It has again been utterly heart breaking to read yet more stories from our 7 Days campaign this week. More vulnerable people completely failed by the very system that is supposed to protect and care for them. Can you imagine just what it must be like for families and their sons and daughters to have to go through this? Imagine if this happened to you and your family.
I have said before that right minded citizens should be thoroughly ashamed of what has gone on here in the name of assessment and treatment. Even within the Care sector I am certain that there will be many, many dedicated mental health staff who are just as shocked and saddened by these reports of abuse and disgraceful treatment as the rest of us.
Sadly, despite a huge amount of work being carried out by the Transforming Care programme change is happening very slowly. The statistics do show modest progress but at the current rate it will take many years before the end is in sight. How many more lives will be ruined along the way?
The whole purpose of 7 Days of course is to get as many people as possible out of Assessment and Treatment Units and to have their needs met closer to home in their local communities. By itself this is a fairly simple concept and making this happen should also not be at all difficult.
Clearly the system itself is in need of significant assessment and treatment so I have drawn up seven essential requirements below that I would like all commissioners and providers of care services to reflect and act upon. Much of what I say should be common sense but there are many shortcomings that must be addressed if we are to stand a chance of treating and healing this poorly system. If the first thing that comes to mind is affordability please remember in your list of priorities that these vulnerable people come first, I hope you agree?
One – Early Intervention. Support families effectively rather than waiting for a crisis to develop. To do this we need CAMHS services that are fit for purpose. Make sure that services are accessible, proactive, work with and support families both in their homes and communities and that adequate respite is available.
Two – Crisis Intervention. If a crisis does happen make sure that robust support is available 24 hours a day. Crisis support for young people or adults should be seen as an emergency service, A&E must not continue to be used simply because local commissioners can’t be bothered to provide effective crisis intervention day or night.
Three – Risk of Admission. For anyone judged to be at a significant risk of admission to an assessment and treatment unit Local Authority and CCG contingency planning must ensure that there are sufficient emergency beds available locally to cope with the need. This is not a nice-to-have if we are to stop patients being sent away to far flung destinations, out of sight and out of mind.
Four – Assessment and Treatment. If all else fails and an admission to an ATU happens regular Care and Treatment reviews are vital and MUST be seen as a right for every single patient at least every six months. Hopefully the current review ongoing by NHS England will see CTRs even more effective at holding Care teams to account in future to make sure that incarceration lasts for the shortest time possible.
Five – Discharge. When a patient is approaching discharge the CCG, commissioner and the Local Authority must ensure that appropriate resources are available so that discharge is not delayed. Planners must consider appropriate accommodation and robust care support needs well before discharge. If the patient is returning to the family home effective support must continue as necessary to avoid a further crisis developing.
Six – Resources. Thanks to central Government cuts resources are being severely stretched or rationed and most if not all professionals reading these messages would no doubt say that the things I am asking for are unaffordable. However providing good local services simply MUST be provided otherwise we will never meet the needs of those like our 7 Days families. Providing local services is always a matter of priority and need. I would suggest that what I am asking for here is vital and therefore should be afforded top priority at all times. Having said that I don’t think CCGs or LAs should be forced to rob Peter to pay Paul. Sufficient funds should be allocated centrally and ring fenced for this specific use.
Seven – Equal Treatment. This is a general plea for equal rights and treatment. Sometimes it seems that those with mental health issues or disabilities are seen as inferior or damaged goods, their needs and lives less important as a result. Often legal rights are ignored or access to support and treatment increasingly compromised due to a lack of interest, resources or both. Even the one health intervention designed to provide a safety net for those with a learning disability, the annual health check, is an optional extra for GP contracts and its pot luck whether your GP offers one. How can this be fair or appropriate? I think anyone living with a disability or a mental health illness deserves equal support and treatment. If you agree, and I really hope you do, please do what you can to make sure that every patient is treated equally. Every life, has the same worth and value.
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