Welcome 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.
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.
Welcome to the February update of the Lewisham BAME Mental Health carers forum. The forum is aimed at black Afo-Caribbean, Asian and other minorities carers in the borough of Lewisham, however I am happy for other carers in surrounding boroughs to attend. The forum is run from Bromley, Lewisham and Greenwich Mind centre under the arm of Community Wellbeing.
The forum is more educational and allows carers to discuss with mental health service providers any queries about services. A high majority of the BAME community use mental health services and some of the issues are specific regarding race, culture and even language. The issues are complex and deep, but discussions, forming relationships, education and working together is the way forward.
Welcome to the January update of the Lewisham BAME Mental Health Carer forum. This is one of the 4 carer forums I use to help engagement between unpaid carers and mental health or even health services. I feel if patients and their families are at the heart of health services, then there should be some form of engagement, involvement and influence. The forum is run from one of the Bromley, Lewisham and Greenwich MIND offices with support from Community wellbeing.
Hello 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Welcome 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.
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.
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.
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.
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.
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.
The next Lewisham MH Carers forum will be in January for the new year.
Welcome 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.
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.
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.
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.
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.
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
Welcome to another update from an unpaid carer who is involved in their local mental health trust and communities. I often try and engage with communities as much as possible, be it through running carer strategy groups, giving my views and engaging with events.
For the August Lewisham BAME Mental Health Carers forum, we focused on Patient Participation Groups and also updates from the South London and Maudsley Inpatient Social worker over at Lewisham hospital.
The Lewisham Black Asian Minority Ethnic Carers group is one of the 4 groups that not only focuses on carers, but makes a distinction on their background, culture and ethnicity.
BAME groups are more likely to experience stigma and distress due to cultural interpretations and systems set up or designed that does not take into account BAME communities. Lewisham is certainly one of the most diverse London boroughs around so it really helps that communities get together to discuss and educate each other on issues regarding health.
The Lewisham BAME carers forums also accommodates those using services, but there still needs to be a drive to engage with more BAME carers who are very uncertain of their role and perhaps lack peer support and identity.
The carers forum runs from Lewisham, Bromley and Greenwich Mind under the Community Wellbeing umbrella.
Lewisham Community Wellbeing is delivered in partnership with several other local charities and public sector organisations. We have been very lucky to get the support of Mind who probably have a lot on as it is and there will be some very exciting community projects coming up soon.
We have around 45 to 50 doctor’s practices in Lewisham and I was fortunate enough to have the chair of one of the largest doctors practice in Lewisham. Alexandra Camies does an immense amount of work engaging with patients for the doctors practice she helps with. The doctors surgery is also a member of the National Association Of Patient Participation or N.A.P.P. I have always said to carers and patients that doctors are usually the gatekeeper to services, if you feel your doctors practice could do more for you or the community, perhaps look into how their Patient Participation group works.
So what is a PPG anyway? What do they do?
- PPGs offer patients an opportunity to be involved with and support their local General Practice. For the South Lewisham Health Centre. Here are some of the following things that PPG involves.
- Patients wishing to join must, in order to comply with General Data Protection Regulation (GDPR), complete an application form.
- They currently have a committee of 8 patients, including aChair and Secretary.Committee members are provided with written details of their roles, responsibilities and key relationships.
- They have the assistance of the surgery Patient Liaison Officer, who attends each meeting and provides us with any help needed at the surgery.
- They have a GP representative (usually a partner), and the Patient Services Manager that attends the meeting.
- All members are invited to general meeting, held quarterly, and asked if they have any agenda items to put forward for discussion.
- Members that are unable to attend are able to have a virtual input via email. Virtual members are sent copies of the minutes, which are also placed on the practice web site for all to view.
- Committee members take on a little more responsibility at the South Lewisham PPG, taking a part in organising events or projects, or helping with various admin tasks. Committee meetings take place as and when needed.
- Members may be being asked to help out for such things as events.
Take note not all doctor’s surgeries are alike. Some do not have the resources to have a PPG, but it does not stop patients from helping set one up. I explained to the forum that your doctors surgery is only as good as the community that cares for it and uses it.
How can a success for Patient participation group operate?
- The PPG should try monitor progress against objectives
- Publicise their successes
- Involve people and not that would mean patients, especially those whose voice is not often heard.
- Learn from other groups, usually other PPGs hence the PPG Network.
- Build on and work with their network of health and wellbeing groups and organisations.
- Expand activity where possible
- Make sure to review our objectives regularly
There are only a very small part of what a PPG doctors surgery should work towards. Alex gave the group an excellent presentation and we both learnt and picked up ideas from each other. I reminded the group that they could start their own projects and inquire about their local doctors patient participation group.
If you want more information about South Lewisham GP Practice, check out their website below.
Next up was Errol Chambers who is the social work for the Lewisham Hospital Ladywell unit. It was great that SLaM engages with the BAME forum, because I have always stressed the the forum represents empowerment when we form as a group. If SLaM staff recognise this, then they can support us, although we try hard not to be antagonistic. Errol gave us a choice on what information the group would want be it on benefits or on how the Ladywell unit is operating currently. The group wanted updates on the ladywell unit and we discussed changes and progress regarding patients experience of the mental health unit.
Lewisham CCG was mentioned quite a lot as they invest in the services and are keen to see if the hospital is working to the best of its abilities. Many members pressed for a relationship with the units, but also felt that staff development must be key as a good quality service. This is mainly down to how staff engage with patients and their carers.
At the end of the forum, I updated on the planning meeting for Lewisham CCG’s stakeholder event and also for Lewisham’s Carers conference requested by my MP Janet Daby who is a carer herself. I also pointed out that the Lewisham HR lead will be at the BAME forum for September. I have asked we are updated on the following.
BME staff engagement – What else is happening to engage with BAME community.
Plus small updates on the following.
- SLaM’s Health and well-being strategy
- SLaM’s Talent management programme
- The South London Partnership collaboration (South west london & St georges, South London & Maudsley and Oxleas NHS Trust)
Plus an update on whats been done for staff to tackle.
- Equal opportunity for career progression
- Bullying & harassment
- Flexible working
I guess as a carer, I do not ask for much. Still, I mentioned to the group…knowledge is power.
That is the August update for the Lewisham BAME MH carers forum.
Welcome to the latest update of the Lewisham BME MH carer/SU forum for august. This is the first time that the forum took place in the evening, so to allow other carer members Who cannot always attends during friday morning.
For the August forum, we hoped to have the Mental Health Act officer attend and give a presentation regarding the Mental Health Act and how south London and Maudsley were going to adapt to the latest changes to the mental Health Act. Unfortunately he could not make it, so we decided to discuss south London and Maudsley carer strategy.
Hello 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.