Wednesday, March 31, 2010
Tuesday, March 30, 2010
We know the above "appropriation" of the old Tory idea that people queue up for anything from Labour is circulating even on Facebook ... The devils !
In mental health if you are Sectionable (1983 Act) and under crisis you will get no choice . You might expect that.
However if you are non acute (not on a section ) but have mental health problems you will not get a choice of consultant through your G.P. who might then under equality of patient opportunity indicate a choice of secondary care provision, like a therapy supply, for say, Personality Disorder and damaged personality problems .. That's just one realistic example of possible Patient Choice ..
The Dept Of Health are currently handing out misleading information about mental health patient pathways and care via a G.P. in order to obfuscate issues surrounding equality of patient choice .
They stated in a response to an enquiry passed on to UserWatch :
"Thank you for your emails of 18 and 22 February to the Department of Health about mental health and choice. I have been asked to reply.
I note your concerns about this policy and have shared your further comments with our mental health and patient choice teams. The policy teams feel there is little to add to information provided in previous correspondence from the Department to which you refer in your email.
To reiterate, the legal right to choice applies only to referrals for first outpatient consultant-led appointments for elective care. Most mental health treatments are not consultant-led, but take place mainly in primary care or community settings: that is, mostly outside of hospital inpatient or outpatient settings. These are typically delivered by GPs, nurses or clinical psychologists. Even most hospital-based mental health treatment would not be consultant-led, so would be outside of the remit of choice.
This information is still correct. Beyond that, with regard to the current policy and future developments, I can only assure you that officials are continuing to look into options for extending choice to mental health service users.
I hope this reply is helpful.
Customer Service Centre
Department of Health"
In fact this Dept of Health originated text is totally misleading. The non acute mental health patient pathway even at this point in time can very easily go through a G.P. then a referred Consultant and even onto a secondary care provision such as a psychological talking therapy for mental health issues .. There could be choices of where to go too but clearly the DOH is guiding Primary Care Trusts etc , now to circumvent equality of opportunity to important service provisions matched and shaped by equal rights to Patient Choice ..
Figure out for yourself why MIND and Rethink are not up in arms about this . After all they are now paid provisioners and are like another arm of the NHS State .. Labour along with their new "User Elites" cropping up in "user-involvement" circles and frothy promotional jobs , create stigma through making mental health patients second class or non-class zeroes, with no choices of provisions . How very happy happy seem the elite trance dancers of Users In Wonderland ......
Thursday, March 25, 2010
Can Political Miracles Happen ?
According to Hansard below, the soon to be (?) Ghost of Gordon Brown has been approached regarding Main House the emotionally severe Tier 4 mental health Borderline Personality Disorder Unit in Birmingham UK and its possibility of resurrection.
It closed in February this year after three patients attempted suicide halfway through a public consultation about its future . Once part of a nationally commissioned service - its funding from other parts of the mental health NHS services in the UK have dried up since further afield they have been developing their own local services as per new ideas of localising Personality Disorder services to address a greater need than was previously aided .
Dr Lynne Jones has asked questions now about Main House . The word in Birmingham according to our staffy contacts (yes we have some 20 moles) is a new smaller Tier 4 services is likely to be commissioned but a more community inclusive service for all tiers 1 -4 is being developed . Gordon is looking into things too ... Oh yeah....
From Hansard Parliamentary Proceedings 24 Mar 2010 : Column 246
Lynne Jones (Birmingham, Selly Oak) (Lab): Main House in Birmingham has been providing a much valued residential therapeutic service for people with a personality disorder since being nationally commissioned more than 10 years ago. That service has just closed because when national commissioning ended, Ministers' intentions that commissioning should be picked up regionally were not undertaken by the strategic health authority. Will the Prime Minister look into what went wrong, with a view to reopening the service as soon as possible?
Tuesday, March 23, 2010
Empower Yourself : By signing up for
Written answers and statements, 22 March 2010
Simon Burns (Whip, Whips; West Chelmsford, Conservative)
To ask the Secretary of State for Justice
(1) how many deaths of prisoners serving a determinate sentence were recorded in each year since 2005; how many such deaths were self-inflicted; and how many determinate sentenced prisoners there were in each of those years;
(2) how many incidents of self-harm were recorded by prisoners serving a determinate sentence in each year since 2005.
Maria Eagle (Minister of State (also in the Government Equalities Office), Ministry of Justice; Liverpool, Garston, Labour)
The information requested is combined in the following table:
|Determinate sentenced prisoners( 1)||2005||2006||2007||2008||2009( 2)||2010( 3)|
|Deaths in custody||94||94||85||98||78||20|
|Self-inflicted deaths only||29||36||29||25||20||4|
|Self-harm incidents||13,128||12,241||10,719||11,730||n/a||n/a |
|(1) Determinate prisoners in this answer are defined as those recorded as serving the following sentences: less than or equal to six months; more than six months but less than 12 months; more than or equal to 12 months but less than four years and more than or equal to four years but excluding life. (2) Population figures for 2009 are not available at the time of writing. (3) Self-harm figures for 2009 remain subject to verification and are not yet available. 2010 figures are not available for similar reasons. Two deaths are currently awaiting further information before classifying.|
Any death in prison custody is a tragic event. The Government, Ministry of Justice and the National Offender Management Service, (NOMS) are committed to learning from such events and reducing the number of self-inflicted deaths in prison custody.
NOMS has a broad, integrated and evidence-based prisoner suicide prevention and self harm management strategy that seeks to reduce the distress of all those in prison. This encompasses a wide spectrum of prison and Department of Health work around such issues as mental health, substance misuse and resettlement. Any prisoner identified as at risk of suicide or self-harm is cared for using the Assessment, Care in Custody and Teamwork procedures.
Sunday, March 21, 2010
“The Trust is committed to maintaining an open and sensitive dialogue with both Main House residents and staff during what will naturally be an anxious and unsettling time.” (Bham Mail Source)
By Feb 20th Sue Turner reportedly stated of the suicide-trio :
"Sue Turner, chief executive of Birmingham and Solihull Mental Health Trust, said: “The three residents broke the rules, going out drinking alcohol, coming back and developing between them a pact to self harm and take overdoses." (Alison Dayani Bham Mail Source)
By then, halfway through the sensitive patient and public consultation, Main House was closed . It could no longer be a point of protest or "risk" - even to the Trust's reputation for sensitivity ?
Below is the continuing story of the Borderline Tier Main House story and its connection to a wider picture of need in the often serviceless Personality Disorder community ..
17th March 2010 Birmingham Overview Scrutiny Committee Birmingham
Remit : To Hold Health Services To Account Over Consultations
The Chairman commenced the discussion by advising that she was disappointed that changes had been made to the service before the consultation had been completed. Sue Turner, Chief Executive of the Birmingham and Solihull Mental Health Foundation Trust, advised that there had been no other way of managing the situation. She explained that patients had come to the end of their treatment period and that in the previous week there had been only 3 patients remaining at Main House. She had contacted commissioners, but it had become clear that the service could not be sustained.
The clinical viewpoint was that Main House should close and that a follow-up package should be provided for the 3 remaining patients. The Chairman was concerned that such action would not have been taken in the case of patients with a physical illness, but she was advised by Sue Turner that there was a danger of problems arising that could have been coped with only if a larger group had been present to maintain the community process.
Sue Turner advised Councillor Margaret Byrne that arrangements had been changed 18 months previously to improve the funding process and that 8 potential patients had been assessed and had been awaiting funding approval. She confirmed that that number of patients awaiting funding approval was not unusual and advised that funding approvals had declined significantly in recent years.
Members noted the explanation regarding the 8 potential patients given at page 4 to the report. Councillor Barbara Tassa expressed concern regarding the situation and that the service would not be commissioned now that the facility had closed. However, Sue Turner confirmed that the consultation was actively continuing, even though there were no patients in Main House at present. Councillor Jane James advised that she had an understanding of the situation from her own previous work experience, but expressed grave concerns regarding some of the details in the report and questioned what the implications would be for patients in the future. She was advised by Sue Turner that employees had been redeployed on a temporary basis, but that a clear and explicit statement would be needed from commissioners regarding the Tier 4 model required for the future.
In response to a question from Councillor Margaret Byrne regarding whether an assessment had been made of overall outcomes, Sue Turner advised that that had not been undertaken in detail, but that some patients would have left early and would probably have benefited from their time at the unit. Jane Collier, Pan Birmingham Health Commissioning Director at NHS Birmingham East and North, advised that Birmingham Commissioners believed there would be a need for residential treatment, but questioned what level of need there would be in the future in view of the predicted level of 3 patients per year from the Birmingham population. In the past, Main House had been the only facility available and there had been a need to develop community services.
Sue Turner confirmed to Councillor Anne Underwood that the Trust was consulting with commissioners, users/patients and major stakeholders. She confirmed that the Trust believed that the 3 patients were being safely treated in other services and advised that they were likely to meet, as such meetings were not unusual. With regard to employees, the Trust was maintaining their expertise and holding weekly employee group meetings with the 20 to 30 employees involved.
Councillor Jane James requested a written statement on the future funding of the service and questioned the viability of the national service. Jane Collier advised that she could answer only regarding Birmingham residents and that it was important that local services were provided, close to home. Sue Turner advised that she was not convinced that providing additional funding would increase the take-up of the residential service. The Chairman noted that the closure had been discussed with employees, but questioned whether 1 senior member of staff had been absent on leave. Sue Turner confirmed that 1 clinician had been on study leave, but had kept in touch with discussions and had accepted the decision on his return.
The Overview and Scrutiny Manager drew attention to the Commissioning strategy and questioned what would be reported to the Committee in March 2010. Patrick Nyarumbu, Senior PPI Manager at NHS Birmingham East and North, advised that the Primary Care Trust wanted to continue dialogue on the strategy and had established stakeholder panels. He noted concern that the Strategic Health Authority (NHS West Midlands) had signed off the plan for the strategy, but that information had not been provided to this Committee, and he confirmed that the Primary Care Trust would share with the Committee details of the discussions that had taken place with stakeholders. Sue Turner advised also that she had intended to submit a summary of the responses received to the consultation to the March 2010 of the Committee. The Link Officer accepted that the situation regarding the Personality Disorders Service involved not only Birmingham services and he was concerned that it was not clear what the overall service arrangements would be.
Jane Collier advised that Tier 1 and 2 commissioning strategies were in place and that an outline strategy had been prepared for Tier 3. The Link Officer suggested that the Main House residential service would be viable only with input from outside of the City. Sue Turner confirmed that there was a need for clarity on the national and regional strategies, which was beyond the Birmingham remit.
That the report be noted.
Saturday, March 20, 2010
Birmingham Local Involvement Network ?
Meaningful monitoring , what was left of it, was broken up and smashed by the Dept of Health and Gov't in early 2008. They both sensed in fortress NHS that some Patient and Public Involvement Forums were developing some serious teeth . Its true some PPI's were very ineffective - but some did have more independence and sometimes were able to act true to the spirit of protecting the patient needs and rights . They were a mixed bag though - some were worse than useless .
LINk's evolved in 2008 as a new gummy arrangement. Teeth pulled.
Less powers than the PPI's and no governance arrangements and in Birmingham grease and slip has ruled .
In Birmingham, the LINk, we have heard, time and time again, is headed by inexperience and a slow but certain tendency to become bunkered in bureaucracy. Monitoring health as a practice has been lost and ignorance reigns . The public have a right to question the Birmingham LINk's credibility. So who has supported it ? Who ?
On March 17th the Birmingham Council's Overview Scrutiny Committee (OSC) met to ask about the B'ham LINk progress . Its remit was a legal one - to assess the Bham LINk's value for money .
Alison Dayani writes : But in a city of more than one million people, it only has 500 active members and the NHS and city council cash funding it has been called into question with claims no-one knows what it is . That £1 million is equivalent to nearly 400 heart bypass operations or the salary of 50 extra nurses. Health scrutiny committee criticised the group, aimed to replace Patient and Public Involvement Forums and funded for three years until March next year.
UserWatch can also reveal - from papers that are in the public domain that Birmingham City Council Officer Maria Bailey the LINk Project Manager working in a performance manager role regarding the Bham LINk wrote a 7 page report to the Overview Scrutiny Committee :
"part 3.3.1 (Our italics in bold) ) The Link Core group was elected by the full membership in Oct 2009."
But was the Birmingham Core LINk elected by its full membership ? NO IT WAS NOT! That is quite untrue ..
Who was it elected by ? Paperwork once again that was produced at the 17th March OSC public domain meeting which shows the Birmingham LINk had elected a "CORE" group showed no numbers at all and you can see that below (CLICK ON IMAGE TO CLARIFY)
Why the omission of figures in the second picture shown here ? Because hardly any serious numbers voted for it ?
Sadly over £3000 was used to run the last Birmingham LINk "elections" ....
While it might have ideally been putting on public meetings and doing the job of monitoring health systems in 2009 it opted though for building different layers of structural bureaucracy which is arguably moving out of touch with ordinary people and living beyond the capability of its realizable ambitions . Its only funded up to March 2011..Its used up 2 years of its 3 years grant-life and probably £1 million..
Wednesday, March 03, 2010
"HEALTH secretary Andy Burnham is facing calls for a probe into “shocking” death rates at Wrightington, Wigan and Leigh Trust hospitals" (Leigh Journal 1st Feb 2010)
So what are the unexpected death rates at this hospital ?
"Mr Cubells said in 2007/8 there were more than 340 unexpected deaths. "
What we also have here in this report is the UK Care Quality Commission being forced to think again about its monitoring role and the implication is it did not pick up the increased death rates but the Trust involved knows there were increases
"The Trust was given Foundation Trust status last year, and managers say they brought the death rate back below average at the end of 2008-9. " (Leigh Journal)
Once again FT status and the rush for it is implicated . In the push for FT status hospitals typically had to clear "debts" which translated as curbing overspends on their Dept of Health PCT grants and this often meant decreasing staff ratio's and that put the quality of care at risk . The Francis Report into the Mid Staffs 400 Deaths found that was a pattern at the Mid Staffs NHS Trust which also rushed for FT status .
Monday, March 01, 2010
Balladic Poem By Silvis Rivers
In Staffordshire I am going to bed for care
And to leave my relatives later in despair
I went there with a kiss
And died in blood, stress , and chemical piss
I had illusions of beauty and a nurse
And the rocking dance of black is
Now my hearse
I am one of the 400 ghosts
In the cemeteries of the unexplained national hosts
My family showed their open heart surgery
But top hat managers sent in their burglar thoughts
And financial circus thief
The caring ethos is boned and gone
And there's a real steel feel
And I died from idiots not cleaning
And on and on