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A public inquiry examining a tragic series of events in Nottingham has revealed that a man suffering from paranoid schizophrenia, Valdo Calocane, was discharged from mental health services several months before he fatally stabbed three individuals. The decision to discharge Calocane came after healthcare workers were unable to locate him or maintain contact, according to testimony at the inquiry. NHS trust team leader Emma Robinson explained that by September 2022, the Early Intervention in Psychosis (EIP) team had been unable to engage with Calocane, who had repeatedly missed appointments and failed to respond to outreach efforts.
Calocane’s last interaction with the EIP team occurred via phone in mid-July 2022, during which he falsely claimed to be abroad. Despite repeated attempts by his care coordinator, including home visits, calls, and letters, no contact was successfully made. Robinson acknowledged, “We couldn’t work with him, we couldn’t find him at this point.” When asked if the decision to discharge him considered potential risks to the public—given that visits to Calocane were only made under special precautions—she admitted that while risks were considered, the team felt limited due to the lack of legal holding powers and the inability to locate him. Ultimately, Calocane was discharged to the care of his general practitioner.
The inquiry also examined the adequacy of information shared following Calocane’s discharge. Robinson accepted that the communication sent to his GP was insufficient, describing the discharge letter as lacking critical details such as an updated risk assessment and care plan. Furthermore, the trust did not notify Nottinghamshire Police about Calocane’s discharge. Sharon Heath, who took over as clinical team leader after Robinson, noted that although she had requested these documents be sent, they were never dispatched, and by the time of discharge, any existing documents were already outdated.
Reflecting on the challenges of managing patients who disengage from services, Robinson admitted that individuals like Calocane require a more intensive form of care than what early intervention teams can provide. She stated, “He was very difficult person to engage with. I think he needed a more robust service than early intervention could offer.” The inquiry also revealed the EIP team’s lack of specialized training related to handling disengaging patients or protocols on when to refer individuals to forensic services. Overall, the proceedings highlighted significant systemic issues surrounding patient follow-up and risk management that have since undergone scrutiny and prompted calls for improved practices
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