Publications

Independent inquiry into the care and treatment of StephenSoans-Wade

In September 2002 Stephen Soans-Wade pushed Christophe Duclos into the path of an oncoming underground train at Mile End Station; Mr Duclos died as a result of his injuries.

Stephen Soans-Wade was convicted of his murder in February 2004 and sentenced to life imprisonment. At the time of the homicide Mr Soans-Wade had been receiving treatment from a number of mental health and substance misuse services in Tower Hamlets, he was also receiving care from his GP.

Mr Soans-Wade had a complex range of needs including personality disorder, mental illness, drug and alcohol dependence. Following the homicide, an Independent Inquiry into his care and treatment was commissioned by North East London Strategic Health Authority (now part of NHS London).

The report of the Inquiry highlights a number of areas where improvements in services and processes are required, making a total of 8 recommendations. These include a requirement to improve practice, delivery and monitoring of the Care Programme Approach particularly related to joint risk assessments and discharge planning the call to develop a better range of services for people with personality disorders and other conditions The agencies involved in providing care to Stephen Soans-Wade have jointly agreed an Action Plan setting out what has already been done to improve services since the death of Mr Duclos. The Action Plan establishes what other action will be taken to fully meet the reports recommendations.

Published July 2006