Can you keep yourself safe? An adventure with Crisis.

Can you keep yourself safe?

So there's no local care.  We know about this and at least two people yesterday who are following this campaign have been deterred from seeking help because they are scared of what will happen. 

Fear.  Fear is a bad thing when you are already fearful, or perhaps not thinking rationally, or seeing every small set back as a huge challenge that can't be overcome.  Catastrophising.  Every little thing lending weight to the idea sat in your head that life isn't worth living and you'd be better off dead.

In steps the Crisis Team.

Except there's not many people in the Crisis team, and personal experiences shared by Service Users expose the huge disparity of the care given by individual members. 

If you have a crisis in the middle of the night, you need to vie to speak to the lone worker who is covering all of the area.  On other nights you find yourself being transferred to the lone worker sat in another area of the Trust, miles away.  What can they do?  Not much.


But surely you will get a sympathetic response?  Not always.

"What do you want me to do about it?"

"Was it you calling over and over again when I was on another call?  We do have other people you know".

So you end up feeling worse, like you're wasting their time.  Like you're even more nothing than you were before.  This makes the usual "what can you do to distract yourself" and "What has helped before when you've felt like this." seem benign, although generally very unhelpful.

Then you have the assessment of risk, except if you don't fit nicely into their check-sheet for risk then you're not as likely to be taken seriously to get help.  You have a mental illness - fine.  Not a man of a low socioeconomic background who lives alone?  Well why aren't you organising your own help then?

Because its that easy, isn't it.

Then you have the pejorative way in which some members of the team treat people who even have a whiff of a note of "personality disorder" against them - or worse, when someone in the team decides you have a PD despite there being no such pathology in any report.

They can't really mean it, they're manipulative and attention seeking. Missing the point that each case needs to be taken on its own merit.

Then the last question - Can you keep yourself safe?

Well no, no I don't think I can, that's why I am calling you, but by calling, you dismiss the sincerity of what I am saying because I've called you.

Can you keep yourself safe?  You better be able to as there's no help to be found.

#crisisteamfail

Judicial Review - Letter Before Claim to be sent to the LCFT

After taking advice yesterday, Beds in the Orchard contacted their solicitor and asked for a Letter Before Claim to be sent to the Lancashire Care NHS Foundation Trust with regards to taking them to court for a Judicial Review into their action of closing The Orchard to women.

When taking action, even temporary, that has a direct affect on a Protected Characteristic as outlined in the Equality Act of 2010, in this case a person's sex, a public body must pay due regard to the act and must publish documentation about how due regard was given when asked. The Trust as unable to provide such information and are therefore liable to Judicial Review.

Below are some of the questions that have been asked amongst campaigners and our responses.

What does this mean?
The Letter Before Claim will lay out the case for how the Trust has made a decision in a way that contravenes the Equality Act.  It will give them the opportunity to negotiate a resolution with our campaign before it goes to court.

Sounds expensive.
Judicial Review claims are eligible for Legal Aid.  For someone to be eligible for Legal Aid they need to be in receipt of certain benefits - in our case ESA, have savings of less than 8K and less than 100k of equity in any property they own.  Because of the nature of the people we are supporting, there are a number of our group who qualify for Legal Aid.

Do you really want to go to court?
This campaign has always been about returning inpatient care to the women of North Lancashire and that is all we want.  We would naturally prefer to do this out of court so that the public money that funds the NHS was spent on patient care rather than court cases.  

What next?
We would appeal to the LCFT to find a way to return The Orchard to a mixed sex facility as soon as possible and to not close the facility to women again.  We are still at a stage where we can resolve this together and as our case is quite clear cut it would benefit no one for this to be taken fully down the legal route.

Orchard Beds Vindicated by The Freedom of Information Requests

Today Beds in the Orchard received the responses to the FOI requests.

All along, we have said that the closure of the ward was for financial reasons, that it was due to impact of closing the 22 male beds in Burnley and that it was until The Harbour opened.  The Trust have denied this.

They have denied this on BBC Radio, in the Lancaster Guardian, to our service users in response to our letter of complaint and in the letters to the MPs.  Below are some of the things that have been said.

• "The intention isn't for this to run for weeks and weeks".
• "I would like to reassure you that the use of The Orchard as an all-male facility is very much a temporary measure."
• "This isn't for financial reasons."
• "This has nothing to do with the closure of the ward in Burnley."

To reiterate:-

This was a short term, temporary measure that wasn't for financial reasons and had nothing to do with the closure of 22 beds in Burnley.

The FOI information should have backed this up.  The Trust have been consistent in their reply and surely they would not give misleading information to the media, their service users or the MPs would they?

Perhaps we're misunderstanding what we've been sent, but here is some of the information provided to us from our FOI requests.

From 9/9/14 Sustainability Minutes - Suggestion made to open male ward on Darwen as no extra staff will be required. Discussed use of the Orchard as a ‘flexible friend’ to support longer term pressures of gender demand and we could scale down females to make all male to support this transition.

Longer term pressures of gender demand.  Please note: Longer term pressures.  Not short term pressures. Making the ward all male for longer term pressures.


Many thanks for your input and pragmatism yesterday in the meeting around managing the correct number of male vs female bed reductions, in line with our need to close a ward in total this financial year.

Our need to close a ward in this financial year.  Please note: Close in financial year, for financial reasons.


We all agreed we couldn’t manage with the loss of 22 male beds though so we agreed mitigation plans (some dates for the mitigation actions below TBC):

We couldn't manage with the loss of 22 male beds.  Please note: The closure of the 22 male beds in Burnley was acknowledged as unmanageable and therefore would have a known impact on the rest of the inpatient provision provided by the Trust.


TH suggested using The Orchard as a flexible ward if the network is under pressure for male or female beds for a period of time. The current female patients could be moved to Scarisbrick Unit. AW stated that as the Orchard is a standalone unit it would have to be clear which patients could be admitted as there is only 1 seclusion room. The ward would be flexible until the opening of the Harbour.

Flexible until the opening of the Harbour.  Please note: Until the opening of The Harbour.  The hospital due to open in March 15 if it runs to time. 

There are other details in the FOI information, mainly talking about where they were going to make up the shortfall of beds, and talk of the transitional period - which we believe to be the period before the beds being closed and The Harbour opening.


What is clear is that what we said all along was true.  That the women of North Lancashire were the victims of cost cutting measures and the closure of the Male ward in Burnley and that the Closure of the ward was until The Harbour opened.

Shame on you Lancashire Care NHS Trust.  Shame on you for treating your female service users like this.

Full response publicly available here.

Today we are Angry

Today we are angry.

We are angry because there is a woman from our area experiencing all of the problems we have been talking about.

We are angry that she is miles away from her home.

We are angry that she is miles away from her family.

We are angry because she's separated from her children.

We are angry that she doesn't have any visitors as its too far to travel.

We are angry that she's being treated by people who don't know her or her history.

We are angry that she was treated in a dismissive and disrespectful way.

We are angry that she couldn't leave easily as she is ill, alone and miles from home.

We are angry that this will continue as there's no chance of her being moved closer to home.

We are angry that it took intervention from people on twitter for anything to change.

We are angry that this has even happened.

There are a number of us who have found what happened today with the women being treated in Burnley very triggering as it reminded us of the experiences we have faced ourselves when being treated away from home.

There was a time when this would have upset us and maybe we would have withdrawn into ourselves and let it churn and churn into introspective negativity.

But no.  While we are deeply, deeply concerned that there is someone out there who is struggling with the situation she finds herself in, through no fault of her own, we are not running away.

We are angry.  Very angry.  And that anger is galvanising us to make sure that we keep on going and we keep on fighting this until we have the female beds back at The Orchard.

If you share our sense of anger and injustice at this, see the pinned post on our blog about how you can help.  Sign our petition.  Get angry and speak out as well.  Every voice helps.

If it was a general ward no one would suggest closing it.

A response to their letter from the Trust from another one of our campaigners.

I've head back from my letter.  They're still talking about home treatment being better.  I still say that if this was a general ward, no-one would suggest closing it because more men needed treatment.

Its gone beyond their "Lancashire wide provision" which they are saying in all letters.  They have to rethink their whole strategy of provision of care in Lancashire.  As I said before, 6 women have been sent elsewhere already and its probably more by now.  Do you know if the men's beds have been full up since they did this?  I was in hospital in winter, and the female beds were so full, when I went home on a trial, the bed was swiped!

I was at a Green Party Fayre today, and put it across to a man and put a quick note for their next meeting.  He said he will look into it.  I think he was earnest.

I sent my story with my letters, and they said that they would make exceptional provision if there was a serious family problem that meant local care was needed.  But I fail to see how they can if there is only one woman on the unit.  It also shows that they aren't telling the whole truth.  They also told me that the provision in the community is being made better  - I really think that is a crock of shit!  I'm being treated in the community and all we do is fill in endless forms, which mean nothing to me! 

I'm trying to get support on a mental health forum but only a few are willing to sign a petition as they are mostly very ill people, so not able to help in this.  Its an indictment of the care that they need a good forum to support them - there is so little good care in the NHS.

Not financial reasons LCFT? Tsk!

First of all, Beds in the Orchard would like to send an apology to Lancashire Care NHS Foundation Trust.  We have previously stated that the Trust closed 15 bed male ward in Burnley.  It now turns out that Ward 18 held 22 beds.  We are assuming that the Trust were happy with this misinformation as they haven't corrected it.

However, we think that the Trust owe Beds in the Orchard an apology for stating publicly on BBC Radio that these changes have not been for financial reasons.


http://www.lancashiretelegraph.co.uk/news/11077649.Burnley_mental_health_ward_still_set_to_close/?ref=rss

In the above Lancashire Telegraph article from March this year, it states...

"Ward 18 was due to close this year, saving £720,000 for the Trust's in year 7.45million cost improvement plan. But it has been confirmed the plans are slightly behind schedule – though the ward is still expected to finally close this year"

This makes it quite clear that the closure was indeed for financial reasons.  The article goes on further to state,

"Trust chiefs have been working on a programme to provide more community services, decreasing the need for in-patient beds."

We have submitted a FOI request to find out how the Crisis and other home treatment teams have been augmented in the East Lancs area to meet the needs of service users affected by this closure.

Finally, on the subject of the ward closure, the Trust says.

"The closure will only take place when it is clinically appropriate to do so."

We've heard that phrase before as we've been told that the 6 beds in The Orchard unit will revert back to female "when it is clinically appropriate to do so."

"Clinically appropriate", in our opinion, appears to be a meaningless phrase used to defend cuts to services.  The female service users of North Lancashire appear to be the victims of these "clinically appropriate" decisions.

The Equality Act 2010 - How is this not discrimination?

The Equality Act of 2010 sets out a list of Protected Characteristics.  These are: (in no particular order)

1. Sex.
2. Sexual orientation.
3. Race, including colour, nationality, ethnic or national  origin.
4. Being or becoming transsexual.
5. Age.
6. Disability.
7. Being pregnant of having a child.
8. Being married or in a civil partnership.
9. Religion, belief or lack of religion/belief

You’re protected from discrimination in these situations:

1. at work
2. in education
3. as a consumer
4. when using public services
5. when buying or renting property
6. as a member or guest of a private club or association

We believe that the women of North Lancashire are being discriminated against due to their sex when using public services.

The Trust says it's flexing, not discrimination,  but we'd like to change male and female for a few other protected characteristics to make our point.  How about...

There are more heterosexuals needing beds than homosexuals, so we will only treat heterosexual patients at The Orchard. All beds will be made for heterosexual use only and all homosexual patients will be sent out of the area.

There are more White British needing beds than Asian British, so we will only treat White British patients at The Orchard. All beds will be made for White British use only and all Asian British patients will be sent out of the area.

There are more young people needing beds than older people, so we will only treat young patients at The Orchard. All beds will be made for use by young people only and all older people will be sent out of the area.

It sounds so wrong doesn't it.  So why is THIS acceptable?

There are more men needing beds than women, so we will only treat men at The Orchard.  All beds will be made for male use only and all female patients will be sent out of the area.

More Freedom of Information

Another Freedom of Information Request has been sent to the Lancashire Care NHS Trust this morning.  Today, we are looking for answers about equality, who is filling the beds and how Home Treatment has been expanded to meet the needs of the men and women no longer treated on Ward 18 or at The Orchard.

Dear Sir/Madam,

Please can you provide me with the following information.

1. The Equality Impact Assessment of closing female inpatient beds at The Orchard in Lancaster conducted by the Lancashire Care NHS Trust before the beds were closed to women.

2. The number of male patients from the East Lancashire region treated, or being treated in hospitals run by the Lancashire Care NHS Foundation Trust elsewhere in the county (Preston, Chorley, Ormskirk, Lancaster and Blackpool etc.) since the closure of Ward 18 at Burnley General Hospital.

3. The number of male patients transferred from Ward 18 in Burnley to The Orchard in Lancaster when Ward 18 was closed.

4. The number of male patients from East Lancashire treated in The Orchard since 01/09/14 to date.

5. The FTE of staff in the Crisis, Home Treatment and CCTT teams in Burnley and the surrounding area the months before, and then after the closure of Ward 18 in Burnley.

6. The FTE of staff in the Crisis, Home Treatment and CCTT teams in Lancaster and the surrounding area the month before, and after the closure of The Orchard to women.

Best regards,

Beds in the Orchard takes on the Trust on BBC Radio Lancashire

If you are from out of the county or just weren't awake at 7am this morning, you can listen again on their website - http://www.bbc.co.uk/programmes/p0293ql6.  The podcast is available for 7 days from today.

Listen to Claire speaking on behalf of the Beds in the Orchard Campaign at around 7am and the response from Deputy Network Director of Lancashire Care NHS Trust at around 8am.

A lot of what Claire said is already on this blog.  She's kicking herself slightly about missing some things out, but it was Live Radio and there was a lot to say in a small space of time.

A quick take on the Trusts response:

If this is 'county wide' care, then you really can't then argue that the closure of 15 male beds in the county wouldn't have an impact on the need for male beds in the county.

Travel expenses - If they have to be claimed back, then families without the money to pay up front will still be unable to visit their relatives.

We were delighted to hear that female beds will be open back in The Orchard 'as soon as possible'.  We've heard you say that now, Lancashire Care.  "As soon as possible" is NOT March 2015 when the Harbour is due to open.

This campaign will continue to run and will continue to apply pressure until the female beds are reinstated at the Orchard.

Views of a worker in the Lancashire Care NHS Trust

I cannot thank enough the writer of this piece.  Our campaign has been noticed by people who work in the trust and one person has been kind enough to share their thoughts.  For good reason they wished to remain anonymous and as such we don't have details for them.  We have mailed our heartfelt thanks to them for sending this to us tonight.

I am greatly troubled and saddened by the closure of The Orchard Psychiatric Unit to women in Lancashire, whether permanent or temporary.  I am incensed that this was executed without patient and carer consultation, but I am in no way surprised.

The word is that this is temporary until The Harbour the new 'flagship' hospital opens next year, yet amazingly there was no need to stop women's access to the Orchard because until a few weeks ago a full male ward of around 22 beds, was open and fully functioning; Ward 18 in Burnley General Hospital. This should have remained open until the 'Harbour' was open to accept this extra population of patients.

The reason for this process can only be financial.

As a worker within this same Trust, I see the effects upon patients, their carers, families, friends and wider social networks of certain Trust policies.  However; we must remember that Trust Executives and Governors are duty bound to tow the line set by the Department of Health, and this Government.

In other words the Trust Board, it's Governors and high tier management are generally formulating policies which in essence look purely at apparent immediate and short term financial reductions not normally genuine economic benefit.

I have to question where the Duty of Care has disappeared for both Trust Board members and the Department of Health. The government quite rightly espouses duty of care, but acts like it has no duty of care where short term finance is concerned. I believe Stafford was also partly a result of 'Target' driven management which seriously affected staff morale.

Government and Trust policies often ignore true patient need; i.e. an excellent package of care, looking specifically at an actual in depth holistic assessment of the patients and families therapeutic needs; followed by a full and rigorous provision of the identified therapeutic needs with fully trained staff at all levels.

I wonder whether people are aware that just 3 or 4 years back, the Trust initiated it's DoH ordered programme of budget cuts by a fifth (20%).   Within the last year I was advised that this figure was increased to a quarter (25%). This programme had a 5 year time period. 

What this means in real term reductions, someone smarter than I will have to say. These cuts march on, contrary to the statement earlier this year by David Cameron that NHS budgets are safe and 'Ring fenced'.

It should also be noted that in the midst of this earlier 20% cut, the board approved and the Chief Executive accepted a 20% RISE in her salary. This took her already incredible salary way over £200,000.  In my opinion, if someone needs such a salary as an inducement to stay in post, I have to ask; does that person have the right motive to be there?

Surely providing what is NEEDED has to be the MOST economical way of caring for a person who is ill. I believe especially so with mental illness. With physical brain lesions, we expect everything to be thrown at brain Surgery; e.g. if a family member has a brain tumour or has been involved in a fall; yet we give as little as possible towards brain manipulation (Psychiatry / Psychology), where the affect is functional. This is the same organ.

I feel duty bound to loudly state that providing the necessary holistic and comprehensive person centred care package is an imperative for all patients, their families/carers and the wider socio-economic setting.  Common sense says that this care package has to include ready access to a LOCAL inpatient unit when hospitalisation is necessary.

People with Mental Illness are so often sidelined, minimalised and misunderstood even by their own family.  Not to mention their friends, fellow colleagues, Workplace Management, and dare I say it, yes even a number of so called Mental Health 'Professionals'. This ignorance affects their attitude and therefore behaviour towards the person with the illness, and results in the knock on effect of increased interpersonal stress which can only exacerbate the symptoms of the 'Broken Mind'.

If we break our leg, we put the utmost care into protecting it. We talk with empathy and treat the person suffering with compassion. We put a rigid cast on the injury site. We provide crutches to allow the person to support their leg whilst walking, or a wheel chair if things are more complicated; and we all rally around to help, even wanting to push the wheelchair.

However, with a fracture or a break in the mind, we act as though the mind does not require this protection. It's uncomfortable for us so we say- get a grip, pull yourself together, your just behaving badly. We are full of negative clichés. Yet, trust me, I know from experience that a person CANNOT just do these things without the 'appropriate' support and time.

With mental illness a 'glitch' has occurred in the brain's development or programming; or neurones are not communicating as and when they should. It is probably short term, but it WILL be longer term without the appropriate Stress free help; but this will likely develop into a permanent illness for many if we stay on the road we are on.  Would you wash a burn site with hot water? No,; likewise you should not add stress to a broken mind.

My own family have suffered greatly due to mental illness and we are still affected many years on.  When a member of your family is in a hospital away from home and you have to travel far to see them, it impacts greatly on the family all in areas such as emotion and finance. 

Mental illness impacts on the economy, with time taken off work and adds extra pressure on Health Services and staff.  Proper mental health care will have financial benefit across the national economy, including maximised productivity in the individual’s workplace.

As is the need of all, give these women all that they need to recover close to their homes, and the costs will be as low as it is possible to be.  Holistic and appropriate care should be the Government and Trust values, not back room cuts and decisions for financial, not caring reasons.

Remember, it may be your Mother, Wife or Sister who has a sudden breakdown soon.

                                                                           

There's no trusting the Trust

A Source at the Lancashire Care NHS Trust today said that closing The Orchard to women is a 'temporary measure' until the new hospital "The Harbour" is opened in Blackpool.

This is a step away from the previous reasons of protecting the vulnerable, but could cover their reason of it being 'based on need'.

So why do they need more male beds now?

Following further enquires and investigation, we discovered that just weeks before The Orchard was closed to women, they closed Ward 18, a 15 bed male psychiatric ward in Burnley, with no means to cater for the number of beds they knew they needed.

If the Trust closes male beds, they should mitigate that closure by providing treatment in the community to the men they otherwise should have admitted as inpatients.  Instead, they withdrew inpatient care to women of a large area of the trust. This is not acceptable.

It's the women of North Lancashire who are paying for this cost saving exercise.  It is the women of North Lancashire who are being denied local treatment and its their families who are paying the cost in time, travel and disruption for this decision.

Lancashire Care is failing in its duty of care to the women it is meant to treat and support.

It has to change.

So, I asked my Children. "What was it like when I was in hospital?"

Daniel and Cait (not real names) were 4 and 7 when their mum was admitted to inpatient psychiatric care in Lancaster this year. 

Daniel has Autism and found it difficult to comprehend why his mum was no longer at home.  He counted how many days she was gone.  Cait just missed her mum a lot.  Their mum has talked to them about what it was like while she was in hospital and what made it better.


When you were in hospital we really missed you and we never want you to go back. 

You were sad and daddy was sad, it was horrible.  I counted how many days you were there and you didn't come back when you came back before.

We liked visiting you and feeding the horse.  We liked the cafe too as they were nice and there was chocolate.  Sometimes I cried when you didn't come home with us.

I missed you mummy.  Grandma doesn't hug the same.

Their mum asked - what do you think it would be like if I was in a hospital in another town?

That would be really sad because we couldn't get there.  I'd be very, very sad if I couldn't visit you and we'd cry.  I'd cry.

Lack of local care would have isolated Daniel and Cait's mum from them and caused the children additional upset and distress.  Local inpatient psychiatric care isn't just important for women, its important for their families too.