Monthly Archives: August 2019

Royal College of Nursing involvement day

Rcn-logoThanks for stopping by. Here is another blog post by unpaid carer Matthew Mckenzie. This blog post is about involvement, but I have added to this post my involvement with another organisation the Royal College of Nursing. Usually I spend most my time at carer or community centres running family and carer strategy forums. We aim to engage with hospital trusts, healthwatch, health commissioners and councils. Most forums look to increase education and engagement on mental health and the health services.

Still, education is not enough and there should be involvement and empowerment for services users and carers. Anyway, I would like to put a bit of background into the RCN otherwise known as Royal college of Nursing. I have been hinting about nursing and the Royal college of Nursing from my previous blog posts, although there are many other organisations I will post about soon.

The RCN represents nurses and nursing, promotes excellence in practice and shapes health policies. It is the biggest and well known union for nursing in the UK. They do not just represent nurses, but also midwives, Mental Health nurses, health care assistants, assistant practitioners, student nurses and trainee nursing associates.

They have around half a million members and are growing in number every day. The RCN also have a vast history in the field of nursing and have made major impacts in advocating for the field of nursing in the UK. The RCN also runs forums, consultations, conferences and allows members to get involved or even become an RCN Rep.

It has not been an easy time for nurses or the NHS at present, I am not going to get too political today, but never has there been a greater need for the RCN to vouch for nursing as pressure is brought to bear on nurses via lack of funds, bursaries and incentives to stay in the industry.

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The RCN now wishes to expand its involvement and has been honest that in its prestigious history, it has lacked the drive to engage with its mental health patients, however many a large organisation can fall into this situation, although some are worse than others.

I have noticed that the RCN looks to take on engagement and involvement policies regarding its mental health programme, but to do this it must feed into its patient forum and also draw from Triangle of Care representatives. Of course no one is going to say such a drive is not without its challenges, but the sooner work begins on involvement, then the better the outcome.

Early this august I was invited to the first of many reference groups to collectively figure out inclusion and co-production within the RCN. I was joined by many patients and carers like myself. I did hear that reps from a mental health forum could not make it, but hope they are free next time.

The group was chaired and facilitated by both Catherine Gamble and Tim Coupland. Catherine is a RCN Mental health lead & Head of Nursing. She is also proactive in eduction practice & research at South West London and ST Georges NHS Trust. Tim Coupland is the RCN Programme Lead for Parity of Esteem and promotes many policies on mental wellness for all including nurses themselves.

I will not go into too much detail on how the group went, but I felt I was very looked after at the group and I felt everyone got their chance to have their say. We had many passionate and rich experiences from the members of the group, everyone truly deserved their place there. I was amazed that some members have had an impact promoting nursing and service user experience in other countries.

We each also asked what our involvement and interests lie, where mine was on the NHS Long term plan, mental health act and Suicide prevention due to my involvement at South London and Maudsley Suicide prevention group. I was excited to hear that the RCN have representatives engaging in the areas I have raised.

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There is however a lot I can say regarding involvement, inclusion, engagement, co-design and co-production, but I think I will leave that to another blog post. There is much out there that carers like myself can get involved with. We never have enough carers getting involved at an exciting and challenging time in the health services.

You can find out more about the Royal College of Nursing from the link below

https://www.rcn.org.uk/

My summing up of the day is that there is a lot of work to do, but I feel that the RCN as a body is massive and offers many opportunities even if it is just to understand its core principles and the future of nursing.

Carers and GP Surgeries

me_edited-1Welcome back to another blog post by unpaid Mental Health carer Matthew Mckenzie. I often write blog posts that try to focus on carer issues, but sometimes I stray into areas of mental health, events and the field of psychology, sociology and maybe psychiatry. Of course I don’t stop there. I run carer engagement/strategy forums in south London and every so often I tend to update how they went on this site. Feel free to check out my Youtube channel or twitter channels where one channel focuses on the carer experience and the other channel on mental health developments.

Enough with the shameless advertising, this particular post is on a much needed subject and it is aimed at unpaid carers, however I hope GP surgeries get the time to read considering at the last Lambeth forum there was major discussion on the Lambeth Patient Participation group network. I have also arranged for the Lewisham PPG chair of South Lewisham Practice to present and update the members of Lewisham BAME Carers forum.

But what if you are a carer and are dithering on visiting your GP or doctor regarding who you care for, or even yourself?

Young couple gets counseled by a doctor

My first advice is not to dither or wait it out. Vising your GP can help make major decisions easier. There are very good reasons why it is so important to visit your GP and one of them is if you are feeling unwell. Most carers tend to visit their doctor due to raising issues on their ‘loved one’s’ health.

Still if you think the person you are looking after might recover, then it is still a good idea to check up with your GP. Some chance is better than none at all.

Whats the risk in putting it off?

I bet if I was to look for some stats, then it would be horrifying. Too many people across the country tend to delay or put off from visiting their GP, males can be the worst offenders and then things get too late to be detected. Carers, especially those caring for someone with a mental health need, should be more cautious. The reason usually is that if someone suffering mental illness, it can be very hard to let others know of physical health problems as well. Families and carers need that professional advice to help come to a decision to get access to other health services.

GP as Gatekeeper

It is well known that a doctor is the gatekeeper to other services. Without referral to other services then recovery or support is that much harder for the patient.

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Many might be still waiting for access to their mental health trust, while some might be trying to access psychological therapies, although it has been made self referral. GPs should know where to send patients or carers if they are in need of specialist support.

Being identified as carer

Without a doubt, carers risk too much without being identified. It should not have to be the situation of carers coping by themselves. If you are a carer certainly take the time to get registered as a carer at your GP surgery. It is difficult I know, because all GP practices are not alike. You might try to register with a larger more established GP practice, but it depends how far they are away from your area. If you are lucky, you might come across a GP practice that actually has its own carers group, it depends if they have resources. Plus I know some carers centers often works hard developing a carers relationship with the GP surgeries.

Leaflets and booklets

Even if not booking an appointment with your GP, it does not hurt to visit the GP practice and pick up a booklet about caring for others or about certain conditions. If some information is not there, then it does not hurt to request specific information. It is all about tooling oneself up with information to cope with illness.

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Carers should not be afraid to ask, if you can ask politely then there should no reason why a GP manager or receptionist can add the booklet or state where it can be accessed.

A chance to be more involved in care

If you are fortunate enough to book an appointment for the person you care for, then you have the added chance of being involved in their care. Do not let anyone put you off being involved even if confidentiality is used to block you. You can always put your concerns to the GP across and when things settle down, then try again on being involved. Still if you attend the GP with your relative or friend, then the GP usually wants to note down your details and might even ask if you are the carer.

With mental health patients, there might be need for education on what a carer is and why they are important to be involved, this can be more complicated with requested changes on the mental health law. Still, families and carers should be given the chance to be involved in a case by case method. There should be very good reasons why a patient does not want their family involved and sometimes even confidentiality should not be enough if their is a risk the patients life e.g. suicidal behaviour, lack of early intervention on bipolar, eating disorders, addictions and so on.

Connecting to more services and referral

The GP practice cannot do it all, which is why there are more specialist services out there, but unfortunately the GP can be the gatekeeper to these services. If you do not see your doctor, then access to such services e.g. mental health trust is difficult unless an incident happens in the community, which we all want to avoid. Plus families and carers accessing their GP should be referred to their carer’s center or a carers network.

Not all GP surgeries are proactive on this and carers centres should work on engaging their GP practices, as of now I observing the projects on how Lambeth and Lewisham plan to engage with GP practices. I have mentioned there should be a rating system on what is available for carers at GP surgeries, just as what NHS choices used to have.

A chance for health to be identified

As usual, carers are so busy caring that they do not often have time for themselves. Its not surprising that carers risk burn out, stress, depression and worse physical health symptoms. Usually the GPs or a good GP can pick this up when a carer decides to visit or form a relation with their GP surgery. Each time a carer visits their GP then there is a chance the doctor can assess the carer for health problems. A good GP will ask every now and again if the carer has had a check up.

Health journey recorded

GPs usually love to note things down. There is not a time when I see a GP not type something into a patient database. If you as a carer have trouble mapping out the events of the ‘cared for’ health journey, then the GP will do this for you. Especially on recording warning signs, missed appointments, medication issues and looking out for side effects.

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Your GP can also give the added benefit of inquiring with other health professionals worrying concerns, e.g. lack of engagement and missing notes or hospital reports. It is not uncommon for health systems to not talk to each other. GPs and families are the glue the try to hold these systems together.

We know some things, but not everything

Carers are not health professionals, try as hard as they might, we cannot take the risk of guessing what is going to happen with those we care for. We must seek expert advice from our doctors and if we are not sure, then speak to another doctor. Your health and your ‘cared for’ person’s health is too important for guessing games. We do not want to burden our doctors with our worries or concerns, but our doctors would be very upset if their was a missed opportunity to avoid a serious incident. GPs want to help and yes, they are under a lot of pressure, but if we can plan the appointments well enough then things should work out alright. Listen to your doctor and work with them.

GP surgeries have a lot to focus on with dealing with carers

I know poor doctors are under a lot of pressure as it is, not helped by government initiatives and working hours, but carers can take some pressure off GPs by being forthcoming about concerns they have. If families and carers leave things to the last moment, then the patient suffers and then the family can suffer and the health services will have more to deal with. Recovery would take longer for the patient, the risks are too great.

Despite confidentiality and all the red tape policies, GPs cannot do without the support of families and carers, it is part of the health system for relatives and friends to step in and support who they care for if they are unwell.

If a carer cannot get that support from the GP, then they might just give up trying to care and thus the patient will end up in the rotating door of hospital admittance.

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As a last point on all that I have mentioned above, a carer should look around the surgery to feedback their experiences. If forms are not around then try do this on the GP website. All feedback, information and even complaints should influence the GPs patient participation group on helping to develop the doctor’s surgery.