In the Adver’s Hotseat this week was Avon and Wiltshire Partnership Mental Health Trust’s head of professions and practice for Swindon, Newlands Anning.
Here's what he had to say to your questions.
Q) What does AWP do?
A) Avon and Wiltshire Partnership Mental Health Trust is an NHS organisation which provides specialist secondary services to those suffering with severe and enduring mental illnesses. These are people who, due to their illness, are unable to receive treatment from primary care providers, such as GPs. The symptoms can be severe depression or psychosis including schizophrenia or mood disorders. We assess and treat the service users and provide the service most likely to meet their individual needs. We discuss this collaboratively with the service user, carer and specialist practitioner and it can include short-term interventions or more longer term interventions, such as in-patients.
Around one in four people suffer with some form of mental illness but many would not be assessed as serious enough to require secondary care and can be treated through primary care.
I am unable to give an accurate figure as the stats are always changing with new referrals and discharges, however it is clear that with all the services provided by AWP within the Swindon the number of Service users receiving our support is considerable and runs into the thousands.
Q) When Sandalwood Hospital opened there were 35-40 inpatient beds. Today there are only 18. Why?
A) I would say this is a historic question really and it goes back to when Sandalwood Court first opened it had three in-patient wards, which included a Psychiatric Intensive Care Unit for people at significant risk associated with them. That was a very small unit.
The organisation looked at the needs of the localities and 18 beds for Swindon service users was assessed to meet the demand. The number of wards was reduced from three to one. We are always reviewing the amount of beds we have.
We now provide a rehabilitation unit which is a 10-bed in-patient unit and there are two in-patient wards for older adults in Swindon in Victoria Centre. That means we have a total of four wards in Swindon, with the in-patient wards at Sandalwood Court being replaced with the rehab unit.
Q) Why does AWP call the police when someone is feeling suicidal?
A) That’s a really difficult question to answer as I don’t know the circumstances and it is obviously an individual situation. What I would say is all the services by AWP want to be accessible to the service users and meet their individual needs as best we can. However, there may be times where a significnant risk has been assessed, other partner agencies might be contacted.
That includes paramedics and the police - there has to be a significant risk that they could cause harm to themselves and while this may be an extremely distressing time for the service user, we have a duty of care to that person, members of the public and ours staff.
Q) Why, when a meeting has been arranged for the Intensive Team to do a home visit, do they call and ask if they are still needed because they are short-staffed and busy?
A) Again, this is a specific question. My advice would be that if people receiving our services feel they are not at the standard they expect there is a clear complaint process within AWP, called the Patient Advice and Liason Service (PALS). This can be contacted on 0800 0731778. People are able to talk to an indepedent person to express their concerns in an informal or formal way and these concerns will be addressed by the locality management.
Q) Does AWP think mental health service users should have a choice of care provider?
A) Yes, you should have a choice of your care provider. At AWP, we want to be the provider of choice for service users in Swindon. We are working hard to demonstrate that we are changing and evolving what we do through feedback directly from service users and to meet the needs of the local population.
Q) Given the chronic underfunding of mental health services over many years, with resultant shortages of professional staff and beds, how do you foresee the service coping with the rapid increase in the number of people with dementia?
A) I would say the NHS as a whole will continue to have to demonstrate it runs as efficiently as possible and provides services to the thighest quality that it can. We are constantly reviewing our resources and demand and that includes the increase in people suffering dementia. As part of our evolution and reviewing we will be able to to provide sufficient services for these people. The older adult in-patient unit is a dedicated unit which runs memory services and community services. We will continue to review the trajectory and look at how best to meet the needs of the population.
Q) Is there still a stigma attached to mental health patients in wider society?
A) I do think there remains some stigma, however by talking about mental health, illness and services and people having a better understanding I think it has improved a lot over recent years. For AWP we are actively engaging with the general public. We have got an engagement event this Friday at West Swindon Asda at 9.30am, with the senior management team going out meeting the public and that is something we have not done before.
I think people have got a better understanding now, and with some celebrities talking about depression that has helped.
Q) In cases where someone is killed by a person with mental health issues, why does it take so long for reports into failings to be completed and the lessons learned?
A) AWP take all the appropriate measures it can for learning from significant events that have occured in the past. There is a legal process that must be followed with any serious incident and that contributes to the delay. It requires an independent review as well which contributes to the delay in serious failings coming to public attention.
Q) What more can be done to improve care for mental health patients locally? It seems like there’s a regional broad-brush approach that isn’t tailored to everyone individually.
A) We have taken major steps within AWP and currently within the Swindon locality and across the Trust as a whole, vision and motto is ‘you matter, we care’. We need to make that locally focused and we have changed the management structure through direct feedback from service users and members of the public. They wanted a local management team that they would know and be able to approach to talk about their concerns.
We have a clinical director, a managing director and myslef, the head for professions and practice. We directly egnage with service users and carers to design service improvements with their involvement through our experience-based design project.
It’s really important for us that we are brilliant at the basics and we will also look to integrate with other services, such as third sector agencies, commissioners and GPs to improve our provision.
The AWP Swindon locality is looking to improve and we are actively recruiting service user representatives and peer mentors to help redesign our services. If anyone wishes to participate in working with our service development initiative they can contact Ivor Bermingham at Chatsworth House, Bath Road. We open the door up to all volunteer and third sector agencies in Swindon.