Tag Archives: mental health

Joint Southwark & Lambeth MH Carers forum June 2020

Maudsley_Hospital_Main_BuildingWelcome to the month of June joint Southwark and Lambeth MH carers forum.  I usually run this forum at the Maudsley hospital. As a reminder the carer forums are aimed at carers who care for someone with a mental health need. I run around 5 carer groups each month and most of the groups work towards engagement, co-production, involvement, education and querying about mental health and social care services.

The Joint Southwark and Lambeth carers forum runs online due to the corona virus. Carers from either Southwark or Lambeth will need a free application called Zoom either on their computer, laptop or mobile phone to attend the meeting.

For the June meeting we were Joined by Southwark Healthwatch, Lambeth Healthwatch, Lewisham Healthwatch and also Greenwich Healthwatch where they traded ideas about carer projects. We were also joined by the trustees of Southwark Carers, Southwark impatient carer lead and also a carer who is a carer peer supporter. Both SLaM Southwark and Lambeth advisory group carer members attended and we were also jointed by Cllr Jasmine Ali who is Southwark Council’s Cabinet Member for Children, Schools and Adult Care. In attendance was Cllr Danial Adilypour who is the Lambeth Cabinet Member for Health and Social Care and Finally the main speaker to engage with carers is MP Helen Hayes.

Coming off the back of carers week, the forum was interested to hear what Southwark and Lambeth council had been doing for carers in both boroughs. First we heard from Southwark Healthwatch from all the work they have been doing to highlight the situation unpaid carers face in the borough.

Southwark Healthwatch update on carers

Southwark Healthwatch spoke about listening to peoples experiences of health and social care and trying to make change to the wider community. Over the years Southwark Healthwatch spoke about the priority areas and one of them being unpaid carers. In 2019 their project on unpaid carers looked at surveys, focus groups and interviews with carers.

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Results of the project looked at the daily life of carers with themes being on qualitative experiences. The project looked looked at the Impact of caring, which was reported to be very extensive, emotional and intense.

Other findings were

  • Carers felt they were going on beyond the roles of caring – especially on care coordination.
  • It was noted some carers were doing 69 hrs of unpaid care each week.
  • Stress levels, tiredness a strain on carers Mental Health.
  • Financial situation under strain due to multiple levels of care.

Southwark Healthwatch looked at the support carers were getting through social care services, this became an additional challenge for carers due to chasing people on the phone. Bureaucracy led to isolation of carers. Carers reported back that interaction with social workers or GP was not always a positive about the experience. Many felt the levels of service was inconsistent, lacking support and empathy, which led to distrust of council provision.

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Carers did value one off support for benefits applications, carer assessments. Carers also felt activity groups were useful along with respite, but must be flexible. Counselling was hugely important for carers.

Carer members at the forum queried carer counselling services either from Southwark Carers, SLaM or Southwark council.

Southwark HW are going to raise this at Southwark Council’s “Carers Board”, hopefully the forum will get some feedback on this. The forum is worried about funding and accessiblity of counselling since Southwark carers lost their counselling service due to funding.

greenwich healthwatch

Greenwich Healthwatch fed back that on young carers awareness day they visited some schools and wrote a report on the experience of young carers, they felt that young carers are not heard in the borough and will be learning from others on what could be needed.

MP Helen Hayes engagement with forum

Helen gave overview of issues raised from when she the last attend our forum back in November 2019 . Helen updated the forum on how COVID-19 affected both Southwark and Lambeth boroughs. She noted that COVID-19 has shone a spotlight on inequalities in Health and social care. Corona virus has impacted the community’s mental health due to lose of income and difficulties accessing food and medicine. Helen’s email inbox is hitting over 1000 emails a week due to the coronavirus alone

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MP Helen Hayes

She wants to take back views of Mental Health carers back to parliament and spoke how one of Labour’s previous election pledges was on increase of carer allowance. There is also a focus on the need for paid leave for carers, which they will continue to work on.

Helen spoke on how Carers assessments under carers act and how the Care Act a welcome reform, but was not supported by levels of funding. Helen mentioned that she is the Co-Chair of the All Party Parliament Group on Adult Social Care and they were working hard to reduce the fragmentation of the care sector.

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She stressed that both Southwark and Lambeth council have been working very hard to address those needs and although she has been MP for Dulwich and Norwood for 5 years, she felt that MH issues will rise due to the problems corona virus has impacted on the communities.

The forum raised the issue of care homes especially the problem of how COVID impacted them as many carers have loved ones in support housing or care homes.

I also asked Helen about involvement for carers at the highest levels, where Helen phrased the importance of “Nothing about me without me”. She agrees that those who are expert by experience should be involved in policy or carers be allowed to co-design and co-produce.

Update from Cllr Jasmine Ali on Southwark Council commitment to carers

Jasmine thanked Helen Hayes for her support when COVID caused so much distress in the borough of Southwark.

Cllr Jasmine Ali

Cllr Jasmine Ali

Jasmine was not a fan of the work Matt Hancock has done so far, but at least we are slowly getting in a better place. Jasmine noted that adult social care and carers are a big priority in the borough. She reported that there are around 26,000 carers in Soutwark alone, but she was proud of the work that Southwark’s Wellbeing hub, Southwark carers and older peoples hub were doing. Jasmine talked to the forum about Southwark’s future plans and that there will be a strong emphasis on advocacy, guidence and signposting.

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She spoke about the importance of SLaM’s recovery college and how a focus needs to look at increasing the caring relationship between cared for and carer. There are plans to Link carers with Universal services e.g. public health, learning and leisure and the developing work on Southwark’s Carers joint strategy, need assessments and the carers pathway board. She wanted to hear what are issues being raised from the forum.

Jasmine spoke on the importance and need for the Ethical care charter and carers charter, although a lot of work has stopped she fedback that by the end of June things will start up again.

Update from Cllr Danial Adilypour on Lambeth Council’s commitment to carers

Danial agreed with what both speakers raised at the forum and mentioned carers are a very important issue in the borough of Lambeth. There are big pieces of work from the boroughs “carers card” scheme which came out of Lambeth Carers Strategy. First part of the launch was actually off carers week 2020. The Second part of the ‘carers card’ launch will be at the end of the year, where businesses will provide a range of discounts to carers.

Cllr Danial Adilypour

Cllr Danial Adilypour

Daniel gave out stats and showed there are around 20,000 carers in Lambeth. He mentioned that the Lambeth carers card is not the end of what is being offered off Lambeth Carers strategy, there will be more to come.

Currently there is a helpline open during the corona crisis. Lambeth council will work on several strands being.

  • A&E services (the problem of people not accessing services due to MH), but will work with Lambeth’s ‘Living well network alliance’ to increase access to A&E.
  • The problem of Social isolation is another strand Lambeth is going to work on where they will develop a strategy.
  • Lastly Daniel stated that Mental Health will hit Lambeth due to the COVID situation, Lambeth will continue to engage with groups on this topic, especially the MH carers forum.

Carers from the forum were queried Cllr Danial regarding the SLaMs Lambeth hospital consultation. There will be wider plans over the coming years involved with Lambeth carers strategy to engage with forum.

Healthwatch Lambeth Update

The forum was joined by Lambeth’s Healthwatch Natalia Sali​​​​​​ who is their Engagement Manager. She Updated us on the 80 page report of Lambeth Hospital consultation recommendations.

lambeth healthwatch

She reported that over the month carers were fearful of using services. So because of this, Lambeth Healthwatch put on an webinar event where Speakers from Kings college hospital and a GP from a surgery presented what services are available for users.

Consultations are online at least and Lambeth HW will expect changes to face to face appointments, but this depends on virus

Lambeth Healthwatch will continue to speak to carers, older adults and young people regarding experiences in care packages during pandemic. As of this moment Lambeth HW are runing webinar’s every 2 weeks, the latest one on pregnancy, which did interest a member of the forum.

Updates from SLaM and forum carer members

David Meyrick SLaM’s carer inpatient rep fed back on how SLaM’s wards were

  • Allowing visitors back on ward, but visitors need to respect social distancing.
  • Developing a ‘missing in action’ project on female wards.
  • Looking into wards becoming more family friendly during visiting hours.
  • Carers strategy is in a draft.
  • Webinar course at SLaM recovery in July.
  • How the Peer support groups were continuing to run online.

The SLaM carer peer support runs every Wednesday from 6 till 7 online, where the carer peer support updated the forum on how the carers group was getting along.

We also had Updates from Southwark Advisory group members on

  • Producing a video for SLaM website on what Service user involvement does
  • What can be learnt from COVID-19
  • Qualification courses for patients

Updates from Lambeth Advisory group

  • Richie QI peer lead asked the group on what patients expect from services
  • Met with the Head of Lambeth Alliance chair on regarding how their Covid-19 strategy would be developing.

This concludes the update for June.

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.

lewisham hospital A&E

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 BAME MH Carer Forum May 2020

enteranceWelcome to the May update of my Lewisham BAME mental health carers forum. This is one of my 5 carer groups that focuses on the experiences of BAME carers and sometimes BAME groups suffering mental ill health.  I usually run this forum from the Lewisham Branch of Bromley, Lewisham & Greenwich MIND.  Due to CoronaVirus I have moved the forum online via ZOOM.

As a reminder the forum is not a support group, but a way to connect to health providers in the community. The forums focus is of course on mental health services so our local mental health trust (South London and Maudsley) engages with BAME families and carers at the forum.

Continue reading

Beyond Carers Week 2020

smallerHello everyone and fellow carers. Just a quick blog post now that Carers Week has ended. For those who do not know about Carers Week, basically it is an awareness event that looks to raise the awareness of unpaid carers throughout the week of June 8th – 14th.

Carers Week is an annual awareness campaign to celebrate and recognise the vital contribution made by the UK’s 6.5 million carers.

My view on how Carers Week 2020 went

I am not sure if many people or blogs mention views on post events. I felt Carers Week 2020 really raised the bar for Carers week 2021 due to the amount of activities, events and awareness drives from people, charities and organisations. I have been involved in quite a few carer awareness events over that week.

It was great to see so many mental health trusts help promote the awareness of mental health carers. Mental Health can often be portrayed as the hidden illness and due to the theme of Carers Week 2020 “Making Carers visible”, it is so important carers become unhidden.

Mental illness can come with stigma and so caring can also come with its own stigma. Some people caring for someone with a serious mental illness can remain hidden due to shame, guilt or desperately holding on to the family relationships. Many do not know or understand that if they are caring then they ARE carers.

Carers Week gives the chance to tackle carer stigma and more.  Carers need as much awareness as possible.

My Thanks for Carers Week

I would like to thank Carers Week for involving me and giving me a chance to voice my carer’s experience.

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It was great to see my story mentioned in South London and Maudsley’s blog posts.

https://slam.nhs.uk/media/our-blog/carers-week-matthew-s-story/?fbclid=IwAR2ZsJiAElOqRwiLE5LB-agDHL8MyuDsbaop_HelUTKHVQn9LiBR9Rnd1zM

There of course were other carer awareness raising events from other MH NHS trusts I am involved in as I noticed West London’s own carer story also appeared  (shown below).

https://www.westlondon.nhs.uk/news-events/carers-at-the-heart-of-patient-care-anns-story/

With Oxleas,  SWLSTG, CNWL NHS Trust and many others also promoting Carers Week, I hope they continue to support the important work carers do.

I would also like to thank Carers Lambeth Hub for their promotional video on Carers Week shown below

I even did my own video

Lastly I want to thank the charity SANE for helping to promote my views regarding mental health Caring.

Matthew Mckenzie - SANE

Beyond Carers Week

With Carers Week there is always a chance to educate not only health professionals and decision makers, but also the carers themselves. There is no shame in being there for someone, even if the mental illness pushes you away. You would want to be there for the person you care for and not see them continue to suffer.

The state of health and social care now demands carers put in extra to support who they care for, because with the strain on the system it seems the community must take on more. We know health and social care has done so much, but with the lack of nurses entering the profession, lack of social workers, strain on the NHS and the impact of COVID-19 more will be asked of the millions of carers across the UK.

Carers Week is aware of these challenges and those involved will do as much as they can to reduce the strain on Carers. Still we all know that with the end of Carers Week, Carers will continue to rely on charities like Carers Trust and CarersUK and the support of the carer centres and the health and social care system.

I am not asking for much but continued awareness and involvement of families and carers, we deserve to be recognised.

My Carers Pledge

As I move from my role as carer to expert by experience. I will strive to also continue my role running my carer forums and carer support groups aimed at mental health carers.   You can check out my online carer groups below

https://caringmindblog.com/mental-health-events/

I will promote the importance of involving, identifying and engaging with carers of those suffering mental illness and I will work to promote mental health.  My focus will also be on carer peer support, but also advocating for carer empowerment as carers must be given the chance to query systems and policies.

Thanks for reading my blog post.

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.

Continue reading

Southwark MH Carers forum April 2020

matthewWelcome to the April update of the Southwark Mental Health Carers forum. Just a short intro about the forum. The forum is aimed at carers who care for someone with a mental illness. I obviously try to aim the forum at carers based in Southwark, but we often ask for engagement with MH, health services, commissioners and social services.

All my carer forums including carer peer support groups are run via Zoom due to the COVID-19 crisis.

For the April forum we were joined by carers from Lambeth who are interested to hear more about the Lambeth hospital consultation. Members of the forum also wanted to submit queries and questions regarding the hospital move. The forum was also joined by South London & Maudsley’s Quality improvement peer supporter Richard Morton who kindly networked with carers at the forum.

We were also joined by a rep with lived experience from Healthwatch Southwark who have taken a keen interest with the carer forums since the forums are usually designed to engage with health services. Alice has taken over from Bron who engaged with the Southwark carers forum in the past.

The forum also was attended by a representative from PohWER who are one of the largest providers of advocacy services in the UK.  They provide information, advice, support and advocacy to people who experience mental ill health. We also had SLaM’s carer lead for southwark inpatient wards, southwark carer peer  facilitator and advisor and also a trustee from Southwark Carers along with carers from Lambeth and also Southwark.

First we had an update concerning the mental health patient wards in Southwark from the Southwark carer inpatient lead.  It was noted that some wards are being used by patients infected with COVID-19.  No training can be carried out during this phase, but carer peer support groups are running weekly instead of monthly.  I queried about other carer groups running in the community and by Southwark Council.

Emma Crowe the director of the London communications agency along with collegue Matthew spoke to the joint forum about the consultation of Lambeth hospital. Members of the carers forum were taken through a presentation used by the scrtuny committees.

We where shown the following

1. Why Lambeth Hospital has been around a very long time, some of its wards are not sufficient for MH patients and visiting family members.
2. We were given a virtual tour of the proposed hospital site in Southwark.
3. An explanation and discussion of the new Douglas Bennett House
4. The consultation plan and consultation progress along with timeframes

Notable key issues with the Lambeth hospital wards are

  • Current structural design of the buildings are deemed not safe as they should be for treating MH patients.
  • Most bedrooms do not have their own en-suite bathrooms and there are not enough bathroom facilities.
  • Lines of sight for staff looking after patients are rather poor in order to keep service users safe.
  • A poor quality of working environment for staff
  • Out off all the Lambeth hospital wards, only one ward has unsupervised access to an outdoor area and fresh air.
  • The environment at Lambeth Hospital is very cramped for service users and staff.

The Proposed New Facility

I will mention some of the consultation presentation at April’s Southwark Carers forum. Some points of the proposed new facility looked at

consultation

How clinicians, service users and carers from a number of boroughs attended workshops to help shape the design of the Douglas Bennett House facility on the Maudsley Hospital site.

  • The facility would include 72 acute beds for Lambeth patients across four 18 bedded wards.
  • The wards would all be single gender, compliant with modern standards, be light and naturally ventilated with direct, unsupervised, access to outside space.
  • The facility would also include a Psychiatric intensive Care unit and a rehabilitation ward designed to support needs of these services.
  • Two national specialist wards, neuropsychaitry and eating disorders, would be transferred from Bethlem Hospital.

These are obviously just some of the benefits of the proposed facility, although there were plenty of chances for carer members to query about the proposed changes. In regards to the consultation (which runs from March 2020 to 31 May 2020), SLaM have already received a number of responses.

Still the consultation will use a large range of media services to engage with the community from Printed consultation documents, posters, online questionnaires, letter and email to working with partners to distribute information.

The SLaM consultation team were polite and thankful for engaging with the forum and I suspect they will be back later on during the Year.

Next up was Richard Morton who is in SLaM’s quality Improvement role looking to network and engage carers on involvement routes at the Mental Health trust. Richard spoke about the range of committees at the trust some of them mentioned was the family and carer committee and the quality improvement committee along with borough advisory groups.

Even though some involvement groups have been suspended due to the covid-19 situation, others have started to use video conferencing to still engage with Service users and carers.

involvement

The Southwark MH carer forum was taken through the “Inpatient care process model” on how patients are supported by SLaM through their care journey. This was kindly provided to the forum by the Southwark carer lead for inpatient wards.

Richard Morton will be back engaging carers at the forum in the future as he will update on how involvement at the trust is progressing.

This concludes the April update for the Southwark MH Carers forum.

Southwark MH Carers forum February 2020

Southwark MH Carer forum v2Welcome to a quick update from the Southwark Mental Health carers forum. I know I have not been blogging for around a month, but I have recently suffered a bereavement. It has taken a fair bit of energy to do much, but I am quite proud to be able to continue to run the forums even though I have to take time and look after myself.

Given the time I will eventually write more about the current situation, but for now I want to at least update carer members. On the February update of the MH carers forum for Southwark, we are able to get support and engaged with King’s College Hospital NHS Foundation Trust, Guys and St Thomas NHS Trust and South London & Maudsley. For February King’s college hospital Mental Health Lead kindly attended the forum to speak to carers about Kings Mental Health strategy, which is still going through development.

Due to the nature of our forum carers focus on mental health services, although the core interest is how health and social care services engage and involve families and carers. We get a lot of support from the healthwatches and are constantly looking for support from the CCGs, but at the same time families and carers must get the chance to be updated by health providers.

The february Southwark MH carers forum has moved to the Maudsley site for now, although as of the blog, I am running the forum remotely.

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Going back to King’s College NHS Trust, their MH strategy is a Five year strategy for mental health. I felt it so important acute trusts not only focus on physical health, but also include mental health, which will be even more important because once the covid-19 situation moves on, there will be an immense strain on mental health for staff, patients and their families.

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Gavin Smith the MH lead of King’s NHS Trust explained that the strategy should take into account several things

  • Population need: High levels of mental health need, including mental health presentations at the Emergency Departments.
  • Outcomes and experience: People with a mental health condition have poorer health outcomes and experience.
  • Current range of service provision: Areas of excellence, but inconsistency of provision of mental health support across services and sites.
  • System working: Strong relationships with SLaM and Oxleas and KHP Mind & Body programme; opportunity for improved relationships with primary, community and voluntary sector.
  • Training and development: Distinct training programmes mean few staff have skills across mental and physical health; some bespoke training exists for staff and mental health training is available via KHP Mind & Body
  • Governance: Mental Health Board and Mental Health Lead post established but intermediate structures around mental health are inconsistent.

Out of these areas mentioned, the system working and governance stands out as important not only to the Southwark MH carer forum, but to all the other forums. It was expained to carer members that the accute trusts will co-produce many things with involved carer champions.

The forum was then presented with an update on how far Kings NHS Trust have been working with these outcomes.

Next we were presented with why mental health is important to the health sector

  • Mental health has an impact on people’s physical health, wellbeing and outcomes.
  • 30% of people with long-term physical health conditions also have a mental illness
  • Shockingly 15-20 years shorter life expectancy for someone with a severe mental illness or learning disability
  • It does not help that patients with mental health needs have a poorer experience of care due to stigma
  • There can be a lack of confidence and awareness of staff regarding mental health
  • It does not stop there as 8 Billion a year is spent by the NHS treating the effect of poor mental health on physical illnesses.

As you can see Kings NHS Trust has a clear interest into tackling mental health with what was raised to the forum. Of course more was mentioned in the presentation, but by focusing on meeting Kings NHS Trust patients’ mental and physical health needs, they will :-

  • Respond to the population needs and system priorities.
  • Improve access, outcomes, experience and safety.
  • improve the sustainability of their services

As presented at the Southwark MH carers forum, King’s operates within a complex landscape of mental health services in South London.

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Members of the forum were taken through a whirlwind tour of King’s services and how they seek to improve mental health provision on those services including

  • KCH services regarding SLaM and Oxleas.
  • Local Emergency and s136 services
  • Key acute and hospital-based services
  • Other specialist teams including – Drugs and Alcohol, Adolescent At-risk and Forensic Service (AAFS) and Forensic Services provide by SLaM.
  • Community services
  • Primary care – Being General practice and Improving Access to Psychological Therapies (IAPT)
  • Voluntary and social care
  • Self-help – being IMPARTS resources, COMPASS (in Southwark), Wellbeing Hub & online Mycommunity Directory

It is important King’s engage with their staff on producing these outcomes, as they must engage with Core delivery partners and external stakeholders. King’s have engaged with the following of their staff.

  • Acute and emergency care
  • Gerontology/frailty
  • Liver specialist
  • Maternity – Took up a good discussion at the forum
  • Neurosciences – will be interested on their response
  • Paediatrics
  • Rheumatology
  • Corporate Nursing
  • Divisional Management Teams
  • Patient Outcomes
  • Public and Patient Engagement – should include families and carers
  • Research and Innovation
  • Workforce
  • Princess Royal University Hospital Transformation team
  • Strategy
  • Online survey to all KCH staff

Member of the Southwark MH carers forum were then presented with how King’s have explored areas of good practice and areas for improvement. Then we were presented with the strategic aim being that to continue to build on good practice, they will focus on their priority areas, and ensure the will consistently meet their patients’ mental and physical health needs. However King’s are well aware that their priorities must align with system priorities.

Kings have developed three priorities being

  • KHP Mind & Body priorities
  • NHS Long Term Plan priorities
  • SEL STP priorities

There are challenges to these aims being

  • The highest proportion of patients with a mental health condition recorded as primary at King’s is in A&E (27%).
  • The Emergency Department (ED) is frequently the default, but often an adverse, environment for people in crisis. Patients frequently spend over 12 hours in ED waiting for a mental health inpatient bed – the majority of our 12 hour breaches are for patients with a mental health condition.
  • There is a lack of mental health inpatient beds across South London, particularly CAMHS beds.
  • Patient feedback highlights positive experiences, as well as challenges including instances of stigma and lack of awareness, lack of confidence in adequately signposting or supporting patients with mental health needs, and long waits in a busy environment.

Nevertheless the forum was presented with how King’s will meet those challenges.

I am thankful for King’s engagement with carer members of the forum all of the members are more than happy to see how the MH strategy works out. A further update of the Soutwark Mental Health carer forum is we were presented with South London & maudsley’s involvement register into improving services and a way for the forum to engage with SLaM staff on familiy and carer engagment at the trust.

The forum seeks to work with SLaM’s family and carer committee when issues arise, although due to covid-19 SLaM’s involvement is on hold, but engagement will still continue with use of technology. For the March Southwark MH carers forum Guys & St Thomas NHS Trust presented their mental Health strategy.

I am as of present continuing to run 3 carer forums remotely and run the Greenwich carer peer support group remotely. This concludes the update for the Southwark MH carers forum with thanks to Kings NHS trust and SLaM.

Lewisham BAME MH Carer Forum February 2020

IMG_20200228_095949Welcome 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.

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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.

Lambeth MH Carers Forum update January 2020

20140710_143445Welcome to my first forum update for the new year. The first forum is the Lambeth Mental Health carer forum, which took place over at Brixton 336 on the 23rd of January 2020. The Lambeth carers forum exists to give unpaid carers a chance to know what Health and Social services are doing for them and also what those services have planned.

Lambeth has some of the highest rates of mental health problems in the country and perhaps even further, it is important carers come together and ask why this is the case and what are the authorities doing about it. As you might already know, South London & Maudsley NHS Foundation Trust cover the mental health services in Lambeth and also in Lewisham, Croydon and Southwark, so he forum seeks to engage with the Mental Health Trust over the coming year.

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More importantly, there are other NHS trusts serving the community in Lambeth and we had the opportunity to have Guy’s and St Thomas NHS trust Mental Health lead engage with the forum, more on this later.

The January forum was very well attended and word is spreading about the importance of the Lambeth MH carers forum, with the help of Lambeth Carers hub, unfortunately the forum took place at the same time of the SLaM carers committee, so some members had to send apologies.

At the start of the forum, we took time to go through the minutes of the last forum which was held over at Moasic Clubhouse. The forum was attended by Helen Hayes Labour candidate for Dulwich and West Norwood and also Lambeth Healthwatch who are seeking consultation from Carers on the future of Lambeth Hospital. There was a lot of discussion from the updates from the last forum.

Next we had a presentation from Caroline Sweeney who is the Mental Health Lead for Guys & St Thomas NHS Trust. You might not already know, but Acute NHS Trusts tend to develop, renew or plan mental health strategies, however both Kings NHS trust, SLaM NHS Trust and Guys & St Thomas NHS trust are working on their Carer’s Strategies as well. If you are a carer or are lucky enough to attend a carers forum, certainly inquire if your hospital trust is working on either or both policies and strategies, especially carer engagement/involvement policies.

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For the Lambeth MH carer forum, Caroline updated us on G&STT Mental Health strategy. The strategy was not developed in isolation as the trust held six workshops in the past via the hospital and its community sites.

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Their external workshop had a range of stakeholders including Service Users and carers, London Ambulance service other MH Trusts, CCG’s, Black Thrive, Oasis and Papyrus (youth suicide prevention), Lambeth Alliance and more.

Their Strategy contained many important sections being

Developments and Good Practice.
Linking to National Drivers.
Objectives of the Strategy.
Overview on Patients, People and Partnerships.

There were more, but due to limited time, we could only cover a few areas off the presentation.

GSTT Developments and Good Practice

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The plans and targets for GSTT are

  • Improving partnership working with South London and Maudsley NHS Trust
  • Delivery of training across in-patient and community services
  • Development of improved assessment processes for district nursing
  • Improve experience of patients who receive Enhanced care
  • Development of primary care hub for adolescents
  • Implementation of the Children and Young People Healthy Partnership (CYPHP), probably due to GSTT children’s hospital (Evelina London Children’s Hospital).
  • Mind & Body and IMPARTS service
  • GSTT psychology service

Linking to National Drivers

  • GSTT Long term plan is to
  • Increase Mental Health Liaison capacity e.g. specialised MH nurses in Accute wards
  • Equipping Ambulance staff to deal with MH crisis
  • Importance of improving child and adolescent MH care
  • Commitment to reducing National Suicide rates (Zero Suicide national driver).

Other drivers

GSTT also have internal drivers mentioned in their MH Strategy.

  • These drivers were from audits and reports about Liaison teams and children services experiencing an increase in referrals, this was especially noted in A&E departments and long waiting times for those experiencing MH crisis are not helping.

GSTT Mental Health Strategy Vision and Objectives

A MH Strategy would not be much without its Vision and Objectives.

  • GSTT seeks to improve quality of care that it delivers to Patients, carers and families living with serious mental illness.
  • GSTT also seeks to support patients with long term physical health conditions and manage their MH needs
  • GSTT seeks to ensure their workforce has the right skills, knowledge and attributes to care for patients, their carers and families dealing with MH needs.

There were other things discussed in regards to GSTT MH Strategy, that due to time I have not mentioned in this blog post.

GSTT and carers

  • We did not have GSTT carers engagement on their carers strategy, but Caroline did cover some part of that stategy, that being the introduction of Carers Passport to identify carers.
  • Use of Carer network study days
  • Dementia specific Carer days (which is still under development).
  • Continued work on Alzheimer’s society and Dementia UK.
  • There is more in the pipeline regarding how GSTT engages with Families and carers, but the above is a start.

The rest of the forum was discussing on the rota for chairing the meeting and future attendees for the Lambeth MH carers forum. Many hope for the Helen can update the forum regarding carers later on in the year and for other MPs to engage with the group. Other members want engagement from Lambeth leads who run social services.

This concludes the update from the Lambeth MH Carers forum for January.