a multidisciplinary approach
• Drug or alcohol misuse

Immediate Risk and Urgent Support

If you believe a client is at immediate risk, please follow your own private practice process initially and complete any urgent actions required to maintain safety. This may include:

• Contacting 999 for immediate intervention
• Contacting 111 for crisis support
• Requesting a priority GP review via a phone call
• Completing a collaborative safety plan with the client

Once urgent actions are completed, please inform VHG at your earliest convenience so we can provide further support.

Please note that the Clinical and Risk Team are available Monday–Friday, 9am–5pm (excluding bank holidays). Outside these hours, we ask that you follow your private practice procedures to maintain client safety. If you need to debrief after a difficult session, we are available during office hours and happy to support you.

What happens if I disagree with the advice and guidance given?

Please let us know if you have concerns about carrying out any of our advice or recommendations, are unclear on the rationale, or feel that there are factors we have not taken into consideration when advising. We will be happy to discuss this with you further and aim to reach a consensus wherever possible. There are some cases where we may feel that to pursue an alternative course of action would represent a risk to the safety of a client or others, or that a client’s needs fall outside the scope of their contractual provision. We will be clear when this is the case and would expect in those cases our advice and any recommended actions are carried out as requested.

What happens if processes are not followed?

If we identify that our processes have not been followed or clinical advice has been disregarded and this represents a potential risk to client safety, this would be addressed under our network performance management policy.

Our intention is always to support and work collaboratively with you to ensure client safety, contractual compliance and consistent clinical governance across the network. We appreciate all of your hard work and dedication to ensuring the best care and support is provided to our clients. 

Kind regards,

Network Clinical Team