Friday, 1 February 2008

More on notes

Reading my complaints file has made me more aware of the activity going on behind the scenes in "managing" me and my complaint.
As I said to someone yesterday, if some of the effort put into "managing" the situation had gone into answering my queries (instead of ignoring them), the whole situation could have been resolved relatively easily by BLPT. Instead, huge amounts of time have been spent by people who have never met me deciding how best to "handle" me, preparing reports (which are about me but which do not exist in the Complaints file or in any centralised records relating to me, as far as I can see) and in telling others not to respond to my appeals for help.

I'm very very concerned by the amount of information which appears to be floating around in "the system" about me - but which is not centralised or recorded in any accountable fashion. I'm curious about how the demands of the Data Protection Act fit into this behaviour. I'm actually quite horrified that two senior members of staff were asked to prepare a report about me which was presented (in secret) to the Trust Board (albeit, allegedly, in anonomised form) - and yet neither of these two members of staff had had any direct contact with me. Instead I assume they relied on the opinions of others. These "others" presumably included people who had not followed the Trust's own complaints policy and who had, in many cases, lied about their own actions and words.

From the Complaints file, it is now clear that M (BE CMHT manager) gave at least four different reasons for not providing me with support when my care coordinator was away ill. These range from there being insufficient staff in her department, to my not being a priority for allocation, to me not deserving continued support because I had already been provided with support in the past.
My verdict is that M was antagonistic to me from the start because the decision of her CMHT not to provide me with any support initially was overruled after I managed to obtain a psychological assessment with a consultant clinical psychologist who was not attached to her team. Evidence in terms of her attitude to me in phone calls, breaks in support and delays in providing support despite exhortations to do so from staff within the Trust supports this view. She probably was heading a team which was short of staff, but did not appear to highlight the shortfall in service to someone in need as she should have done. I remain convinced that she discriminated against me because of my earlier complaint, and that the Trust has decided to ignore this because the consequences of acknowledging it would impact upon them. They would rather leave me to deal with the consequences of being invalidated. M's main strategy seems to be one of changing her story - it's a recurring theme...

Another M (this one the local manager) lied about his communications with me. He too was unwilling to provide me with support. He has relied on asserting his point of view and implying that mine is unreliable because I am a "service user". However, I know what he said, the Complaints Manager knows what he said and what she said (and wrote to me) and his version of events does not tally with either of these (though he is very good at presenting only part of the truth and ignoring other parts, such as the fact that my psychologist told me his suggestion of a transfer of my care to another CMHT had been refused). M is also very good at fudging dates. Selective recall seems to be his main strategy.

Considerable weight seems to have been placed in my Complaints file on the fact that I approached a number of people for help. It has been implied that I can therefore be classed as a "vexatious complainant". However, what is ignored in this judgement of me is that I only approached further sources for help after the initial or routine approaches were refused or not responded to. So, when the local manager, M, told me my care would not be transferred, I appealed to his line manager. When he told me I had to wait for a response to my complaint (which I had been told would take 25 days, I understood this to mean that there would be no transfer of care until my complaint was answered and sent an email to members of the Trust board and anyone else I had contact with within the Trust, because I did not know who else I could ask. My actions were not an attempt to confuse matters or to get attention for myself, they were an attempt to solve an unbearable situation when those who should have resolved it were refusing to do so. Similarly in other situations.

And, of course, BLPT did not follow its own Complaints Policy. This has been partially acknowledged. It appears (from Trust Board minutes) that the Complaints Policy itself is being rewritten. That's all well and good - but the main question is surely not what is in the policy, but whether it is being followed.

Obviously I believe I am in the right. The Trust appears to believe they are in the right. That's understandable. But the Complaints notes reveal an awful lot of behind the scenes activity, which suggest to me a desire to cover things up and shut me up, rather than an attempt to help me and resolve the situation.

I guess I have to wait now and see what (if anything) the HCC decide - sometime within the next 6 months. It's taken me a long time to be able to move on to that stage of the process. The CEO referred to this delay in an email, saying that "for some reason" I had not taken this step. It's not that I didn't want to or intend to - just that I have been so damaged by the actions of BLPT I was unable to do so.

And I am not forgetting the good people in all this. I've been at pains to acknowledge, here and in contact with representatives of the Trust, what a positive difference certain individuals have made. But they have been fighting an uphill battle, and they have been in the minority. So many people seem to have been primarily concerned with fighting their own corner or protecting the "Trust". But then, why does BLPT exist? What is supposed to be its purpose?


MMP said... ensure it passes its audit?

Disillusioned said...


Nah, surely not?

Made me smile - quite an achievement tonight. Thanks.

marcella said...

"Considerable weight seems to have been placed in my Complaints file on the fact that I approached a number of people for help" - if a student DOESN'T approach a number of resources as research, it's called plagiarism. If a consumer doesn't look round at the alternatives before making a large purchase it's called foolhardiness, if a religion doesn't consider a number of points of view it's called bigotry. OF COURSE you approached a number of people when the initial responses were lacking - any intelligent person would. Seems like they're not used to dealing with intelligent people but they'll just have to get used to it. Just think what substandard treatment the poor unintelligent, uneducated service users are getting because they DON'T ask around.

mandy lifeboats appeal said...

I agree with mmp.

The problem with MH Trusts is they are too busy finding or producing evidence that they have met their targets or showing out to get Foundation status. Not just that but there seem to be so many external influences (not patients mind)..that require evidence of the paper based variety.

I wouldn't mind that if it made them better at providing care but it doesn't. It makes them even more bureaucratic and less human.

What Disillusioned wrote about being given four different reasons why they wouldn't provide care support is typical. Trusts are very good at providing reasons why they don't do things.

At least you got reasons, not that that helped. Dad and me haven't even been given reasons in the past. Except one CPN who said her caseload was too big. that should not be a patient's problem. Everyone else just passed the buck.

I think the Trusts are in a mess, on the surface they are shiny and quite excellent at form filling but underneath it is chaotic and most of the front line staff seem to use that as an excuse to do so little or delegate it back to patients. And there are exceptions to that rule but I haven't come across that many in recent years.

A couple of people have said to me that Trusts shouldn't exist because they are so bad...Hmm...I think that would be worse (certainly if there were no acute units or crisis care) but I dunno anywhere. What would replace them?

I have heard that Mind want to run services. Now, if they could run services better than Trusts I would say go for it. But I am sceptical. There seems to be this notion that service users could run the services. Maybe in some areas and with real support but putting that kind of pressure on ill people, well I don't think that is a good idea.

Could it get any worse? Yes it could but maybe not much.

Disillusioned said...

Marcella, thank you. It's so tempting at times to "buy into" their explanations. I think I have reached the stage where I no longer expect an apology (I suspect even the HCC won't be able to make them do that), but I'm trying to gather as much information as I can to try to understand. It does frighten me how easily the trust appears to have written my enquiries and perseverence off as a symptom of my mental health problems. But there you go.

Mandy, I agree with what you have posted. The comment about not being taken on because a worker's caseload is too large, and your response that "that should not be the patient's problem" is so very very true. Bureaucracy is a key factor, I am sure, but so too is a preoccupation with meeting targets that do not necessarily make any difference to people seeking support.
At the same time, I have been lucky and encountered some excellent front line staff. I wouldn't write them all off. I think part of the issue is that resources genuinely are stretched - and that the systems and safeguards that should be in place and followed aren't always. For example, I know there is a system for reporting a lack of resources where that leads to lack of provision for service users. I also know that system is not always used. And I don't know how much notice is taken of it if it is used. In many front-line aspects there seems to be a total lack of monitoring (eg monitoring of complaints).
As to whether there is a better solution than Trusts - I am not at all sure. I'm NOT keen on this particular trust being given even more freedom to run itself, given the way it is currently performing. And I don't feel that Service Users can or should be asked to run services themselves - but I do think more notice should be taken of what we are trying to say.

MMP said...

....back to needs-led or rescources-led...

Disillusioned said...

Indeed, mmp.

I fully accept that there is a finite limit on resources. But the needs of individuals should be a prime consideration, imo.

I think the bigger issue is the willingness of people working in an environment such as BLPT, especially those in management, to put the needs of service users above the needs of the organisation.