Category Archives: Carers Lewisham MH Forum

Lewisham MH Carers forum June 2020

133Welcome to the June update of the Lewisham mental health carers forum. A forum aimed at unpaid carers supporting someone close who has a mental illness. This is one of the 4 carer groups that I run per month. In attendance were our usual carer members along with representatives from Lewisham Healthwatch. The speakers from South London & Maudsley NHS trust being psychiatric Liaison staff and the lead from SLaM Patient Advice Liaison service. We were also joined by SLaMs involvement lead for Lewisham and Croydon, plus we were also joined by the Mental Health Lead of Lewisham and Greenwich Hospital trust.

Speaking first was the psychiatric liaison nurse who spoke about the importance of their service. Ama the Liaison Nurse mentioned that SLaM’s psychiatric liaison is a 24 hour crisis service that works in partnership with the Emergency Department. Specially trained mental health professionals are there at Lewisham Accident & Emergency to assess acute MH referrals.

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Once the assessment is done, the patient is signposted to the appropriate service to provide further support to manage the patient’s crisis.

The patient might be sign posted to the following services.

  • Primary Care Services – GP, Solidarity in a Crisis (charity), Harbour Cafe (MH crisis cafe) or IAPTs which is a counselling service.
  • Secondary Care Services – Community MH Teams or to Early Intevention Service.
  • Other services – Home Treatment Teams or Inpatient Admission if patient is very unwell.

The Psychiatric Liaison Team consists of the following

– Band 1 seven senior PLN (Triage Function)
– Band 3 six PLNs
– Band 1 five RMN
– One Harbour Cafe Staff and a Clinical Support Worker
– 1 Occupational Therapist (in-hours)
– Doctors

Ama spoke about why the role is important. Which the main points are

  • Accessibility in that it is a 24 hour service that is readily available to support patients when they are in a crisis.
  • Provides appropriate signposting
  • Saves time
  • Provides psycho-education for the Emergency Department who may lack the knowledge of mental health symptoms.

Ama then spoke about her role as Carer’s Lead in the service as their are many carer leads on the other inpatient wards. The role of a Carer Lead in the NHS Trust is to ensure that those caring for people with mental health problems raise their concerns and are supported. They also lead on ways to improve how staff work with carers.

Carers Leads encourage carers to get involved and have their say about NHS Mental health services that SLaM offers to both carers and service users. This is so that they might be able to make improvements and provide a better service for all.

Ama then presented the forum with a template of the NHS Trusts Electronic Patient Journal with is SLaM’s patient database system. One of the main aims of the system is to help identify patient their family or who their main carer is. The NHS Staff check on EPJs to ensure that patient or carers can have a conversation with the staff about what is recorded on the system.

Ama explained some of the patient system database processes to the carer members. One of the things some members of the forum were interested was the NHS Trusts “Carer Engagement and Support Plan”. A member of the forum has never heard or had a CESP and were wondering what is its function.

Ama moved on to explain what a Caldicott Guardian’s role at the NHS trust does. She also explained some notes about the information governance team. She explained the following.

  • How Caldicott Principles justify the purpose for using confidential data.
  • How the NHS Staff only use information when necessary
  • How access to data should be on a ‘Need to know’ basis
  • How everyone must understand their responsibilities
  • On how the duty to share information can be as important as the duty to protect confidentiality.

Ama then talked about the Patient survey and how it goes on to improve services.

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Ama admitted that a lot of the times in the A&E setting a lot of patients that turn up do not actually have family, close relatives or carers, which is unfortunately a sad fact. It is stated that some families or carers might give up on someone who has serve mental health illness or that the patient does not want anything to do with their family, friends or relatives. A lot of the time it could be that the illness pushes people away and it is well known that those suffering psychosis are suspicous of those trying to help them.

The presentation moved on to the changes to the team due to the COVID-19 situation as the team has moved to the Ladywell Unit Outpatients department. When a patients does present at A&E a band 7 nurse will decide if the patient can be transferred safely to the outpatient department or any of the Primary or Secondary services.

After the presentation we had a number of questions from the carer members of the forum. The questions raised were of the following

  • Where does the patient survey information or PEDIC data go and how does anyone outside of SLaM get an idea that the data is valid.
  • Without carers how do patients who have MH illness manage to present to A&E
  • How hard does the trust tackle the problem of patients who do have families or carers and try to include them in the patients care?
  • Another carer agreed on the importance of confidentiality and wanted more information about services provided.
  • One carer spoke about how SLaM’s OASIS service was of great help to them and wondered if or why young patients were not referred to them.
  • Another carer member spoke about the importance of “Advanced directives” and wondered how often the MH trust were using these, especially if patients relations with their carer was breaking down causing a risk of patients ending up without a carer and becoming more vulnerable.
  • Other members were worried that because of COVID-19 that services especially the DWP were under so much strain that this caused more patients MH to flare up.
  • We also had a long discussion on what the state of data is regarding patient to carer ratio. People are wondering how many carers are identified in Lewisham.
  • There was concern that Primary and Secondary services do not speak to each other and even though their patient systems are different, it is hard to track the situation of MH patients. This is a big problem if confidentiality is added and the family or carer cannot get their concerns across.

Although some of the questions were responded to at the online forum, a lot of the questions will be taken back to the trust where members are hoping for an update in the future forum. The forum moved to discuss how families and carers should be encouraged to be aware that they are carers and identify themselves to patient systems. This is so families and carers can be tracked and be involved in the care and support of their loved one. The forum requests someone responsible for GP services in Lewisham present to the forum regarding carer identification at GP practices.

Next we had Kevin Ramjeet speak about his position as Mental Health Lead for Lewisham University Hospital and Queen’s Elizabeth Hospital in Greenwich, Kevin works closely with SLaM in Lewisham and Oxleas in Greenwich. I mentioned in the forum that Greenwich Healthwatch are looking into what is provided for MH carers in borough. Kevin is particular interested in patient feedback regarding hospital emergency departments regarding waiting for bed, waiting times and patient experience of services.

Lewisham and Greenwich NHS Trust

Next we had Jim Ells from SLaM PALs speak about the service. Jim responded to the following queries from the forum.

What is PALs?

Basically Patient Advice and Liason service, which is a way to allow people to be placed in touch with the correct department.

What is the PALs query process?

There was a bit of confusion with this one, since Jim felt this question was on how staff at the NHS trust would run a query to look for information, although I had meant it to be some process on if a service user/carer raised a question on where it would go.

What type of compliments, queries or complaints from carers?

These are varied and queries can raise enormously. It depends what type of information a person was looking for. It would be easier if queries are dealt first within PALs before it escalates to a complaint unless the query was a complaint in the first place.

How can PALs work with this forum or the Lewisham BAME one?

Its about time and relationship, as long as Jim can attend the forum, but it depends on what the forum requires of the PALs service. The forum is interested in stats to get an overall view of the service to see what is working and what is not.

The forum was interested in the complaints process, but Jim mentioned that complaints is under a different department. A request has been put in for the complaints staff to attend the carers forum. Some were concerned what would happen if a complaint was made about a staff, what would be the reprecussions especially if carers are not aware how to make a complaint or refuse to.

A carer raised an interesting question regarding the use of staff email accounts being closed causing complaints and queuries to be lost. It was noted there is a database system for queries to be placed into rather than relying on emails, but there is a system where staff can access email accounts if information is required in extreme circumstances.

Update from SLaM involvement lead

The last part of the carer forum was updates from the Lewisham and Croydon involvement lead. As you might already know SLaM prides itself on involvement and co-production, which is something I am interested in when I engage with other Mental Health NHS Trusts, it is also something I am looking out for in Acute NHS Trusts being Guys & St Thomas, Kings NHS Trust, Lewisham & Greenwich NHS Trust.

The update from the involvement lead was on discussion of the IAPTs service lead regarding waiting times and when they can present to the forum regarding IAPTs and how things are progressing with the service.

There was also an update on counselling for carers via Carers Lewisham, which cannot be offered for newly registered carers but this is something they are looking into.

There is also a new trust online service from SLaM called “BETH”. which used to be called “My Health Locker”. Basically “BETH” is a new way for service users, carers and staff to communicate and collaborate.

For service users, Beth supports personal choice and autonomy. Where SUs can link their Beth account with their NHS number to access their health records in order to:

  • see who is in their care team and support network
  • securely message their care team
  • access their current care plan
  • see all their appointments
  • keep track of their mood and sleep
  • use online free and trusted health resources

There will be an remote online demonstration of BETH via recovery college booking process next week.  Other updates were on the Lewisham Advisory group regarding developing links to the BAME community, investigating how services were responding to Mental and physical health and looking more deeply into online services via the COVID-19 situation.

For the July forum we will have the Patient Experience and Quality Manager to speak about

– Their role at the trust.
– The importance of patient data
– A Brief overview of how PEDIC data is gathered
– PEDIC stats on patients in Lewisham so far plus if possible, ethnicity
– Plus Any data regarding carers in Lewisham.

The forum is interested in data queries showing identification of carers and what has been offered to the carers e.g. Carer Support and Engagement Plans or Carer Assessments.

Lewisham MH Carers forum May 2020

Welcome to the month of May’s update of the Lewisham Mental Health Carer forum. This is one of the 5 carer groups I run once a month to give carers a chance to find out what is happening to health, mental health and local authority services aimed at carers.

For this month we were joined by South London and Maudsley’s Associate Medical Director Dr Zain Sadiq who is also a psychiatrist. We were also joined by Lewisam’s Wellbeing Map coordinator Tim Bradley. At the forum we had a number of carers as well as carer champions, the modern matron from SLaM’s Ladywell inpatient wards. We also had in attendance the SLaM involvement lead for Lewisham and Croydon as well as Carers Lewisham staff and a representative from POhWER mental health advocacy.

I explained the reasons for the forum being the following.

1. It can be difficult for Carers in Lewisham have an idea on MH services and influencing them.
2. MH carers need some empowerment in their role.
3. Services have suffered from cuts, carers need to act in order to support everyone.
4. There needs to be an engagement platform for carers to discuss issues.

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Lewisham MH Carers forum April 2020

133Welcome to the April update of the Lewisham Mental Health carers forum. This is one of the several forums that I run in the community aimed at carers who look after someone with a mental illness. The forum is not a support group since it focuses on carers engaging with health and social care services. I feel there is a lack of carer led forums where carers can come together and seek engagement, information, co-production and querying of health services.

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Lewisham MH Carers forum February 2020

133Hello fellow reader. Welcome to the February edition of the Lewisham Mental Health carers forum. Each of the 4 MH carer forums I run focus on mental health service engagement for MH carers. The forums also seek engagement, updates and involvement from other parties, but usually mental health services come first.

For the Lewisham forum with thanks to SLaM’s public and patient engagement lead for Lewisham & Croydon, we were delighted to have in attendance SLaM’s Lewisham Quality Improvement clinical Nurse.

I also presented the new Carers UK online application to the members and shared this on our Carers Whatsapp group.  If you are a carer and are interested in boosting your skills.  Please check out the following link.

https://www.learning4living.org/login/index.php

I also shared the Carers UK State of Caring online Survey, which you can also fill out below

https://www.surveymonkey.co.uk/r/C8KH7CY

Going back to SLaM QI  I can almost hear the following.

What is Quality Improvement I hear you ask?

There has been a drive at mental health trusts to strengthen services through quality engagement and indicators. The quality improvement drive has unfortunately come from reports due to serious incidents in the past, but it has led to action and families and carers need to know more about NHS Trusts QI.

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Emma Jones who is the SLaM QI clinical Nurse spoke to us about the importance of QI. She spoke about the recent visit from NHS England querying the trust on involvement and co-production. From what I remember, SLaM were good in some areas, but struggled in others. Emma admitted there was still a long way to go.

We were shown a video which can be viewed below.

I felt the video was very good and certainly set the agenda for a good discussion.

The forum felt more carers need to be involved on SLaM’s carers register and more carers need to be involved on SLaM’s projects. The Lewisham MH forum await the focus groups QI are planning. There was a lot of discussion on SLAM’s changing lives strategy.

The core components of the Strategy are

  • Quality – SLaM will get the basics right in every contact and keep improving what matters to services users.
  • Partnership – SLaM will work together with service users, their support networks and whole populations to realise their potential.
  • A great place to work – SLaM will value, support and develop our leaders, managers and staff.
  • Innovation – SLaM will strive to be at the forefront of what is possible, exploiting our unique strengths in research and development, with everyone involved and learning.
  • Value – SLaM will make the best use of our assets, resources, relationships and reputation to support best quality outcomes.

The forum fed back on if the changing lives strategy has a space for carers and was not keen on the word ‘support networks’, although they agreed the word could stay, but certainly wanted the word ‘family and carer’ to be added. The view is even carers are also users of services not as patients but what SLaM can provide.

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There were also talk about other words as in the word ‘Huddle’, which is an american term for taking action and planning strategy instead of consulting.

There was more discussion on Carer & Service User Involvement in QI

Where the forum was presented on how SLaM QI in Lewisham or overall were engaging with those off the Involvement Register. The following was presented.

  • How the Inpatient Care process Model works – A Lewisham Pilot.
  • How each acute ward eventually had a 1 hour group every 2 weeks.
  • How to get patient involvement/feedback.
  • Positive & constructive Feedback from persons supporting group.
  • Pointing out that patients change ideas do make a difference.
  • How patients feel listened to, more informed of what to expect & given feedback from actions.
  • Moving Forward: Each Ward to take ownership of group with IR.

Again the forum pressed QI for carer focus and involvement, however the good thing is that SLaM QI were there to listen. Near the end of the talk, the forum discussed SLaM’s patient discharge follow up regarding SLaM’s suicide policy and touched on the QI projects each ward was working on. A lot of projects were focused on patiet flow, but some looked at the patient and carer experience.

All in all, I was happy that Emma from Lewisham SLaM QI attended, even though she was pregnant I felt this showed dedication to her role and set an example to engaging with carers. I shared the forum notes with carer members to 2 other forums in the hope those members can query Quality Improvement in other SLaM boroughs.

Next up was Carers Lewisham new support worker who has a vast amount of Mental Health knowledge.  He updated the forum on some new groups that Carers Lewisham is running and we look forward to working with him and Carers Lewisham.

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This concludes the update for February Lewisham MH carers forum.

Lewisham MH Carers forum January 2020

133Welcome to the first Lewisham Mental Health carer forum of the year. Before I do a brief update of how the forum went, I must say thank you to Carers Lewisham for hosting the forum for almost 6 years. As a carer I often mention to fellow carers that we must support our carer centres. Without carer centers then it is harder to keep the profile of carers at local and community level. Carers need that safe space, access to activities and a place for support. I am aware that so many carer centers are struggling due to lack funds, staff and resources, but my respect for the ones that keep fighting for carers will continue.

As a reminder the Lewisham MH carer forum works to give carers a chance to find out what the mental health and social services are doing for them in the community. The Lewisham MH carer forum is carer led, which serves as a message of empowerment, I always try to make sure families and carers understand the importance of inclusion, empowerment and a chance at co-production, which should be at the heart of Health and social care.

If someone is making decisions that affects patients and their families then they must include those views, if they cannot include those views then they must present what they are doing. Failure to include, co-produce or present health and social care changes leaves the community being distrustful and avoiding to engage with services.

This is precisely why we had SLaM’s involvement lead for the boroughs of Croydon and Lewisham attend to update the members on how things are getting along for involvement. Members of course were interested on the involvement updates regarding carers.

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Jane Lyon who is SLaM’s involvement lead for Lewisham and Croydon updated us on how services in the community were progressing, she unfortunately had to miss the new Lewisham Mental Health Alliance lunch in order to attend the forum, but we were glad that she sent 2 advisory group members to attend the event.

A lot of discussion centered on the Ladywell unit as we also had Eunice Adeshokan in attendance. Eunice is the modern matron for the inpatient wards at Ladywell Unit. I have known Eunice for more around 8 years or more so it will be interesting to see what developments will take place on the wards.

Eunice took the time to explain to carer members of her role and how the profile of families and carers will be raised at the MH wards. She also updated the forum of the special Carers Champion event and how carer leads on the wards across the trust are working in line with trust carers policies and strategies.

There was a discussion about SLaM PALs (a way to complain, compliment or query), since members wanted to know how carers will have the confidence to ask questions regarding the cared for. There will be work to see how staff deal with carers on the wards. One important start is that myself and another carer will visit the wards to check what is standing out for families & carers as I raised something regarding information at one of the wards.

In the meantime, I also raised the query of when the Lewisham and Croydon Staff Carer leads meeting will start up again, however we are waiting to see if staff can take on specific roles for the groups again, it could be the Lead Occupational therapists.

The second half of the Lewisham MH carers forum focuses on the NHS Trusts draft carers strategy. This is something that could not possibly be discussed at a peer support group as members need to have an interest of NHS carer engagement. It takes quite a while to get carers to have an interest of trust strategy and policies and a longer time for them to query it. The problem is the nature of NHS services can say one thing and do another.

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So we are glad that South London & Maudsley is working with carers to query their strategy, because strategies can be used to hold services to account or at least let interested carers know what the Mental health NHS is doing.

I went through the 7-page strategy with carers and spoke about what carers should have a special interest in.

The following important points of the strategy were discussed

  • The Care Act.
  • What is the Trust’s Changing Lives Strategy, Think Family Strategy and the Trust’s Quality priorities.
  • The importance of the Triangle of Care initiative.
  • Understanding the MH NHS Trusts Carer’s Charter
  • Using the trust’s view of what is a carer – in case someone is told that they are not a carer.
  • Querying number of carers since the draft points this out as a challenge.
  • The importance of diversity and how it relates to the Lewisham BAME MH carer forum priorities.
  • The trusts strategy aims
  • Explaining the trusts priorities
  • How the trust will Increase the number of Carer Champions on wards and in community teams
  • How the NHS trust will support the health and wellbeing of carers (A major challenge).
  • I was glad to see in the draft that the trust is looking to go forward and register in the Triangle of Care membership scheme. This of course will take some work and will be something a trust representative can take to the regional ToC meeting to be held at Central and North West London NHS Foundation Trust.

I would like to thank Carer’s Greenwich for also attending the Lewisham MH carers forum as I am working to set another carer forum for the borough of Greenwich where Oxleas MH NHS trust can engage with carers at community level.

In the meantime I have set up 2 carer led peer support groups for the borough of Greenwich in order to build a carer base.

This concludes the update for the Lewisham MH carers forum.

Lewisham MH Carers forum November 2019 update

Mental Health Open ForumWelcome to my quick update of the Lewisham Mental Health Carers forum. This forum runs usually on the last Tuesday of the month and runs from Lewisham’s Carer’s centre. The forum looks at the issues affecting unpaid Mental Health carers in the borough of Lewisham and sometimes further beyond.

The forum does not look into the mental health of unpaid carers, but the situations of families and carers supporting someone with mental health needs. A bit more about the Charity ‘Carers Lewisham’. From their website.

Carers Lewisham provide a range of services including advice, information, emotional support, breaks, opportunities to meet other carers, relaxation days and well-being sessions, coping strategies, specialist support for parent carers, carers of people with dementia, carers of people with mental health problems, older carers and carers who are caring for someone nearing the end of their life.

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As you can see, families can have complex relations and unpaid carers are no different, unpaid carers need that support, but they also need empowerment. This is what the Lewisham MH carers forum tries to provide.

The Lewisham Mental Health Carers forum runs once a month, just like the other 3 carer forums I try run. All MH Carer forums run in South London, but do not be fooled into thinking I just run forums since my activities spread much further than that, e.g. helping out Mental Health carers in other boroughs where mental health NHS Trusts have some idea of empowering unpaid carers in their area.

A first for the November forum was the use of a telecommunications application called Zoom, which allows unpaid carers to attend the forum via Video Chat. I am still trialing the device and checking out the hardware, but I have made it clear to members that I am happy to train them in usage.

Updates from Healthwatch Lewisham

For the November MH Carers forum, we were glad to welcome Healthwatch Lewisham.

Healthwatch Lewisham is the independent champion for people who use health and social care services. They exist to ensure that people are at the heart of care, and they listen to what people like about services, and what could be improved. Healthwatch Lewisham share their views with those with the power to make change happen, that being the Local Authority, CCG or those who provide services.

Marzena Zoladz who is Healthwatch Lewisham’s Involvement and Projects Manager has been actively engaging with both the Lewisham MH Carers forum and the Lewisham BAME MH Carers forum. She was there to update the members on Healthwatches Intelligence report, which is about a summary of reports and actions that have been undertaken by Healthwatch, including information on what they are currently working on, what work they are planning and updates on work they have previously undertaken.

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Most of the members have already read some of the latest reports are queried Marzena on why some reports are not highlighting unpaid carers, but in the future Healthwatch wants to develop stronger links to families and carers. This is something the forum is looking forward to as many feel that those who they care for is at the mercy of the health services.

You can look at more reports from Healthwatch Lewisham show below.

Healthwatch Lewisham Reports

Other queries from members were on the lack of figures and stats from the Local authority and from SLaM, many feel that SLaM Quality Improvement has a huge part to play in revealing statistics. A big query came from a member concerned that access to services via primary care is severly lacking. They feel secondary care focuses a lot more on those who have managed to use the mental health system, but those outside the system, it will be a hard struggle. There is dismay that Local Authority will be taking over more services in the area, which means it will be harder to raise queries to healthwatch.

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Marzena was kind enough to give out information leaflets, booklets, forms, pens and hygiene kits. The forum members took a few forms to feedback information from other services.

Updates from SLaM

Also at the November forum, we were joined by South London & Maudsley NHS Foundation Trust’s (SLaM) Involvement lead for Croydon and Lewisham. Plus we were also joined by SLaM’s Head of Nursing. Before I continue, a bit of info about SLaM. Since some people think they are some trend for a basketball team.

South London and Maudsley NHS Foundation Trust provides the widest range of NHS mental health services in the UK.

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They also provide substance misuse services for people who are addicted to drugs and alcohol. Their services include the Maudsley Hospital and Bethlem Royal Hospital. They also work closely with the Institute of Psychiatry, Psychology and Neuroscience and King’s College London.

They are supported by Maudsley Charity and are are part of King’s Health Partners Academic Health Sciences Centre. You might notice off my Southwark or Lambeth forums NHS Staff turn up from King’s NHS Trust or Guys & St Thomas Hospital to engage with unpaid carers.

We had some good news from SLaM’s involvement lead as they have a new inpatient Modern Matron, who I will be closely working with in the new year. There will also be a community carer’s lead for the borough, but again this might be something or the new year as a lot of carer issues are out in the community.

There is a plan for SLaM to set up a support group probably on the wards, which I feel would be great even though I am already setting up carer-led peer support groups in several boroughs. I really hope the development of the SLaM carer’s support group involves ideas from the Lewisham MH Carers forum.

This wraps up the brief update from November’s update of the Lewisham MH Carers forum.  I can see Lewisham Carers becoming more festive as I await any Xmas party from the Carers centre.

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The next Lewisham MH Carers forum will be in January for the new year.

Lewisham MH Carers forum September 2019 update

133Welcome to the September update of the Lewisham Mental Health Carers forum. I guess you might already know, that I facilitate two carer strategy forums in the borough of Lewisham.

 

 

However one of the forums focuses more on BAME queries/issues with families and unpaid carers. The one that runs at Lewisham Carers tends to focus on unpaid MH carers as a whole.

Mental Health Open Forum

Just as a reminder, the term ‘mental health carers’ refers to unpaid carers supporting those with mental health needs. I know not many people are happy with labels, but on some level it just helps with identification and at best helps to lessen isolation as people know they have something in common with each other.

For the September Lewisham Mental Health Carers forum, we were lucky to have Lewisham’s latest mental health Champion James Rathbone, who is also the Labour Councillor for Lee Green. As unpaid MH carers, we were also joined by South London & Maudsley’s Quality Improvement QI Facilitator. It is important NHS mental health trusts engage with families and carers at grassroots level.

We first heard from Cllr James Rathbone who has lived experience of mental health. He spoke about how he became a mental health champion and why he would like to make a difference in the community regarding mental health needs. Not every service user can speak out when addressing mental health issues and it helps when someone is high profile enough to raise mental health at important meetings.

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James specified he does not control how Lewisham health services run, but he will bring mental health to attention when the issue arises. It is important that a mental health champion gets out and engages with the community. It is important to hear what the community says about the issue of mental health needs. James raised the situation of mental health needs from the BAME community and felt there needs to be more priority due to a high level of BAME using mental health services.

James was critical with the term ‘parity of esteem’, because he felt the term itself does nothing to address the real issues. He felt the main issue was funding and the new term should be ‘parity of funding’. He felt what are services bringing to the table? It is easy to talk, but funding matters in the end, plus how the funding is used.

James talked about the big launch of the Lewisham suicide prevention strategy held on the 11th of September 2019. I am not fully aware of the suicide stats in Lewisham or other London boroughs, so it would be interesting to chase that up. Especially since I am a carer member of SLaM’s suicide prevention group.

The next and last point raise by Lewisham’s Mental Health Champion was on how Families and carers can be involved in shaping Lewisham’s mental health services. I asked this query, because families and carers should feel part of the system, they should have their views and experiences taken into account and feel empowered they have the chance to be involved.

James spoke of how carers can become members of their NHS trust and have a greater say on what is going on. James spoke that we should pay attention to what SLaM governors are doing and try query what they are involved in. James mentioned that Lewisham CCG have their public reference group, which allows for involvement and it helps to understand the important health policies affecting the community.

We were glad James mentioned the important Lewisham stakeholder event on the 14th of October, since members of the MH Carers forum will be holding a workshop there about carers.  The link has been added below.

https://www.eventbrite.co.uk/e/lewisham-mental-health-stakeholder-event-me-and-my-community-tickets-72248203321

On the 16th of October will be Lewisham Child & Adolescent event, although not sure where it will be.

Some questions from the forum asked at James were on the merger of the six CCGs, the use of the Joint Health and Safety Committee and James returning for the Lewisham BAME forum.

Next up was Aaron Brewer who is SLaM’s quality improvement facilitor. Many NHS trusts around the country have quality improvement projects to work out how to improve services for patient and carer (yes, thats right! carers also use services). They want to ensure that the people that access our services experience the same standards of care no matter which borough they live in or which service they com are under.

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Aaron spoke about SLaM’s Inpatient Care Process Model. The model is broken down in to six phases of an admission. Lewisham are currently implementing three phases. The decision made to admit and first 24 hours, First 24 to 72 hours in
hospital and Final discharge preparation and discharge.

The model is broken down in the following sections.

– Decision made to admit and first 24 hours
– First 24 to 72 hours in hospital
– Getting better
– Getting ready to leave
– Final discharge preparation and discharge
– Staying well

Aaron then spoke about Lewisham’s Hospital patient system ‘I Care’ and how data can be used to focus on quality issues and quality behaviour. The group were shown some graphs and quality data to help educate members on how hospital data can help make decisions. We were shown nothing confidential, but numbers and figures. It was pointed out that the graphs look very complex, but I always stress carers MUST get used to poking their noses on data and quality. We need to understand how NHS systems work and how they make decisions on services.

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The following graphs were shown on

Hospital Length of Stay
Discharges by directorate
Readmissions within 30 days
Admissions and Transfers into External Overspill

The next discussion was on how the Hospital’s patient system can help in improving care and outcomes. These will follow on from the Red2Green tool. The Red2Green is a tool to aid daily multi disciplinary team decision making to ensure that every day spent in hospital is meaningful and contributing to a person’s recovery. Red2Green was developed in an acute general hospital but has since been adapted for mental health settings, multiple NHS trusts are now using it and having success in reducing unnecessary delays, length of stay and bed occupancy.

The Ladywell unit based at Lewisham hospital has several mental health wards. We were shown how one of the wards operates in regards to the Red2Green tool. The ward chosen was the ‘Powell Ward’, where we were explained the following

180 Green Days and 4 Red Days for 18 patients in August.
No Delayed Discharges.
Targetted Theme: Awaiting Social Services

The last part of the discussion was on Standard Operating Procedures (SOP). The aim is to agree Standard Operating Procedures (SOP) to unblock common barriers to discharges between community and inpatient services. The more I looked at who was involved at the SOP, the more my head began to spin because I felt they need to engage with the forum somehow or the risk is the community would not always know what is going on, however we did mention we have invited Lewisham’s head of social care to attend.

This concludes the update for the September Lewisham MH Carers forum. As a note due to resources, I cannot always update on the 4 forums, but will try every so often.

The next Lewisham MH Carers forum is on the 29th of October

Lewisham MH Carers forum August 2019 update

133Welcome to the August update of the Lewisham Mental Health Carers forum. This forum runs from Carers Lewisham over by Forest Hill, just near Forest Hill train station. The forum focuses on unpaid carers who support/care for someone with mental health needs e.g. schizophrenia, eating disorders, bipolar, major depression, addictions and so on. I even try and involve those caring for learning disabilities.

The forum tends to try and form a relationship with the local mental health trust, that being South London & Maudsley, we also seek for ways to educate, discuss and empower families and carers. We also seek engagement from Lewisham Hospital, Lewisham CCG, Lewisham council, Lewisham Healthwatch and other important stakeholders.

I have always mentioned to members or perhaps anyone that knowledge and information is power. So for August we were very fortunate enough to have South London & Maudsley’s former Patient Information Manager. Roslyn Byfield is a trained Counseller and therapist, she has her own practice and is very active in discussions about BACP, which stands for the British Association for Counselling and Psychotherapy. I have known her for quite a while now and was happy that she took some time out of her schedule to engage with families and carers.

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As she placed leaflets and booklets on the tablet for carers to take, it brought back a lot of memories. Infact one of the booklets, which was the physical wellness booklet won an award.

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We were hoping to be joined by SLaM quality Improvement, but they are more likely to attend in September. Plus in some ways, perhaps that was a good thing because the forum had a major discussion with Roslyn. Part of the talk was on carer empowerment and several organisations were mentioned. We also talked about the Government’s anticipated release of the Green Paper which focuses on Social care, but there has been major disappointment that political parties are kicking the social care can down the road. There was also talk about the Carers Action Plan, but many are skeptical about it.

In regards to empowerment we were told to form links regarding the NHS Constitution and focus on the Human Rights Act 1998 and the Equality Act 2010 as well as the Care Act 2014. We can make the mistake of trying to hold authorities to account, but its very hard to do that on your own and getting links to the human rights organisations can really speed things up if carers are not given the right information and support.

Here is a link, which might interest unpaid carers on their human rights.

https://www.bihr.org.uk/carersguide

The forum also focused on European Convention on Human Rights and what to learn from them. This could be useful if policies really begin to put pressure on carers and it would be important to make links.

At some point I will map out organisations to pull in to educate families and carers and also form stronger links as high up as possible.

There was some talk about the review of the Mental Health Act, which hopefully can put a spotlight on how families and carers can be pushed aside, especially when a loved one comes to harm, neglect or serious incident. We spoke about the problem with documentation from the health services, but it was mentioned some documents can be complex to stop people delving too far into things. It can be a strategy at some meetings to place jargon to ward off stakeholders querying why NHS systems are not working or why is there a high rate of Serious incidents. A lot of talk was on quality improvement, but without engagement then some members were wondering what to do.

We were focusing a lot on NHS constitution Section 3A and how it can support families and carers. Plus focusing on the National Institute for Health and Care Excellence. It does not help that guidelines are not enforceable and there was queries as to why NHS services are struggling. It does not help that funds are lacking for NHS trusts and then government places targets putting staff under pressure, which in turn affects families and carers.

We did not spend all the time focusing on carer empowerment, but also on therapy and counselling. I myself certainly have had not very good experiences with counselling, especially family therapy. I felt the outcome was a way to cover up the lack of services and then blame the family or carer for the patient relapsing. Some carers are in a worse situation when they are pressured to admit they are the cause of mental distress, leaving them confused, stigmatised, ashamed and isolated.

This is when accreditation came into the discussion. It is well known that there are good and bad counselors, but what happens if accreditation does not pick out the bad ones? Who is to blame? The big push for IAPTs has caused a massive break up of the counselling industry. Some people feel that counselling is not a journey, but now like popping in for advice. Roslyn mentioned counselling should not dis-empower the patient into looking for advice. Counsellers need to have life experience before they can examine someones life, no course be it a BSc or Honours would be enough for such a profession. There was talk about the BACP and PSA (Professional Standards Authority), which carers should keep an eye out for updates.

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Lastly there was talk about how carers MUST make time for themselves, it is important to look after our own health and wellbeing with emphasis put on spirituality. Many of the members felt that they were pressured to focus on their cared for, but it was mentioned that such mindset should change. It was however not an order but to be mindful of our own health needs.

Below was a set of tips given by a veteran carer.

• Seek help at an early stage
• Don’t be ashamed of mental illness
• Speak out if you think something is wrong
• Take care of yourself with counselling and exercise
• Keep in touch with your spiritual side

I was glad that Roslyn had time for the forum and will certainly follow up on making those links. The forum was told that they already have the resources to make some serious pathways, but there still needs to be some support for empowerment.

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This concludes the August update for the Lewisham MH Carers forum.

Lewisham MH Carers forum September 2018 update

133This is the last of the four MH carer forum update for September. This one runs from carers Lewisham, the Carers Centre is run by and for carers: many of their staff, trustees and volunteers are or have been carers.

The carers Centre provides information, support and advocacy for carers for the borough of Lewisham. You were hoping to have the head of social care for Adult Mental Health attend the forum, but she was unable to make it due to being unwell. The forum members are interested in her role and how it impacts on families and carers.

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Lewisham MH Carers forum August 2018 update

IMG_20180828_141300Hello everyone, welcome to the latest update from the Lewisham mental health carers forum, which took place on August the 28th carers Lewisham. I know I have missed a few updates regarding the other forums that took place in July, I am hoping to add those at a later date.

As a quick reminder, the MH carers forums give a chance for carers to get updates, engagement, empowerment and also query NHS services and policies. We had some good attendance for the latest lewisham carers forum.

The forum usually runs for 2 hours, however so much was discussed at this particular forum we actually overran. I gave updates from our local mental health trust, which is South London and Maudsley. The NHS Trust has been really good in engaging with carers forums from the Boroughs of Lambeth, Southwark, Croydon and Lewisham.

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