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The end of the NHS listening exercise
Posted Monday 13 June 2011
The future of the NHS is all over the media. Stung by criticism from politicians, health professionals and the public, in April the Government announced a pause in its reforms and set up a 'listening exercise'.
The group overseeing the listening exercise, charged with investigating people’s concerns and recommending changes to the proposals, was the NHS Future Forum. I was asked to be on the panel of this group, and for the last few weeks have worked to ensure that the concerns and needs of people who use mental health service are represented on the panel. While it’s clear that many people hugely value the NHS and the way it supports mental health service users, it would certainly be wrong to assume that nothing needs to be changed (perhaps the impression created by some media coverage).
At the start of the listening exercise, Mind launched a survey asking for your thoughts on the reform proposals. We received an incredible response, with over 1,300 surveys submitted in just a couple of weeks. Using this feedback, input from focus groups and our policy recommendations, I’ve been making the case for changes to be made to the Government’s reforms.
I’ve emphasised to the group the importance of ensuring meaningful choice, and in focusing on an individual’s whole journey through mental health services when commissioning these services (incredibly, one in 10 people that responded to our survey had been assessed eight times or more in a single year!). With 75 per cent of you telling us that you had never been asked for your views on mental health services in your area, I’ve argued that much more needs to be done to guarantee proper patient involvement in the design of services in a local area. Finally, it’s clear that a lot more needs to be done to better join up health and social care services.
The Future Forums report is published today. Many of its recommendations could make the reforms work a lot better for people with mental health problems. These include:
- a call throughout the health and social care systems for ‘no decision about me, without me’
- using competition to support meaningful patient choice, rather than for its own sake
- better integration between health and social care sectors
- the creation of a governing body for the new GP consortia, that meets in public and has effective independent representation.
Of course, the Government is not obliged to adopt these recommendations. However, it is keen to win public and professional support and push its reforms through Parliament, and will be under considerable pressure to do so.
Either way, this is not the end of the story. There’s a lot of political wrangling to come, and it will be the responsibility of Mind to ensure that these reforms deliver a real improvement in the services used by people with mental health problems. We must also ensure that mental health aspects of these reforms tie in with the mental health strategy announced by the Government earlier in the year.
This is the end of the listening exercise, but now the talking really begins. Thank you to all of you that gave your feedback through surveys and focus groups. I'll continue to work towards getting your voices heard, and ultimately helping you shape the services that you use.
I’m sure there will be more opportunities for you to feed back, engage with and influence these reforms — we'll keep you posted. In the meantime, do have a look at the NHS Future Forum recommendations and let me know what you think.
Paul Farmer, Mind Chief Executive
5 Comments
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Assessments are frequently a means to no end or a very time limited diagnosis-led fixed end. Access through a single entry point [ASTI services] for a fixed period, then onto the 'recovery' service which is another version of OT and focused on the real recovery aim - employment of any kind at any cost, and that's it. In - out - as quickly as possible preferably within 6 months with a 'choice' of CBT or its variants and/or medication then discharge back to GP [which means no support to many]. There's only ongoing support for a few [those viewed as potentially dangerous to others] and if you seek further support then it's back to the GP through ASTI again so it counts as a 'new' referral because the aim now is to get as many 'new' referrals through. Few people have vocational support in their enforced recovery period and that is time limited often with a very low bar [manual/shelf stacking/retail]. I note the Access to Work offers time limited help with taxi's to work though I'm sceptical this would apply to mental health and probably be reserved for people with physical disabilities. I doubt it would cover people's unpaid sick leave so I fail to see the enthusiasm for this. Its as though all the charities are resigned to a million sick/disabled people being relocated to JSA into non existent jobs or jobs no one wants to do but can be forced to do via sanctions whilst Access to Work is bigged up like Pathways was and back-to-work schemes make millions. No charity speaks of chosen voluntary work as an additional outcome in between working and not working, nor of a more creative system where people could work as they are able and remain on their income with paid work deducted [people not working full-time would still require benefits anyway]. None of these government 'listening exercises' have any intention to listening to what service users have to say, they are hell bent on reducing mental health services to the bare minimum using the bare minimum
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I resent the current appropriation of the US term 'nothing about us without us' because it's meaningless here, service users have no say
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http://www.guardian.co.uk/society/2011/jun/20/mental-health-services-in-crisis-over-staff-shortages
Staff shortages, psychiatrists and therapists, massive benefit cuts workfare, sanctions, no jobs, media and social hostility. legal aid cuts. a snap shot of life for the mentally ill in 2011 and beyond.
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The NHS hounded me out of nursing and labelled me personality disorder-it can go to hell as far as I'm concerned.
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obviously they are not listening when they have decided how much of the budget to cut. It would really save money if they could do it properly. For instance why not ask people to get reports from an occupational therapist that isn't from the benfits agency? shouldn't it be their job to say what level of activity a person is capable of?
the current system is draconian. It leads to relapses like in other areas it leads to homelessness and then costs more money. If you make people relapse on mass then they are even further away from being able to work. I feel I would be further on with it by now if they didn't keep prodding me to see if Im really genuine. That should have been decided in the first assessments which was years ago! once that is decided then you need to cut the disabled some slack if they are going to be able to move a muscle!
oh and how about having some disabled people on the panels that interview people for the benefits...thanks for listening
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