Data sharing partnership in Lanarkshire

Officials in Lanarkshire announced that their initiative to share patient/client information between agencies had been a success. That conclusion was reached after interviews with staff and key partner agencies.

Senior management encouraged the difficult changes and offered support, from fresh mindsets, to revised working procedures, to using technology. Staff realised that the sharing partnership was not about IT, it was about improving services
 
These extraordinary claims continue: 

At the heart of joined-up care are trusted professional relationships. Don’t even consider communicating complex patient/client contexts by electronic means. Pick up the phone to the colleague you know, or wait till the next team meeting  

If information sharing is in the interests of patient/clients and improved services, there has to be a good reason not to share. Which is a somewhat different mindset to security threats, confidentiality obstacles, silo ownership and sanctions.  

Lanarkshire Data Sharing Partnership (LDSP) was established in 2006 and tasked with Single Shared Assessment and Child Protection messaging. It replaced the Joint Working Across Care Agencies Group established in 2002. This group was responsible for the sharing of older people and adult information i.e. Joint future Agenda and Community Care Act requirements, sharing demographics, assessments/plans, contact and service provision details and service requests for homecare and aids and adaptations. The Children’s eCare Project was established in 2004. Its remit was sharing children’s information and creating and implementing the child protection messaging, linked child protection children and linked child protection adult messages. Annex 1 contains a summary of the Lanarkshire eCare journey (so far) 2002 to 2012.

http://ssrg.org.uk/wp-content/uploads/2012/02/Data_Sharing_Technologies_Board_-_8_May_2012_-_Lanarkshire_eCare_Review.pdf

John Kilbride did not know that this project was on the go when his mother was imprisoned in the care home but it explains a lot.

It was obvious to John Kilbride at the time that whilst Social Services refused to communicate with him regarding his mother`s care, they were communicating with all the other agencies involved in her case, including the Housing Department, care home manager and solicitor, as well as other members of his family. How easily joint working across care agencies becomes collusion - too easy in fact, and for that reason should be discouraged.

Draconian amendments to Scottish Mental Health Act (2003)

The Scottish Parliament is seeking to make draconian amendments to its proposed changes to the Scottish Mental Health Act (2003), allowing medical and legal professions tyrannical powers to detain individuals... The new proposals have very serious implications for the freedom of Scottish people, the changes would make it even easier for individuals to be detained in hospital and gives far too much power to psychiatrists who can, and do, subject their patients to unnecessary treatment.

Details of submissons and Petition:
http://www.scottish.parliament.uk/GettingInvolved/Petitions/mentalhealthlegislation

The consultation on the new Mental Health bill referred to contains proposals from the Scottish Government that appear aimed at drastically weakening the patient’s right of appeal.

In Paragraph II they suggest

1) removing the right of the Named Person to be involved in Tribunals (that will be up to the Trubunals), and also

2) removing the right of the Named Person to see papers relating to the evidence even at the patient’s behest. And

3) in Paragraph 13 they express a wish to allow MHO’s to indicate to Tribunals who the Named Person should be.
http://www.scotland.gov.uk/Resource/0044/00441187.pdf

These three proposals would appear to effectively permit the complete removal (at the discretion of the Sectioners) of the right of appeal from any patient who is unable to coherently and vigorously specify and insist on their own rights. As most are forced to take drugs before their first Tribunal, this could be the vast majority of patients.

The MHO can suggest a ‘Named Person’ to the Tribunal who they think is agreeable to the section, and the Tribunal can agree that the MHO is ‘best placed’ to judge. Should a Named Person be appointed that the MHO or the Tribunals believe might actually fight for the patients’ rights, they will no longer have to cook up a story about them being unsuitable, as the Named Person will apparently require permission to represent the patient at Tribunals. And if all else fails, they Named Person can be rendered unable to help the patient refute the evidence, by denying them permission to see the evidence even at the patient’s behest...

If all else fails, strong appeal cases (or those where there have been blatant breaches of the legislation or the guidelines) can simply be ‘vetoed’ by denying permission.

The proposals seems to be aimed at making the denial of the patient’s human rights appear to be legitimate.

Original article at Namaste Publishing http://namastepublishing.co.uk/tyranical-powers-sought-by-scottish-government-to-change-mental-health-act/

Prisoners of care homes

Mrs Kilbride is not the only person who has been kept in a care home against her will as the following article reveals:

Seldom does a parliamentary inquiry manage to uncover a national scandal on the terrifying scale of the one blazoned across yesterday’s Daily Mail front page under the headline ‘Prisoners of Care Homes’.

Astonishingly, this report by a House of Lords committee on the workings of the Blair government’s 2005 Mental Capacity Act found that ‘thousands, if not tens of thousands’ of old people have been forcibly incarcerated in care homes or hospitals against their wishes and are being ‘de facto detained unlawfully’.

At the heart of the scandal is the ultra-secretive Court of Protection, set up under the Act, which rules every year that thousands of people are deemed to ‘lack mental capacity’ — so that control of their lives and property can be handed over to social workers and other state officials.

http://www.dailymail.co.uk/news/article-2580636/Read-stories-secret-courts-imprison-elderly-care-homes-against-weep.html

10 days in hospital without food

A frail hospital patient was left without food for ten days after several failed attempts by medical staff to insert a feeding tube.

The revelations came to light in a report into Victoria Hospital in Kirkcaldy, Fife, after an unannounced inspection.

The report by Healthcare Improvement Scotland revealed that in one ward the elderly patient "had lost a significant amount of their body weight" as a result of not being fed.

A nurse was observed bringing the patient a meal despite the patient being assessed as unsafe to swallow food or drink.

The same report stated that in a different ward a dementia sufferer also received "little or no" food or fluid intake for five days in a row.


http://news.stv.tv/east-central/268274-elderly-patient-left-without-food-for-ten-days-at-victoria-hospital/

NHS Scotland too slow to deal with problems

Duncan McNeil MSP for Greenock and Inverclyde

Critics last night warned patients are suffering while the NHS is too slow to deal with the problems identified. Labour MSP Duncan McNeil, convenor of the health committee, said: "The Scottish government has been singing loudly about its dementia strategy but these figures show the reality is very different.

"The majority in hospitals are older people and deserve much better. What is particularly damning about this is the health boards are being judged by the inspectors on their own guidelines, the inspectors are simply trying to get them to keep to their own agreed standards and it is not working in so many respects.

"My concern is the health boards are more worried about the cycle of inspections than the root problems and what is happening in the months or years between a failing being identified and then fixed."

HIS figures released under freedom of information show that a total of 303 "areas of improvement" have been identified in its 24 hospital inspection reports since 2012.

Just over a third of the failings relate to "care planning for dementia" with every single HIS report warning that screening for the condition on admission to hospital is "not routinely being carried out".

http://www.sundaypost.com/news-views/scotland/hospitals-slow-to-act-on-elderly-care-failings-1.271302

The Eugenics movement

The buzz word these days is SUSTAINABILITY. Now we are expected to be concerned about unsustainable pressures like the young having to plug the gap in the care budget which has been reduced by austerity. No mention of getting rid of austerity which is making things worse.

Then we are informed that the gap in the care budget has actually been plugged by tightening the eligibility rules for the elderly. So why mention unsustainble pressures on the young at all?

But I think we will be hearing a lot more propaganda like that. The young are supposed to feel aggrieved and hard done by because of the elderly and their care needs.

Families and the NHS are being placed under "unsustainable pressure" to plug the gap created by major cuts to care for elderly and disabled people, the public spending watchdog has warned.

The National Audit Office found that despite a Government pledge to protect social care from the impact of austerity, spending on help for older people in England plunged by 12 per cent in just two years in real terms.

While councils have spoken of protecting services by focusing on other cost-saving measures, the NAO concluded that the vast majority of the reduction had been achieved by cutting the amount of care provided by tightening the eligibility rules.

http://www.telegraph.co.uk/health/healthnews/10693548/Even-Government-does-not-know-how-long-care-system-can-cope-with-cuts-spending-watchdog.html

Annette Bruton CEO of Care Inspectorate explains her role

Guest blogger Annette Bruton, Chief Executive of the Care Inspectorate, explains how the organisation is developing its approach.  www.careinspectorate.com. 

Almost everyone in Scotland will use a care service at some point in their lives. That simple fact means everyone in the country has an interest in the quality of services provided across Scotland right now, from nurseries to care homes, and it means the question of what standards we expect will become an ever more important one in the future.

Care standards are always important..

As Scotland’s regulator for care services we have a duty to ensure everyone receives the best possible care; which means care that is safe, compassionate, meet people’s needs and respects their rights..

Talking about a duty is one thing. Putting it into practice is another.

But there’s more to our role than that, because not only do we have a duty to inspect and regulate, we also have a duty to inform people about the work we do.  Fundamental to the principle of respecting a person’s rights is respecting their right to choose.

Is that why an elderly person was taken into care against her will, perhaps?

And people can only make informed decisions if they have all the information they need. 

Is that why Mrs Kilbride was provided with no information, perhaps?

That’s why we have now embarked on a new way of highlighting some of the things we find out through our rigorous inspections.

GOOD. But you only have rigorous inspections for the situations you are prepared to inspect. Your department was certainly not willing to inspect the abuse of a Power of Attorney in Mrs Kilbride`s case, were they?  How many times has that happened?

On top of that we have just launched an innovative new way to communicate some of the other information we gather. The Hub is our new online resource aimed at Scotland’s 200,000 care workers.

Dare I tell you that the information you gather at the Hub is only as good as the people supplying the information?

Put simply our inspectors who are experts in early years provision inspect nurseries, and those with corresponding experience of care services for the elderly inspect care homes for the elderly...And that’s why we recently launched a bid to recruit more inspection volunteers.

Volunteers (?) who want to get close to vulnerable children and the elderly? I shudder to think ...and you are crowing about this?  How about stopping the banning of relatives from visiting their loved ones? That would be an even more robust system I assure you. How about dealing with complaints about it.

 To find out more about the work we do, (or less, as the case may be) and to get involved as a volunteer inspector, log on to our website www.careinspectorate.com

 

 

Care of elderly is not sustainable

Audit Scotland warns that: "Caring for older people in Scotland’s hospitals and care homes at a cost of billions of pounds a year is not sustainable as the elderly population continues to grow.

Audit Scotland said the Scottish Government has estimated that spending on health and social care for over-65s will have to increase from £4.5 billion to £8bn by 2031 unless there are changes to people’s wellbeing and how services are provided.
But Audit Scotland concluded that overall progress in delivering better services had so far been slow. It also found spending did not appear to be moving away from emergency and residential care and into local initiatives.

And it said the current way that services were delivered was "unsustainable". 

Their answer is to keep the elderly out of hospitals and care homes and to provide support closer to home but it does not say how emergencies can be dealt with in this way. This proposal is cunningly equated with improvement in delivering services.

But we have to ask what kind of services? Without the equipment and specialist medical knowledge available in hospitals anything on offer is going to be substandard for those who require emergency treatment.

http://www.scotsman.com/news/health/elderly-care-costs-unsustainable-says-watchdog-1-3295977

Division between age groups

Here is another report which divides young and old. According to the study `The State of Living Standards` by the think-tank  Resolution Foundation, young people and working families have seen their incomes fall in real terms compared with a decade ago while average pensioner households have enjoyed an 18% rise.  The trend is set to continue, as further cuts to working-age benefits come into force in the next few years, while pensions are protected.

The findings will highlight how falling real wages combined with political decisions about who should benefit from public spending have created a sharp divide across age groups, with the young faring worst and pensioners the best.

The RF report – the first of its type to look at inter-generational income patterns across the last decade – finds that the typical income of pensioner households grew from £313 a week in 2001-2 (at 2011-12 prices) to £370 in 2011-12, representing an 18% rise. By contrast, the weekly income of a couple without children in a median working-age household fell slightly from £453 (in 2001-2) to £445 in 2011-12, despite GDP growth of almost 10% over the decade.

For young people, the fall in real wages was even more acute. Between 2001 and 2011, median weekly wages for 18-21 year olds fell by 21.7%, and for 22-29 year olds by 7.6%

James Plunkett, director of policy at the RF, said that while many pensioners were still hard up, and their incomes remained on average below those of working-age families, they had enjoyed a recent good run that looked set to continue.

The report goes on to remind us that further cuts and more austerity is on its way. But isn`t that the problem, and the fact that there is no real recovery in terms of jobs which offer a living wage for young people and families?

http://www.theguardian.com/politics/2014/feb/09/pensioners-thrive-while-working-families-and-young-suffer