Health and Wellbeing Board Agenda Papers for 20

9.57 Campaign for action from Health and Wellbeing Board

(agenda papers for 20.3.13).

1The need for action in the NHS

Front page of the local paper on23.2.13

2 Press release 22.2.13

REFORM OF NHS POST FRANCIS AND LSE REPORTS

I have just written to the chairman of the Brighton and Hove Wellbeing Board (Cllr Rob Jarrett) and other members and officers, asking him to consider improving the regulatory system to prevent the failure in Mid Staffs hospital in which hundreds of patients died, as reported in the Francis report in mid Feb.

The new regulatory body to prevent this sort of occurrence is called Healthwatch, (HW) and takes over from the Local Involvement Network (LINk) on 1.4.13. The local LINk failed as a watchdog (gamekeeper, whistleblower) because it’s constitution (terms of reference) allowed its governing body to be packed with employees of provider (poacher) organisations who had an undisclosed conflict of financial interest in not blowing the whistle on their employer, to keep their jobs.

I submitted to Cllr Jarrett a proposed constitution which specifically excludes employees of providers (poachers) from membership of HW, and hence from being officers of HW. I also proposed a model constitution (terms of reference) for each of the 47 Patient Participation Groups in the city, who report to HW. This constitution enables the patients of the PPG to hold their officers and GPs to account in improving the services. These documents are available on request from me.

REFORM OF MENTAL HEALTH SERVICES

I have also written to Dr Becky Jarvis, clinical board member for mental health in the Brighton and Hove Clinical Commissioning Group (CCG) enclosing a paper titled: ‘Can mental sickness be prevented, healed and cured? Medication to meditation’. (60 pages, available on request) This addresses the indictment of the NHS in the LSE report (June 2012) that ¾ m mental patients are losing out by not being treated. Our paper asks her to remedy that locally by doing the following:

a) Pilot a mental health service to prevent, heal and cure mental sickness, reduce the staff sickness rate in the NHS and other public services, and reduce health inequalities.

b) Mass-commission and mass-provide a menu of therapeutic courses for depressed patients on GP prescription, and for sick public sector staff on occupational health doctor prescription within an 18 week wait.

c) Finance these courses (£3-12 mpa) out of the mental health drugs budget (£25 mpa) which don’t work, and do harm, under a programme called: ‘medication to meditation.’

d) Negotiate with the directors of the Social Enterprise Complementary Therapy Company (SECTCo) to provide these courses according to our bid dated 23.7.12 to the Community Mental Health Support Prospectus.

This is a radical proposal for a new, drug-free way of treating mental sickness through education. This policy is not just a matter for the NHS, as many public sector staff are off sick with mental illness, and it is public sector policy to reduce their staff sickness rate.

We have asked Cllr Jarrett and the HWBB to consider this proposal, in the hope that it will recommend Dr Jarvis and the CCG to implement it for not only their patients, but also their staff, whose staff sickness rate is 5% (2.5 times the private sector) Under the Boorman target since 2009 they are required to reduce this by 1%, but it has not been achieved, and may have got worse.

We also ask the Council (biggest employer in the city with 12,000 staff) to implement this proposal in their occupational health policy, with a view to reducing their staff absence rate from 4% (double that of the private sector) For example, Transport for London with 20,000 staff have reduced their staff sickness rate by 73% by providing the mindfulness courses that we are offering. We hope that the HWBB will recommend the Council and NHS to do the same here. If they do, the city could be a pilot, and a beacon for the nationin it’s objective of halving the public health statistics by 2020.

Further information is available from John Kapp () company secretary of SECTCo, 22, Saxon RdHove BN3 4LE, 01273 417997, who is available for interview. ,

3 Letter to the leader of Brighton and HoveCity council 25.2.13

SECTCo

Social Enterprise Complementary Therapy Company

Mission: To provide patients with their statutory rightunder the NHS constitution to National Institute for Clinical Excellence (NICE)-recommended complementary treatmentto promote wellness, prevent illness and remove health inequalities in the city of Brighton and Hove. Our logo is the wounded healer, Chiron.

Registered number 7319842 From the secretary, John Kapp

Website Registered address 22, Saxon Rd Hove,

E.Sussex, BN3 4LE

01273 417997

25.2.13

Cllr Jason Kitcat

Leader, Brighton and Hove City Council

Dear Jason

TRANSFORMING PUBLIC HEALTH IN THE CITY

I have written to Cllr Rob Jarrett asking him to add 3 items to the agenda of the next Health and Wellbeing Board, copies of supporting documents enclosed. They are the letter dated 22.2.13, a press release, the front page of the Argus last Sat stating the emergency at the hospital, and a paper: ‘Can mental sickness be prevented, healed and cured? Medication to meditation.’

They indicate a solution to ease the crisis in the NHS:

a) To improve the way that the NHS is regulated by Healthwatch and the Patient Participation Groups (when it takes over from the LINk on 1.4.13)

b) To ask the Council to pilot a menu of therapeutic courses to help depressed patients and sick public sector staff.

The advantages of this proposal include:

1 It is patient-centred, (rather than provider-centred).

2 It could halve the public health statistics by 2020.

3 It could cost the taxpayer20% less.

4 It could create at least 1,000 new jobs for complementary therapists.

I hope that you and your Group will support this initiative, which will be very popular with the electorate. I am available to meet you and other councillors to discuss this whenever you wish.

With best wishes Yours sincerely John Kapp

Board of directors: Penny Kinton (chairman) Anne Pether (finance) Martina Roe (clinical) Mike Turpin (technical) John Kapp (company secretary) Tony Bell, Sonia Gomez, Paul Jenner, Tom Sydenham

4Letter to the leader of the Conservative Group Geoffrey Theobald 25.2.13

Dear Geoffrey

Further to my e mail last Sat, congratulations on your piece in Sat’s Argus ‘Labour sitting on the fence…’ showing how their antiquated ideology is stifling cost-effective Council service provision. Nationally, they did the same thing opposing the Health and Social Care Act (Mar12). I saw car stickers: ‘kill Lansley’s bill before it kills the NHS.’ I am trying to use the powers of that Act to outsource mental health service provision to the third sector to get a more cost-effective mental health service.

A good example of this was shown on the news (9.1.13) National government outsourced the low risk 70% of offenders (190,000) presently under the probation service, (but who they cannot help) to charities like St Giles Trust. who employ ex-offenders to run courses which halve the offending rates on payment by results. Labour calls this ‘privatisation’ but the government rightly calls it getting better value for taxpayers money.

In a similar way, my company (SECTCo) proposes to employ ex-mental health service users to run MBCT courses to halve the 5 year relapse rate for mildly depressed patients (worried well) as recommended by NICE. We are not seeking to compete with Sussex Partnership Foundation Trust, (SPFT) who will still be required to treat the acute cases (psychosis, secure units etc) We are offering therapeutic courses to mildly depressed patients (that SPFT cannot help) to prevent them from becoming severe, and costing the taxpayer mush more. (the cost of treating the average psychotic patient is £27k.)

Yours John

5 Letter to chairman of Health and Wellbeing Board, Brighton and Hove

SECTCo

Social Enterprise Complementary Therapy Company

Registered number 7319842 From the secretary, John Kapp

Website Registered address 22, Saxon Rd Hove,

E.Sussex, BN3 4LE

01273 417997

22.12.13

Cllr Rob Jarrett,

Chairman of the Health and Wellbeing Board (HWBB)

Dear Cllr Jarrett

THREE PROPOSED ITEMS FOR HWBB AGENDA ON 20TH MARCH 2013

I have spoken to Caroline de Marco and Giles Rossington, and understand that it may still be possible to add items to the agenda for the next meeting on 20th March. I would like the following 3 items to be added:

1 Constitution for the new Healthwatch

Last November, SECTCo bid unsuccessfully to be the organisation to run Healthwatch. The successful tenderer is due to be announced soon. In our bid, we enclosed the following:

A diagram showing the new regulatory system over Health and Social Care, (appendix 1)
‘Draft constitution for the Brighton and Hove Healthwatch’ (appendix 2)
‘Proposed Model Terms of Reference (constitution) for Patient Participation Groups (PPGs)’ (appendix 3)

As Healthwatch (HW) is a statutory body (unlike the LINk) I said in our bid that the constitution of HW should be approved by the Council. I would therefore propose that the HWBB considers our draft, (appendix 2). This was written out of my sad experience of the LINk, which failed as a watchdog because it’s terms of reference were provider-centred, (‘packed’ with providers with an undeclared financial conflict of interest) and gave no rights to members to hold its officers to account. Appendix 2 remedies these failings, so gives HW the potential to succeed as a watchdog. The Francis report shows how the regulatory system failed in Mid Staffs, as its whistle-blowers were not heard. The Council should ensure that this does not happen in the city.

2 Terms of reference for the Patient Participation Groups (PPGs)

The 47 PPGs in the city are the local watchdogs in each of the 47 surgeries. They should report upwards to HW, as in the diagram (appendix 1) I am the secretary of the Wish Park Patient Participation Group (PPG) who adopted the terms of reference shown in appendix 3, which was copied from many sources. I have spoken with members of other PPGs in the city who are lost, as nobody has given them any guidance in what their terms of reference should contain. This was the problem for the LINk in 2008, which caused it to fail.

Board of directors: Penny Kinton (chairman) Anne Pether (finance) Martina Roe (clinical) Mike Turpin (technical) John Kapp (company secretary) Lizzie Beckett, Tony Bell, Bob Bleach, Paul Jenner, Tom Sydenham

I ask the HWBB to agree model terms of reference as guidance for the 47 PPGs in the city, so suggest that they discuss appendix 3 be discussed. Again, it is user-centred, giving rights to patients to hold their officers and GPs to account, which is essential if PPGs are to succeed intheir job as watchdogs to improve servicesin each surgery.

3 Can mental sickness be prevented, healed and cured?

I have just written to Dr Becky Jarvis, clinical board member for mental health in the Clinical Commissioning Group (CCG) enclosing a paper of the above title (60 pages) as a printed and bound copy. This paper asks her to do the following:

a) Pilot a mental health service toprevent, heal and cure mental sickness, reduce the staff sickness rate in the NHS and other public services, and reduce health inequalities.

b) Mass-commission and mass-provide a menu of therapeutic courses for depressed patients on GP prescription, and for sick public sector staff on occupational health doctor prescription.

c) Finance these courses (£3-12 mpa) out of the mental health drugs budget (£25 mpa) under a programme called: ‘medication to meditation.’

d) Negotiate with us directors of the Social Enterprise Complementary Therapy Company (SECTCo) to provide these courses according to our bid dated 23.7.12 to the Community Mental Health Support Prospectus.

This is a radical proposal for a new, drug-free way of treating mental sickness throughout the city. This is not just a matter for the NHS, as many public sector staff are off sick with mental illness, and it is public sector policy to reduce the staff sickness rate.

I would therefore like the HWBB to consider this proposal, in the hope that it will recommend Dr Jarvis and the CCG to implement for their patients. The NHS should also offer it to their staff, whose staff sickness rate is 5% (2.5 times the private sector) They are supposed toreduce this by 1%, under the Boorman target since 2009, which has not been achieved.

I also hope that the Council (biggest employer with 12,000 staff) will implement this proposal in their occupational health policy, with a view to reducing their staff absence rate from 4% (double that of the private sector) For example, Transport for London with 20,000 staff have reduced their staff sickness rate by 73% by providing the mindfulness courses that we are offering. I hope that the HWBB will recommend the Council and NHS to do the same here in the city. If you do, we could be a pilot, and beacon for the nation.

I would be pleased to assist the Board in any way I can.

With best wishes Yours sincerely John Kapp

Cc Giles Rossington (business manager, Health and Wellbeing Board HWBB)

Cllr Ken Norman (HWBB) Cllr Jayne Bennett (HWBB)

Dr Xavier Nalletamby (HWBB) Dr Christa Beesely (HWBB) Dr Becky Jarvis (CCG)

Dr Kay Macdonald (Clinical director Sussex Partnership Foundation Trust)

Appendix 1 The new regulatory system over Health and Social Care (the numbers refer to the desired number of elected members/staff)

Appendix 2 Draft constitution for the Brighton and Hove Healthwatch(HW)

1 Name

The body hereby constituted shall beHealthwatch Brighton and Hove, hereafter called ‘the HW’, for the Local Authority of Brighton and HoveCity (hereafter called ‘the city’).

2 Purpose

The purpose of the HW shall be to promote wellness, prevent illness and remove health inequalities in the city by improving health and social care services.

3 Mission

The mission of the HW shall be to halve the public health statistics in the city by 2020.

4 Aim

The aim of the HW shall be to create a user-centred National Health Service (NHS) and Social Care Services (hereafter called ‘the Services’) in the city.

3 Objectives

a) To monitor and report on the safety, quality, effectiveness and user experience of the Services provided in the city.

b) To make recommendations to improve the Servicescommissioned and provided in the city.

c) To be a statutory consultee on consultations concerning Services policy formulation in the city.

d) To request representation of user representatives (lay members) on every Services committee concerned with user care, such as patients, clients, service users, carers, hereafter called ‘users’, in the city.

e) To recruit and support such user representatives (lay members) on those committees,to have equal rights with clinicians and managers to speak and to vote.

4 Powers

HWis a statutory regulating body (a ‘gamekeeper’) to monitor the Services (the ‘poachers’) It is set up under the Health and Social Care Act 2012. It shall have the following statutory powers:

a)To monitor the Services as a watchdog of Healthwatch England,by beingits local eyes and ears.

b)To be a statutory consultee in all policy matters relating to Patient and Public Involvement (PPI) of the Services in the city.

c)To receive information from Healthwatch England.

d)To receive from other HWs,other PPI bodies, Health and Wellbeing Board, Health Overview and Scrutiny Committees (HOSCs) Patient Participation Groups (PPGs)and other like bodies, reports of unsatisfactory service, (whistle blowing) and recommendations of what should be done to improve the Services.

e)To request information from commissioners and providers of the Services,and other bodies, and to get a reply within 20 working days.

f)To enter and viewthe premises of Services providers and report on them.

g)To write and send reports recommending action to commissioners and providers of the Services, and get a response within 20 working days.

h)To report to Healthwatch England and other Services regulatory bodies, and government departments to get changes made to the system to improve the Services.

5 Accountability

The HWshall be accountable to users in the city as part of the government regulation of the Services.

6 Funding

The HW shall be funded by a government grant on contract from 1.4.13 to 31.3.16.

7 Eligibility for membership of the HW

All adults residing in the area who are not employees of the Services shall be eligible for membership of the HW.

Employees of the Services are ineligible for membership. They are specifically excluded from membership of the HW because, being paid by the providers (poachers) they have a financial conflict of interest, so cannot be expected to be the gamekeeper and blow the whistle on their employer.

8 Members of HW

Members of HW shall be those persons eligible for membership who have registered to be a member, and been put on the membership list. To register they shall give their name, address, e mail address and telephone numberto the membership secretary of the HW.

9 Rights of membership of the HW

a) All members shall have the right to stand for election to the Executive Council of the HW.

b) All members shall be publicly informed of the date, time and place of meetings to which they are entitled to attend, speak and vote, by those details being placed on the HW website.