Minutes of the Patients and Carers Committee Meeting ... March 2017...Minutes of the Patients and Carers Committee Meeting – Wednesday 1st March 2017 2 Copies of the papers for the

Minutes of the Patients and Carers Committee Meeting – Wednesday 1st March 2017

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Wednesday 1st March 2017

at the Royal College of Psychiatrists

Minutes of the Carers Forum Business meeting held on, Wednesday 1st March 2017, at 2:00pm, at the Royal College of Psychiatrists, 21 Prescot Street,

London E1 8BB

1.Welcome and apologies

Present Following people attended the meeting:

Michelle Long (Co-Chair) Dr Tony Rao (Co-Chair) Laurie Beed

Jayne Brown Maire Grattan

Bernard Hart Jacquie Jamieson Mahbub Khan

Noel McKenna Sara Muzira

Nick Nalladorai Karen Parsaud Giuliana Rosenow

Karen Smith

Richa Kataria – Minute Taker Apologies

Apologies were received from the following people: Clare Campbell

Elaine Ellis Dawn Lewis Hasina Sarwari

Michelle Long as the Co-Chair welcomed everyone and commenced the

proceedings of the meeting. ML also advised that she would have to leave earlier than scheduled hence, it was decided to change the order of the agenda.

2. Minutes of previous meeting held on 7 December 2016 Minutes of the Carers’ Meeting held on 7 Decembers 2016 were circulated.

Some minor amendments were noted on page 2, page 5 and page 8 and the minutes were then signed as a correct record.

3. Chairs’ report Michelle Long (Co-Chair) advised that as she has just started a new role and

with Dawn Lewis (Co-Chair) not keeping so well, it has not been possible for them to liaise and work on the report.

It was advised by Fora members that although they received email


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Copies of the papers for the Service Users Forum meeting, in future, they would like to receive hard copies too for cross working and transparency.

Action – Richa Kataria

Furthermore, Jacquie Jamieson referred to the Service Users Forum papers and queried if at the Council meeting there were items that were not for wide

information sharing. Michelle Long advised that there were items on the Council agenda that were classed as confidential. It was also advised that the reason for

them to remain confidential could be as they were still in preliminary stages or due to data protection. In addition, RK advised that the Co-Chairs receive a summary paper from the Council meeting that they can use to extract the

relevant information from, to incorporate in the Chair’s report to circulate for the members of the Patients and Carers Committee meetings. The summary paper

is also accessible on the internet by Council members using their login details. Jacquie Jamieson queried if in Dawn Lewis’ absence and Michelle Long’s limited

availability, it would be useful to have another Forum member represent at the Council Meeting. Michelle Long expressed that she would like to approve the

suggestion.

It was advised that Michelle Long will write to the relevant person at the College to seek approval so another member of the Forum could attend the Council meeting.

Action – Michelle Long

4. Reports / Updates from Committee / Reference Group Representatives

a) Report from Informatics Committee (Laurie Beed)

Report from Informatics Committee, submitted by Laure Beed was circulated for updates as below.

One of the main items discussed at the Committee meeting was the

Report of the “National Advisory Group on Health Information

Technology in England”.

This Report can be accessed from:-

www.gov.uk/government/uploads/system/uploads/attachment_data/file/5

50866/Wachter_Review_Accessible.pdf.

The report was set up at the request of the Health Secretary under the

Chairmanship of Prof Wachter. I consider this Report an excellent report

that addresses the main concerns, problems and difficulties of delivering a

successful and beneficial Health Information Technology in England that

has a positive impact on Healthcare Technology.

A few extracts from the Report are as follows.

http://www.gov.uk/government/uploads/system/uploads/attachment_data/file/550866/Wachter_Review_Accessible.pdf

http://www.gov.uk/government/uploads/system/uploads/attachment_data/file/550866/Wachter_Review_Accessible.pdf


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Interoperability is mentioned throughout the Report. P20:- The pressure

for interoperability has grown tremendously in the past few years.

Page 23 9) refers to “cloud-based” systems as follows. Although not the

subject of this review, privacy and security issues need to be addressed.

While the idea of a fully wired, integrated, cloud-based system in which a

patient’s complete information is stored in one place is tremendously

attractive, it also means that an intruder could gain access to all the

information about a single patient, or millions of patients, with a single

breach. Getting this balance right is challenging, and critical. There is in

my view a rush to use “Cloud-based” systems which I think should be

used with caution.

Page 27 refers to “Triple Aim” thus: - ‘Triple Aim for healthcare systems:

better health, better healthcare, and lower cost.

Page 37 in the highlight box states as a Recommendation thus: - The campaign needs to emphasise that the goal is not to ‘go digital’, ‘go paperless’, or even ‘save money’. Instead, digitisation is an essential tool

for meeting the needs of patients, their families, healthcare professionals, and the entire nation – in short, to improve the way care is delivered in

the NHS. Elsewhere in the Report refers to ‘going Paper-light’. In my view this is more sensible. Going paperless bluntly is not totally achievable except in some self contained examples.

Dr Rao (Co-Chair) asked Laurie Beed to provide any additional comments

to the report. Laurie Beed re-iterated that the aim of the report was whether all the

items suggested will improve healthcare and save money. Laurie also elaborated on the information that was included in the report, page 37 (as

above). Laurie Beed also suggested that if anyone had any feedback or comments

then they could forward them to Richa Kataria, who will the forward to him to enable him to update the Informatics Committee. He also advised

that his term of office is ending but that one does not need to be technical to take part in the committee and has also sought that approval from the Chair of the Committee.

Dr Rao, then summarised the points Laurie Beed made about how the

technical aspects for healthcare need to be user friendly, not for money savings, but for access to detailed information. Dr Rao also continued to summarise that there were issues and limitations about confidentiality and

balance between paperless and paper light.

b) Report from Policy and Public Affairs Committee (Sara Muzira)

Report from Policy and Public Affairs Committee submitted by Sara Muzira

was circulated for update, as below.


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Telepsychiatry - the committee considered a PIPSIG document on

guidelines for telepsychiatry - interviews or consultations using internet

video platforms or audio consultations over the internet. This allows for

consultations with people in other countries, prisons, areas with

geographically large rural areas. It is being piloted in Lincolnshire, NHS

Oxford. Brings with it various issues of data protection, protocols,

insurance cover (when speaking to people abroad). Generally agreed to be

an interesting development in certain situations, agreed the College

should have a view on it.

‘Three Steps to Positive Practice’ - a Northern Irish publication looking at

restrictive practices for health and social care professional. An interesting

document covering risk and management of vulnerable patients. Includes

some very clear guidelines on human rights. Possibly more relevant to

Northern Ireland where as yet there is no legislation on mental capacity.

Mentoring - the committee discussed whether there should be clear

encouragement from RCPsych for mentoring - discussion suggested a lot

of support for psychiatrists mentoring colleagues, how useful this can be

with the right partnership, and the need for it to become part of normal

working systems so that people have time and space to do it.

A discussion of the terms of reference for the committee emphasised the

value placed on the contribution of service users and carers.

Dr Rao requested details of the acronym PPISG and Sara Muzira advised it

was Private and Independent Practice Special Interest Group. Sara then went on to give an overview of the report.

Dr Rao asked if there was a view from the Committee about the personal touch missing with Telepsychiatry. Sara Muzira advised that the

committee felt that there is definitely a place for it and one such example was providing help in prisons or in remote areas where help was not easily

accessible. There were further discussions within the group where members

expressed their experiences and knowledge about the subject. It was also suggested that Person Centred Scoping could also be linked to it.

c) Report from the Public Engagement Editorial Board (Elaine Ellis)

Report from Public Engagement Editorial Board submitted by Elaine Ellis was circulated for information as below.

Regarding Aspergers (Autistic Spectrum Disorder) late diagnosis/mis-

diagnosis. PEEB has agreed to add paragraphs in the Schizophrenia and personality disorder leaflets, signposting potential for ASD as an alternative or additional diagnosis. Also a paragraph in the Aspergers

(ASD) leaflet signposting potential for and alternative or additional diagnosis. This an interim solution, with further work in future planned.


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This issue was first raised 2 years ago, and is now finally in progress! At the time it was raised as an issue by Taj Gilligan and Evelyn Bitcon and

others, who had all experienced mis-diagnosis of Aspergers as Schizophrenia. We will look to add a separate leaflet on this topic at a later date, when the format and other issues around public information

leaflets are resolved.

It was advised by members that it would be useful to see more emphasis about Aspergers and Autism. It was also advised that a leaflet was produced in collaboration with Taj Gilligan and Sara Robinson and that it

would be useful to see if it was published. Action – Richa Kataria

Note: Further to the above request following is an extract about the leaflet, from the minutes of the PEEB held on Thursday 27 October 2016

for your information.

It was reiterated that at an earlier meeting the Board received copies of

correspondence from PEEB member Elaine Ellis on behalf of the Carers’

Forum proposing a new public information leaflet: Schizophrenia or

Asperger’s Syndrome? It was noted that the resource would address issues

around the potential for mis-diagnosis of Asperger’s Syndrome as

Schizophrenia or Personality Disorder. Elaine had been asked to propose

this on behalf of five members of the Carers Forum, led by Taj Gilligan, all

of whom are parents of children who have been mis-diagnosed in the past.

Taj Gilligan suggested this topic to Dr Jim Bolton some months ago, who

thought it would make a good College leaflet. She is also in communication

with Professor Tony Attwood, a clinical psychologist who has specialised in

autism spectrum disorders since 1975. He is supportive of this initiative,

and is willing to contribute as required. The Board was supportive of this

proposal and it was suggested that Elaine and colleagues from the Carers

Forum should put together the first draft of the leaflet and there was nothing

further to report.

Karen Smith drew attention to the link between the various conditions,

which is rarely made, but frequently occurs. She also expressed her

uncertainly if any research has been published. Karen also expressed that

any literature about Aspergers etc. should include Hoarding as one of the

conditions which often goes with it. She was not sure about any published

research but advised that NICE Guidelines do include Hoarding under OCD

- not necessarily accurately and also advised that The Institute of

Psychiatry have done a twins’ study which refutes this.


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Jacquie Jamieson reported that sometimes mis-diagnosis of personality disorder / autism highlighted in the work of Dr Elaine Aron on ‘the highly

sensitive person’. Members expressed an interest in her work.

Note: The work of Dr Elaine Aron can be found at www.hsperson.com

d) Report from Professional Practice and Ethics Committee (Jacquie

Jamieson)

Report from Professional Practice and Ethics Committee was submitted by Jacquie Jamieson for update as below.

Key Points: The committee has been asked to review and update the two documents below.

1: CR 160 Confidentiality and Information Sharing

2 : CR154 Good Psychiatric Practice Guidelines

We have asked for the following to be considered and will put forward

suggestions;

ensure that

-should/shall/must definitions have been set out

-opt out/in issue has been covered /-recent Caldicott work

-integrate Core Values for Psychiatrists

-reference to Triangle of Care

- advocating for a specific section on relationships with friends,

family,carers- (ffc’s)

- accountability in multi-disciplinary teams

3. Accountability in multi-disciplinary teams

The Committee is currently checking who is ultimately responsible /has

final say regarding allocation of Care Co-ordinators. There seems to be

ambiguity on who has final say v who has ultimate responsibility within a

multi-disciplinary team. We feel this should be covered in above

guidelines also.

4. Consultation on 'providing a safe space' in healthcare safety

investigations:

- Could a ‘safe space’ be provided for patients/ffc’s - instead of a

lengthy complaints procedure?

Implications/Opportunities for Service Users / Carers /NHS / Other Organisations:

1: Service Users and Carers have an opportunity to contribute to the

above guidelines. Please feedback any suggestions.

http://www.hsperson.com/


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2. Feedback on multi-disciplinary teams – we received only four pieces of feedback from the Fora. However, feedback was very informative and

proved the need for someone to be overall accountable regarding decision making in a multi-disciplinary team and someone to be overall

accountable for persons care until they are discharged from needing further care. Any further action required:

1) Response from Service Users, Friends, Family, Carers’ regarding the

Good Psychiatric Practice Guidelines would be greatly appreciated. Please email me with any suggestions. [email protected]

2) I am a great believer in not reinventing the wheel – so would be

grateful for any suggestions/input now regarding the section on

communication with FFC’s, in particular risk-assessment.

3) The committee members are open to exploring any ethical questions and would welcome your contribution. Please email me if you wish me to put forward, on behalf of the Fora, any questions on ethics.

Jacquie Jamieson elaborated on the points above in the report.

A further discussion was held about the accountability in the multi-

disciplinary teams and it was agreed that Dr Rao will approach the Professional Practice and Ethics Committee to see if there was any consensus about the subject. Richa Kataria is to provide Dr Rao with the

relevant contact details. Action – Dr Tony Rao and Richa Kataria

Note: Dr Clementine Maddock is the Consultant Psychiatrist, who brought up the subject regarding allocation of care-co-ordinator in multi-

disciplinary teams.

e) Any other updates and reports from Divisions, Faculties, Committees and Reference Groups

Revalidation CPD Committee Update Sara Muzira provided an update about the Revalidation CPD Committee.

Sara advised that revalidation process for all Doctors has been looked at and a lot of recommendations were collated in the Pearson’s Report. It was advised to collect feedback from the patients. The Revalidation leaflet

produced by CAMERA was then considered for comments and it was highlighted if the patients were clear about why was there an input

needed. Sara Muzira advised that there had been comments about the picture on

the Revalidation leaflet. Further comments were made that the leaflet does not make it clear what the questions were. It was also flagged up

that the leaflet states that ‘You should not be asked to provide identifiable information’ and that it should be changed to ‘you will not be asked to

mailto:[email protected]


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provide identifiable information’ to keep it anonymous. It was advised if Sara Muzira could seek information about what the questions were for the

input required about the leaflet. Action – Sara Muzira

Note: Sara Muzira advised that the questions relate to the patient questionnaires that form part of the 360 degree feedback that doctors are

required to go through for revalidation purposes. The drawing on the leaflet was seen as irrelevant to the process - it related to patient ‘voice’.

Special Committee on Human Rights

Bernard Hart advised that he received communication to confirm that he has been appointed to the committee but since has not heard anything

more. Richa Kataria to send him relevant contact details. Action – Richa Kataria

Note: RK sent an email to the Committee manager requesting her to contact Bernard and send him information about the committee meetings.

RK also confirmed the action with Bernard. Psychiatric Trainees’ Committee

Noel McKenna advised that the carers play a role in Quality Improvement as part of the committee and that a good feedback has been received that

the work carried out is very good and helpful.

Shape of Training Working Group

Karen Persaud advised that there was nothing to report from the above mentioned working group.

Rehabilitation and Social Committee

Karen Persaud advised that the Committee is looking to raise the profile of

the Housing pathway. It would be useful if members were able to provide any good examples of housing to feed back to the committee. Karen

suggested if the examples or comments could be sent to Richa Kataria who can then forward to her.

Action – Carers’ Forum members Autism Steering Group

Bernard Hart advised that he attending a steering group meeting led by Dr Ian Davidson. Bernard did not give any further details as the subject

was covered in detail in the presentation in the morning session. Medical Psychotherapy

Bernard Hart confirmed that he attended the Medical Psychotherapy Committee meeting and advised that it is a very interesting committee as

it brings Psychiatrists and Psychologists to discuss therapy and drugs therapy and how they are both productive. Bernard also advised that multidisciplinary groups attend and develop a process of rapport and

discussion.

5. Items proposed for discussion


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a) Peer Led Initiatives (Jacquie Jamieson) A document about celebrating, sharing and mapping peer led initiatives

submitted by Jacquie Jamieson was circulated for discussion as below.

As the growth of Peer Led Initiatives continues we thought it would be a

worthwhile exercise to create a list of UK wide Peer Led

Initiatives/Services recommended by our Fora Members.

In the spirit of sharing good practice and highlighting the valuable work

that this sector provides we have a unique opportunity to showcase and

share what is available and more importantly what could be made

available within our own communities. It’s time to recover our Services.

Peer Supported and Peer Led Initiatives/services are growing throughout

the UK, yet many of their services are not widely known as they struggle

to secure enough funding to advertise. Sadly, many excellent Peer Led

Initiatives do not receive adequate funding to continue the good work

they started, despite the very real difference they make to the people who

they use their service. Most of the people who are helped in a Peer Led

Initiative go on to become befrienders, mental health community

champions, volunteers, employees within the Initiative. So the Initiative

grows yet the funding diminishes!

It would be great to celebrate and share what is out there already and

hopefully through sharing we will be able to help sow seeds in other areas

and help promote the Peer Network in our own communities.

So to kick start:

Scotland: We are very lucky to have Scottish Recovery Network see

www.scottishrecovery.net although based in Glasgow they serve the

whole of Scotland.

If you can get over the ‘recovery’ word then please take a look at their

site and see how they support the Peer Learning Network in Scotland.

They have given a voice to Peer Led Initiatives. The word recovery may

have been hijacked and misused by many …… however SRN have made

it their mission to ‘recover’ ownership of the word recovery and return it

to its rightful owners !

So to kick start the mapping exercise:

Two Peer Led Initiatives in Scotland that I think are superb:

Doing Things Differently - The Hope Café ( Bun n Blether Lanarkshire,

Scotland) see https://www.facebook.com/pages/The-Hope-Cafe-

Lanarkshire-Sco44352/167051686820711

and

http://www.scottishrecovery.net/

https://www.facebook.com/pages/The-Hope-Cafe-Lanarkshire-Sco44352/167051686820711



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Lanarkshire and Skye and Lochalsh CAB Advise-Ability Project see

https://rightsforlife.org/doing-things-differently/

I am happy to co-ordinate all replies please send your details/links to

[email protected]

Wouldn’t it be fantastic if every GP surgery employed a Peer Support

Worker. If every person, in every community could tap into genuine,

authentic Peer Support in their area at the very start of their mental

health/wellbeing journey?

Wouldn’t it be something if we could encourage DWP to hire Peer Support

Workers within their ‘regime’ to truly support our peers in their attempt to

obtain health benefits they are rightfully entitled to?

For Peer Workers to lead in providing authentic suicide prevention

training.

The opportunities are endless. We need to network to make this a reality.

Jacquie Jamieson gave an overview about the subject and elaborated the work that is being carried out in Scotland.

Michelle Long (Co-Chair) asked if members had any updates about such

initiatives from their individual local areas. Michelle also advised that she was only aware of initiatives in Birmingham that involved service users only and not carers. Noel McKenna also confirmed that he is not aware of

any peer led support in his area.

Further discussions were carried out and Dr Rao (Co-Chair) suggested that these initiatives should be discussed with the relevant Faculties so the work can be further developed. Michelle Long (Co-Chair), advised that

she did try an open dialogue in the Child and Adolescent Faculty but it was not received well.

Jacquie Jamieson emphasised that she would welcome any feedback or comments and would be happy to co-ordinate them.

b) Psychosis - Is there Another Explanation? (Bernard Hart)

Bernard Hart read out an article from Daily mail about’ Schizophrenia Patients ‘may actually be ill’. Bernard advised that Professor Lennox did a

research that indicated that psychosis patients could be physically ill. Bernard suggested that if there is a remote possibility that psychosis can

be triggered with a physical illness, it should therefore be diagnosed effectively.

Dr Tony Rao (Co-Chair) suggested that there is scope for further research as one article cannot be considered as a detailed evidence. Karen Persaud

asked at what stage should one have organic tests. Dr Rao advised that




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as NHS is not privatised hence, elimination is conducted as first stage of diagnosis. Bernard Hart expressed that if a simple blood test can assist

with the diagnosis then as the Patient and Carers Committee it should be suggested to pursue for development of policy. Sara Muzira commented

on the legal implications regarding criminal offence when someone had / lacked capacity in understanding offence. Jacquie Jamieson commented on whether someone had capacity to ‘intentionally’ commit suicide when

experiencing acute psychosis - Parity of esteem in death?

Dr Rao advised that the representatives should take it up for further discussion with Faculties to seek further information about the causes of psychosis. Michelle Long (Co-Chair) expressed at the meeting that she

would like to take it forward to the Child and Adolescent Faculty for consideration.

Action – Michelle Long Note 1: Michelle Long also emailed at a later date to advise that she would be requesting a discussion about causes of psychosis at the Child

and Adolescent Faculty.

Note 2: Michelle Long confirmed at a later date for members that

BSMHFT are currently recruiting their patients to take part in research on

this topic. She also knows of a private organisation, providing secure care

to mental health patients, who are now considering this as an alternative

diagnosis. Michelle further suggested that perhaps this is something which

could be picked up in Council, rather than limiting it to C&YP.

Bernard Hard advised that he will send the relevant articles to Richa Kataria to forward to the members.

Action – Bernard Hart and Richa Kataria Note: The articles were circulated to members on 3rd March.

6. Any other business

i) Noel McKenna suggested if the group should have a section to share

individual Case studies as part of the meeting to enable information

sharing and gaining knowledge through peer support. Dr Rao advised that it may be an idea to phase it out rather than have all case studies

in one meeting. Further to discussions it was suggested that it would be more appropriate to have a section on the relevant webpage to upload such case studies. Richa Kataria requested members to send

the case studies to her if they wished for them to be put on the webpage.

Action – Carers’ Forum Members Michelle Long (Co-Chair) departed at 14:45 hours Karen Persaud departed at 16:00 hours

Meeting concluded at 16:05 hours

7. 2017 meeting dates:

• 14 June 2017 • 1 November 2017


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Wednesday 1st March 2017

at the Royal College of Psychiatrists

Minutes of the Service Users Forum Business meeting held on, Wednesday 1st March 2017, at 2:00pm, at the Royal College of Psychiatrists, 21 Prescot Street,

London E1 8BB

1.Welcome and apologies

Present Robert Milligan (Co-Chair)

Robert Walker (Co-Chair) Diana Brighouse

Anne-Laure Donskoy Angela Etherington Steve Gilbert

Diane Goslar Stephanie Guidera

Jagadish Jha Pippa Jones Martin Lee

Nampo Mzana Stevie Moss

Aakta Patel Veryan Richard

John Sawkins Chris Wright

Devan Turner – Minute Taker

Apologies No apologies had been received

2. Minutes of previous meeting held on 7 December 2016 Minutes of the Service Users Meeting held on 7 Decembers 2016 were circulated.

Some minor amendments were noted and the minutes were then signed as a correct record

The following matters arising from the previous minutes were discussed: • There were some concerns about the length of time taken to inform those

who have applied for vacancies to be informed of the outcome. • There were also concerns about those groups who have advised that their

recruitment is on hold as there is not always an explanation given as to

why this is the case.

3. Chairs’ report There was no report given


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4. Reports / Updates from Committee / Reference Group Representatives

f) Report from Addictions Faculty (Diane Goslar)

Report from the Addictions Faculty, submitted by Diane Goslar, was circulated for updates as below.

Providing integrated care for older substance misusers: CPD update on

best practice. 23-24 February 2017.

The aim of this 2 day Conference is to provide an update on best practice

in the assessment, treatment and care of older people with substance

abuse. It will be suitable for psychiatrists (including trainees),

geriatricians, GP’s and other professionals with an interest in this

(increasingly relevant) area of clinical practice. It is hoped that that this

CPD update will provide scope for networking between different

professionals.

Diane Goslar will be speaking at this RCPsych Conference. Her

presentation is “A service-user’s perspective”.

g) Report from Academy of Medical Royal Colleges (Robert Walker)

Report from the Academy of Medical Royal Colleges, submitted by Robert Walker, was circulated for update, as below.

I do believe that in collaboration with the RCPscyh we could take a lead on

developing CPD within other Medical Colleges such as The Royal College of

GP’s etc.

To do so this would require up skilling members to support any train the trainer requirements that maybe required.

As a representative of the RCPscyh I attended the 2017 Academy Patient & Lay Committee Conference.

The Focus was Patient Engagement with the NHS, it gave me the opportunity to discuss what is happening with the moment because the NHS is rarely out of the news.

Other delegates came from other Royal Colleges and were able to bring a wealth of experience, views and opinions about how engagement can be

made better. Delegates were able to bring concrete evidence to support a viewpoint

that was more valuable than anecdotal evidence. We discussed what is our key personal dilemma about the NHS, I provided details of “Mental Health services in crisis” including bed.

Reductions and lack of sustainable outcomes. At the end of the day we focussed on formulating a number of conclusions

and statements that we will be presenting to NHS England.


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I am confident that this committee will become a major influencing force within Health & Social Care including STP’s.

Decisions required from Fora members:

1. Invite Anu Sigh Director of Patient & Public Voice and Insight NHS

England to a SUF meeting

OBJECTIVE: To develop stronger collaborative links

To ensure our voice is heard within NHS England.

2. Continue to develop an accreditation programme

for Patient & Public Engagement working in collaboration with the CCQI. Working to the principles of “Making a Real Difference”

h) Report from Council (Robert Walker)

Report from Council, submitted by Robert Walker, was circulated for information as below.

Ongoing discussions re self-management trainer modules etc.

Our paper was deferred because the meeting over ran, this was very

disappointing in view of the effort that we have all put in bringing our

workshop proposals to the table.

This will be put on the next agenda.

Robert Milligan and I had lengthy discussions with Dr Kate Lovett, Dean in order to get some clarity regarding future support and long term strategy.

Obtain clarity on how we report information obtained at Council. ACTION:

Richa please clarify

RK advised - A summary paper from the Council gets sent to the Members of the Council. Co-Chairs have access to it, to share relevant information with the Fora members.

Related to this final point, the group were informed that at the West

Midlands Division Executive the Chair provides detailed updates from Council meetings.

The group expressed concern that the workshop reports had been deferred but were made aware that it would be discussed as a priority at

the next Council meeting. The group requested that the workshop reports be circulated.

Action: Devan Turner to circulate workshop reports

Note: Workshop reports circulated to all Fora members

on 19th May


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i) Report from Policy and Public Affairs Committee (Diane Goslar)

Report from Policy and Public Affairs Committee submitted by Diane Goslar was circulated for information as below.

A position statement on mentoring was discussed. Is mentoring a good

thing, who chooses the mentor, is there currently time for it. How can it best be made to work. What if you don’t like your mentor.

Proposal for a position statement on the sustainability and resilience of psychiatrists in the workplace. Document to be finalised by January 2018.

There are New Terms of Reference for the PPAC. Discussion that service users and carers made a big contribution and were

highly valued by the Committee. Diane to provide section on the rôle of service users and Sara to do the same for the rôle of carers. These will

then be put into the New Terms of Reference.

A PIPSIG (Public and Independent Private Special Interest Group) document on telepsychiatry was considered. Telepsychiatry allows for interviews, consultations etc to globally use an internet video platform.

Northern Ireland publication “Three Steps to Positive Practice” looks at restrictive practices for health and social care professionals. This

document covers the risk and management of vulnerable patients. Members are going to liaise with RCPsych in NI about creating a

statement that condemns these practices and suggests the changes that need to be made as soon as possible.

The College Report “When patients should be seen by a psychiatrist” is going to be removed from the web.

It was emphasised the importance of members attending every meeting.

If they couldn’t attend they should make provision for this (suggested someone should sit in on their behalf but not sure how this would work).

j) Report from Psychiatric Trainees Committee (Angela Etherington)

Report from Psychiatric Trainees Committee submitted by Angela Etherington was circulated for information as below.

I was able to attend the Psychiatric Trainees Committee Induction weekend in Sept in Cardiff and a new board of officers were appointed.

The focus on the morale of junior doctors led to members of the committee staging events to promote 'Supported and Valued ' - a survey into trainee psychiatrists’ morale, working conditions, training

opportunities and general wellbeing. I was involved with reviewing some of the process and commenting on how important it was for patients to

have confidence in trainees and their ability to effectively fulfil their roles


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and feeling supported by the NHS trusts and managers. In the light of implementing the new junior Doctors contract there was a lot of lively

debate and concerns about working hours and shift patterns and impact on quality of care provided and potentially patient safety and trainee

wellbeing.

I also attended the meeting in Dec 2016 and had the opportunity to meet

the new Chief executive at RCPsych. The trainees continued with their working groups looking at recruitment and retention issues and the quality

of training opportunities across the UK. The new chair of the PTC Dr Kathryn Milward contacted me individually to thank me for my contribution and look at ways of working together in the future and

keeping patient perspectives very much on the PTC agenda.

Angela also added in the meeting that the impact on patient safety is an important aspect of the Supported and Valued project. She also highly recommended this Committee as she has enjoyed her time with this

group.

k) Update from Royal College of Physicians (Diane Goslar)

Update from Royal College of Physicians, submitted by Diane Goslar, was circulated for information as below.

Event: Royal College of Physicians Patients and Carers Network, Evening Reception. I was invited to attend as I’m a member of the Alcohol Health

Alliance. This was to celebrate the Royal College of Physicians’ Patient and Carer

Network and their Patient involvement work. Their strategy is to involve patients in everything they do. The RCP invite people to be part of their P

and C network if -you have ever been a patient or carer, if you are interested in volunteering and if you would like to contribute to improving standards for patients, carers and the public.

There are several as people who get together regularly for various events

from what I understand but I don’t know what they are specifically.

I’m sure there is training given where necessary.

There is a range of opportunities in being involved from being part of their on-line community to sitting on committees and focus groups to helping shape the RCP’s strategy.

Perhaps some members of the forums would like to apply to be involved.

l) Any other updates and reports from Divisions, Faculties,

Committees and Reference Groups

The following updates were given during the meeting:


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Promoting Recruitment in Psychiatry Committee Steve Gilbert reported that a drop in retention has been raised as a

concern at the West Midlands Division. There was a suggestion that perhaps in future the Forum could think about anything they could do

regarding this issue. Revalidation CPD Committee Update

Pippa Jones provided an update about the Revalidation CPD Committee. The Revalidation leaflet was produced so that service users could

understand the revalidation process. Pippa added that the Committee were not happy about the image on the front of the leaflet. Some had sent in suggestions about the leaflet and everyone who hadn’t yet was

encouraged to do so.

Special Committee on Human Rights Anne-Laure Donskoy provided an update about the Special Committee on Human Rights. At the meeting in January the Committee discussed the

embedding of human rights in all College Faculties; scoping work had showed that not all Faculties currently had this. The Committee also

looked at the Core Values document and suggested that human rights/freedom principles should be included, to make this visible and

clear. At future meetings the Committee will discuss Brexit and look at the rights of asylum seekers. Currently anyone deported can appeal by only after they have been removed from the country. Anne-Laure also

informed the group that from September she will be co-opted and remain on the Committee, but that the service user rep vacancy will be

advertised. Aakta Patel suggested that it may be useful to include asylum seekers or

refugees on College committees as they form a marginalised group which may be more likely to develop mental health issues. Steve Gilbert added

that some previous offenders may have interesting perspectives on human rights violations. Some in the group felt that this may lead to general issues of diversity and how the College would go about appointing

representatives from these backgrounds or how to choose which underrepresented groups to seek volunteers from.

Anne-Laure Donskoy also added that the SCHR applied for a Congress session but it was not accepted. They are, however, taking the session to

a London Division event which will give them more time for the session than they would have had at Congress.

Finally, Anne-Laure reported that there is work going on in the College on capacity legislation, looking at the example from Northern Ireland, the

issue centres on whether a person should be making their own decision, even if they are at risk.

Professional Practice and Ethics Committee John Sawkins provided an update from the Professional Practice and

Ethics Committee. He reported that since the previous meeting, he has contacted Jed Boardman and Masood Khan about DWP letters and

whether the College could have any guidance on this, he is still waiting for


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a response. The group agreed that there is a need for standard template and evidential feedback to be sent to the DWP, and that this will stop

people becoming a danger to themselves. Action: Devan Turner and John Sawkins

to chase up with Jed Boardman and PPEC

Note: Email from JS on 16th February had been forwarded

to Jed Boardman and Masood Khan. Masood Khan responded to JS on 7th April. Details of the outcome

circulated 22nd May.

John Sawkins also reported that at the previous PPEC meeting the group

discussed computer algorithms which may be used to make diagnoses and the PPEC raised concerns about this. John Sawkins will work on a report

with Jacquie Jamieson from the Carers’ Forum looking into relationships with families and carers.

Further to the report given in the previous Service Users’ meeting John followed up the point on the age of 65 being the start of ‘old age’. The

reason given for this is that at this age people are not economically active, therefore their access to services is reduced, they have less frequent appointments and people are at the bottom of waiting lists. The group

expressed various concerns with this, mentioning the work on suicide which shows an increase in suicide of men over 70 and the links between

suicide and the DWP. There was a suggestion that someone from either Disability Rights UK or the Mental Health Alliance could be invited to a future Fora meeting to present on these issues.

Aakta Patel added that these issues are sometimes discussed at the

Medical Psychotherapy Faculty and also recommended a BBC Panorama documentary entitled ‘Britain’s Mental Health Crisis’ which explored the issue of funding cuts and is available to watch on BBC iPlayer.

5. Items proposed for information c) Edinburgh NHS Lothian’s consulation with service users on

Wellness and service provision: From one kind of social

prescribing to another kind of social prescribing: a change in focus? (John Sawkins)

It has long been apparent to service users that their treatment has very little to do with therapy for the individual, and everything to do with social

control, with disinhibition, hyperconnectivity and hypersensitivity being the main causes of concern for society. Thus the individual was treated for

the benefit of his or her fellow-citizens, rather than as a means to help him/her recover. There is, however, some movement on this front. Increasingly, G.P’s are prescribing more with the individual in mind, as

opposed to family, community or state. Hence, creative pursuits, exercise and community engagement are now regularly on the agenda. In

Edinburgh, NHS Lothian has canvassed the views of service users as to how services might more effectively, and consequently, more efficiently, delivered.


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The first stage involved four of us being filmed. During the filming, we

were asked what worked for us, in terms of WELLNESS. This helped us to focus on the positives rather than what was wrong with the system. One

common theme was the therapeutic value of exercise. We acknowledge that getting people motivated in a major hurdle, but for those of us who overcame this there was a marked improvement not only on our mental

health, but also in our physical health. Getting a buddy to accompany you can make all the difference. On another level, we all felt that volunteering

has helped: it is a win-win situation with obvious benefits for the recipients, of course, but also a chance for us as service users to focus for once on other people’s needs as opposed to our own: self-obsession can

be very destructive. Of course, this needs careful management to avoid a volunteer becoming loaded down with other folks’ problems - mentors can

help in this respect. There was a realisation that isolation can be a problem for many of us, and that the best solution to this seems to be community involvement, as well as building good, loving relationships.

Some of us, rather than expecting someone to do it for us, have set up our own community activities, including open mic sessions, gardening and

craft groups. We keep well by eating fresh fruit and vegetables and we try to avoid processed food and fizzy drinks.

The next stage in this initiative is currently being rolled out across Edinburgh as well as further afield. It involves inviting a balanced mix of

professionals and service users to attend events in their locality to debate issues arising around the concept of wellness. Key to this is the re-

examination of terms used. The deficit model needs replacing with one that focusses on people’s assets. It was generally agreed at the first of these meetings, which I also attended, that the NHS does not save money

through a one-size-fits-all system: in fact, it ends up being far more expensive over the long term through “system churn” and the revolving

door scenario. Effectiveness means tailoring treatments to individual patients’ needs, alongside early intervention, and ideally, prevention of conditions that have become increasingly more complex through waiting

until they became a crisis. Again, the one-size-fits-all option is also counterproductive when it comes to the effective use of support-workers.

As one patient put it, “it’s no use offering me help with dealing with rent arrears when I have already paid off my mortgage”. Not everyone needs a support worker, but some of us do. Identifying when, and in what capacity

is crucial.

d) Peer Led Initiatives (Jacquie Jamieson) A document about celebrating, sharing and mapping peer led initiatives submitted by Jacquie Jamieson was circulated for discussion as below.

As the growth of Peer Led Initiatives continues we thought it would be a

worthwhile exercise to create a list of UK wide Peer Led

Initiatives/Services recommended by our Fora Members.

In the spirit of sharing good practice and highlighting the valuable work

that this sector provides we have a unique opportunity to showcase and


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share what is available and more importantly what could be made

available within our own communities. It’s time to recover our Services.

Peer Supported and Peer Led Initiatives/services are growing throughout

the UK, yet many of their services are not widely known as they struggle

to secure enough funding to advertise. Sadly, many excellent Peer Led

Initiatives do not receive adequate funding to continue the good work

they started, despite the very real difference they make to the people who

they use their service. Most of the people who are helped in a Peer Led

Initiative go on to become befrienders, mental health community

champions, volunteers, employees within the Initiative. So the Initiative

grows yet the funding diminishes!

It would be great to celebrate and share what is out there already and

hopefully through sharing we will be able to help sow seeds in other areas

and help promote the Peer Network in our own communities.

So to kick start:

Scotland: We are very lucky to have Scottish Recovery Network see

www.scottishrecovery.net although based in Glasgow they serve the

whole of Scotland.

If you can get over the ‘recovery’ word then please take a look at their

site and see how they support the Peer Learning Network in Scotland.

They have given a voice to Peer Led Initiatives. The word recovery may

have been hijacked and misused by many …… however SRN have made

it their mission to ‘recover’ ownership of the word recovery and return it

to its rightful owners !

So to kick start the mapping exercise:

Two Peer Led Initiatives in Scotland that I think are superb:

Doing Things Differently - The Hope Café ( Bun n Blether Lanarkshire,

Scotland) see https://www.facebook.com/pages/The-Hope-Cafe-

Lanarkshire-Sco44352/167051686820711

and

Lanarkshire and Skye and Lochalsh CAB Advise-Ability Project see


I am happy to co-ordinate all replies please send your details/links to

[email protected]

Wouldn’t it be fantastic if every GP surgery employed a Peer Support

Worker. If every person, in every community could tap into genuine,

http://www.scottishrecovery.net/






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authentic Peer Support in their area at the very start of their mental

health/wellbeing journey?

Wouldn’t it be something if we could encourage DWP to hire Peer Support

Workers within their ‘regime’ to truly support our peers in their attempt to

obtain health benefits they are rightfully entitled to?

For Peer Workers to lead in providing authentic suicide prevention

training.

The opportunities are endless. We need to network to make this a reality.

6. Any other business

a) Expense Claiming Process (Robert Milligan)

Robert Milligan gave a brief update on My Expenses Online, which is the online expense claiming system that he is trying out. This allows

members to scan in their receipts and submit their claims online without using a pink claim form, and is designed to speed up the

process of receiving expenses. Some were concerned about not having the facilities to scan in receipts

or did not like the idea of submitting expenses online. However, the group was informed that it will not be compulsory to submit expenses

online, anyone who wants to can continue to use the pink expense claim forms.

The following points were also raised under any other business:

The group requested that for future meetings they are provided with copies of the Carers’ Forum agenda and previous minutes.

Action: Devan Turner to ensure Carers’ Forum

papers are circulated for the next meeting

Note: Carers’ Forum papers will be circulated to Service Users’

Forum for June meeting.

The group also requested clarity on the current situation regarding vacancies, and also as to which Committees in future will be providing representatives for the Fora.

Action: Devan Turner to circulate up to date list prior to next meeting

Note: Several vacancies advertised since last meeting, these have been emailed to all Fora members. Requests for volunteers

for two different reference groups received no response.


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Robert Walker suggested that it would be useful for those stepping down to give feedback on their experiences of the group as this would be useful for a

handover with the new representatives replacing them.

There was a suggestion that in future some Forum members could join the meeting by teleconference or skype to avoid long travelling times if they live far out of London.

Some felt that the presentations earlier in the day could have been more

interactive or maybe would have been better in a workshop format and smaller groups. Others commented that as the presentations did not relate to each other it felt slightly disjointed and that perhaps in future there could be a theme and

this may give the group a theme to work on for a period of time.

Some concerns were raised over the new Service Users and Carers handbook and whether there had been any consultation for this.

Action: Co-Chairs to clarify with Richa Kataria

Note: Email from RK on 3rd March to all members clarified that the handbook contained College Bye-Laws and regulations. RK

advised members that they could get back to her with any queries or issues regarding the handbook.

The question was raised as to whether the Fora can have any use of the College’s Twitter and other social media channels to promote any of the issues

which are being raised. Action: Devan Turner to investigate

Note: The College’s social media is managed by the Communications team. The PCC can submit requests for certain

topics to be shared which the communications team will consider. Furthermore, there is some work being done on creating a database in consultation with service users and carers

to enable more productive media work. The morning plenary session will expand on this.

The group were reminded that there is still time to apply for bursaries to attend the International Congress in June.

7. 2017 meeting dates:

• 14 June 2017 • 1 November 2017

Documents

Minutes of the Patients and Carers Committee Meeting ... March 2017...Minutes of the Patients and Carers Committee Meeting – Wednesday 1st March 2017 2 Copies of the papers for the