"It feels like SLaM never make any progress with the things that really matter!"

About: South London And Maudsley NHS Foundation Trust

(as a service user),

SLaM has many ways of amassing information about where it is going wrong and it probably fixes the little things or obvious things very quickly, but I feel that they are hopeless at making changes in some very important areas. In my opinion, the complaints system itself works very badly. In my experience, it takes ages to sort out little things and even longer to sort out bigger things. It feels like some things just disappear into a black hole despite being chased. My suggestion would be that the complaints system should get an appropriate decision-maker or an appropriate committee interface person to get in touch with complainants within days, and not weeks. It feels like complainants are chasing SlaM, it should be the other way around.

I see in board papers a section entitled "Proposed MHA Developments for 2009/10." Is this a list of SLaM challenges for the year ahead? If not, I would like to know where service users can get a list of such SLaM challenges as recognised by the board. Also, why is there no mention of the following challenges:

a. To roll out personalisation and recovery agendas as quickly as possible.

b. To train all staff in problem solving skills.

c. To train all staff in how to deliver bad news without causing unnecessary distress.

d. To train all staff in how to be open, honest and transparent.

e. To train all front-line staff in high standards of customer care.

f. To train all staff to use discretion in applying rules and regulations -- implementing the spirit rather than the letter of the law.

g. To train all front-line managers in identifying bad practice and replacing it with good practice.

h. To support all front-line managers in doing an excellent job.

i. To protect individual service users from unnecessary restrictions.

j. To protect individual service users from unnecessary leave restrictions.

k. To protect individual service users from boredom.

l. To protect individual service users from prejudicial documentation.

m. To make sure that rules and regulations are always explained to the satisfaction of the service user, and in writing if this is asked for.

n. To make sure that challenges to rule and regulations are encouraged, supported and resolved very quickly.

o. To dramatically improve the effectiveness of the SLaM complaints handling service.

p. To dramatically improve SLaM's response to crisis, especially out-of-hours, with a focus on desirable outcomes, and on minimising service user distress.

From reading the boardroom documents entitled “Key Performance Indicators Report” I am not convinced that SLaM is monitoring the right things, and I am not convinced that the figures quoted have any meaning at all! Is there anyone I could talk to about this?

In my opinion, the SLaM board is blissfully unaware of just how ineffective their complaints handling system is. The complaints handling department may be collecting information about problems, but it seems to me that this rarely leads to beneficial change and I would suggest that this results in low quality responses to complainants. In my opinion, the SLaM board is presented with minimalist statistics which give the impression that performance is more or less okay, especially when compared to other trusts, but I feel that these statistics do not give the full story. Because of this problem, I think some very important long standing problems are continuing not to be addressed even adequately.

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Response from Su Glazier, Head of Improvement, Innovations and Involvement, South London and Maudsley NHS Foundation Trust

"Dear Optimaxim, Thank you for your posting, we are grateful for your concerns and opinions about general issues in SLaM. In respect to complaints, we understand that in your case you have not been happy with the complaints process. Within the Complaints process we focus on providing thorough and high quality responses as far as we possibly can, which may mean that it can sometimes take a little longer to respond than people might like. Nevertheless, we aim to acknowledge all complaints within three working days and to keep complainants updated throughout the process. All complaints are taken seriously and monitored within the Trustwide Complaints Monitoring Committee where several of the members are also members of the SLaM Board. Where people remain unhappy with the outcome of their complaint, we try to meet with them in an open and transparent way to try to resolve the issues. A recent complaints audit in the Trust showed that the majority of respondents were satisfied with how their complaint was managed and felt their concerns were taken seriously. However, we recognise this is not the experience of all complainants and if this process unfortunately has not resolved matters in your case and you have found the process unresponsive, this is regrettable. This obviously still leaves some further work to do and as a result we now have improvement initiatives in place in relation to the new complaints legislation that came into force in April this year. Our PALS service (0800 7312864) is also available to address problems, to give people information and to try and resolve issues for people quickly. Generally, as a Trust, we are also currently doing a great deal of work to be more systematic about measuring peoples' experiences using electronic survey devices that give much quicker feedback to clinical areas on how service users are experiencing their service, so improvements can be made more rapidly. In respect to the "Proposed MHA developments 2009/10" that you refer to, it appears you are talking about the issues listed at the end of the Mental Health Act Management Annual Report April 2008 - March 2009 which went to the SLaM Board in July 2009. The purpose of the report was to inform the Trust Board of Mental Health Act developments, activity and areas of concern relating to the previous year. The developments referred to are purely operational and educational developments needed in 2009/10 for better administering the Mental Health Act in the Trust, not a general list of SLaM challenges for the year ahead. In respect to your own list of issues, many of your concerns fit into wider programmes of training or development SLaM has running, especially the current training for clinical staff around the Recovery model. We welcome user participation and comments. We have a wide range of mechanisms for involving service users in the work of the Trust. These range from service users being involved in community meetings in local services, to surveys and focus groups of service users' experiences and satisfaction, to service users working along side Trust staff in committees and forums and being involved in staff recruitment and training. The general Trust wide issues that we prioritise to work on are very influenced by collective service user concerns. We have a very large number of service users in the Trust (e.g. there were over 30,000 people referred into our services in the last year). We are always striving to understand peoples' experiences and to hear issues from a wide range of service users, so as many people as possible contribute to this collective voice. If, because of the general concerns you highlight, (including those about the Trust's Key Performance Indicators) you would like to contribute to shaping the Trust's priorities in collaboration with other service users, please email Ray Johannsen-Chapman who is our Lead for Patient and Public Involvement (PPI). Ray supports the Trustwide Involvement Group (TWIG) made up of interested service users and other relevant stakeholders from across the Trust. TWIG is the main mechanism for service user dialogue with SLaM's Executive on Trustwide issues at a more generalised level. We would value your input. Best wishes,
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