Tag Archives: Greenwich

Greenwich Mental Health Carers forum October 2021

Welcome to the October update of my Greenwich Mental Health carer forum. As with my other carer forums, this one focuses on engagement from the local mental health NHS trust that covers greenwich, that being Oxleas MH NHS trust. I run this forum with heavy support from Greenwich carers who fight and advocate for the needs of unpaid carers in the Royal borough of Greenwich.

Speakers for the October Greenwich MH carer forum were

Peter Ley (Oxleas NHS) – Service Manager
Sue Horbury (Oxleas NHS) – Online Patient system
Laurelle Morgan Bruce (Oxleas NHS) – Oxcare

Peter Ley presents about his role

Peter Ley from Oxleas has a very important role that impacts many mental health carers in the borough of Greenwich, which is why some members wanted to find out more about what he does. Peter talked about service updates on what Greenwich MH services were going through, plus also to briefly talk about the Oxleas strategy.

Peter pointed out that he has been at the organization since June 2020, but felt joining an NHS Trust at the heart of pandemic can be challenging, still many months later he has found is that, whilst in that period of time, the organization took the decision to move from borough based services and move towards service lines. Peter did warn that unfortunately, the NHS has got a lot jargon in it and he will try and filter it out during the presentation.

So for borough based this just meant that the Greenwich had a management team, and a set of a set of services, which was inpatients and the community teams, and it was clear that people belonged in those teams. Then there’s a bunch of teams in the community and those are in between the GP surgery and specific teams, there’s a team called PCP as in Primary Care Plus, where they may take the referrals from the GP surgeries and kind of work where patients need access to the right part of the service.

Peter then talked about the inpatient facilities and Oxleas house and on what they provide including explanations on the treatment team and medical liaison team, plus on the older aged services along with the community mental health team and the memory services. Peter talked about the team based out of the hospital that works with older people, and how they link up with the community teams.

Peter was kind enough to mention that he has got access to organisation charts and diagrams that show how the services link together. It is a good way to understand things at a birds eye view. Peter continued to talk about those teams and how they run from Greenwich, the borough of Bexley and also Bromley. Historically the Clinical commission groups were set in each borough for Bexley, Bromley, and Greenwich, So the organization (that being Oxleas NHS) felt it was important to have a local relationship with the commissioners to kind of ensure that things that were in accordance to what was needed. But more recently, people might be aware that we have things called integrated care services now and it has been going on for a number of years. The conclusion from a lot of work nationally was to get services to be more joined up and make them more effective

Some members of the group wanted to talk more about how services were affecting them, which led to a lengthy discussion on the challenges such changes in the organisations need to link to carers. In the end it was felt Peter could link up more with both the forum and our greenwich carer’s peer group, since some carers felt neglected. Peter was kind enough to agree and we hope to see more of him in the new year.

Sue Horbury presents on Oxleas Patient database system

I am always interested to hear how the mental health organisation identified, recorded and referred unpaid carers off their patient database. So Oxleas was very kind to send Sue Horbury who works with the patient database system called ‘RIO’. Now RIO is actually used in many mental health trusts, although other mental health trusts have different patient database systems.

Sue presented herself as the equal transformation program manager for RIO. What that actually means in practice is she looks after and runs the team that works with introducing new technologies to the mental health trust. Sue talked to us at length about the patient record system and how they collect information about carers.

Sue talked about their clinical system and also what they call the support network engagement tool. So the system provides Oxleas with the ability to be able to register carers and wider support networks that they created some time ago to calculate information. However Sue mentioned that they realized earlier this year, that it wasn’t necessarily doing everything they needed it to do. So there was updates which Sue talked to the group about. Sue felt the system needed to capture who is in person support network, that being their primary carers, but also other people that might support them, and also how and when the organisation should engage with carers coming from the patient database system. This is where the clinicians might want to invite carers to be part of the care plan where it could be virtual or it might be face to face. In the end the organisation has a mixed approach, since we are in the world of pandemic.

So one of the key things Sue explained is how to know when Oxleas speak to their patients and service users and what are the fundamental questions. These being who are the most important people in your life? And how would you like them to support you in your care? Should we as Oxleas contact them? And if we should, how often should the contact be and who should Oxleas contact in the event of an emergency So that they have some guidance around how and when your wishes should be met.

Sue was very clear that maybe this isn’t happening as often as it should do, but that is certainly being recorded. The system has the ability to capture, but Oxleas can always strive to do better.

Laurelle Morgan Bruce presents on Oxcare

Following up on Sue’s presentation Laurelle talked Oxcare and what it meant for users of the services. Oxcare shows personal and medical information held on the patient’s personal health record, some of it comes from Oxleas’ record systems (RIO).

It allows patients to add their own information about their health, along with details which may be used to help with them on their current illness. This could include a diary or trackers to record their mood or pain. In some cases, it may reduce the need for them to attend many appointments.

She mentioned what was taken into the live environment some all the new functionality which will link up with Rio and allows Oxleas to bring information from Rio into the records. There has been lots of progress and they have started to work with some of the teams around the trust, but there is always oppertunity for members of the group to be involved and have a look.

There will be 3 Phases for leading on to the new year.

Phase 1 some services and their patients have access in 2021
Phase 2 During 2022 all services will be able to offer Oxcare
Phase 3 Reviewing and adding more functionality

Overall the forum was a little heated, but I was impressed that Oxleas staff did engage with the carers group as unfortunately there are organisations out there where carers do not have a carer’s centre or a group that can be a platform for engagement, querying and updates.

This is my brief update on my Greenwich MH carer forum for October, where the new one will be in January where Oxleas PALS will be talking more about what they do.

Bromley, Greenwich & Lewisham BAME Carer Forum August 2021

This is a brief update for my BAME mental health carer forum covering a mix of London boroughs between Oxleas NHS Foundation Trust and South London & Maudsley NHS Foundation Trust.

Obviously out of my 6 carer groups, this forum focuses and discusses on the unique experiences of Black Asian Minority Ethnic groups. I know some people want such groups to be specific, but to be fair a lot of the topics raised in this forum do focus on the afro caribbean element, although some members are mixed from the Asian community, which is growing as members from other MH NHS trust attend.

The speakers for the month of August were

Malik Gul – Ethnicity & Mental Health Improvement
Jacqui Dillon – Race and mental health
Cordwell Thomas – Black Thrive
Dawn Irving – Maudsley NHS Quality improvement

  • Malik Gul presents on Ethnicity & Mental Health

Malik was really pleased to be among carer members of this forum. Malik felt the issue of race and mental health is not new, this is especially in the field of discrimination and racism in the services of our communities. Malik stressed that what we’ve had to endure as black and brown people has been known since we first landed in this country, But since the main kind of population of migration into this country, following the Second World War, and what is euphemistically known as the Windrush generation.

Since the days that we’ve arrived in this country, we have been discriminated against. Racism is built in to the very fabric of the systems that we all live in, and we must admit that it is a part of the system, and all of us in this conversation have experienced that. We’re all a part of it and we have all been discriminated against, in one form or another.

what Malik finds really interesting about the work he does, is that he has been working in Wandsworth at the Wandsworth Community Empowerment Network for the last 20 years.

More info on the Wandsworth Community Empowerment Network

It is now their 20th anniversary and the organization was founded in 2001. The thing is the organisation knows about the history of black discrimination. Many of us will know about David rocky Bennett, a black man, Rastafarian man, who was in mental health facility in Norfolk, and unfortunately there was a dispute on the ward, something really minor, Malik thinks it was about who could use the phone and who somebody jumped in front of the queue, or something like that. He was held down by the staff, and died in mental health services, what is worse is this is just one of the many cases of ethnic minorities dying not of mental health services, but within mental health services.

So the history of black people in mental health services being discriminated against is a story that we’ve all lived and experienced for the better part of 40 to 50 years. Malik felt that he has to us that nothing has changed.

Malik works very closely with Southwest London & St. George’s mental health trust, and also very closely with South London & Maudsley as well. In fact the new chief executive of SL&M is David Bradley who was the former chief executive of SWL&STG. Malik mentioned how he worked with him for about seven years and over the last 20 years, if you look at the figures for black people where it comes to over representation in medical health services for 20 years, it shows little to nothing has improved, and in fact, in some cases, things have got much worse. Malik mentioned that he has great admiration for David because he always had the foresight to work with the community and is bringing over ideas from his previous MH trust over to SL&M.

Malik challenged us that if you go on to the wards of Springfield hospital, as he does on a regular basis, about 50-60 70% of the people on the wards are for black and minority ethnic communities. Malik pointed out that we had to look at the over representation of black people in communities particularly in services particularly black, Caribbean, and black African.

Malik stated that he has to say that our mental health institutions are not the ones who are going to address this type of problem. He felt SL&M is not the solution to over representation of black people in mental health services, nor is Southwest London St. George’s mental health trust. Nor are any of the institutions that we are relying on to fix this issue. They are not going to address the over representation of black people in mental health services. It will have to be lead by the community, but there is a power problem, an owership problem a distrust problem. This overrepresentation in mental healths services has been going on for so long that the community has felt apathetic to any drive in order to change the status quo.

There was a very long discussion on what was needed to begin to address this issue, but the conclusion is it must from ethnic minorities, but controvesally we cannot expect the victim to solve the problem as we cannot expect the masters tools to change direction.

Jacqui Dillon presents on Race and mental health

Dr Jacqui wanted to talk a little bit about her own experiences, and on why Matthew invited her to the BAME forum. Jacqui Dillion is the former chair of the national hearing voices network, which is a user led charity that was set up about 30 years ago to provide an alternative to mainstream psychiatry.

Jacqui felt she is basically a survivor. she has used psychiatric services and one of the things that she often says about why she has worked as an activist in mental health for 25 years, is because her experiences of psychiatrists, which unfortunately was pretty devastating.

Jacqui felt that one of the things is if she managed to survive services, she would do all she can to try and change them. So that’s what she has been trying to do for about 25 years now. One of the things that she thinks is really important in terms of what we’re talking about today, in terms of the hearing voices network approach is that we do not advocate a Eurocentric model of the mind.

She felt that this is one of the problems that Malik talked really passionately and eloquently about on the huge over representation of black, Asian, and other minority ethnic people using the mental health services. One of the things that’s really important about the hearing voices approach is that this space within that approach is to both acknowledge the live reality of racism and oppression, which in her experience is often taboo in traditional settings, a lot of people flinch and are very frightened, and can get quite defensive about acknowledging that black and Asian people are massively over represented in services, and what’s at the heart of all things, which ian macpherson talked about in the macpherson report.

Our colonial history is built into the fabric of the these institutions, and things like unconscious bias that professionals come with, and often they’re not aware of their own biases, and then making treatment decisions based on some quite racist assumptions that have been intertwined with such systems.

Jacqui feels a lot of despair, about the over representation of many different people from different ethnic backgrounds, although she is really uncomfortable with the term minority ethnic groups, because since she lives in Hackney people from black, Asian and other minority ethnic communities are 50% of her community. So she finds the description a bit reductive and these kind of acronyms we use can be a little bit dehumanizing.

Jacqui also felt she hasnt seen things improve, there used to be an organization’s called family health, ISIS, which she worked with, about 17 years ago with someone called Dennis who she did a lot of work with in terms of trying to bring the hearing voices approach to FHI as an alternative to traditional psychiatry. She was sad to hear that Family Health ISIS is now closed as with many community groups looking to set up protected spaces for those who are vulnerable and what remains are these massive mental health trusts overpowering the voices of the vulnerable.

One of the things she would like to see is a move away from locating people’s problems solely within themselves and seeing that we’re all part of a system. Jacqui feels that one of the problems with the biomedical model, is by saying that people have illnesses, what we’re doing is we’re kind of saying, madness and distress don’t really make sense and limiting away the causes of such illnesses such as the pressure of society, racism, isolation from the community, no safe places, lack of resources, lack of community, lack of understanding and so on.

Jacqui felt that we give illnesses these bizarre names like schizophrenia, which she thinks, further mystifies what are actually very human ways of coping with devastating and overwhelming experiences. So she personally does not subscribe to that kind of biomedical language and feels that it is really unhelpful. There’s actually tons of research that has shown that using medicalized language actually increases stigma and decreases people’s empathy. Jacqui mentioned that someone put on the zoom chat about how trauma informed her, Jacqui felt this was more interesting about how something like trauma informed care can develop, but talking about language is a problem where the term trauma can minimises experiences. We have a long way to go in psychiatry before we even get to the idea of recovery.

If you want to know more of Dr Jacqui Dillon’s work see the link below.

http://www.jacquidillon.org/

Cordwell Thomas presents on Black Thrive

Next to present was Cordwell thomas on his role within the organisation Black Thrive. Cordwell spoke about what Black Thrive is doing to promote and also promote what the imbalance of what Malik and Jacqui clearly stated, and also the questions coming from what carer members raised, Cordwell felt there is a concern on black individuals within the black community, having a say in their mental health and promoting the services and shaping the service to be fit for purpose. Cordwell wanted to go into a small conversation about the Patient Race Equality Framework.

On Cordwell’s role, he has several hats. He has a full time role mainly within the community, one of which is on the Black Thrive committee. On the Black Thrive committee, there are various agencies from public services, these are ranging from social workers, public health officers and directors, where they also have the police and many more. So fortunately they also have directors and decision makers who are on the table of Black Thrive and they shape the way they engage with communities and how those services engage with black communities in particular.

So, within that role Cordwell helps to represent the community, but within Black Thrive, he is an independent advisor, which enables him to liaise with South London & Maudsley NHS, and also help develop services within SL&M. In particular those services that have been disproportionately affecting black individuals within the community, like individuals from Caribbean descent.

With such roles it is what brought him to this forum to have a conversation with us, because one of his roles, actions or projects, is to be the lead person from the black community driving the trusted friend project,

Cordwell mentioned that he presented with a colleague from SL&M the trusted friend project, a couple of weeks ago at the Lambeth Carers Hub peer group, which Matthew attended. from that forum Matthew requested us to speak about trusted friend for this forum. Basically what it’s about is if you imagine a situation where you’re in a strange environment, ie as if you’re now a psychiatric inpatient, at one of SL&Ms hospitals, if you imagine yourself in a strange environment and you do not have a voice. Now the role of the trusted friend is to ease and promote that de escalation. So the impatient ward may go through all their various roles of de escalation on an issue, however the trusted friend will come on the ward and be that middle person that liaises with the ward staff and say what the wishes of the individual are.

More info on Black Thrive

There was most in-depth discussions about other Black Thrive projects, but for now this was the brief update of the Bromley, Lewisham & Greenwich MH carer forum for August 2021

Greenwich Mental Health Carers forum August 2021

Welcome to a brief update for my Greenwich mental health carer forum. One of the carer groups I run with the support of Greenwich carers. As usual the forum focuses on unpaid carers who care for someone with serious mental ill health. The forum runs very 2 months since I mostly focus on my other group for greenwich, which is a carer peer support group.

The greenwich MH carer forum also focuses on engagement with unpaid carers rather than a peer supportive environment. Speakers for the Greenwich MH carer forum were as follow.

Victor Aigbe-Anderson – Social Care Assessor

We also had engagement from Greenwich CCG who have been active engaging in my carer groups.

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Greenwich Mental Health Carers forum June 2021

Here is a brief update of our Greenwich mental health carer forum for June 2021. This carer forum focuses on empowerment for mental health carer, while my Greenwich Mental Health carer peer group is on peer support and carer networking.

We were joined by MP Matthew Pennycook who is the Labour MP for Greenwich and Woolwich.

Matthew was mainly here to listen to unpaid mental health carers, which he could take up be it compliments or concerns. I could not go into any details but a few issues were raised one on the state of GP practices. We were also joined by Nosizo Magaya who is CQC’s lead inspector for Oxleas.

Matthew Pennycook MP for Greenwich

Nosizo spoke about what the CQC that being Care Quality Commission does and how they engage with NHS staff, patients and those who care for service users.

Nosizo reminded us that the CQC are a regulator, so they regulate all health services in England. She felt that perhaps the CQC could describe themselves as the Ofsted of health care. The only difference with the CQC and Ofsted is that they can prosecute, if they feel that there are providers that are not providing the adequate care.

So the CQC as an organization has got teams of inspectors that go in and review the care that’s been given to people. Sometimes they respond to whistleblowing, or any responses from any member of the public. Typically, if they do get a concern, they will contact the provider. If the person who gave the CQC the information is happy for them to share it. The CQC will contact the provider and ask for feedback and query what happened with this consent that has been raised. Their teams are a combination of different people on their health care professionals, anything from doctors to nurses, physiotherapists, and also some that are not healthcare professionals being expert by experience.

Nosizo also mentioned that they are based according to team, so the London mental health and community health service team would look after oxleas and she is the main contact for oxleas. Some queries from members were worried how long it would take to raise questions to the CQC, although another carer reminded that even if the CQC did not speak to a carer during inspection, it is always wise to raise a query off the CQC’s website.

You can check out more from the CQC off the site below.

https://www.cqc.org.uk/

Greenwich Mental Health Carers forum March 2021

Welcome to my Greenwich Mental Health carers forum update for March. This is the 2nd Greenwich MH carers forum for 2021, since this is a fairly new forum aimed at families and carers who are caring for someone with mental illness.

The forum is not a support group, although there are times discussions may dwell on a supportive nature as members switch to talking about their own unpaid caring experiences. The Royal Borough of Greenwich MH carers forum aims to give families and unpaid carers a chance to talk to Mental health, health and social care services about how they can also support carers. The forum is a chance at engagement, involvement and empowerment for unpaid carers who would like to know what is going on with services. There also might be a chance to influence services when the Royol Borough of Greenwich mental health carers network grows in numbers.

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Lewisham BAME MH Carer Forum November 2019

Carers Nov2019Hello again!! Here is the Lewisham BAME Mental Health Carer forum update for November. This is usually the last forum I run out of all the 4 forums per month. The forum is quite unique as the other forums promote mental health carer inclusion and awareness in the other London Boroughs, but this one focuses on Black Asian Minority Ethnic queries. BAME carers and service users suffer a whole different set of issues in regards to mental health services. Most are complex, cultural and historic, but there MUST be some platform for important parties to discuss, network and work on these issues.

Another thing different between this forum and the 3 others is sometimes this forum is a mix of patients and unpaid carers. I often try and leave space for the Service user Rep or chair to update the forum.

Who Attended and spoke

For the November update we had a discussion from Pharmacist Della Bishara in regards to medication and its affects on the patient and how unpaid carers could and should be involved.

We also had a detailed presentation from Rachel Ellis who is from Table Talk, which is a new initiative that aims to help inform senior residents throughout the borough, with the help of volunteers. Table Talk provides leaflets, information and a table in order to engage with the older population.

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We were also joined by a number of unpaid carers and patients, along with a representative from Lewisham Homes, plus Metro’s Representative who provide one-to-one counselling for people who identify as LGBTQ and/or those experiencing issues relating to diversity, equality and identity. We were also joined by Lewisham CCG Engagement Teresa and also Natasha from Greenwich Carers who I approached to set up some carer groups. We were also joined by the rep from Community wellbeing from BLG-Mind who I will also bet setting up a peer support group.

On Medication

We had a very lengthy discussion on medication with Della. Many questions from the attendees she took away to raise at SLaM especially in regards to clinical trials and reporting on side affects. Carers need to be involved because of the patient might not always be able to advocate for their need, especially if dementia takes hold. I raised with Della if there were studies looking at medication effects on BAME groups and if there is a SLaM trust wide forum that engages pharmacist issues.

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It was mentioned that Lewisham Integrated Medicines Optimisation Service (LIMOS) is working in improving medication safety for older people. Basically LIMOS is integrated across the hospital, local care homes and community settings, which means that, if a care home resident is admitted to hospital, or vice versa, there is a seamless approach to managing medication.

As with the psychiatrists bible being the DSM, the pharmacists have an important book, that being the British National Formulary (BNF), the book is not easy to get hold of and is the UKs pharmaceutical reference book that contains a wide spectrum of information and advice on prescribing and pharmacology, along with specific facts and details about many medicines available.

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Della discussed the BNF in detail and how it can help pharmacists, which the forum played close attention to. The forum also discussed the issue of miscommunication of medication between hospitals, covert medication and the issue of control & release medication.

Table Talk presentation

After the discussion with the pharmacist, we moved on to another topic regading older ages people. This was the Table Talk project, which was presented by Rachel Ellis. Rachel has been an outstanding promoter of senior citizen’s causes throughout the borough of Lewisham and has visited a large number different venus in Lewisham this year alone. As mentioned before Table Talk engage with the public on raising awareness of activities, information and support for senior citizens. This is specially important due to the population is ageing as we all are living longer.

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Table Talk work closely with Lewisham council and with Age UK. The Lewisham BAME MH carer forum were shown several leaflets, which can help older people in regards to meter readings, warm homes, fire alarm checks and transport. We discussed how isolated older people can be in the community as Rachel described more information and leaflets.

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Carer led Support Groups

Lastly for the Lewisham BAME MH Carers forum. I discussed the importance of carer-led peer support groups. I will be setting up several carer support groups in a few boroughs. Usually the forums are strategic and engagement focused and there is not enough time to hear carer stories. In fact carer support groups are meant to feed into the carer forums for empowerment purposes, but there were only a few carer support groups in the borough and none carer-led, which means there is not much motivation for carers to connect with each other.

I will be setting a BAME and a general MH carer peer support group with the help of Greenwich carers for that borough and I was so glad Greenwich carers engagement and community officer (Natasha) came along and support me at the Lewisham BAME forum.

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This will be the same for Lewisham as we will work closely with the CCGs. The forum talked about how they felt about the Bromley, Lewisham and Greenwich Mind peer support group event that was held on wednesday the 27th over at York Hall in Beckhenham. We are very glad that they are able to fund that startups of the groups, however I pressed that we do not really need the funding, it will be the passion, drive and connection that can help, not to say funding will not be helpful.

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With Lewisham CCG engagement, the forum has been aware of NHS England’s long term plan and we have made it clear they need to involve patients and carers in that plan. The good news is that the NHS England’s long term plan is beginning to take shape and involve us, but no matter what I do, I want to connect with carers and make them aware that the health system is trying hard to involve them. I am not sure about the social care element, but at least with NHS England, there looks to be some very good and exciting projects coming our way.

BAME Carer experiences Research

As promised I promoted a trainee psychologist’s study into African Caribbean experiences of supporting an individual with MH needs in a forensic setting. She contacted me after reading my blogs to see other researchers were engaging with forums about their own research. The researcher feels there is not enough literature or research papers detailing such experiences and Lewisham CCG will follow this up with the trainee Psychologist studying at the University of East London.

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As usual I thank Kelvin (one of the proactive members) for setting up the talk with the pharmacist.  I also thanks Community wellbeing and BLG Mind for hosting the Lewisham BAME forum and thank Greenwich Carers for the support they have given me and look forward to exciting projects ahead.  I would lastly like to thank Lewisham CCG engagement officer (Teressa) and the other CCGs for engaging with the Carer forums and I am very impressed with the plans they are looking to involve us in.

This concludes the update for November and I will be preparing for the groups with the support of Oxleas and Greenwich carers.