Unanimous plea to save Avondale

Politicians have called for regulators to step in and review the decision-making [...]]]> Hate, hate, hate them and their cutting ways. Currently it is easy and only getting easier to find cuts even the NHS Trusts are having difficulty claiming as efficiency savings. Here is one example that popped up.

Unanimous plea to save Avondale

Politicians have called for regulators to step in and review the decision-making process which led to the planned closure of a Preston mental health unit.

A series of impassioned pleas from Preston councillors ended with a unanimous vote in favour of supporting the campaign to save the Avondale Unit, based at the Royal Preston Hospital.

After writing about NIMBY politicians recently it is nice to see some of them trying to do the right thing.

For some time it is going to be very, very easy to find things like this and decry them. Sadly we know it is likely to make any difference. Public oncsultations only exist to tell us what has been decided and if things are bad this year they are only going to get worse next year.

So what do we do?

We could have campaigns, sign online petitions, write to our local politicians, attend Trust meetings and probably many other things. All of the things are varying degrees of good. If anyone has a good guide on how to organise a good campaign please share it.

Someone told me once that Loughborough was the most average place in the country. I have no idea what that means but has stuck in my head. This seems to be their local Mental Health NHS Trust.

Leicestershire Partnership NHS Trust

Our purpose is to advance health and wellbeing.
We provide mental health and learning disability services mainly ifor people living n the city of Leicester and the neighbouring counties of Leicestershire and Rutland. Anyone being cared for by us or working with us will be treated with respect and integrity. It’s important to us that we work in an honest and trustworthy manner, to provide good quality services that focus on the needs of the people using them.

I am glad they are not one of the other Trusts who do not want to advance health and well being. Their financial information can be found here, not being a cashologist I am going to lift some of their figures if I can without context.

Income seems to be about £134,300,000

Costs are

Staffing costs:
Nursing staff £45,368,000 %35.1
Medical staff £17,665,000 %13.6
Scientific, therapeutic and technical staff £13,319,000 %10.3
Administrative support staff £11,237,000 %8.7
All other staff £12,340,000 %9.5

Sub Total £99,929,000 %77.2

Non-staff costs:
Establishment, premises and transport £13,768,000 %10.7
Supplies and services £11,425,000 %8.8
All other non-staff costs* £4,277,000 %3.3

Subtotal £29,470,000 %22.8
Total staffing and non-staff costs 129,399,000 %100.0

Management cost £8,640,000 (6.43% of income)

I think the management costs are included in the Staffing figures. I suspect in years to come when the NHS protection is removed, as it will be, Trusts will be asked to reduce expenditure by at least ten per cent. The unpopular services will be hit hardest.

So the question is where would you try and make savings given the above figures?

Taking into account that every member of management could be taken out and shot and it would not make ten per cent. The power system could be converted to run on free cold fusion and that would not make sufficient savings.

IF it makes your brain hurt and the numbers make no sense. A stage I have now reached please share your stories of mental health cuts (planned and actual) in your area and the wonderfully entertaining ways the Trusts have of denying these cuts will meaningfully affect service provision.

A quick check of the media coverage would lead anyone to believe that welfare spending is squandered on ‘cheats’ and ‘scroungers’. The suggestion is that slashing this corner of the budget will not hurt anyone honest, whereas cuts in other departments will hit [...]]]> [Guest post by Tom Pollard, Policy and Campaigns Assistant for Mind]

A quick check of the media coverage would lead anyone to believe that welfare spending is squandered on ‘cheats’ and ‘scroungers’. The suggestion is that slashing this corner of the budget will not hurt anyone honest, whereas cuts in other departments will hit decent working folk. The more that can be carved out of the £192bn that is spent on welfare each year, the less painful the cuts in other departments will be.

As it happens, disability benefits only make up a small proportion of welfare, as a closer look at Government spending will show you. But let’s put that aside for now and consider the essence of the Government’s plans: that many people on Incapacity Benefit could and should go back to work.

Many people on Incapacity Benefit with mental health conditions (about 42% of recipients are claiming primarily because of a mental health diagnosis) do want to work and it can be very good for them to do so. People who want to work and are able to do so should be supported back into suitable employment or other meaningful activity, such as voluntary work, at a pace that is right for them. If people are not able to work due to a mental health issue, they should be granted the support, dignity and respect to reflect the nature of their circumstances.

This does not seem to be quite the Government’s approach though. As it stands, the Coalition’s strategy for getting benefit claimants into jobs simply will not succeed, and will risk causing immense distress and leading to unproductive outcomes. This will not help us to move beyond the current system, which is already in a mess, in any meaningful or positive way. Furthermore the language they are using to spearhead the debate may grab headlines but it will do nothing to help genuine reform to welfare and will cause immeasurable damage to those who rely on Government support through no fault of their own.

In the face of this media and political onslaught, benefit claimants are on the back foot: when you’re under attack from forces far more powerful than yourself, you tend to respond defensively. Is it then any surprise that those on benefits are cynical about claims that they will be ‘helped’ back into work, and worried that they will be left to fend for themselves in a job market that would be terrible enough, even if it weren’t insensitive to their circumstances? The drip-drip of strongly worded announcements on benefits may be useful to divert the attention of a worried public away from the more tangible cuts, but it makes the lives of those affected a daily rollercoaster of emotions.

The allegations and insinuations about those on benefits are fired off in an indiscriminate manner, with little regard for the impact it might have on those with experience of mental distress. Regardless of the intended target of these rhetorical attacks, they are having a serious impact on the mental wellbeing of those who need the support provided by benefits.

For those claimants with experience of mental distress to engage productively with the efforts to get some of them back to work, there needs to be a belief that the system will treat them fairly. At the moment, they are being made the scapegoats and fall-guys for a difficult financial situation and are terrified that they will be punished simply for being the victims of mental ill-health.

No opt-out: nurses told of ‘moral duty’ to save money

Nurses have been told how to fulfil their “professional and moral responsibility” to help the NHS cut waste and save money, in comprehensive guidance shared exclusively with Nursing Times.

The 260-page document has been published [...]]]> This got sent to my real life email today.

No opt-out: nurses told of ‘moral duty’ to save money

Nurses have been told how to fulfil their “professional and moral responsibility” to help the NHS cut waste and save money, in comprehensive guidance shared exclusively with Nursing Times.

The 260-page document has been published to show nurses how they can implement and measure the eight “high impact actions” aimed at saving more than £9bn.

The document, linked to from the original story, is a monstrous 39 meg file. It seems to be supported by everyone, except Unison and is on my reading list for tonight.

Now I never thought I was allowed to Opt Out of trying to do my bit to provide a cost effective service. Which is a shame as this document seems to be implying that is exactly what I was meant to be doing.

But my professional and moral responsibility to be cost effective. What?

I wonder who wrote this report telling me about my professional and moral responsibility? Is it the NMC, who tell me the code of professional conduct, or some great moral figure to whom I should listen?

No. It is the NHS Institute for Innovation and Improvement. Or I3 as I shall call them. They are:

The NHS Institute for Innovation and Improvement supports the NHS to transform healthcare for patients and the public by rapidly developing and spreading new ways of working, new technology and world class leadership.

Now I do not know about you but many of my alarm bells are ringing at this fine example of corporate speak. How much do these people cost?

According to their figures approximately 70 million a year. Chump change to the annual NHS budget of over a hundred billion pounds. As a side note the Chair of I3 get paid about 60000 pounds for up to three days work a week. The chair is Dame Yve Buckland. Who previously was the head of National Consumer Council for water, no tell a lie she still is. Hopefully she does not have to spend up to three days a week working for them. That would make for a busy week. The report does not say how many days she works for them but it is about 45 thousand pounds. What about the rest of the board of I3.

Here they all are.

I found one nurse and he is a mental health nurse. Epic win for the board!

But no one who gets to define my moral and professional responsibilities.

The only I3 things I can find related to mental health is this.

Focus on: psychiatric intensive care units

The aim of this project is to build upon the findings of the high volume care acute admissions in adult mental health project by answering the following question:

‘What therapeutic and managerial interventions, actions and processes contribute to the patient’s journey through psychiatric intensive care and demonstrate a safe, effective, cost efficient pathway which delivers a high quality service?’

I wonder how that is working?

Concerns raised over psychiatric unit admissions

Some people are being “inappropriately” admitted to Scotland’s secure psychiatric units, a study has found.

An NHS audit found some Intensive Psychiatric Care Units (IPCUs) had admitted unsuitable groups, such as dementia sufferers.

The report said units provided a lack of activities and access to fresh air, and some patients even claimed prison was less restrictive.

I know the two probably have no link really. I just did that for fun.

I have lost the will to live already. I am going to take the huge PDF file in to work. Print it once, then photocopy several times for my colleagues and then look at ways we can fufill our moral duty to save money. I suggest everyone else does the same …

Liberal Conspiracy: A leftward leaning group blogwhich is a bit whiny but generally interesting.

and,

Guy Fawkes’ Blog: A right wing version of [...]]]> I am not a great reader of blogs. Over the course of the election though I did tend to follow two regularly to try and give me a selection of viewpoints;

Liberal Conspiracy: A leftward leaning group blogwhich is a bit whiny but generally interesting.

and,

Guy Fawkes’ Blog: A right wing version of Speak Your Branes by someone who can spell a bit and has a fine grasp of satire.

I do blame LC for convincing me to vote Lib Dem and making me feel to blame for everything that will ensure over the next several years and Thatcher rips off her Cameron suit and regains power.

I am not sure if I am being whiny and petty here but I came across a post that annoyed me. Quite a lot.

The Former Prime Mentalist

The rumour mill is in full swing this afternoon. There’s a whisper on the wind that some age-old speculation might soon finally be confirmed. Chatter is rife that Gordon Brown has been spending stints in a London hospital. For psychological reasons …

I think back to an earlier story and outcry.

Sun on the ropes over ‘Bonkers Bruno’ story

The Sun was last night forced into a humiliating about-turn following a storm of protest over a front-page headline that labelled former boxer Frank Bruno “bonkers”, after he was taken to a psychiatric hospital.

In the first edition of the paper the front page splashed with the headline “Bonkers Bruno Locked Up” above a story that labelled him a “nut”, prompting a storm of protest from readers and mental health charities.

I know we did not invent the word Mentalist. But I do think that I personally should be paid 50 pence every time someone else uses it. Mentalists excepted.

I did briefly Google for Gordon Brown and Royal Edinburgh Hospital. Which took me into conspiracy town for a trip round some paedophile paranoia. If you want to see here is a link, I strongly suggest you do not follow. link. Googling for Gordon Brown and mental health seems safer.

I generally find Guy Fawkes funny, if unpleasant, but this little piece of bile seemed to be all unpleasant and no funny. Also wildly insulting to anyone that has had to spend time in a psychiatric hospital. Browsing through the comments gives me no hope that anyone else found this in pretty poor taste.

Or am I just being too sensitive?

As it happens, Confessions of a [...]]]> Those of you who’ve seen our recent This Election in Mentalists series may have noticed a glaring omission. We’ve covered the mental health election pledges of the Tories, Labour, Lib Dems, the Greens, Plaid Cymru and the Scottish National Party….but haven’t said anything about the Northern Ireland parties.

As it happens, Confessions of a Serial Insomniac has decided to take up the baton and create a Northern Ireland-themed version of This Election in Mentalists. In a series of three posts, she starts by taking a Norn Iron view of the debates over in mainlaind Britain, before going on to examine the mental health pledges of the Unionist parties, then of the Nationalists. She has a further post due soon which will look at the Alliance and also offer a general conclusion.

I’ll also conclude by doing a quick comparison of the parties [...]]]> In the final instalment of our look at mental health manifesto pledges, we’ll look at the Green Party. Also, for those of us living west of Offa’s Dyke and north of Hadrian’s Wall, a peek at Plaid Cymru and the Scottish National Party.

I’ll also conclude by doing a quick comparison of the parties and deciding who I think are the best and worst on mental health.

As with the Lib Dems, the Green Party manifesto seems to have taken “fair” as their buzzword for this election.

I’ve always been in two minds about the Green Party. On the one hand, I’m a fully-committed eco-worrier who is deeply concerned about climate change, and I love the countryside. On the other, the Greens have a tendency to make rather fluffy and pseudo-scientific claims about complementary therapies, organic foods, GM foods, animal testing, mobile phone masts and so on.

In all fairness, I’m told they’ve been trying to clean up their act on this point, and become more in tune with scientific evidence. That might explain why their pledge on complementary medicine has been reworded to:

Make available on the NHS complementary medicines that are cost-effective and have been shown to work. (p. 22-23)

Though it has to be said that those complementary medicines that have been “shown to work” is actually very few of them. I see they’re still against flouridation of water (p.23). Good to know that somebody’s still looking out for the purity of essence of our precious bodily fluids.

Overall, the emphasis in the Greens’ health policy (and they seem to include mental health in this) is on health promotion and preventative medicine.

We cannot have an effective preventive approach, and thus a long-term-thinking ‘health’ service, unless we encourage healthier eating, more exercise, a lower-stress, slower-living society, a serious reduction in environmental pollutants, and greater access to tranquil countryside. And we recognise the connection between mental and physical well-being.

Simply making our society more equal will improve our health, without spending a penny extra on the NHS. Life expectancy, infant mortality, low birth-weight and self-rated health are worse in more unequal societies. Mental illness is much more common in more unequal countries. Drug addiction is more common in more unequal societies. Obesity is less of a problem in more equal societies like Japan and worst in the most unequal ones like the US.

I don’t really disagree with this, but I as with three main parties’ emphasis on IAPT, I can’t help but feel that this is being aimed more at people with mild-to-moderate depression or anxiety rather than those with severe and enduring mental health conditions. I’m not saying that somebody with bipolar disorder or schizophrenia wouldn’t benefit from good food, less stress and the occasion nice walk in the Lake District – of course they would – but it won’t necessarily alter their core condition. Healthy lifestyles and preventative healthcare are in general A Good Thing, but they’ll only achieve a certain amount.

So, overall their policy is optimistic and clearly well-intentioned, but rather idealistic and a bit fluffy. Rather like the Greens themselves.

Plaid Cymru’s manifesto exhorts the reader to “Think Different, Think Plaid”. Presumably it’s that different thinking that caused them to use a PDF layout that makes the manifesto sit awkwardly in my brower.

Plaid Cymru calls for all powers over mental health to be devolved to the National Assembly. (p. 26)

Certainly mental health services in Wales need a good long, hard looking-at. Smallest ratio of CAMHS inpatient beds to population in the UK, no specialist eating disorder services in the whole of Wales, IAPT not even launched yet. Wales definitely lags behind England in mental health provision. Whether transferring control from Westminster to Cardiff will change this is a matter of debate, though in fairness it suggests that Plaid do regard mental health as a priority.

I delayed posting this while waiting for the Scottish National Party to launch their manifesto, entitled Local MPs for Local People. Sorry, I mean, Elect a Local Champion.

And was it worth the wait? Scrolling to their health pledges (pages 27-28), there isn’t anything at all that mentions mental health services. Phooey.

So, if mental health issues were the only thing you were basing your vote on (obviously that’s almost certainly not the only thing you’re basing your vote on), who are the best and worst parties for mental health?

All three main parties have pledged to support IAPT, but the Lib Dems are the only ones to say anything on mental health in addition to this, with a couple of pledges such as prioritising dementia research. So, overall the Lib Dems come out as marginally the best out of a rather dreary lot. Pretty much like the TV election debate, really.

Labour and Tories come in joint second place with their IAPT pledge. The Greens and Plaid Cymru come in behind them, making some nice-sounding pledges that are somewhat vague about what impact they’d actually have.

UKIP and the SNP would be joint worst since neither of them mention mental health. However, I think I’m going to award some minus points to UKIP for their shockingly retrograde pledge to turn back the clock on community care and ship people with learning disabilities back into institutions. For that reason UKIP can be considered the worst party for mental health.

Oldschoolbaby to start ranting in 10…9…8…

So, in the meantime, let’s have [...]]]> I’m a bit delayed in doing the third instalment of the This Election in Mentalists series, mainly because the Scottish National Party still haven’t published their manifesto yet. Not exactly inspiring confidence in their claim that Scotland would be more efficiently-run if they were left to govern it.

So, in the meantime, let’s have an election-themed caption competition.

As usual, a brief moment to state…

THA ROOLZ: Enter your caption entries via the comments thread. One caption per comment – for multiple entries do multiple comments. Vote for an entry as being WIN and not FAIL by clicking on the thumbs-up icon by the side of each comment. The entry with the most points by Sunday 25th April is declared THA WINNAR OF TEH INTERNETS.

Incidentally, the joint winners of the previous caption competition are Eccedentesiat and The Shrink, with 10 points each, so well done to those two.