Monthly Archives: April 2020

Southwark MH Carers forum April 2020

matthewWelcome to the April update of the Southwark Mental Health Carers forum. Just a short intro about the forum. The forum is aimed at carers who care for someone with a mental illness. I obviously try to aim the forum at carers based in Southwark, but we often ask for engagement with MH, health services, commissioners and social services.

All my carer forums including carer peer support groups are run via Zoom due to the COVID-19 crisis.

For the April forum we were joined by carers from Lambeth who are interested to hear more about the Lambeth hospital consultation. Members of the forum also wanted to submit queries and questions regarding the hospital move. The forum was also joined by South London & Maudsley’s Quality improvement peer supporter Richard Morton who kindly networked with carers at the forum.

We were also joined by a rep with lived experience from Healthwatch Southwark who have taken a keen interest with the carer forums since the forums are usually designed to engage with health services. Alice has taken over from Bron who engaged with the Southwark carers forum in the past.

The forum also was attended by a representative from PohWER who are one of the largest providers of advocacy services in the UK.  They provide information, advice, support and advocacy to people who experience mental ill health. We also had SLaM’s carer lead for southwark inpatient wards, southwark carer peer  facilitator and advisor and also a trustee from Southwark Carers along with carers from Lambeth and also Southwark.

First we had an update concerning the mental health patient wards in Southwark from the Southwark carer inpatient lead.  It was noted that some wards are being used by patients infected with COVID-19.  No training can be carried out during this phase, but carer peer support groups are running weekly instead of monthly.  I queried about other carer groups running in the community and by Southwark Council.

Emma Crowe the director of the London communications agency along with collegue Matthew spoke to the joint forum about the consultation of Lambeth hospital. Members of the carers forum were taken through a presentation used by the scrtuny committees.

We where shown the following

1. Why Lambeth Hospital has been around a very long time, some of its wards are not sufficient for MH patients and visiting family members.
2. We were given a virtual tour of the proposed hospital site in Southwark.
3. An explanation and discussion of the new Douglas Bennett House
4. The consultation plan and consultation progress along with timeframes

Notable key issues with the Lambeth hospital wards are

  • Current structural design of the buildings are deemed not safe as they should be for treating MH patients.
  • Most bedrooms do not have their own en-suite bathrooms and there are not enough bathroom facilities.
  • Lines of sight for staff looking after patients are rather poor in order to keep service users safe.
  • A poor quality of working environment for staff
  • Out off all the Lambeth hospital wards, only one ward has unsupervised access to an outdoor area and fresh air.
  • The environment at Lambeth Hospital is very cramped for service users and staff.

The Proposed New Facility

I will mention some of the consultation presentation at April’s Southwark Carers forum. Some points of the proposed new facility looked at

consultation

How clinicians, service users and carers from a number of boroughs attended workshops to help shape the design of the Douglas Bennett House facility on the Maudsley Hospital site.

  • The facility would include 72 acute beds for Lambeth patients across four 18 bedded wards.
  • The wards would all be single gender, compliant with modern standards, be light and naturally ventilated with direct, unsupervised, access to outside space.
  • The facility would also include a Psychiatric intensive Care unit and a rehabilitation ward designed to support needs of these services.
  • Two national specialist wards, neuropsychaitry and eating disorders, would be transferred from Bethlem Hospital.

These are obviously just some of the benefits of the proposed facility, although there were plenty of chances for carer members to query about the proposed changes. In regards to the consultation (which runs from March 2020 to 31 May 2020), SLaM have already received a number of responses.

Still the consultation will use a large range of media services to engage with the community from Printed consultation documents, posters, online questionnaires, letter and email to working with partners to distribute information.

The SLaM consultation team were polite and thankful for engaging with the forum and I suspect they will be back later on during the Year.

Next up was Richard Morton who is in SLaM’s quality Improvement role looking to network and engage carers on involvement routes at the Mental Health trust. Richard spoke about the range of committees at the trust some of them mentioned was the family and carer committee and the quality improvement committee along with borough advisory groups.

Even though some involvement groups have been suspended due to the covid-19 situation, others have started to use video conferencing to still engage with Service users and carers.

involvement

The Southwark MH carer forum was taken through the “Inpatient care process model” on how patients are supported by SLaM through their care journey. This was kindly provided to the forum by the Southwark carer lead for inpatient wards.

Richard Morton will be back engaging carers at the forum in the future as he will update on how involvement at the trust is progressing.

This concludes the April update for the Southwark MH Carers forum.

Lewisham BAME MH Carer Forum April 2020

10177241_747738765268892_5890142387668348507_nWelcome to the April update of the Lewisham BAME Mental Health Carers forum. This is one of the four forums that I chair in South London. Out of the four forums, this group focuses on BAME carer developments in Health and social care. The group has been going since 3 years or so.  Due to the COVID-19 outbreak, I am running all forums via my own ZOOM account.

The invited speakers for April was Shilpa Ross who is a senior researcher at the Kings Fund policy team that works on a range of health and social care research programmes. Shilpa was invited to the forum to speak about her latest research that not enough progress has been made to address discrimination against black, Asian and minority ethnic (BAME) staff in the NHS.

Our other guest speakers was Sarah Atayero and Deji O BAME in Psychiatry and Psychology Network. Basically BIPPN is a network of Black and Minority Ethnic mental health professionals prioritizing and advancing ethnic representation within the mental health field, that being Psychiatry and Psychology.

Now although I mentioned before that the BAME carers forum focuses on BAME carer queries, I am very aware BAME awareness can suffer not only in the community, but also in the NHS and in education. So in this particular April forum i was hoping members can be aware that representation in all sectors in NHS is vitally important to reflect community values.

Shilpa Ross was first on the agenda where she firstly spoke about The Kings Fund, which is a charitable organisation working to improve health and care in England. The Kings fund was originally set up to raise money for London’s voluntary hospitals, but has evolved to do so much more.

logo

Shilpa then spoke about her past background projects which include emerging lessons from clinical commissioning groups and the future of HIV services in England. She also co-authored a number of publications for The King’s Fund, including Bringing together physical and mental health.

Discrimination regarding BAME groups is a serious issue and still unfortunately happens in the NHS, we have to look at what can be done to address the situation. One way is to report on current problem in the NHS. Data taken from the Workforce Race Equality Standard (which measures NHS Trusts against 9 standards) shows how the NHS is working to improve the situation, but unfortunately BAME staff still need equal access to career opportunities and receive fair treatment in the workplace.

Shilpa spoke more about WRES and also noted that it is worth listening to the Kings Fund podcast on Race equality in the NHS workforce.

Kings fund podcast on race and equality

The forum was shown some types of problems BAME staff experience in the NHS workforce being Bias in recruitment, lack of BAME representation at senior levels in the NHS, reported levels of discrimination are high for BAME staff, white staff more likely to agree on employer treating them fairly regarding career progression, BAME staff more likely referred to disciplinary process and other issues the BAME carer forum should be aware of. More info can be found on the NHS England and NHS improvement website

NHS equality reports

Shilpa updated us on her progress especially talking to experts in the NHS and academics who are tired of seeing little to no change at NHS Trusts. Members of the forum were interested to hear what research was being done to hear the experiences of BAME carers, but no research is being done as present although hopefully this could change in future and there may be some research being done elsewhere. I was shocked to hear that Shilpa had been challenged in the past on why she is researching only about race, but on reflecting back on BAME experiences it is sad to say I am not too surprised.

I did ask Shilpa if there were any NHS Trusts who did well or poorly regarding BAME representation and development and she did mention East London NHS Foundation Trust, but I have managed to find a NHS Trust update on at least the top 10 NHS trust for BAME representation at board level.  I hope more work can be done during this year and onwards to increase identity and representation.

BAME Boards

Most if not all members supported the work Shilpa is currently doing and I am especially interested in her report due out hopefully this summer.

Next up to engage with carers at the Lewisham BAME MH Carers forum was Sarah Atayero Managing Director at BIPP and Deji O. Sarah recently worked at Great Osmond Street Hospital on clinical research trials and now is heavily campaigning to have BAME clinical professionals access fields of psychology and psychiatry. BIPP have been running a series of events at Kings College London regarding BAME psychology and psychiatry development and engagement projects.

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Please check out their Linkedin page below to hear more about their events.

BIPP Link on events and updates

I was delighted to hear that BiPP wanted to hear from carers about how BiPP should go forwards in their events and engagement with BAME groups. I certainly will take them up on their offer especially anything done in collaboration. BiPP presented us more information on what they do and what events they have been holding at Kings College. One of the events being “Addressing Men’s Mental Health”, which attracted an audience of over 200 individuals from various institutions, including the Civil Service, NHS, British Psychological Society and Royal College of Psychiatrists.

BiPP also do a Mini Masters Programme on ‘Race, Racism and Mental Health: Diverse Models and Approaches to Psychiatry & Psychology’. Deji O who is also a managing director at BiPP spoke about the work he does in Forensics regarding youth and gang culture. Sarah mentioned BiPP is still new and although it has had many successes, it is still a year old and has not had time to engage in many BAME groups as of yet, but at least they can add the BAME carers forum as a link.

Still, BiPP hold panels which are hosted by psychiatrists, psychologists, students and service users at KCL. Still even though BiPP network aims are at those who host their events, they also include white audience due to trying to influence change rather than blame culture. BiPP was founded by Keisha York who studied in MSc in Organisational Psychiatry and Psychology at Kings College London. You can read more about BiPP from Keisha’s perspective in the Psychologist, which is a magazine from the British Psychology Society who BiPP also network with.

BPS report on BAME event

As noted by Shilpa earlier BiPP are aware that there is a under representation issue in the psychology and psychiatry field not only in the NHS, but also in education. This was proven via data shown to the carers forum, which is distressing to hear that there is an over representation of BAME service users in the MH services. BiPP want to provide insight into how BAME groups can access careers be it in the NHS or education in psychiatry and psychology. They hope to raise awareness and identity of BAME psychology out in the field, plus they want to explore the situation of racial issues in the NHS and education. Deji spoke more their past events and the outcome of running online feedback about the events.

There was many interesting and relevant questions from carer members of the forum especially on how BiPP can reach harder to access BAME groups. We hope to hear more from BiPP later on during the year.

This concludes the April update of the Lewisham BAME MH Carer forum.

Southwark MH Carers forum February 2020

Southwark MH Carer forum v2Welcome to a quick update from the Southwark Mental Health carers forum. I know I have not been blogging for around a month, but I have recently suffered a bereavement. It has taken a fair bit of energy to do much, but I am quite proud to be able to continue to run the forums even though I have to take time and look after myself.

Given the time I will eventually write more about the current situation, but for now I want to at least update carer members. On the February update of the MH carers forum for Southwark, we are able to get support and engaged with King’s College Hospital NHS Foundation Trust, Guys and St Thomas NHS Trust and South London & Maudsley. For February King’s college hospital Mental Health Lead kindly attended the forum to speak to carers about Kings Mental Health strategy, which is still going through development.

Due to the nature of our forum carers focus on mental health services, although the core interest is how health and social care services engage and involve families and carers. We get a lot of support from the healthwatches and are constantly looking for support from the CCGs, but at the same time families and carers must get the chance to be updated by health providers.

The february Southwark MH carers forum has moved to the Maudsley site for now, although as of the blog, I am running the forum remotely.

Maudsley_Hospital_Main_Building

Going back to King’s College NHS Trust, their MH strategy is a Five year strategy for mental health. I felt it so important acute trusts not only focus on physical health, but also include mental health, which will be even more important because once the covid-19 situation moves on, there will be an immense strain on mental health for staff, patients and their families.

Kings_college_hosiptal_

Gavin Smith the MH lead of King’s NHS Trust explained that the strategy should take into account several things

  • Population need: High levels of mental health need, including mental health presentations at the Emergency Departments.
  • Outcomes and experience: People with a mental health condition have poorer health outcomes and experience.
  • Current range of service provision: Areas of excellence, but inconsistency of provision of mental health support across services and sites.
  • System working: Strong relationships with SLaM and Oxleas and KHP Mind & Body programme; opportunity for improved relationships with primary, community and voluntary sector.
  • Training and development: Distinct training programmes mean few staff have skills across mental and physical health; some bespoke training exists for staff and mental health training is available via KHP Mind & Body
  • Governance: Mental Health Board and Mental Health Lead post established but intermediate structures around mental health are inconsistent.

Out of these areas mentioned, the system working and governance stands out as important not only to the Southwark MH carer forum, but to all the other forums. It was expained to carer members that the accute trusts will co-produce many things with involved carer champions.

The forum was then presented with an update on how far Kings NHS Trust have been working with these outcomes.

Next we were presented with why mental health is important to the health sector

  • Mental health has an impact on people’s physical health, wellbeing and outcomes.
  • 30% of people with long-term physical health conditions also have a mental illness
  • Shockingly 15-20 years shorter life expectancy for someone with a severe mental illness or learning disability
  • It does not help that patients with mental health needs have a poorer experience of care due to stigma
  • There can be a lack of confidence and awareness of staff regarding mental health
  • It does not stop there as 8 Billion a year is spent by the NHS treating the effect of poor mental health on physical illnesses.

As you can see Kings NHS Trust has a clear interest into tackling mental health with what was raised to the forum. Of course more was mentioned in the presentation, but by focusing on meeting Kings NHS Trust patients’ mental and physical health needs, they will :-

  • Respond to the population needs and system priorities.
  • Improve access, outcomes, experience and safety.
  • improve the sustainability of their services

As presented at the Southwark MH carers forum, King’s operates within a complex landscape of mental health services in South London.

kings
Members of the forum were taken through a whirlwind tour of King’s services and how they seek to improve mental health provision on those services including

  • KCH services regarding SLaM and Oxleas.
  • Local Emergency and s136 services
  • Key acute and hospital-based services
  • Other specialist teams including – Drugs and Alcohol, Adolescent At-risk and Forensic Service (AAFS) and Forensic Services provide by SLaM.
  • Community services
  • Primary care – Being General practice and Improving Access to Psychological Therapies (IAPT)
  • Voluntary and social care
  • Self-help – being IMPARTS resources, COMPASS (in Southwark), Wellbeing Hub & online Mycommunity Directory

It is important King’s engage with their staff on producing these outcomes, as they must engage with Core delivery partners and external stakeholders. King’s have engaged with the following of their staff.

  • Acute and emergency care
  • Gerontology/frailty
  • Liver specialist
  • Maternity – Took up a good discussion at the forum
  • Neurosciences – will be interested on their response
  • Paediatrics
  • Rheumatology
  • Corporate Nursing
  • Divisional Management Teams
  • Patient Outcomes
  • Public and Patient Engagement – should include families and carers
  • Research and Innovation
  • Workforce
  • Princess Royal University Hospital Transformation team
  • Strategy
  • Online survey to all KCH staff

Member of the Southwark MH carers forum were then presented with how King’s have explored areas of good practice and areas for improvement. Then we were presented with the strategic aim being that to continue to build on good practice, they will focus on their priority areas, and ensure the will consistently meet their patients’ mental and physical health needs. However King’s are well aware that their priorities must align with system priorities.

Kings have developed three priorities being

  • KHP Mind & Body priorities
  • NHS Long Term Plan priorities
  • SEL STP priorities

There are challenges to these aims being

  • The highest proportion of patients with a mental health condition recorded as primary at King’s is in A&E (27%).
  • The Emergency Department (ED) is frequently the default, but often an adverse, environment for people in crisis. Patients frequently spend over 12 hours in ED waiting for a mental health inpatient bed – the majority of our 12 hour breaches are for patients with a mental health condition.
  • There is a lack of mental health inpatient beds across South London, particularly CAMHS beds.
  • Patient feedback highlights positive experiences, as well as challenges including instances of stigma and lack of awareness, lack of confidence in adequately signposting or supporting patients with mental health needs, and long waits in a busy environment.

Nevertheless the forum was presented with how King’s will meet those challenges.

I am thankful for King’s engagement with carer members of the forum all of the members are more than happy to see how the MH strategy works out. A further update of the Soutwark Mental Health carer forum is we were presented with South London & maudsley’s involvement register into improving services and a way for the forum to engage with SLaM staff on familiy and carer engagment at the trust.

The forum seeks to work with SLaM’s family and carer committee when issues arise, although due to covid-19 SLaM’s involvement is on hold, but engagement will still continue with use of technology. For the March Southwark MH carers forum Guys & St Thomas NHS Trust presented their mental Health strategy.

I am as of present continuing to run 3 carer forums remotely and run the Greenwich carer peer support group remotely. This concludes the update for the Southwark MH carers forum with thanks to Kings NHS trust and SLaM.