Nottingham triple killer Valdo Calocane was allowed to avoid antipsychotic medication because he did ‘not like needles’.
Calocane was diagnosed with paranoid schizophrenia after murdering 65-year-old caretaker Ian Coates and 19-year-old University of Nottingham students Grace O’Malley-Kumar and Barnaby Webber.
Calocane was sentenced to an indefinite hospital order after the Nottingham attacks in June 2023.
NHS England commissioned Theemis Consulting to carry out an independent investigation into the care and treatment provided to Calocane by NHS services.
A new report also found other patients cared for by the mental health
Depot medication – a type of treatment which releases slowly over time, meaning patients need to administer medications less frequently – was discussed a number of times but the report said: ‘The inpatient teams involved in Calocane’s care were trying to treat him in the least restrictive way and took on board his reasons for not wanting to take depot medication which included him not liking needles.’
The report also cited four hospital admissions between 2020 and 2022 and multiple contacts with community teams before he was discharged to his GP because of a lack of interaction with mental health services.
Investigators found that ‘the offer of care and treatment available for VC (Valdo Calocane) was not always sufficient to meet his needs’ and this was ‘not unique’ to his case.
Health officials have admitted it is ‘clear the system got it wrong’.
Repeated requests to medicate Calocane
Repeated requests were made for Calocane to be put on antipsychotic depot medication – a type of treatment which releases slowly over time, meaning patients need to administer medications less frequently.
Calocane didn’t consistently take his medication when he was out of the hospital.
Requests were also made for Calocane to be put on a community treatment order (CTO) which would have permitted him to be put on depot medication.
The risk wasn’t ‘fully understood or managed’
Each hospital admission was seen in isolation with a ‘lack of cumulative perspective’ over how Calocane appeared to engage in the hospital but not when he was at home.
The way he was discharged from community services back to his GP due to ‘non-engagement’.
The authors said a lack of engagement had become an ‘accepted reason for discharge’ and ‘normalised’, adding: ‘Discharge in the absence of a face-to-face meeting with a patient creates the potential for greater risk to the person using mental health services and to others.’
The risk from Calocane was ‘not fully understood, managed, documented or communicated’.
Heavy workload for his case manager
A high workload could have contributed to his discharge to GP services in September 2022.
At the time his care co-ordinator had an average caseload of 20 service users – five above the limit advised by leading psychiatrists.
Barnaby Webber’s family reveals they spoke to the family of a Southport victim
Emma Webber, mum of Barnaby, 19, who was killed in June 2023, said a family reached out to her privately after the stabbing at a Taylor Swift dance event at a centre in the Merseyside town on July 29 last year.
Mrs Webber said being in a bereaved family is an ‘awful club that you’d never want to be in’.
She added: ‘I’ve been in contact with one of the families who reached out to me because suddenly you’re just in this awful club that you’d never want to be in.
‘With Southport, it was one of the direct families of one of the little girls. Actually we’ve been in contact – not talking from a legal perspective or even a media perspective at all – it’s very private.
‘It’s very rare that you can say to someone ‘I know how dreadful that is’ and know that that person really does know. Because what you hear is ‘I can only imagine’.’
The report added: ‘A theme running through VC’s clinical records is that he did not consider himself to have a mental health condition.
‘His insight into his condition did not appear to increase and therefore his understanding of the importance of medication in his case never appeared to be understood by VC.’
It said this ‘may have meant that he lacked full capacity’ to make decisions about his care and treatments.
Investigators said NHS England should examine the ‘dissonance between what people think should be happening, for example, care described in national policies and guidance, compared to what is actually being delivered in some services’.
NHS England has reversed its decision not to publish a full report into the care received by Nottingham triple killer Valdo Calocane after previously planning to only release a summary because of data protection laws.
The full version of the independent mental health homicide report was made publicly available today ‘in line with the wishes of the families and given the level of detail already in the public domain’.
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