The NHS putting a firewall around failure

As an NHS supporter it pains me to offer any criticism.

However after 7 months of my daughter being in a mental hospital (when she is not even described as unwell by her doctors),  I am obviously a tad questioning what is going on. 

My daughter has a Learning Disability, she is not mentally ill.  She wants to live independently just like the rest of us but in her case that means with support. She has heard people talking about independent living for 4 years but she has never been provided with it. 

She is unhappy. 


I am trying to move things forwards - while at the same time looking after her at home as much as possible (she thinks that by refusing to be at home Social Care will house her, sometimes she gets so unhappy she comes home), being here for her, and doing my full time job.

On behalf of her I have asked for digital copies of my daughter's meeting notes (multi-disciplinary meetings with NHS and Social Care staff in attendance that I have been present at, and have already seen some written notes for, so really I'm just asking for copies of things I have already seen about meetings that I was present in). 

This request for digital copies is treated as a complaint by the NHS Trust 'legal department'- meaning that the very simple notes of conversations will not be forwarded until a complaints procedure is completed that takes x months. It has been pointed out that no complaint has actually been made by me or anyone. (I don't know what x months is).

When I attend the next meeting I receive the patronising lecture from the NHS Psychiatrist about records being confidential (the point that it is actually my daughter the patient that is asking for the records doesn't register a reply, and no-one backs me up, it is one of those regular quiet moments in these meetings before they 'move on' in order to be 'positive', leaving me to feel that I haven't been 'positive'). Asking questions is not positive. Everyone look at their shoes now....shhhh.

Social Care reply that my daughter has not given consent for the documents to be produced - ignoring that it is actually her asking for them to be given to me.  Everyone looks at their shoes. Nobody says a word. Shhhh.

Why don't they supply these things?

Could it be that it is because they know that after months and years I have been driven to the point that I want a solicitor to look at them to establish whether they have managed her case properly and that her statutory rights have been adhered to? It has been SEVEN MONTHS in hospital….and previously it was EIGHT MONTHS and the time before that it was X MONTHS and the time before that it was Y MONTHS. X was 4, Y was 3 in these cases.

Not ill. In mental hospital.

Emails are not replied to - pretty much consistently.  When you ask why this is the case you are told it is not policy to reply to emails 'due to confidentiality'. They used to reply to emails, fairly routinely. But now they have decided not to.

I ask for a copy of the policy about emails. Negative dad. Bad negative dad. 


I am then told that this request is also being dealt with as a complaint (again pointed out that it isn't) - meaning that a reply or policy will not be supplied until a complaints procedure is completed that takes x months. I don't know what x is.

You ask negative questions questions like - "who is actually in charge of my daughter's case?", "why has an assessment not been done?", "why is she here?", "if it is because Social Care are not providing a meaningful alternative to her being in hospital why don't you get the Director of the Health Trust to write to the Director of Social Services to say it is not good for someone with Learning Disabilty to effectively live in hospital?", "do you think that it is ok for her to be here (you miss out the words - becoming institutionalised, and more service dependent)?". Quiet moments ensue, and we move on, to be 'positive'. shhhhh. Look at your shoes everyone.

Whereas one might think that those charged with health might be concerned or supportive of your questions about the quite evidently broken Social Care system that appears to be blocking a positive outcome and costing an NHS bed, the worst part is when you realise that there is a tacit collusion between NHS and Social Care to not criticise the failings that are occurring.

It is almost as if the staff of each service are so pissed off (with the systems they work in) that they (counter-intuitively) defend each other, as if it is a personal compact, because they feel personally complicit and 'blamed'.  Though the other thing that is very obvious is that junior staff must never criticise (or offer any opinion) on senior staff decisions - this is the poorest model for operation that I can think of.

The atmosphere of the meetings is utterly unchallenging of systemic failings. So when the Social Worker doesn't turn up for a monthly 'multi-disciplinary' meeting, so meaning that a key 'partner' is not in the room for two months, she is not even asked 'why not', 'where were you' at the next meeting - chaired by the NHS Psychiatrist (she of the let's be positive meme).

The meetings are called and billed as meetings to make plans but are in fact just reporting sessions, where each party (if they turn up) reports on what has happened (and in the case of making progress with solutions - what hasn't). More months go by.

You sit there feeling that you are being 'negative' when you point out that nothing has happened since the last meeting a month ago - your daughter is STILL an in-patient in a mental hospital when she isn't mentally ill - and that you find yourself forgiving the staff because you know that they are under-resourced, but actually the irony is that robustly discussing matters in order to find solutions is NOT actually a resourcing issue at all, it is a problem of no-one being decisive and doing everything you can to get the best outcome for the patient; no-one standing up and being counted.  It is a problem of NO-ONE BEING IN CHARGE.

The problem has become that no-one is challenging the status quo, services are making excuses for each other.

One senior voice (NHS) today told me that x solution (a bespoke service solution) can't be delivered by Social Care for everyone, so don't even ask for it in your case - when in fact I have been told that the very solution we have discussed HAS been provided for others, locally, by the service provider who was in the meeting earlier.

He was clearly saying you are being too demanding, and in that moment forgiving the abject failure of Social Care to provide the solution, in effect suggesting that I and my daughter should just accept the situation.  He is also misinforming us, in order to suppress us.  He probably doesn't even notice that he is doing it, as with all of them they are nice enough people.

Between them the services are creating a firewall around failure.

In the meeting today the distressed ‘patient’ (not ill, but referred to as a patient) clearly said "it is as if you don't care". She was assured that everyone does.

#noteneough