"Mental Health in Nottingham"

(as a relative),

I see an in patient on a regular basis for social activities outside his unit. Recently he has become unwell as a result of trying a new drug. He has had to be moved from his unit as they did not feel they could manage his behaviour. He went to Highbury to a unit with greater capacity to care for him. They claimed he was too difficult to manage. He then was moved to the Highbury Intensive care unit. What bothers me is that, despite being so unwell that he needed to move, he has not seen a Doctor at either unit at Highbury and there has been no review of his medication. It feels like he is stuck in a unit that should address the underlying issues ie is he on the correct drug? Yet there has been no medical oversight of his care. He was moved late last week and its now mid week and I am sure this is not correct. The mantra I keep hearing at all of these places is there are not enough staff.

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Response from Jane Danforth, Involvement Team , Involvement & Experience, Nottinghamshire Healthcare NHS Trust

picture of Jane Danforth

Dear Bikerboy

Thank you for taking the time to feedback and for raising these areas of concern. I have forwarded your posting to the in-patient services manager and the Associate Director of Nursing Quality and Patient Experience for further comment.

Please be reassured we take all feedback seriously as listening to what people say is the only way we can improve our services and communications.

A further response will be posted soon.

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Response from Steven Daykin, Ward Manager , Redwood 1, Nottinghamshire Healthcare NHS Trust

To Bikerboy

After looking at your comments and indirect experience of your friend’s negative experience of in-patient services, sometimes when new treatment plans are changed, to attempt to improve someone’s mental health initially people’s mental state can take a dip in level and this to me sounds a possible cause in your friend’s circumstance. On the whole admissions are onto an inpatient ward, but due to the individuals’ safety and their mental state /behaviour they have to be moved to a intensive care area where their are less patients and increased staffing levels. This is done through a thorough decision making process involving all members of the multi-disciplinary team (often including Doctors).

Your main concerns were around your friend not seeing a Doctor, Doctors would always clerk someone onto the ward on admission and attend the ward if staff saw fit. Depending on when your friend was admitted (I.e. at weekends) then no regular doctors on at a weekend and also depending on when your friends consultants reviews are they may not see their consultant straight away but they should see a junior doctor at least, and if this did not occur then I am sorry about this and would want to know a little more information so I can look into this in more detail. However the nursing team are there to assess changes in need and treatment and would liaise with the medics if they felt necessary.

Your point about being on the right type of medication is a difficult one as with not knowing more details I would not like to go into different medication unnecessarily, but what I would say is that at times consultants feel that it is the person’s best interest to change their medication to attempt to improve their mental health. Unfortunately in some cases this does not always have the expected response initially, but it might seem like things are being left but the team maybe waiting

Finally to respond to your point on there not seeming enough staff on, Staffing levels on wards are a contentious subject and are attempted to be maintained at a level which is safe and assists our patients in being safe and having therapeutic interactions and facilitating escorts. Unfortunately due to covering and supporting other ward patient needs, unforeseen reduced staffing levels E.g. such as sickness, staff teams have to be moved where need necessitates which can have a huge impact on addressing immediate patient need.

I would just like to say thank you for feeling you can put your concerns across on this site, where we as a Trust read and listen to opinion and feedback in the necessary management meeting using your comments to improve our service.

If you would like to meet with myself or someone else within the management structure of Nottinghamshire Healthcare NHS Trust then please feel free to contact me on 0115 9691300 ex 16364 where I am more than happy to meet with you to discuss this in more detail.

Thank you again.

Steven Daykin

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