Welcome 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.

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.

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.

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.