Hittin’ it, not quittin’ it

Hello again, I’m back after a couple of months of being on medication that dispelled any creative urges, including the capacity to complain when being treated like dirt by mental health services. I suppose it’s a cunning plan on their part, dope you up so you no longer have the faculties to oppose their blatant bullying and discrimination.

I’ll warn you in advance, this is a long post, but it’s worth a skim till the end. 😉

I’m afraid I’ve decided to join the mischief of rats leaving the sinking the Good Ship NHS, and through the kindness of strangers I’ve managed to raise enough for a few months private treatment at least. This blog post is just to let you know that I have no intention of deserting my brothers and sisters still dealing with the nightmares of NHS mental healthcare, I’m still here fighting for you.

And if you think I’m overestimating how awful Camden and Islington’s acute (emergency) mental healthcare is, don’t just take it from me. Here’s there full report on Camden and Islington Foundation Trust.

http://www.cqc.org.uk/provider/TAF/inspection-summary#mhcrisis

Now for those of you who can’t be bothered to go into the full report, I’ll summarise. Here are the ratings the Care Quality Commission uses:

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Camden and Islington Foundation Trust as a whole have been awarded a rating of “requires improvement”. The report details their findings in full.

Now, the bit that those poorliest are on the sharp end of, is the Acute Care division. This includes Crisis Teams, Psychiatric Hospitals, Psychiatric Assessment Teams (the ones who decide if you need the nuthouse following a suicide attempt) Recovery or Crisis Houses and short-term day hospitals. I’ve had the joy of being on the receiving end of all of these throughout my time in Camden.

The Care Quality Commission deems Camden and Islington Acute Services to be inadequate, the only area of the trust to receive this worst rating. So those in the most desperate need are receiving the worst level of service in the entire trust.

The CQC found:

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I’m not going to rephrase the report. It speaks for itself. What I will say, though, as a citizen and a taxpayer I have the right to raise issues when I meet with bad practice. This is not my subjective assessment, this is the objective  assessment of the CQC.

I have been unlawfully detained on a ward because the doctor refused to gain my informed consent before admitting me as a voluntary patient. Once I was admitted I was told that if I chose to leave (“voluntarily”) I would be sectioned. I was literally sitting in the kitchen of a psychiatric hospital – their choice of setting, privacy presumably not being a priority – holding my iphone with the information page, published by their own trustshowing them that their own laywers deemed my admission was unlawful. It made no difference. I had my human rights, my dignity and my chances of recovery stripped away by a staff culture that allowed an authoritarian contempt for patients.

At 9am the next morning I phoned Camden and Islington’s lawyers (as named on their own information leaflet), and was immediately summonsed by the hospital manager and informed that I was free to leave.

Of course, I tried to complain. To do so, I needed a copy of my medical notes which I had to obtain via a Subject Access Request under the Data Protection Act. Camden and Islington had 40 days in which to produce these, but informed me that ‘due to backlogs’ they were not meeting this statutory service standard. When I finally received my records, nearly four months had passed and I just wanted to move on.

On another occasion, I attempted suicide and was assessed as needing crisis care. When I arrived at the unit, I was told they would not treat me because I was obtaining medication via a private doctor. This is in direct contravention of  Section 3a of the NHS Constitution which states:

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Of course. I complained (can you see a pattern here?). But my complaint, researched and drafted weeks later when I was less ill, was useless to me on my discharge from hospital; turned away from Daleham Gardens Crisis House, still with bruises on my hands from the catheter and cuts on my arms and legs from my poor tortured mind. They let me walk away. They refused to treat me on the grounds that they could not manage the ‘risk’ of me receiving medication from another provider, but they were prepared to deal with the risk of letting a recently suicidal patient who had been deemed at need of crisis care, walk away to a home where I lived alone with no support or monitoring.

Of course, dear reader, I complained. In this case my complaint, again, heard some months after the event and way too late in the day to give me the help I needed at the time, was upheld. I was thanked for ‘bringing this matter to the attention of the NHS’.

On a recent visit to the same unit, I saw that they had updated their patient information to include the statements that ‘we cannot treat you if you are receiving private healthcare elsewhere’.

So the outcome of my complaint is they have acknowledged that they are in breach of the NHS Constitution, but instead of finding a pragmatic way of dealing with the fact that these days people purchase many things perfectly legally from online pharmacies, from hair restoring medication to the weight loss medication I was taking. Instead of responding to change, Acute Services have chosen to continue to ignore their own ruling bodies and operate as they please.

I wish this was the end of this catalogue of woes. But this years my mental health seriously deteriorated. I found myself accessing Acute/Crisis services more and more often, and eventually asked for a referral to one of the day hospitals, in this case the Jules Thorne day unit on the St Pancras site. I was offered care at Daleham Gardens, but since they had shown so little care for me in the past I had little confidence that I’d get fair treatment there.

I was assessed at Jules Thorne and although I found them a little less than progressive in their attitudes I agreed to give it a go. I was desperate for some help and I knew some services offered by the day unit (like art therapy) really did help.

A few days later I received a call from the person who assessed me who seemed hung up on a comment I had made. I’d asked her if it were possible to email (rather than phone) the service if I couldn’t make it in to the unit. The worker repetitively emphasised that ‘we are not an email service’ and although I understood that, I asked her if she could provide me with some policy or rationalisation for this, because it was something which has been accommodated at every service I’d ever attended in the past. Phone phobia is not uncommon with those with high anxiety.

The woman flat out refused to answer my question. I can only describe the conversation as akin to John Humphrys trying to get an answer out of Boris Johnson, with each of my questions being stonewalled. By this point I was appalled at the way I was being treated. I had briefly sat on the Board of Governors before my health deteriorated and was aware of how staff were supposed to be trained to work with service users in a respectful manner, and to be frank I would have been disgusted at being spoken to like this in a shop, let alone a caring institution.

The conversation reached an impasse, and I asked to speak to a superior. When the call came through, I missed it and so phoned straight back. I spoke the the deputy manager, Mary Hurley, who seemed almost hysterically angry with me. She asked me if I was suicidal and I replied I was, and yet she could not understand why I was upset that a staff member wouldn’t answer my question.

I replied that I could only make a decision about coming to work with the staff at Jules Thorne if I felt I would be treated with respect, and thus far I was concerned I would not be.

It was at this point she really seemed to lose her professionalism. She said (and I took notes, as I could barely believe my ears)  ‘as far as I see your expectations are unrealistic. I can see from your file that you have made complaints in the last about my colleagues’.

I was disbelieving; firstly that copies of complaints of a service that we know – through the CQC no less –  to be inadequate, were being held with my clinical notes. The only reason for this that I can see is that it clearly marks me out as a ‘troublecauser’, and as a result prejudices my care. I was aghast that complaints we being held on my care notes (it’s explicit in the complaints policy that complaining should not influence future care) but Ms Hurley stated that she was no longer willing to discuss the matter, that she had been on the phone far too long and lastly the somewhat daft claim, repeatedly stated, that ‘you’ve phoned here five times this afternoon’ Once, Ms Hurley, once.

In a state of extreme distress, I asked to speak to another manager. I was told that Marian McHugh was based at another site and that the next manager up the line was someone called Lindsey Cole. I asked if I would be called back the same day and Ms Hurley said that was not guaranteed.

At a subsequent meeting some weeks later with Marian McHugh, she confirmed that she was informed that same day of the call with Mary Hurley of my wish to speak to a manager. However, she did not call. So Marian McHugh, service manager of the acute day units, chose to leave a suicidal person for a week with no contact – she could have even spoken to the crisis team and asked them to check up on me, but heard nothing.

She finally called me a full week later. You can imagine how I felt about the service by this point.

Result: Once more, I got no care. I’ve been too ill to complain, but as I recover, I shall raise my concerns once more. Sick of getting nowhere with the formal complaints department, I have arranged to speak to my MP Keir Starmer and will copy in that  letter to the MP for Islington, Jeremy Corbyn. I am making attempts to meet with Richard Olszewski, the Camden Council Cabinet Member for Health and Social Care. I will speak to the Care Quality Commission and the Chair of the Board of Governors.

In 2016 the CQC damned Camden and Islington Acute Care with the worst possible rating they could receive, and yet they continue to fail the most vulnerable people in the borough.

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Just in case you’re interested in how Camden and Islington should  be working, why not wade through a copy of their core values:

Our values

Our patients expect the very best levels of service, respect, dignity and compassion and as an organisation we are committed to demonstrating these standards all day, every day. Hundreds of staff and service users worked  together to create a set of values which make sure people who use our services  get the best possible chance of rapid recovery and receive the best care possible.

Our staff are committed to living and breathing our values, and everything we do should reflect them in full.  We also make sure that when we recruit people they demonstrate the right behaviours before joining our Trust. However, if staff don’t live up to our values, let us know – and even better, when we do live up to them tell us how well we have done .  All feedback is shared with relevant staff and teams.

We have six values which ensure we are welcoming, respectful and kind.  Professional in our behaviour. Positive in our outlook. Working as a team C&I is your partner in care and improvement.

Our six values are:  

Welcoming

We aim to use the 3Ms when we welcome you:  “My name is … , My role is … , May I help you?” We will always be friendly and polite, calm and approachable, and ensure we make time for you.  We are accessible and open, helping you to access the right services at the right time so you have the best chance of recovery.

Respectful

We are respectful so you can feel understood and you feel like an individual.  We champion the rights of people with mental health problems.  As well as respecting your dignity and privacy we look out for the dignity and privacy of others, and speak up if it’s compromised.

Kind

We are kind so our patients feel cared for. When we are kind it means we are compassionate, helpful and encouraging.  It means we are patient and sensitive.  We go the extra mile to help and encourage others to do things for themselves.

Professional

By being professional we demonstrate our expertise and knowledge so you feel safe in our care.  It also means we constantly develop our own skills and ensure we and others have had the right training.
It also means we speak up if we see unsafe care, and learn from any mistakes.

Positive

We are positive ensuring we act as a role model and encourage positive attitudes and hope. We enjoy feedback on what we do, involving everyone in any improvements we make. And we deliver a consistent service, based on best available evidence.

Working as a Team

By working as a team we mean we work together so you feel involved.  We listen and communicate with each other, offering solutions to issues.  We look for opportunities and inspire others to achieve more. We listen even if the message is uncomfortable as we always want to do things better.

Our values are designed to drive up the standards of care across our Trust and to assure you of the quality of care and treatment you will receive as you journey to recovery. Our values continue to be embedded throughout our organisation and are part of our continuous drive and commitment to a values-led culture. This work is referred to in our organisation as ‘Changing Lives’.

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