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26 Recommendation 24 on Communications Around Changes to Support All providers of mental health services should ensure that the service user or patient receives clear communications around any changes to their care or support arrangements, including a clear explanation as to the reason for this change. Service users and, where possible, their carers should be involved in drawing up and agreeing any plan to make changes to an individual service user’s care or support arrangements, including a back-up plan in case of emergency. In improving their communication with patients, it is essential that professionals do not overlook carers. We heard that patients and carers do not always feel listened to when they raise concerns. For example, on one of our Enter and View visits, where carers were dissatisfied with the patient’s care, the family member felt that the ‘patient was too scared to complain and that staff didn’t want to talk to relatives.’ Recommendation 25 to Listen to and Communicate with Carers Mental health professionals should be more willing to listen to informal carers and to communicate with them when carers express concern over the apparent deterioration in the mental wellbeing of a patient. Carers and service users should be invited to be involved in drawing up good practice guidelines for professionals to follow and in determining measures of success in making improvements. There were numerous comments about changes of staff across all services. While Healthwatch Enfield understands the reasons behind some of the staffing issues, we believe that more could be done to mitigate the impact on patients and service users. Recommendation 26 on Improving Communications between Staff Service users and Carers should be invited to work with professionals to draw up a protocol on what sort of information they would like to be recorded and passed on among staff to improve the seamlessness of their care. Throughout our engagement work, service users and their carers expressed their discontent with the poor communication of cancelled appointments, which could have an adverse impact on service users. It was noted that: ‘Service users receiving these services are very vulnerable people, and professionals cancelling an appointment should always send a letter explaining the reason for the cancellation.’ (Community worker) Recommendation 27 to Inform People of Cancelled Appointments Care coordinators and other professionals should make every effort to keep appointments, should always let service users and carers know immediately if an appointment needs to be cancelled at short notice, and should follow up promptly with a full explanation and a rearranged
Listening to Local Voices on Mental health 27 continued... appointment. Service users and carers told us of lack of clarity around personal budgets. Recommendation 28 to Improve Professionals’ Knowledge of Personal Budgets Care coordinators and other professionals should receive regular, up-to-date training to ensure they understand and can explain to service users the basics of personal budgets and know who can provide them with more detailed information. Although there has been a very welcome change in tone in the public debate around mental health in recent years, the problems of poor understanding and stigma remain. These can contribute to delays in people seeking help and to delays in recovery, as people may not feel able to communicate openly with others about their mental health problem. As noted in The Five Year Forward View for Mental Health, “The employment rate for adults with mental health problems remains unacceptably low: 43 per cent of all people with mental health problems are in employment, compared to 74 per cent of the general population and 65 per cent of people with other health conditions.” Poor understanding of mental health issues can cause specific problems for service users, for example: from mental illness and the sort of jobs which would be appropriate, sometimes leading to people being sanctioned and having their benefits withdrawn because they were perceived as not making themselves “available for work”.’ (Comments recorded at mental health strategy consultation 2014) Recommendation 29 to Extend Mental Health Awareness Training to JobCentre Plus Enfield Clinical Commissioning Group and London Borough of Enfield commissioners should work together to commission mental health awareness training for frontline staff of JobCentre Plus offices in the borough. Service users should be invited to be involved in designing, and possibly delivering, the training. “Employment is vital to health and should be recognised as a health outcome. The NHS must play a greater role in supporting people to find or keep a job.” The Five Year Forward View for Mental Health ‘There is a mismatch between the sort of jobs suggested at job centres to people in recovery www.healthwatchenfield.co.uk @HealthwatchEnf www.facebook.com/healthwatchenfield
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