“Where are Southern Health’s Chief Executive or the Chair of Governors?”
So asked Cllr David Harrison at a meeting of Hampshire County Council’s Health & Social Care Sub-Committee (“HASC”) on 4 March 2020, when members were asked to not only consider the latest CQC report but also The Pascoe Report.
The Committee heard deputations about Southern Health NHS Foundation Trust from three members of the public totalling about 25 minutes. The full text of the deputations is available here→.
The only Southern Health employee present during the deputations was Southern Health’s infamous spin doctor, he who acted in an unbecoming and disrespectful manner after the Inquest into the death of Ellie Brabant: BBC South Today report here→.
Readers may have realised already that the CEO, Dr Broughton and Chair, Ms Hunt chickened out. Instead, they sent along a frit Chief Nurse, Paula Hull to ‘face the music’. Her frankly amateurish presentation was in distinct contrast to the re-assuring, confident and professional presentation to HASC by Southampton General Hospital.
It appears Paula is being ‘used’ by the Board for unpleasant jobs – one could have some sympathy for her if it were not for the fact that she would not look any of us in the face!
“It worries me. We are the select committee and we must do something.”
Whilst Cllr Mike Thornton stressed that some of the CQC’s ‘must do‘ actions were so obvious that it shouldn’t have needed the CQC to point them out. For example
“Ensure consistency in the disposal of clinical waste in line with policy on handling and disposal of healthcare waste.”
It beggars believe that any hospital does not have consistency in disposing of clinical waste!
Others common sense issues in the report, which do not need clinical expertise, include:
- Ensure all patients have access to a clinical psychologist and psychological therapies.
- Ensure staff record their decision-making when carrying out mental capacity assessments and ensure staff have a sound understanding of the Mental Capacity Act 2005.
- Ensure there is a patient alarm system on all older people’s wards, which enables patients and visitors to alert staff to their need for urgent support.
- Ensure all patients in the crisis service have holistic, person-centred care and a crisis plan in their records. Records must be clear, up-to-date and recorded consistently in the electronic record.
- Ensure the physical environment of the health-based places of safety are fit for purpose and meet the requirements of the Mental Health Act Code of Practice 8.
- Ensure the Trust meets its legal obligations in the health-based places of safety.
There was also an important contribution by Cllr Marge Harvey, who has personal experience of unsatisfactory service by Southern Health.
Coincidentally, Health Service Journal reported recently that Simon Stevens might give unearned incentive cash to mental health sector. However, a reader asserts that psychiatry has encouraged ‘mission creep’ of the mental health agenda in a classic example of provider capture and went on to comment:
Before there is any more money, the sector must define what is and is not mental health, how one counts it and how outcomes should be measured. At the moment vast chunks of what is best termed ‘the human condition’ are labelled as MH in the pursuit of various secondary gains.
Perhaps if Southern Health targeted budgets on psychologists and therapies, it would prevent ‘the human condition’ tipping over to serious mental ill-health. In parallel , it would reduce costs of prescribed drugs; reduce Psychiatrists’ workload; and improve bed availability for those who need it.
And finally, one of the ‘should do’ actions prescribed by the CQC is:
- Ensure there is clear senior oversight of the service, particularly the health-based places of safety.
In the light of these and other ‘must do’ and ‘should do’ actions, it seems bizarre that the CQC rates Southern Health as ‘Good’ in 16 of 18 domains. For example:
- How can the ‘safe’ domain be ‘GOOD’ when consistency of clinical waste disposal is sloppy [pun intended!] and the Trust implicitly is not meeting its legal obligations in health-based places of safety.
- How can the ‘well-led’ domain be ‘GOOD’ when, aside from the upside-down management structure, there is lack of clear senior oversight of the service, particularly health-based places of safety.