Service User Involvement in Manchester Mental Health and Social Care Trust: Rhetoric and Reality

Recently I came across an article by the Head of Patient Experience in Manchester Mental Health and Social Care Trust (MMHSCT) published in the Health Service Journal. The article is dated 22 November 2012 and is entitled ‘Building patient engagement from the ground up‘.

The Head of Patient Experience says: ‘We [MMHSCT] had the best scores for treating people with respect and dignity (9.7 out of 10), making people feel listened to (9.3), and taking service user views into account (9.0).The Trust also received the highest national scores in helping people to achieve their goals, making sure people know what to do in a crisis and supporting people with mental health problems to address their physical health needs’.

This is what I (somebody who uses services in MMHSCT) say:  ‘In Manchester Mental Health and Social Care Trust, inpatient and community adult mental health services are currently being ‘reviewed’ and re-structured. 

With regard to inpatient services, one of the adult inpatient wards (Edale House in the MRI in central Manchester) closed in spite of the strong and longstanding opposition expressed by service users, carers, and staff alike. The decision to close Edale House was clearly based on cost, given that the Trust was apparently not keen on continuing to pay rent for the ward premises. All patients from Edale House have been transferred to Park House, an inpatient facility in North Manchester General Hospital (in north Manchester), where the Trust owns the land and thus there is no payment of rent involved. Now that Edale House has become unavailable, people living in central or south Manchester are likely to find visiting relatives and friends admitted to Park House, in north Manchester, particularly difficult and off-putting given the increased amount of travelling involved. In addition, I understand that there are few individual rooms in Park House – at least that was the case back in 2009 when I was detained there. So, now that Edale House has become unavailable, people admitted to Park House are faced with the dormitory situation which can be very frightening and exposing, raising serious issues of lack of privacy and dignity – it was actually really traumatising for me. Finally, when I was detained in Park House in north Manchester, I lived in central Manchester; this meant that using my Section 17 Leave (6 hours per day at some point) in a meaningful way was a real challenge given that for instance it used to take me over 2 hours to go home from Park House on public transport. So, now that Edale House has become unavailable, people living in central or south Manchester and detained in Park House are likely to be hindered from using their leave (their only glimpse of freedom and autonomy within an everyday reality defined by compulsion) in a meaningful way due to the excess travelling involved.

 With regard to community services, the existing 11 Community Mental Health Teams in the Trust are expected to shrink to 6, which means workers will have bigger case-loads and less time for meaningful interaction with service users; there will be loss of staff (we have been told this will amount to 46 people but this is not certain); workers (including people with care co-ordination responsibilities) know that the nature of their jobs will change but they do not know exactly how, and they have been in this insecure state of not knowing for over a year now; service users are told that all this change will improve services and make them more ‘targeted’ but there is only general, vague talk and no specifics. There are fears among service users that people will be discharged from hospital into the community without the appropriate support from Community Mental Health Teams. Last, service users are treated as ‘recovered’ and being discharged from Community Mental Health Teams whereas they are not ready for discharge and would undoubtedly benefit from ongoing support from Community Mental Health Team staff. All this paints a picture of funding cuts and drastic change that have given rise to a great deal of insecurity and uncertainty amongst workers and service users alike; Community Mental Health Team staff characterise all this as ‘disheartening‘; the Trust claims that the changes in adult mental health services are not determined by cost but that they are going to save a couple of million pounds nevertheless!’ 

Service User Involvement in Manchester Mental Health and Social Care Trust: Rhetoric and Reality….

 

(From Community Care; ‘Social Work: Swimming or Drowning?’) 

 

 

 

 

  • reply an ,

    Hi Dina

    I’ve just been involved with an NHS NW project to produce a NHS Disability Timeline (Equality, Diversity, Human Rights) and travelling exhibition which would highlight the contribution of disabled people/people with disabilities (wholly inclusive). The Chair I discovered is assistant Director Communication and Engagement for NHS NW Equality and Diversity – I would never have guessed! A bit of browsing and I found the there is a director of Equality, Diversity and Human Rights introducing a booklet ,An Equal Partnership: captured learning from setting up a health equalities stakeholder engagement model. This is top down stuff responding to requirments for the NHS to address equality. Also on the group was a disabled director of inclusion and partnership NHS 5 Boroughs Trust.

    Partnership and engagement – they must be joking. The Greater Manchester Coalition of Disabled People withdrew from formal involvement, a Liverpool group didn’t actually contribute, there was very little response to the stakeholder meetings that were arranged and proposals coming out from our meeting (co-production and a necessary extension of the deadline) were over-ruled. I stayed around a bit longer as a stakeholder because of my two historical archives (an archive of ken Lumb a longtime disabled activist in the NW, and my own, Survivor and ally Voices, organisation and action) but no interest was expressed in either, a disabled/mental health researcher was sidelined…

    This was clearly a top down initiative following a preset plan which allowed for very little meaningful engagement. My understanding is that the chair and the assistant director (inclusion and partnership) will now produce the timeline and launch it on International Day of People with Disabilities.

    I did manage to get an agreement that the time line should be about the contributions AND challenges of disabled people, but I don’t expect to see much about the challenges on the timeline (QALYs, DNR and DNI, Genetics, reproductive rights, discharging of young people into care homes where most of the residents are elderly, treatment without consent, coercive care packages, institutionalisation within hospitals – ward procedures, health and safety – and standardised equipment). The Steering group’s let out clause is that the timeline will be placed on their website and people can add to it.

    • reply Dina ,

      thanks for this, Anne.
      a very pertinent example of rhetoric vs. reality when it comes to service user engagement…
      dina

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