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National Ethnic mental health Carer Forum : March Update 2026

Chaired by Matthew McKenzie – Carer Activist

The March session of the National Ethnic Mental Health Carer Forum brought together carers, researchers, NHS professionals and community organisations for a conversation that felt both familiar and urgent.

Chaired by Matthew McKenzie, the forum stayed rooted in what it does best: creating a national grassroots space where lived experience meets systems, and where difficult truths are not avoided.

The agenda reflected that balance clearly:

10:35 – Professor Saffron Karlsen (University of Bristol)
11:20 – King’s College London (Phoebe Averill & team)
11:50 – Parliamentary and Health Service Ombudsman
12:00 – Thomas Ince – Universal Care Plan

Racism and Mental Health: Naming What We Already Know

Professor Saffron Karlsen opened the forum with a presentation that didn’t just describe inequality it explained how it is produced, sustained, and experienced in everyday life.

Drawing on over 30 years of research, Professor Saffron Karlsen is a sociologist at the University of Bristol whose research examines how racism and social inequality affect health, particularly within ethnic minority communities.

she spoke about racism not as a single act or incident, but as something woven into the fabric of society. It operates quietly and persistently, through institutions, through policies, through media narratives, and through the ways people interact with one another. The effect is cumulative. It builds over time, shaping not just opportunities, but health itself.

What made the presentation particularly powerful was how it connected these structural ideas to real human consequences. Racism was described as something that works on multiple levels at once: from overt abuse or violence, to the less visible but equally damaging experience of simply knowing that you live in a society where you may be treated unfairly. That awareness alone carrying the expectation of discrimination creates a constant undercurrent of stress and anxiety.

She explained how this stress doesn’t just sit in the mind. It translates into physical outcomes. People exposed to racism are more likely to experience anxiety, depression, and long-term distress, but also physical health inequalities such as cardiovascular disease. These outcomes are often misunderstood or misrepresented. Too frequently, they are explained away as lifestyle issues diet, exercise, personal choice without recognising the deeper social conditions that shape those behaviours in the first place.

A particularly striking part of the presentation focused on how people respond to these pressures. When individuals feel powerless to change their circumstances, they may turn to coping mechanisms smoking, drinking, or withdrawing from services. These responses are then judged in isolation, rather than understood as part of a wider context. In this way, the system not only fails to address the root causes but can end up reinforcing blame on the individual.

Perhaps the most important insight came when the discussion turned to healthcare itself. Even when services are available, they are not always experienced as safe or trustworthy. Saffron shared research showing that people may avoid seeking help not necessarily because of direct negative experiences, but because of what they have seen and heard about racism more broadly. The perception of risk becomes enough to keep people away.

One example described a woman who, during the COVID period, chose to avoid hospital care entirely. Her decision was shaped by what she had seen in public discourse and online reactions to racial justice movements. It left her feeling that she could not trust how she would be treated. This kind of anticipatory fear of not being treated with dignity or fairness adds another layer of stress to an already difficult situation.

The presentation also challenged the way healthcare systems understand illness. Many services still operate within a narrow biomedical framework, focusing on symptoms and diagnoses while overlooking the social realities that contribute to them. For people from marginalised communities, this can lead to experiences where their perspectives are dismissed or misunderstood. They may try to explain how racism, housing, poverty, or life circumstances have shaped their health, only to find those explanations sidelined.

This is where the concept of “epistemic injustice” becomes important, although Saffron didn’t dwell on jargon, the meaning was clear. It is about whose knowledge counts. When patients and carers are not listened to, or when their experiences are not taken seriously, care becomes something done to them, rather than with them. For many, this is not just frustrating it is re-traumatising.

Professor Saffron also showed a video – Nilaari delivering hope A community mental health provider for people of colour, which you can watch below.

Nilaari delivering hope

Q&A Section : From Evidence to Frustration

1. “You’ve explained the problems, but what are the solutions?”

Answer:
Saffron acknowledged that addressing racism at its root is complex and long-term, but highlighted practical steps:

Services must be co-produced with people who have lived experience
Communities need to be actively involved in decision-making spaces
Grassroots and voluntary organisations should be:
- properly funded
- meaningfully included in policy and service design

She emphasised that change should be done with communities, not to them, and that learning from effective third-sector approaches is key.

2. “Do you look at drug and alcohol use as part of racism-related issues?”

Answer:
Yes, but not in the way systems often frame it.

Saffron explained that:

Substance use is often a response to difficult life experiences, including racism and poverty
Systems tend to treat it as an individual problem, rather than understanding the wider causes
These behaviours can reflect a lack of:
- support
- options
- alternative coping mechanisms

She stressed the importance of shifting away from blame and towards understanding context.

3. “Is trauma-informed care part of the solution?”

Answer:
Trauma-informed care is important, but not sufficient on its own.

Saffron highlighted that:

Current models of trauma-informed care can be too narrow
They often fail to fully account for:
- systemic racism
- structural inequalities
Services also need to recognise that they themselves can contribute to trauma

She suggested that trauma-informed approaches must be:

culturally sensitive
shaped by different communities’ understandings of trauma

4. “What do you mean by ‘racism is a virus’?”

Answer:
Saffron used this idea as a metaphor.

She explained that:

Racism spreads and reproduces across society, much like a virus
It moves through:
- institutions
- policies
- social interactions
It grows and reinforces itself over time

At the same time, she used this idea to challenge overly individualised thinking—highlighting that racism is structural, not just personal.

King’s College London: When Crisis Care Comes Too Late presented by Phoebe Averill.

After the earlier discussion on racism and inequality, the presentation from King’s College London brought the conversation into something more immediate what actually happens when someone reaches crisis point and needs urgent mental health support.

Phoebe Averill and her team focused on pathways under the Mental Health Act, but what emerged wasn’t a technical discussion. It was a picture of a system that often struggles at the exact moment it is supposed to respond.

They began by looking at the period just before crisis. In many cases, there are early warning signs. Carers and families notice changes subtle at first, then more obvious. They often try to raise concerns early, hoping intervention might prevent things from escalating. But too often, those early signals are not acted on.

By the time the system responds, the situation has already deteriorated.

The research highlighted that delays are not caused by a single issue, but by a combination of pressures within the system. These include:

shortages in hospital beds
fragmented coordination between services
breakdowns in communication across teams

While these explanations are familiar, the impact of them feels anything but routine. During the waiting period, people do not remain stable. They become more unwell, more distressed, and more at risk. What could have been addressed earlier becomes a crisis that is harder to manage.

One of the most striking parts of the presentation was the focus on what happens in that gap between “something is wrong” and “help arrives.” That space is where much of the pressure shifts onto carers.

Carers described being left to manage situations that are escalating in real time. They are expected to keep someone safe, to monitor behaviour, and to absorb the emotional weight of what is happening all while waiting for services to respond. In some cases, this can last days or even weeks.

This isn’t a formal role, and it’s not one carers are prepared for. It’s something they step into because there is no alternative.

The consequences of these delays don’t end when care finally arrives. By that point, the impact can already be significant. The research pointed to outcomes such as:

worsening mental health leading to longer hospital stays
increased risk of avoidable harm during the waiting period
disruption to housing, employment, and relationships

In other words, the delay itself becomes part of the problem, shaping what happens next.

Another important thread running through the presentation was the role of carers’ knowledge. Carers are often the first to recognise when something is changing. They understand patterns, triggers, and early warning signs in a way that professionals may not see immediately. Yet this insight is not always taken seriously or acted upon.

The result is a system that tends to respond late rather than early intervening at crisis point, rather than preventing it.

The KCL team were clear that their research is trying to address this gap. They spoke about building a lived experience advisory group and involving carers and service users directly in shaping the work. There was a clear intention to move beyond observation and towards something more collaborative, where lived experience informs how the research develops.

At the same time, there was a quiet recognition in the room that much of this is not new. Similar issues have been raised repeatedly over the years. The difference here was not the discovery of the problem, but the clarity of where it sits in that critical moment where response is needed, and the system is slow to act.

Placed alongside the earlier discussion on racism, this presentation added another layer of understanding. It showed how broader inequalities are not abstract—they play out in very real ways at the point of crisis. Where trust is already fragile, delays make it harder to engage. Where carers are already stretched, the system’s response can increase that pressure rather than relieve it.

By the end of the session, one idea stood out clearly: this is not just about whether care is available. It is about whether it comes at the right time, whether the right people are listened to, and whether the system is able to act before situations reach breaking point.

Parliamentary and Health Service Ombudsman: When Accountability Feels Out of Reach

The next presentation of the forum came from the Parliamentary and Health Service Ombudsman team, who joined to explain how carers and families can raise concerns when NHS care goes wrong.

On the surface, this was a session about process how complaints move through the system and when the Ombudsman becomes involved. But as the discussion unfolded, it became clear that this was really about something deeper: whether accountability is genuinely accessible to carers in practice.

The team described their role as an independent body that steps in once local complaints processes have been completed. In theory, the pathway is clear. Before approaching the Ombudsman, people are expected to go through several stages:

raise concerns with the service directly
receive a formal response, often referred to as the “final response letter”
only then escalate the complaint for independent review

What sounds straightforward on paper quickly became more complex when viewed through lived experience.

Carers shared how difficult it can be to even reach that final stage. The process can take months, sometimes longer, and often requires sustained effort just to keep it moving. Following up, chasing responses, and navigating unclear communication becomes part of the experience.

One comment in the chat captured this reality clearly:

“It can be hard to get to the point of getting a final outcome letter… the amount of advocacy and chasing that needs to happen…”

Another highlighted how far removed the process can feel from everyday awareness:

“It takes far more than 12 months to even come into awareness…”

In response, the Ombudsman team acknowledged that delays particularly at the final response stage are common. They explained that in some cases, where delays are extreme, they may contact organisations directly, and they encouraged people to use their helpline for guidance when processes stall.

But even with that support, there was a sense in the room that the system places a significant burden on those trying to access it. By the time someone considers making a complaint, they are often already dealing with the aftermath of a difficult experience. Adding a lengthy and sometimes frustrating process on top of that can feel overwhelming.

The conversation also turned to accessibility. Questions were raised about language, digital access, and the assumptions built into how information is shared. Not everyone engages with systems in the same way, and not everyone finds it easy to navigate written guidance or formal processes.

Participants pointed out that some communities may never reach the complaints stage at all—not because issues don’t exist, but because the pathway itself is difficult to access.

This was reflected in a simple but powerful comment:

“We are assuming that everyone reads…”

There were also wider reflections about how systems could better meet people where they are, including:

making information available in more accessible formats and languages
reaching people through community networks, not just formal channels

Even within this practical discussion, the themes from earlier in the forum remained present. Trust, accessibility, and lived experience all shaped how people understood the complaints process.

Placed alongside the earlier presentations, this session added an important dimension. If the system fails as described in the discussions on racism and crisis care—then the ability to challenge that failure becomes critical. But if the route to accountability is difficult to navigate, many experiences may never be formally recognised.

What emerged was not a rejection of the Ombudsman’s role, but a recognition of the gap between what exists and what is accessible.

Because accountability is not just about having a process in place.
It is about whether people can realistically use it especially at a time when they may already be stretched, exhausted, and navigating multiple pressures.

Universal Care Plan and Carer Contingency Planning: A System Trying to Catch Up

The final contribution to the forum came from Thomas Ince, introducing the Universal Care Plan often referred to as UCP. After the earlier discussions on racism, crisis care, and accountability, this felt like a shift towards something more practical: what the system is trying to build in response to the gaps carers have been describing.

At its core, the Universal Care Plan is a digital tool designed to allow people to record and share information about their care. It sits within the NHS App and is intended to bring together health, social care, and voluntary services around a shared understanding of a person’s needs and preferences.

Thomas described how the system has evolved over time. It began with a focus on end-of-life care, making sure that a person’s wishes could be accessed quickly by professionals such as ambulance crews. It then expanded into areas like sickle cell crisis planning and is now being extended further to cover a wider range of conditions and situations.

The direction of travel is clear: moving from a professionally controlled system towards something more person-owned, where individuals can enter their own information and shape how their care is understood.

A Tool That Centres “What Matters to You”

One of the key features Thomas highlighted was a section within the plan that allows people to describe themselves in their own words. Rather than being defined only by diagnosis or clinical notes, individuals can record what matters to them information that can then be seen by anyone involved in their care.

In principle, this is a shift towards more personalised and human-centred care. It offers a way to capture context, preferences, and lived experience in a system that often reduces people to categories.

But for this forum, the most significant element was something more specific.

The Carer Contingency Plan

Thomas introduced a feature that immediately resonated with the group: the carer contingency plan.

This allows carers to record what should happen if they are suddenly unable to provide care. For example:

if they become unwell or need urgent medical attention
if there is a sudden change in their circumstances

In those situations, the system can alert professionals to the fact that someone is dependent on that carer and provide information about what support is needed.

For many carers, this addressed a very real and often unspoken concern:
what happens to the person they care for if something happens to them?

The idea that this information could be visible across services—rather than held informally or not at all felt like a meaningful step.

From Concept to Reality: The Challenge of Engagement

While the tool itself was broadly welcomed, the discussion quickly moved beyond what it does to how it will actually be used.

Thomas was open about the current stage of development. Although the system is available, it remains largely driven by professionals, with limited public awareness. One of the key aims now is to shift towards wider engagement encouraging people to take ownership of their care plans and input their own information.

This raised an important question in the room: how do you introduce a digital solution into communities where trust in services is already fragile?

Participants pointed out that many people particularly from ethnic minority backgrounds—do not engage easily with primary care systems. If the entry point to the Universal Care Plan is through those same systems, there is a risk that the people who could benefit most may not use it at all.

Suggestions began to emerge organically from the group, reflecting a more community-led approach:

working through carer centres, peer groups, and local networks
engaging cultural organisations and community leaders
using spaces where trust already exists, rather than relying solely on formal channels

There was a clear sense that communication could not be an afterthought. It needed to be built into the design of how the tool is introduced.

Language and Accessibility: A Tension Exposed

One of the most striking moments in this section came when language accessibility was discussed.

At present, the NHS App and therefore the Universal Care Plan is only available in English (and Welsh). Thomas acknowledged that this is a limitation and that while there are conversations about future solutions, no immediate changes are in place.

This prompted a strong reaction from participants. There was frustration that a tool described as “universal” could exclude large sections of the population from the outset. For some, this was not just a technical issue but a reflection of a wider pattern—systems being designed without fully considering the diversity of the communities they serve.

It brought the discussion back to a familiar theme from earlier in the forum:
inclusion cannot be added later, it has to be built in from the beginning.

A Step Forward With Conditions

Despite these concerns, there was recognition that the Universal Care Plan has real potential.

The idea of having:

shared, accessible information across services
visibility of carers and their responsibilities
a contingency plan that reduces risk in emergencies

addresses issues that carers have been raising for years.

But the conversation made it clear that the success of the tool will depend on more than its functionality. It will depend on whether people:

know about it
trust it
can access it
and feel that it reflects their needs and realities

Without that, there is a risk that it becomes another well-intentioned solution that doesn’t reach the people it was designed for.

Placing It in the Wider Conversation

Coming at the end of the forum, this presentation connected in an important way to everything that had been discussed earlier.

Where Saffron’s presentation explored the structural roots of inequality, and the KCL research showed how system delays affect people in crisis, the Universal Care Plan represented an attempt however early to respond to those issues in practice.

But it also revealed the ongoing challenge.

Because even when new tools are introduced, they are still shaped by the same system dynamics:
questions of trust, access, communication, and inclusion do not disappear they simply take new forms.

Hospital Carer Discharge Meeting – November Update 2025

Chaired by: Matthew McKenzie – Lived Experience Carer

Welcome to the November 2025 update of the Hosptial Carer discharge group. The Hospital Carer Discharge Group is a collaborative network chaired by lived-experience carer Matthew McKenzie, bringing together unpaid carers, carer-centre teams, hospital staff and local authority representatives to improve how carers are identified, supported and involved throughout a patient’s hospital journey.

The group provides a space to share updates from hospitals and carers’ organisations, highlight challenges in discharge processes, strengthen links between community and acute services, and promote consistent carer-focused practices such as using the Carers Hospital Discharge Toolkit, developing standard operating procedures, and raising staff awareness.

The November meeting focused updates from the South East London Carer Standard Operating Procedure pilot, improving carer identification, strengthening links between community and hospital services, and practical challenges in engaging hospital teams.

For those who don’t know, In the context of the Hospital Carer Discharge an SOP is a step-by-step, structured process that hospital staff follow to ensure unpaid carers are identified, informed, supported and included consistently during a patient’s hospital stay and discharge.

It usually outlines:

How to record, communicate and follow up on carer involvement
Who is responsible at each stage (nurses, discharge teams, carer services)
What actions must be taken (e.g., asking about caring roles, sharing information, making referrals)
When these actions should happen (admission, treatment phase, discharge planning)

Who Attended

The session was well attended by a mix of carers, hospital representatives, and carer-centre staff, including:

Carer representatives

Matthew McKenzie – Chair; lived experience mental health carer; Carers UK, Carers Trust & NHS England Citizens Advisory Group volunteer.
Caroline – Lewisham carer, Healthwatch Lewisham member & Patient Experience Committee representative.
Various peer supporters, carers involved in local networks and PPGs.

Carer support organisations

Carers Hub Lambeth
Tower Hamlets Carer Centre
Wandsworth Carer Centre
North Central London Carers Support Project

Apologies

Sutton Carers Centre
Richmond Carers Centre
Greenwich Carers Centre
Harrow Carers Centre
Bromley Well
IMAGO – Lewisham carers Centre
Bexley Carers Support
Involve Kent

Hospitals & NHS staff

Queen Elizabeth Hospital (Lewisham & Greenwich NHS Trust)
Public Service Consultants (PSC)
Bromley, Lambeth, Lewisham, Greenwich council leads (mentioned in discussion)
St George’s Hospital (GESH) – references to staff

Meeting Overview

The growing importance of carer involvement in hospitals, especially with mental health pressures and changes to the Mental Health Act.
The group’s purpose: sharing updates, strengthening links between carers and hospitals, and improving the implementation of the Carers Hospital Discharge Toolkit.

Key Presentation – Update on the South East London Carer SOP Pilot

Speaker: Public Service Consultants (PSC)

The major portion of the meeting focused on the pilot testing of a new 11-step Standard Operating Procedure for identifying and supporting unpaid carers across hospitals in South East London.

🔹 Hospitals involved in the SOP pilot

King’s College Hospital – Acute Medicine ward
University Hospital Lewisham – Hawthorne (older patients) and Alder (specialty medicine) wards
Princess Royal University Hospital (Bromley) – Frailty Unit via Transfer of Care Hub

🔹 Key outcomes

King’s College Hospital saw the strongest progress.
- Nurses proactively engaged unpaid carers.
- All leaflets and materials were distributed within weeks.
- Carer details (with consent) were passed to Lambeth Carers Hub.
- Nursing staff requested feedback loops to see the impact of referrals.
Lewisham Hospital
- Progress slower initially; improved after site visits.
- Ward managers highly supportive and embedding SOP practices.
- Lewisham Council exploring funding for an in-hospital carers support team.
Princess Royal (Bromley)
- SOP and leaflets now shared with the frailty unit.
- Council to continue taking work forward.

🔹 Overall reflections

Hospitals still experience heavy winter pressures and staff capacity issues.
Engagement differs widely between NHS trusts.
Many ward teams had never seen the London Carers Toolkit, indicating a need for simplification.
Councils intend to continue cross-borough meetings after PSC’s involvement ends.

Issues & Discussion Points

1. Gaps in consistency across hospital sites

Queen Elizabeth Hospital (QEH) had not been part of the pilot, they have requested to be included
Staff expressed interest in adopting SOP materials and joining future rollout.

2. Carer diversity and training needs

Caroline highlighted the need for:

Training reflecting different care needs: LD, dementia, mental health, elderly carers.
Cultural diversity considerations in how carers interact with hospital teams.
Better alignment with Lewisham & Greenwich’s Compassion in Care programme.

3. Current SOP scope limitations

SOP starts at the ward stage, but carers need involvement pre-admission and post-discharge.
Best practice from NICE and the national toolkit emphasises whole-journey support.

4. Hospital culture & resistance

Carer-centre staff described feeling:

Like a “hindrance” in MDT or discharge meetings
Sometimes unwelcome or blocked from engaging on wards
Fighting clinical priorities vs. carer rights
Still needing major awareness-raising to reduce resistance

A carer noted power imbalances and the risk that carers are seen as “barriers to discharge” rather than essential partners.

Updates from Carer Centres & Hospital Teams

Carers Hub Lambeth

Significant increase in referrals, especially from King’s.
Engagement seems weaker at Guy’s & St Thomas’, it looks to be still pushing for a stronger carers strategy there, but hopeful the strategy should pick up.
Working with ward rounds and direct conversations with carers.

North Central London Carers Project

Working across 8 hospital sites, possilbly

Royal Free Hospital
Barnet Hospital
North Middlesex Hospital
Chase Farm Hospital
The Whittington Hospital
University College Hospital
St Pancras Rehabilitation (Camden and West London)
Community Central London Trust
North London Foundation Trust (Mental Health)

Updates include:

A hospital “menu” to track progress across the toolkit (training, comms, discharge planning).
Embedding carers into induction programmes.
Co-authoring discharge documentation at St Pancras Rehab Centre with dedicated “carer sections”.
Upcoming use of Cerner electronic records system to automatically flag carers.

Tower Hamlets Carer Centre

Carer representative based at Royal London Hospital (east London)

Challenges include:

Slow referrals & reliance on staff awareness
Some carers only identified at crisis stage
Need to expand the carers passport across Royal London
Hackney pilot ends in March concerns about future funding

Wandsworth Carer Centre / St George’s

Developing carer awareness training with Patient Experience Team
Growth in referrals after training sessions, though staff forget over time
Plan to expand ward coverage
As chair I shared St George’s new Carers Charter as a tool for accountability

Carer-Led Developments in Primary Care

A group of Lewisham unpaid carers has begun major work with GP practices, including:

Creating a PCN-wide carers information pack
Ensuring carer champions in GP surgeries
Working with pharmacies to distribute information
Improving identification on GP systems
Exploring alignment with Lewisham’s new Carers Action Plan

Plans for the Future

More invitations to NHS carer strategy leads
Sharing SOP materials with non-pilot hospitals where possible.
Matthew to link contacts across councils and hospitals for ongoing monitoring, being the following boroughs e.g.

Lewisham

Assistant Director – Adult Mental Health & Wellbeing
Joint Commissioner – Adult Mental Health & Wellbeing

Greenwich

Strategic Commissioning Lead
Commissioning Lead for Carers

Bromley

Assistant Director – Commissioning
Commissioning Officer

Bexley

Service Manager – Adult Social Care

Lambeth

Integrated Commissioning Manager – Adults and Health

Southwark

Strategic Programmes Manager
Commissioning Manager

Medium-term aims

Push for in-hospital carer support teams in Lewisham & Greenwich.
Expand training and embed carers into staff induction.
Improve pre-admission and discharge-planning pathways on carer identification and involvement for familes and carers.
Stronger collaboration between LD nurses, dementia teams, and carers services.

Longer-term aspirations

Greater consistency across trusts
Unified carers strategy within each hospital
A system where carers are routinely recognised, supported, and involved in decisions

Closing Remarks

As cchair I closed the meeting by thanking attendees and acknowledging the collective effort to improve carers’ experiences across London hospitals. I reaffirmed the importance of:

Making carers visible
Ensuring rights are upheld
Strengthening trust–carer relationships
Carrying learning into the new year

The next meeting will be scheduled in January, with hopes of smoother cross-hospital collaboration in 2024.

SW London Carers Forum – November 2025 Update

By Matthew McKenzie, Co-Facilitator – SW London Carers Forum

About the South West London Carers Group

The South West London Carers Group brings together unpaid mental health carers from across the boroughs of Sutton, Merton, Wandsworth, Richmond and Kingston, to share experiences, gain peer support, and stay informed about local health and social care developments.

The group provides a safe and welcoming space where carers can discuss the challenges of supporting loved ones particularly those with long-term conditions or mental health needs while also learning from guest speakers, professionals, and each other. Co-facilitated by myself, the forum plays an important role in making carers’ voices heard and strengthening connections between carers and local NHS, mental health, and community services.

Our November South West London Carers Group meeting brought one of the most informative sessions we’ve had all year. We were joined by Dalvinder, the Patient Experience Lead for NHS 111, who provided a thorough and eye-opening look at how the 111 urgent care service really works, what carers can expect, and how the system is evolving.

Dal’s role involves reviewing patient feedback, monitoring the quality of calls, and ensuring that the service remains compassionate, safe, and responsive. He also regularly meets with community groups, like ours to raise awareness of what 111 can offer.

24/7 Telephone Assessments

Dal opened by reminding us that NHS 111 operates 24 hours a day, 365 days a year, and never closes. The telephone assessment is often the first point of contact, and callers speak to a trained health advisor who uses the NHS Pathways system to ask structured questions. This ensures the call handler can rule out serious issues and direct the caller to the right service quickly. Dal emphasised that while questions can feel detailed or repetitive, each answer opens or closes clinical “pathways,” helping the system determine the safest next step.

GP Home Visiting (Evenings, Overnights, Weekends)

One of the biggest surprises for many carers was learning that NHS 111 has a GP home visiting service, specifically for times when GP surgeries are closed weekday evenings, overnight, weekends, and bank holidays. This service is intended for people who cannot safely travel, including those with mobility issues, caring responsibilities, or urgent health needs that don’t require hospital care. If a home visit is determined to be appropriate, a GP working for 111 can visit in a dedicated GP car and may provide medication on the spot or issue prescriptions if needed.

Primary Care Clinics (PCCs) – Same-Day Appointments via 111

Dal also explained the role of Primary Care Clinics (PCCs) located across South West London. These clinics operate outside normal GP hours and can see patients the same day—but crucially, access is by 111 referral only. If 111 decides that someone needs to see a GP face-to-face and can travel, they may be booked into a PCC appointment. Carers learned that you cannot walk into these clinics directly; 111 must assess the situation and confirm the appointment. This helps manage demand and ensures that appointments go to those who need them most urgently.

The Expanding Role of Pharmacies and “Pharmacy First”

Another major theme was the evolving role of pharmacies in urgent care. Dal explained that pharmacists are highly trained professionals—more trained than many realise—and 111 can now direct callers to pharmacists for assessments, repeat prescriptions, and urgent medication needs. The Pharmacy First scheme allows some pharmacies to provide consultations and treatment in private rooms for a range of minor illnesses. 111 can also arrange emergency prescription access if someone runs out of routine medication while travelling, provided the medication is part of their regular treatment.

Arranging Call-Backs From Your Own GP

In certain situations, NHS 111 can request that your own GP practice contacts you, especially for non-face-to-face issues such as renewal of regular medication, questions about paperwork, or administrative needs. While GP appointment slots reserved for 111 are limited and fill quickly, the service can still send urgent notifications to GP surgeries when clinically necessary. Dal encouraged carers to mention when the need is time-sensitive so the system can prioritise appropriately.

Mental Health Support via 111 Option 2

One of the most important updates for mental health carers was the introduction of 111 Option 2, currently being trialled across London. When callers choose this option, the call is diverted away from standard 111 and straight to local specialist mental health teams, who can assess issues such as relapse, agitation, distress, changes in behaviour, or crises at home. Dal emphasised that while 111 is not a specialist mental health service, Option 2 ensures that people with mental health needs receive expert support. Data from the pilot is expected next year, and Dal offered to return to share the outcomes.

What We Learned About NHS 111

Many carers know the NHS 111 number exists, but few realise the range of services behind it. Dal explained that 111 is a free, 24/7 service (including weekends and holidays) designed for urgent health concerns that are not life-threatening.

Many carers commented that they had no idea 111 provided such a broad range of services.

Questions From Carers

Carers asked many thoughtful and practical questions during the session, including:

1. Mental Health Crises

A carer asked how 111 responds to mental health emergencies, particularly when someone becomes distressed, unwell, or difficult to support at home.

Dal explained that 111 itself is a generic urgent care service, but Option 2 sends callers straight to trained mental health professionals, who can triage cases such as relapse, agitation, or risk concerns in a more specialist way.

2. Access to Medical Records

A question was raised about whether 111’s clinicians can view a patient’s medical history.

Dal clarified that clinicians have access to the Summary Care Record, containing essential medical information, medications, conditions, and recent interactions—if the caller gives consent.

3. Home Visiting Times and Coverage

Carers asked about response times and geographical limits.

Dal explained that SW London is fully covered, though travel times vary depending on the area and how busy the service is. Home visiting is evenings, nights, and weekends only.

4. Staffing Levels and Training

One question focused on whether call handlers are medically trained.

Dal shared that 111 employs 180 health advisors in SW London—non-clinical staff who have completed an intensive six-week training program. They follow the NHS Pathways system and are supported by clinical advisors (GPs, nurses, paramedics) who can join or take over calls when needed.

5. Using 111 When Travelling

A carer asked about getting medication while away from home.

Dal explained that 111 can arrange for prescription collections at pharmacies in another part of England, which has helped many travellers who forget medication.

6. Hearing Impairment and Accessibility

There was interest in support for people who cannot make phone calls.

Dal confirmed services such as text relay, online 111, and the NHS App, all of which improve accessibility for carers and patients with additional needs.

Carer Reflections and Experiences

Several carers shared personal experiences both positive and challenging. One described how 111 triage was vital when they urgently needed treatment for a severe infection, while another discussed difficulties when GP surgeries didn’t always respond quickly to reports sent by 111.
These real stories helped emphasise how important it is for carers to know when and how to use the service, and how essential accurate information is during triage.

Key Tips Dal Shared for Carers

Give as much information as possible, including social factors such as caring responsibilities, mobility challenges, or inability to travel.
Stay with the person you’re calling about, as the call handler will ask you to check symptoms in real time.
Tell 111 if symptoms change—this can alter the urgency and outcome.
Always keep your phone nearby when waiting for a callback; 111 will try only three times.
Don’t hesitate to call again if you’re unsure or worried.

Closing Thoughts

The session was incredibly well-received. Many carers said they learned things they never knew, even though they had used 111 before. Dal’s openness and honesty—both about what the service can do and what its limitations are—made his presentation especially valuable.

As co-facilitator, I (Matthew McKenzie) will continue to share information like this to help carers navigate local health services more confidently. We hope to invite Dal back once the evaluation of 111 Option 2 (mental health) is published, we also have a keen interest on what the ICB is doing especially regarding carer involvement.

Hospital Carers Discharge toolkit Meeting Update September 2025

By Matthew McKenzie – Carer activist

London Carer Organizations Network Update

The meeting focused on introductions and updates from various organizations supporting unpaid carers across London. Matthew McKenzie facilitated the session, introducing participants from different boroughs and organizations, including

NHS England
Healthwatch (local advisory committee involvement)
North Central London Carer Support Project (covering Barnet, Haringey, Camden, Enfield, and Islington)
The PSE (supporting South East London local authorities: Bexley, Bromley, Lambeth, Lewisham, Greenwich, and Southwark)
Richmond Borough Mind
Richmond Carers Centre
Kingston Carers Network
St George’s, Epsom and St Helier Hospital Group
Sutton Carers Centre
Carers Hub Lambeth (supporting unpaid carers, with hospital carers leads at King’s College Hospital and Guy’s & St Thomas’ Hospital)
Lewisham carers services (Imargo service manager)

Apologies from

Bromley Wells
Bexley Carers Support
Greenwich Carers
Ealing Carers Partnership
Tower Hamlets Carers Centre

NHS England updates including Universal Care Plan Updates

A representative from NHS England highlighted good news about the Hospital Discharge Toolkit, which had been originally developed in London by Debbie Hustings. The toolkit has already been adopted across much of southwest London with strong results. Recently, all NHS regions were asked to contribute work on hospital discharge, focusing particularly on carers’ experiences. When this went up to the Executive Quality Board at the national level, the London toolkit received recognition. The recommendation that came back was that all regions should develop something similar they could adopt London’s version directly or tailor one for their own needs. The representative stressed that this kind of recognition is significant because it helps the toolkit be taken more seriously and provides momentum for further rollout

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My Review on Healthwatch Southwark – 1 Year on event

I thought this time I would do a post on an healthwatch event. Now I have done some posts about healthwatch before, sometimes Healthwatch Lewisham and other times Lambeth, but this time I was over in the London borough of Southwark for the Healthwatch Southwark event – One Year on.

Before I continue on how the event went, what is healthwatch Southwark all about? Well basically taken from their site – Healthwatch gives people a POWERFUL voice locally and nationally on matters concerning health services. At a local level, local Healthwatch will work to help local people get the best out of their local health and social care services. Whether it’s improving them today or helping to shape them for tomorrow.

Now there are healthwatches across different boroughs of London and the UK, all giving people the chance to form an opinion of the health services. Healthwatch does more than just listen and engage, they also do enter and view of health services and produce many reports. So the thing is what has Healthwatch Southwark been up to over the year they have been in action?

Well on the 22nd of November, I took a trip over to Pembroke House over in Southwark and was greeted friendly by the healthwatch staff and a staff member of “Community Action Southwark”. As a reminder, the Healthwatches are heavily volunteer focused and depend on involvement by the community, especially by those who have a passion for improving or championing the health service in the UK.

When I entered the premises, I was glad to see quite a few stalls on display, although one of my main interest was the stall about mental health awareness and engagement. I took the opportunity to visit the CoolTan Wellbeing stall. CoolTan Arts exists to inspire and transform peoples lives though creativity and self-advocacy. The stall advertised the up and coming CoolTan Coolwalks, which I have been on several times. The stall also had booklets and information about mental health and a video about different periods the coolwalks focused on.

The next stall I visited was a stall promoting sexual health research and awareness, which is one of Southwark Healthwatch’s main area on raising awareness about sexual Health. I spoke to the stall holder about her research and its main aim is to have people from the area of Lambeth & Southwark from aged 16-30 be part of an innovative sexual health study, where people can look to getting a sexual health check and tell them what they think about the service. Getting tested on sexual health is very important for many reasons.

Soon I spoke to the stall holders of the Southwark & Lambeth Integrated care where Health and social care organisations and people in Southwark and Lambeth have come together so that local people can lead healthier and happier lives. I was impressed by their display and the stall holders explained some important reasons for building a community along the lines of better healthcare. They want people to at least

– Feel they are a part of the community
– Have systems in place so they can avoid having a crisis at a later stage
– Live independently
– For carers to live the life they want to the best of their ability.
– and lots more

Another stall I visited was the Southwark CCG stall, where they had lots of interesting information on what Southwark Doctors have been doing to improve healthcare for the borough. The CCG stands for Clinical Commissioning Group, which basically means a membership organisation of all the GP surgeries in a borough who help organise the delivery of NHS services. One of the main focus of the CCG is of the commissioning of services hence where should the money be allocated to on providers of health services.

My main interest was the Southwark CCG summary annual report for 2013-14. I also picked up and took away people’s health information is used in the borough of southwark. I urge those interested in their health and health services to read up on such information when they can.

I also noticed stalls doing free health checks, free eye check examinations and I was also given a free health goodie bag. I guess Xmas has come early for me.

After having some tasty lunch, which was provided free of charge by Healthwatch Southwark. We then went upstairs for the main event. The event was to hear what has healthwatch Southwark been up to? It was time to hear their story.

First to speak was Southwark Healthwatch Chair David Cooper. David spoke on the following being how much work and effort HW Southwark has been doing, The new NHS 5 year plan in south london, how financially difficult it has been for the health services and the importance of Healthwatch Southwark.

David then moved on to the agenda of today’s speakers, which I was keen to hear from.

We were then introduced to the new Healthwatch Southwark Manager Aarti Gandesha, now Aarti spoke about more about Healthwatch Southwark’s aims as you can see from the picture. She also talked about how people can get involved with healthwatch and there are many ways to get involved if you are passionate about your health services.

Aarti then talked about what HW Southwark has been up to so far and many of their engagements have been on the community focus groups involving different members of Southwark’s communities. Healthwatch Southwark have also held many public forum events and community events. Plus HW Southwark have been busy collecting stories for their joint ‘1000 lives’ project.

The Healthwatch Manager then moved on to explain what Healthwatch priorities are for Southwark and there are 4 being

1. Access to GP Services
2. Access to Mental Health Services (my main area of interest)
3. Sexual Health Services
4. Social care Services

Next Aarti talked about Healthwatch Southwark’s archievements during the past year where they have

– Engaged with a large number of people over group sessions
– Established 4 priority areas
– have 676 supporters
– received 194 info and signposting queries
– and more

After Aarti’s presentation and talk, we then got to hear a story from a carer in the borough of Southwark. The story resonated similar themes that I go through as a carer e.g. the worry of services being closed down, being able to relate to others, the hope that things will get better and having to provide advice for others.

We then got to hear a talk and presentation from Southwark CCG Director Paul Jenkins. Now Paul’s talk was on the current & Future Opportunities for locality and neighbourhood working. Paul talked about understanding Southwark’s population and health needs (shown as a tree in picture).

Plus Paul talked about the direction of travel when people needed to access health services in Southwark. The aim was to look into providing GP practices that will work closer together in the borough, plus providing a wider range of hospital care closer to patients homes. The thing I noticed from Paul’s talk is that services will need to work together since there will be many challenges.

We were shown the different neighbourhood groups of practices and their reach into the community. Plus the explanation of the direction of travel where many schemes and projects will be set with the aim of GPs working together

The last speaker was Kerry Crichlow who is Southwark Councils director of strategy and commissioning. Her talk was about health and social care commissioning and the integration in the borough of Southwark.

Kerry gave a quick run down on the big issues about commissioning. Those being an ageing population and responding to financial challenges, plus health inequalities. Next Kerry moved onto opportunities where a strategy developed to aid the patient’s journey through their experiences in health. Plus building a stronger framework on prevention and inclusion. Kerry spoke more about the opportunities to shape provisioning around people and maximising integration of health services.

After the presentations, the public and patients who attended got to ask some quick questions, I won’t go into the answers, but some questions were based on

What can be of assistance for those who have physical disabilities or those who have hearing impairment?
What can bridge the divide in health equalities in the borough of Southwark?
How can personalisation help those who have had bad experiences health assessment?

The next and last stage of the event was people to seperate into groups and provide HW Southwark and their facilitators opinions on the following

1 – Service Changes
2 – HW Priorities
3 – Involvement in HW Southwark

The one I chose was the “Involvement” table on how can Healthwatch get more people to volunteer. Each person on our table talked about their role and connections and we also talked about who do each of us talk to when we experience good or bad things in health service. Usually it would be our friends, family or specific groups. For me I tend to speak about my experiences at a carer’s group.

We also discussed the importance of social media, which is one of my area of expertise and also the purpose of volunteering since some would like to volunteer, but are not sure how much work it would involve.

After feedback from each table. David then thanked all for attending. I was particularly glad I attended the event and was allowed to even blog the event. What I got most off this event is learning more about Southwark’s Health and social care setting, learning even more about Healthwatch, networking as I got access to sit on more groups and also giving my opinions.

Thanks for reading my blog post of this event.