Lousia Ovington independent investigation report ... - NHS North East

CHAPTER 7 – PROVISION OF MENTAL HEALTH SERVICES
• Primary care services covers a wide range of responsibilities from supporting GP’s
to providing new services within practices. An example of this is the appointment
of practice counsellors who would see people who do not have severe mental
disorder and support them over a defined period of time. There would also be an
opportunity to look at clinical records within GP surgeries to identify whether there
are people with undetected mental illness who may benefit from treatment.
• Mental health promotion looks at the incidence of mental illness in local
communities with a view to reducing and resolving causative factors.
The work involved in developing these new services was significant and required
considerable organisational change with the imaginative use of new and existing
funding sources.
The changes had a major impact on staff, in terms of how they adjusted to the change
from traditional to new ways of working and how each of the new services related to
each other and other partners in both primary and secondary care.
The pace of change was rapid and closely ‘performance managed’. The introduction
of the new services however varied in different localities, depending on resource
allocation and the ability to recruit and retain staff.
The setting up of the new teams also affected the way in which traditional mental
health care was offered. The crisis resolution and home treatment team changed
the way that hospitals used their inpatient beds and as people were being cared for
more intensively at home, the requirement for beds diminished and trusts took the
opportunity to review the provision. There was also an effect on the way CMHTs and
consultant psychiatrists worked as the more specialised services were introduced and it
is almost certain that these changes were being worked through during the time that
Louisa Ovington was receiving care from the local services.
In addition to the modernisation agenda, there was also major organisational change
in respect of trust mergers and the aspirations of mental health service providers to
become NHS Foundation Trusts.
The impact of these considerable changes on Louisa Ovington’s healthcare and
treatment was significant. In the first instance, there was a period when services were
grossly underdeveloped and required a major injection of resources. From the evidence
received from witnesses and from available records there was a lack of coordinated
care due in the main to the general absence of appropriate services and the inability to
recruit and retain clinicians.
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