Ex-health chief: Tayside mental health inquiry ‘screwed’ service plans

Ex-health chief: Tayside mental health inquiry ‘screwed’ service plans

A former health board chief has sparked fury by suggesting a landmark inquiry into mental health services should not have gone ahead because it held up work to improve care.

Crawford Reid, former chairman of the Perth and Kinross integrated joint board (IJB), believes the independent inquiry “completely screwed” plans to redesign local mental health facilities.

The inquiry, led by former prisons governor David Strang, strongly criticised what it described as a loss of “trust and respect” in local psychiatric services.

But Dr Reid believes the launch of the inquiry – at the behest of the bereaved families of suicide victims – has set progress back in Tayside by two years.

The redesign was signed off in January 2018 by Perth and Kinross IJB, which is in charge of inpatient mental health services, but was put on hold following the inquiry’s interim report in May last year.

Ahead of an NHS meeting to discuss a proposed action plan on mental health tomorrow (Thursday), Dr Reid said: “Several aspects of the inquiry report give me great concern. (Ex-chair and ex-chief executive) John Brown and Malcolm Wright came in at a time when Tayside was in a dysfunctional shape – it was a knee-jerk reaction.

“I’m not minimising how ruinous suicide is but what’s happened is the mental health transformation programme has been basically put on hold.

“If the transformation programme had started to move in, things would have improved with a full complement of consultants.

“They completely screwed it.”

Relatives of those who took their own lives after engaging with local mental health services have criticised Dr Reid’s comments as poorly considered.

Gillian Murray, whose uncle David Ramsay died in 2016 due to alleged “negligence” of NHS staff, said: “I’m quite shocked to read these comments.

“There have been ample opportunities for genuine change with regards to mental health services in Tayside over the years given the sheer volume of investigations and horror stories.

“Nothing was changing hence why I, and others campaigned for this inquiry.

“Perhaps if these fantastic changes that are being proposed had actually been implemented years ago, lives would have been saved and there would have been no need for an inquiry.”

Gillian Murray

She added: “I feel yet again that we, the bereaved families who campaigned tirelessly for change, are being used as a scapegoat for the never-ending list of failures.”

Mandy McLaren, who lost her son Dale Thomson to suicide in 2015, said: “The redesign was in the interim report, and it did say it should be halted.

“The matter with him is he doesn’t want to take any responsibility for the part they all played in allowing these failures and allowing these deaths.”

Following a near-two-year investigation, the Independent Inquiry issued 51 recommendations  on February 5.

Witnesses who gave accounts to the inquiry described how the transformation programme appeared to be little more than an asset management plan to save money.

However, Dr Reid believes that, with time, the programme could have gradually reintroduced localised care at facilities such as the Mulberry Unit in Angus, which was mothballed in 2017 despite being only despite being opened in 2011.

He also believes independent case reviews should have been held for each person who dies after engaging with mental health services.

“If you look at each and every recommendation there’s not one that moves the process of improving mental health services in Tayside one inch forward,” he added.

“Not one of those 51 recommendations, without the transformation programme going on, will improve anything.

The Susan Carnegie Centre, at Stracathro Hospital, which housed the Mulberry unit.

“The transformation programme had no time to bed in and move forward – if it had been allowed to develop the situation would have been fantastic compared to what it was two years ago.

“It’s not perfect but it’s far better than what we’ve been left with at this time. The sooner it gets put back on the boiler the better.

“Without a shadow of a doubt, this inquiry should not have gone ahead.”

NHS Tayside and the independent inquiry have been contacted for comment.

“We really need to work with staff to fix mental health”

Renewed calls have been made by NHS staff representatives for health bosses to work with them to improve mental health services in Tayside following the publication of the Strang report.

Jenny Alexander, employee director at NHS Tayside and a Unison rep, said the 51 recommendations were unlikely to be met unless staff were on board with the health board’s plans

She warned that actions could not be rushed through in the way the mental health transformation programme was perceived to be by some observers in 2018.

She told a meeting of Dundee’s health and social care partnership board (HSCP) yesterday: “The partnership aspect of this is very, very important.

“If we are running off and doing things like in 2018 we’re not going to do anything differently.

“We really need to start working in partnership with staff-side – if we don’t have staff on side we will never get through those 51 recommendations.

“We need to make sure we have improvements done for these people that we’re caring for.”

The independent inquiry found that staff reported feeling disrespected and undervalued by senior colleagues.

One mental health staffer described the atmosphere in mental health services as “a culture of fear”.

Arlene Mitchell, Dundee HSCP locality manager, says actions have already been taken in response to the inquiry.

These include the creation of new senior mental health posts, a new process for investigating adverse events and a plan to improve better support for those leaving mental health inpatient services.

Ms Mitchell said: “From a Dundee perspective, we’re in a good position…to ensure a strong staff partnership approach.

“We feel there’s a need to strengthen some of the staff partnership activity.”

 

Link to Evening Telegraph article here  

Please follow and like us:
Nearly half of Dundee suicide victims sought crisis help in the year before death

Nearly half of Dundee suicide victims sought crisis help in the year before death

Please follow and like us:
Dundee mental health support scheme hailed as national success story

Dundee mental health support scheme hailed as national success story

Link to Dundee Courier article here

Please follow and like us:
Tayside mental health review hampered by ‘workforce challenges’ as objectors predicted

Tayside mental health review hampered by ‘workforce challenges’ as objectors predicted

Please follow and like us:
Patients’ concerns highlighted in NHS Tayside mental health inquiry report

Patients’ concerns highlighted in NHS Tayside mental health inquiry report

Illegal drugs on wards and concerns over patient restraint have been highlighted in a report into NHS Tayside’s mental health services.

The independent inquiry’s interim report has identified “key themes for further investigation” after hearing evidence from more than 1,300 people.

It said some patients were frightened of certain staff members.

NHS Tayside said improvements had been made in key areas highlighted in the interim report.

The inquiry is reviewing safety, care standards and access to mental health services.

An investigation was initially ordered into Dundee’s Carseview Centre but was expanded following a campaign by families of people who took their own lives.

More than 200 written submissions were received by the inquiry team following its call for evidence, and more than 70 oral evidence sessions were held.

It said the key themes were patient access to mental health services, patient sense of safety, quality of care, organisational learning, leadership and governance.

Referring to risk management, the report said: “Patients report telling staff they were suicidal but the risk was not taken seriously until they made a serious attempt to take their own life.”

‘Violated and traumatised’

In relation to patient safety, the report noted: “Some patients report being frightened of certain staff on the wards who have a poor attitude to the patients in their care.

“Others mentioned that another patient had assaulted them whilst they were on the ward.”

The report said the use of restraint within inpatient facilities was of “great concern” to patients, who had experienced it or witnessed it taking place.

It said: “Patients feel violated and traumatised, particularly if they have personally suffered violent abuse in the past.”

People talking

It added that staff seemed unable to control the availability and use of illegal drugs on the wards in the inpatient facilities.

“Both patients and families report seeing drugs delivered, sold and taken within the Carseview Centre site,” the report said.

“Staff confirm this is a serious issue which is not being adequately addressed.

“There is a lack of support from management for frontline staff attempting to address this issue and it is having a detrimental effect on patient care and treatment regimes”.

‘Unexpected and concerning’

In a section on the Crisis Service, the report said that the Crisis team “struggles to respond to sudden surges in demand on the service.”

It said: “There are occasions when the length of time to wait to be seen is long and families supporting someone in crisis are advised to phone the police or NHS24, if they are worried.

“This advice is unexpected and concerning to carers coping with a crisis in a domestic situation.”

The report said the centralisation of the out-of-hours Crisis team to Carseview Centre has had a “detrimental effect on those patients in Angus and Perth & Kinross who are experiencing mental health crisis”.

It said: “There is a perception that whilst the Crisis service has expanded in recent months, the situation has worsened in terms of patients being assessed then not being offered any crisis intervention, or referred back to the GP.”

Inquiry chairman David Strang said: “The themes which have been identified will shape the next stage of the inquiry.

“Our final report will include conclusions and recommendations which will lead to the improvement of mental health services in Tayside.”

‘Top priority’

NHS Tayside chief executive Grant Archibald said: “We are taking on board all comments in the interim report, alongside the feedback we received from the Health and Social Care Alliance (the Alliance) published in their report in December 2018.

“The key themes which have been identified in both the Alliance report and in today’s interim report are recognised by the board and the mental health leadership team – and we are taking action on these.

“I also recognise and want to thank the many staff who are already working really hard to improve services and look forward to their continued support.

“It is clear that we have further work to do but since I came to Tayside, I have made mental health a top priority and I am confident we can learn lessons, strengthen our engagement with patients, service users, families and the public and make the right kinds of changes, at the right time, to transform our mental health services.”

He added: “We would like to thank everyone who has shared their experiences so far and we look forward to the independent inquiry’s final report and recommendations which will be a major influence on the future shape of mental health services in Tayside.”

Please follow and like us:
Thousands of mental health appointments missed every year

Thousands of mental health appointments missed every year

More than five appointments with mental health specialists are missed every day across Tayside.

On average, 2,286 mental health appointments have been missed each year since 2013.

And the no-shows are increasing, with 2,667 appointments missed in 2018 being the highest figure in the last five years.

The reasons for patients not making it to appointments after a GP referral are complicated, according to a local mental health charity.

Wendy Callander, chief executive of Wellbeing Works Dundee, said anxiety is just one of many reasons.

Wellbeing Works is the rebranded name for the Dundee Association for Mental Health, following a change last month.

Ms Callander said: “It is difficult for me to say why people miss appointments with the NHS, but we have similar examples when people are referred to us.

“They often miss their first meeting if we send them a letter inviting them in after a referral. If we reach out to someone, there is a chance they will not show.

“There’s a lot of anxiety and not knowing what to expect that causes that.

“We get referrals from a wide source of people and places.

“What is more likely to work for us is if someone comes with them — a friend or family member of support worker, for example.

“With mental health, you don’t just wake up deciding you have a problem. It can take weeks and months to creep up.

“Going to a doctor about a cough can provide anxiety, so if it’s about mental health that can be even worse.”

While understanding how difficult it can be for someone with mental health issues to  reach out for help, Wendy insists it is worthwhile.

She added: “It’s a huge problem.

“NHS are telling us about missed appointments and they are trying to address that particular issue.

“Wellbeing wants to resolve the issues because the help is there, but if people aren’t able to get to it then they’re not getting the benefit.

“One problem is people not knowing what to say to a GP, but there is nothing you can tell them that they haven’t heard before.”

NHS Tayside does not report reasons for why appointments have been missed, as most of the time it is not known.

Missed GP appointments for all ailments cost the health board £277,000 in just one week last year.

At the time, NHS Tayside estimated that one in 10 GP appointments are wasted every week.

 

link to Courier article here

Please follow and like us: