Sunday, 3 February 2008

Information from BLPT Trust Board minutes

I always try to read these - not just out of nosiness, but as a service user it gives me a lot of insight into what is happening behind the scenes, and what might happen in the future. I thought others might be interested in some of the items (but not have time to go through them all) and I'd be interested in the comments of others, given that it has been suggested by BLPT officials that I do not see things objectively.

The latest meeting was held last Wednesday, and the agenda can be found here. The agenda links to a number of documents, which is where i obtained the information below.

The first piece of information I found relates to BLPT's performance in the Healthcare Commission Service User ratings. As BLPT itself admits in this document, "The Trust is in the bottom 10% of mental health trusts nationally for performance on the service user survey." As I understand it, the HCC provides the guidelines for random selection of service users and sends this to individual mental health trusts. Mental health trusts then provide the HCC with a list of names and addresses. BLPT has, it seems, decided to add in to this system a mailshot on its own behalf. The Trust Board document states that,

"It was agreed to pre-empt the National Survey distribution by designing and mailing a leaflet explaining the Care Programme Approach and listing CMHT and emergency contact numbers to those service users randomly selected to receive the 2008 survey. The leaflet gave an explanation of the CPA and outlined the service that users could expect from the Trust, using the same terminology as the National Survey document, and the leaflet was mailed during the first week of January."

Since the HCC questionnaire asks whether service users have a care plan, have had a care plan review, know who to contact in an emergency, I can only think this will have the beneficial impact BLPT is hoping. I wonder whether the leaflet they have sent out urges service users to contact their CMHT if they do not have such information - which clearly would affect the results of the survey. If the Trust had chosen to send this leaflet to all service users, I would have no quibbles; it would seem to be very good practice. But to send it out only to those selected to receive the HCC questionnaire seems rather selective and suggests the priority is to affect the survey results rather than to ensure they are providing information and support to all service users.

Another interesting piece of information came from the excellent Performance Report. Undertakings have historically been made by the Trust Board to survey those who have made complaints to find out whether or not they are satisfied with the way their complaint was handled, and to provide evidence for their statement to the HCC (as part of the annual health check) that sevice users are not discriminated against as a result of making a complaint. This was initially stated to happen by Nov 2006, then by Nov 2007. The latest is that a draft survey will apparently be completed by January 28th 2008. I'm sure this has nothing to do with the question I asked of the Board on this very matter this month. I just wonder whether distributing the survey will take the same 14 months it has taken to produce this initial draft.

Also from the Trust Board meeting was information on the recent consutation process regarding Foundation Trust status. For 12 weeks, from October 8th, the Trust ran a series of events seeking the views of the public on how a Foundation Trust should be structured. There were "Presentations to Primary Care Trusts, Overview and Scrutiny Committees, service user and carer groups, staff forums, 9 formal public and 4 staff events." It also distributed "over 17,000 summary consultation documents and 2,600 full documents ... to service users, external and internal stakeholders, as well as being included on the Trust website seeking responses from the public and interested bodies. "

How many people were interested enough to attend the 9 formal public events and 4 staff events? 54.

How many responses were received from the distribution of "over 17, 000 summary consultations and 2,600 full documents"? 27.

I wonder what this level of involvement and response shows about the view of local people of the Trust.


mandy lifeboats appeal said...

Hi Disillusioned

Consultation and Involvement is a minefield.

Apathy and people thinking things aren't relevant to them plays it's part. As does, incapacity to get to meetings to be involved.

When I was more actively involved myself, I raised concerns that organisations didn't do enough to provide access to involvement.

I spoke about using the net, about holding localised meetings and more effective marketing/communications.

One of the winges of the PPI was that they said members didn't use computers. My view was that PPI money should be used to address that. They spend plenty enough on creating audit trails of there own that do sod all. And running training events in London that only those with transport can get to.

NIMHE are the same. They hold events in the 'capital' or most central of their regions. Hence, I had to treck to Cambridge or NIMHE HQ to attend meetings.

Obviously they are not MH Trusts but it seems to be the path of easiest access to the fittest with all these organisations.

My experience in my job, through trying to get evaluations for training events back from staff is that about 30% would willingly complete evaluations...another 20-25% would do it with a ever so gentle prod (full of warm and fluffy stuff) and sometimes Mohameed would literally have to get off her jacksie and go the mountain and help people with this to get it done. Once people understood the relevance, which I did have to remind them about, they got into the habit of doing it...but it took time and there are always those who will think anything not essential to the here and now of their lives is a waste of.

And getting back to the plot, what service users tell me, or I read via the net, is that they have said things before, involved themselves, filled in surveys and nothing has changed for the better.

The motivation to do something like be involved comes from a desire to get things improved, if that doesn't happen...the motivation levels ebb. And who can blame people eh?

MMP said...

hey....the GOOD thing
( and there absolutly has to be something good in all of this )
is that the HCC will always attempt to work WITH the trusts
to enable them to get better.

which is always and always a plus!

The thing many trusts haven't got yet is how to realise that our Early questions of clarification are not questions of confrontation.

But if not addressed fairly early, the requests for clarification rapidly become Issues Of Confrontation.

Then it's battle lines and power struggles.

I'd SO LOVE for it not to be this....

Disillusioned said...

Hi Mandy

I can see some truth in what you say - if people are ignored often enough they stop responding. My experience is that in some areas, my complaint has made a difference - notably in Information Governance, where procedures have clearly been put in place to stop what happened to me (when I was refused information) happening to others. That is good.
How can it happen in one section of the organisation and not in others? I suspect it is down to one or two people in IG leading the way and enforcing change. Which just goes to prove it CAN be done - and makes me think that highlighting the issues I have is worth doing.
MMP, I just made a list of the good things that have come from this terrible experience for me - and you'll be glad to know that there were some! I hope you are right in terms of the HCC. I do think you are right in the implication that Trusts see complaints as confrontations where they don't need to be. I've said it many times before, and I'll say it again - if the Trust had given me the apology I sought (and the apology they promised) this would all have been settled long ago and I probably would no longer be pointing out the continuing issues. In fact, I would probably be onboard in their bid for Foundation Trust status and maybe even contributing positively to their training and development - all without pay.

mandy lifeboats appeal said...

I haven't got to the complaint's stage yet.

I guess my view is that it is another lot of procedures to get caught up in and I would have to have faith in an organisation that it would deal properly with the complaint, which I don't but maybe time will prove more positive for you. Not that that would prompt me to start one, because, in all honesty I haven't got the time.

I need Dad to have appropriate follow on care, imminently, rather than through 6 to 12 months of a complaints procedure.

At present, I am following what i think is correct procedure but more importantly relevant to Dad and Me and going to his ward meeting tomorrow. From there, I can decide whether I believe the CMHT will pick things up or whether I then go via the PALs and if that doesn't work Director at Trust route or whether I go straight back to my MP.

Time is of the essence for Dad and me.

Would like to see evidence of how the HCC has dealt with complaints that have not been resolved before.

Disillusioned said...

Hi Mandy

I'm afraid my experience gives me no hope at all in the BLPT complaints system - their key staff didn't follow their own procedures in my case, which made their initial investigation a complete farce and very damaging to me. On the other hand, if I hadn't complained I would never have got the support I needed. After 6 months of hell and increased mental ill-health, I am just now getting to the stage I was before my former Care Coordinator went off work sick. If the support had been there for me at that time I believe I would now have been discharged from mental health services, and if the Trust had not made such a balls-up of my complaint I wouldn't have needed the extra input I have needed. Nor would I have been self harming and suicidal in the intervening time.
I hope your Dad's ward round goes well and is a helpful process. I suspect after inpatient admittance they will have to provide CMHT support. Let me know what happens - I have various pieces of documentation which might help if things do not go as you hope.

The Shrink said...

I guess the acid test is, "would I be happy for me, my nearest or my dearest to receive care from that unit?"

There are very few units where I'd say "yes."

Disillusioned said...


Good comment.

There are certainly individuals within the Trust whose judgements I trust. But this Trust as a whole? No.
Unfortunately there isn't a choice, not one that I can afford anyway.