Category Archives: Carers Lewisham MH Forum

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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Lewisham MH Carers forum June 2018 update

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Here is the June 2018 update for the Lewisham mental health carers forum. We had a visit from the involvement lead for Croydon and Lewisham. With support from south London and Maudsley NHS trust, the purpose of this forum is to see who will engage with the forum throughout the year and beyond.

 

The Forum looks forward to the Deputy Director of the Crisis Services Psychological Medicine Management lead attending the forum in July. Members of the forum were also pleased to hear that in future in Lewisham Execitive would also drop by to explain about service updates and engage with the members.

We were also pleased to hear that a lead from the “Centre for Anxiety disorders and Trauma” would engage with the forum in October.

In regards to Triangle of care policy launched for NHS trusts, no new applications are taking place for Trusts to join. We hope that in September there will be a review and an update regarding applications to join the policy.

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Last month the forum members were interested in the staffing structure at the NHS Trust particularly in Lewisham. Due to the recent structure changes the NHS Trust will update the forum once job posts have been filled.

Members of the forum also wanted a carers handbook to be placed at GP surgeries across the borough of Lewisham, however due to funding issues this cannot be possible although Lewisham CCG have kindly put information about carers in the GPS newsletter.

After the discussion with the involvement lead carers had a group discussion regarding problems carers are currently facing. We discussed the following issues:-

1. GP not always understanding carers in regards to the ‘cared for’ being referred to services.
2. The lack of respite and breaks for carers.
3. The lack of emergency respite.
4. The lack of carer activities.
5. Limited education on carers rights.

Members of the forum were wondering what on earth happened to the borough of Lewisham carers strategy considering other boroughs have their own carers strategy.

Lastly members were very pleased with the involvement lead working so hard to support the forum. We hope to hear from the lead soon.

This concludes the update for the June 2018 Lewisham mental health carers forum.

 

Lewisham MH Carers forum April 2018 update

IMG_20180529_135451Welcome to the Lewisham MH carers forum update for May. Out of all the four Mental Health carer forums in South London, this is the oldest one I chair. The MH carers forum ran on the 29th of May.

Carers Lewisham have been very good in supporting the forum and helping to advertise it, but we still need to reach other mental health carers in the borough of Lewisham. It is very important unpaid mental health carers know what is going on with the mental health services, let alone being engaged and trying to influence them.

For the month of May, we had guest speaker Stephanie Edwards who is the Clinical Team Leader for the Psychosis service in Lewisham. This forum was highly strategic as the forum members got a brief breakdown of the mental health services in Lewisham. The mental health service structure for the borough of Lewisham was complicated due to the current restructuring of SLaM staff, but hopefully we will have Donna Hayward-Sussex at the April forum, she is the Deputy Director of the Crisis Services within the Psychological Medicine Team.

The forum members need to know and query how mental health staff restructuring will affect service user and carers in the borough of Lewisham. As far as the forum knows, there will be be senior management consultations regarding interim posts.

Lewisham Ward Map

The mental health trust that covers 4 boroughs and a few more regarding mental health services is preparing for the CQC visit in July, they have spent a long time preparing services and involving carers and service users in ward/service inspections, which was good to hear. The MH carers forum appreciates staff have worked very hard.

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Regarding future forum engagement, the members look to be updated on the NHS trusts estate developments, governance structure and involvement oppertunities. I queried how many carers does Lewisham MH services have on the books, but it can be difficult to pin down the answer, still heard that around about over 800 Mental health cases are in the books, so it gives us some idea of the number of families and carers we need to reach.

Stephanie Edwards is preparing for Lewisham’s People’s Day, so the forum looks to provide cards, posters and leaflets.

After discussions, I brought out a large map of SLaM’s services and Stephanie took time to explain what the services in Lewisham are about, who was responsible and answered queries from the forum members.

There is concern that not enough carers in the borough know what is going on and are not getting involved. There are plans to have the forum held alternatively in the evenings at the Depford community centre. We also hope the carers support group can be set up in Lewisham Hospital so new carers can gain therapeutic support since there is limited time for carers stories at a Carer MH Forum.

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The forum has requested an MP visit soon from the borough of Lewisham to boost carer empowerment and understand carer issues with the borough

This concludes the update for the Lewisham MH carer forum.

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Lewisham MH Carers forum April 2018

Welcome back to my MH carer forum update from the Lewisham carers group. At the Lewisham Mental Health carer forum, we discuss carer engagement from our local mental health trust, 3 party organisations, the council and lewisham based GP surguries.

We also discuss carers rights, reports and learning about the carers role. For the april 2018 meeting. We discussed the report sent back from out local Mental health foundation trust, which is South London & Maudsley.

I usually attend and chair carer forums across South London, so it was important quality improvements for the mental health services get views from Carers. The report is fairly well written and easy to digest. I had printed out some copies for members to read at the Lewisham MH Carers forum.

We spent most of the time discussing the report, especially page 7 of the report, because that is where the write up of the carers forums were placed regarding carer issues. Despite the report being very easy to read, there were some problems. Some members felt the report was too vague and missed some things out. Other members of the Lewisham MH Carers forum felt the report is lacking in a conclusion on what needs to be done to tackle quality issues.

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One of the members of the forum is going to raise their concerns back at the trust, although I am glad the quality project did mention our concerns. We hope SLaMs Head of quality can engage with the forum regarding SLaMs quality priorites.

We also had a guest speaker at the forum who promises to return to the forum again. The head of the Ladywell Mental Health unit based at Lewisham Hospital engaged with the forum. I was delighted that she was able to make it, even though she had to deal with many emergency meetings. Sam Grey spoke about her role and what a Unit manager does. She described around 7 wards and their purpose and gave an update of changing service structures regarding borough based services rather than trust wide services.

I spoke about the need for a carer support group to be set up for the whole of the Unit, mainly because such a support group existed there years ago. Plus families and carers can always make the tuesday evening for a support group. I am fortunate enough to get support from the trust’s modern matrons who themselves focus on quality priorities. The forum wanted updates and engagement from the Ladywell Unit’s phamacist also the psychriatric nurse from Lewisham hospital, unfortunately we are not sure if it is possible to get their time, but the forum is interested on how such staff deal with medication issues and also how Lewisham hospital’s A&E engages with patients and their friends/families.

I hope the update was a useful read, see you next time.