"PALS, Community Teams (mental health)."

About: Tees, Esk And Wear Valleys NHS Foundation Trust / Adult mental health

(as the patient),

I am meant to see a care co-ordinator every week. In the last 12 weeks I have had 2 visits. I have requested to be referred to the local resource centre over the road from me so I have some support until my mental health team is able to deliver my care plan.

4 weeks ago I contacted PALS asking them to sort out this referral with the team. 2 weeks ago I chased this up with PALS and was told and the locality manager was dealing with all issues and they could make no comment as it was under the formal complaints process (I have not made a formal complaint about the referral). I contacted the team manager who said he had heard nothing about it but would get a referral done that day by the duty worker.

Despite another 2 weeks passing no referral has been received. I have contacted the team twice and each time been told both the manager and duty worker are unavailable. The purpose of the referral was to ensure I had support, especially while my care plan is not being implemented in relation to care co-ordinator visits. Even if it did come under the formal complaints process (which it doesn't) I don't believe the submission of a formal complaint should be used to delay care.

I am living in squalid conditions. I am malnourished. I am paying more than I should for utilities. My participation in education and social activities has disintegrated. I have missed/had to cancel necessary hospital investigations for physical health problems. My GP has had to prescribe me psychiatric drugs that have dangerous interactions with my physical health problems, just so I don't get more mentally ill. I live in a fog sleeping on the couch in the same clothes day after day too fatigued to carry out tasks of daily living. The resource centre would be able to provide housing and other support but instead it feels like I'm being left to rot. I realise TEWV is having difficulties assigning me a suitable care co-ordinator, but that should not stop them referring me to a mental health resource centre in the meantime.

I am under section 117 aftercare. That means that of all patients with mental health problems I am in the group that is specifically meant to be protected from falling through the cracks in the system. 40 years ago, in my view, I would probably have been a long stay patient in an asylum. Community care was meant to be an improvement on that, not an excuse for cutting corners and leaving the most vulnerable patients in squalor. If this is the kind of care TEWV is giving to patients on enhanced care plans under s117 aftercare then I am scared about what would be the real situation for me if I wasn't on enhanced care. I am left feeling sad that the CQC didn't inspect the team I'm under when it assessed TEWV, because if it had maybe I would be protected from the kind of conditions I'm experiencing.

Things that were good or could be improved include that PALS were easy to get hold of but there was an issue with them actually doing what they were asked to do. PALS should help patients liaise when an urgent referral is required to provide support . There should be policies, that go beyond acute crisis treatment, to protect patients when there is no keyworker: S117 patients in particular should have arrangements that keep them safe from relapse and ensure referrals to other services to prevent or manage relapse are dealt with quickly. Team managers should do what they say they will do.

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Response from Corinne Aspel, Lead Senior Nurse – Patient Experience, Tees, Esk and Wear Valleys NHS Foundation Trust We are preparing to make a change

We are very sorry to read of your concerns and experience about community services and contact with PALS. We note your positive comment that PALS was easy to get hold of, but sorry to read that your contact did not result in the urgent referral appointment that you were requesting from the community service.

Please be assured of the commitment that both our PALS and community services have in trying to resolve people’s concerns and would suggest that if you contact PALS again they will liaise on your behalf with clinical services, the Freephone number is 0800 052 0219 or email tewv.pals@nhs.net.

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