Winterbourne View: learning disability providers have learned a crucial lesson

The launch of a quality code three years after the Winterbourne revelations means some good has come out of the scandal, says David Brindle of The Gaurdian

Three years ago next month, whistleblower Terry Bryan set in train a sequence of events that was to send a devastating shockwave through the adult care sector and culminated last week in the sale of what remained of the company he was working for.

That company was Castlebeck and the shockwave has become known as Winterbourne View, the name of its hospital facility for people with learning disabilities and autism near Bristol, where Bryan was a charge nurse and where he had witnessed what he described in an email to management as the "confrontational and aggressive" approach of named staff towards vulnerable patients.

The whole nation was to see such behaviour, and worse, on TV seven months later, after Bryan – his complaints having prompted no action by the company or regulatory bodies – approached BBC's Panorama team. An undercover reporter went into Winterbourne to film covertly and the resulting programme led to the prosecution and conviction of 11 staff, six of whom were jailed; the closure of the unit; the collapse of Castlebeck into administration; and, most significantly, a government decision to stop using similar hospitals in England and to find, by next June, new forms of care for 1,300 people languishing in them. The hospitals had sprung up since the rundown of long-stay learning disability institutions, and claimed to offer short-term assessment and treatment of people with challenging behaviour. In reality, care commissioners were using them routinely to "park" such people, often for years at a time. All too often, there was little assessment going on and still less treatment......

http://www.theguardian.com/society/2013/sep/11/winterbourne-view-learning-disability-care-providers

Today is RU OK? Day. 

Today is RU OK? Day. So make sure you ask someone if they’re OK today.

Today is RU OK? Day. So make sure you take the time to inquire after someone’s mental health, because sometimes all someone needs is to know that someone cares.

Today is RU OK? Day. So make sure that you act as if you’re interested in someone’s wellbeing – you could be the difference between them going a whole day without a person acting that way for a few seconds, and them not having to suffer through that.

Today is RU OK? Day. So make sure that you check up on your friends and see if they’re OK at least once a year: mental health professionals recommend an annual diagnosis of OK-ness to stay healthy.....

http://www.theguardian.com/commentisfree/2013/sep/12/r-u-ok-day

Dementia campaign could lead to over-diagnosis, say experts

Specialists criticise efforts to increase early discovery, saying it could lead to two-thirds of over-80s being diagnosed

The current prevalence of dementia is thought to be 10-30% in people over the age of 80. Photograph: John Stillwell/PA

Two-thirds of people aged 80 or over could be diagnosed with dementiain future because doctors are subjecting patients to needless investigation for and potentially damaging treatment of the disease, experts say.

The specialists in dementia, geriatric medicine and public health claim the growing trend towards older people having their risk of dementia assessed could lead to considerable over-diagnosis.

"The current prevalence of dementia is thought to be 10-30% in people over the age of 80, but the adoption of new diagnostic criteria will result in up to 65% of this age group having Alzheimer's disease diagnosis and up to 23% of non-demented older people being diagnosed with dementia," say the British and Australian experts, writing in the British Medical Journal...........

http://www.theguardian.com/society/2013/sep/10/dementia-over-diagnosis

The Rise of Health Apps

"The Rise of Health Apps

My teenage niece rarely utters more than 2 words to adults nowadays. So you can imagine my utter shock when she casually declared that 'its kind of cool' that the service I work with has developed a mental health app. 

The app she was referring to is the 'My Journey' youth mental health app. I had to come clean and inform her that even though I led the project, the credit for developing the app belongs to the young people accessing theEarly Intervention in Psychosis Service who have been key in progressing the project. My status of cool was therefore short lived but it opened up one of our longest discussions - on youth mental health and apps.

'My Journey' is one of several youth mental health health apps developed recently alongside a variety of other health apps. This months newsletter looks at 2 other youth health apps and possible implications for clinical systems:

1. The Well Happy App was developed by Kat Cormack and the team at NHS London. It offers a handy guide to a range youth services in London as well as other features;
2. Doc Ready aims to help young people prepare for appointments with doctors and other health professionals. The app has been developed by Innovation Labs;
3. We also take a brief look at some of the possible implications of mobile health for clinicians and health IT systems.".......

http://us2.campaign-archive1.com/?u=ab247a6ad6b0e2d93ab084c28&id=1795ed9a2c&e=08a5ace56b

'My Journey' EIIP App

Many young people experience thoughts and feelings that can leave them feeling lonely and scared. They can pop up with no warning; changes in your mood, suddenly feeling anxious, withdrawn or lacking in energy can be hard for you or your loved ones to understand if you’ve never experienced those things before. They can leave you feeling isolated too, because they’re difficult to talk about.

The My Journey app is designed to help you keep track of how you’re feeling. By working through the set questions with an easy-to-use rating wheel, My Journey can help you make informed choices about what to do to improve your mental health.

Using My Journey, you can:

• Monitor your mood
• Set goals and track your progress at your own pace
• Receive advice on what to do and who to contact if you need help
• Keep track of any medication you take
• As you work through the app, it also gives you simple tips on things you can do to help you feel better such as sleep, dietary and exercise advice.

The app doesn’t store your ratings, so you can use it repeatedly and receive targeted advice on how you’re feeling day by day.

My Journey was created by Surrey and Borders Partnership NHS Foundation Trust and young people who have used our services............

http://us2.campaign-archive1.com/?u=ab247a6ad6b0e2d93ab084c28&id=1795ed9a2c&e=08a5ace56b

Demand for advocacy is rising as funding and access fall

As Action for Advocacy closes, a former chief executive discusses its legacy and the challenges that remain.

Advocacy now has no coherent voice to lobby for people’s access to rights. Photograph: Alamy

Action for Advocacy (A4a) recently announced that it has ceased trading. As someone who was (briefly) a chief executive of A4a, I want to talk about some of what we achieved and some of the challenges left to meet.

When A4a started in 2001 (as Advocacy Across London), the advocacy movement was perceived as disorganised, unaccountable and possibly dangerous. Within the sector, a preoccupation with method led to disagreements that felt vital but that ultimately undermined our ability to support those who were being ignored. A passionate belief in what groups did to support people's rights ran dangerously close to purism. There is no way you would ever have written such a thing into law.

The mission of Action for Advocacy was to secure a strong and equal voice for all citizens. That allowed A4a to use the language of voice, choice and control to challenge both public authorities and advocacy providers. Our belief that advocacy is fundamentally important in upholding people's legal and human rights meant we were determined that it should be understood, and that it should be done well.

By focusing on the principles underlying the different approaches to advocacy, we could bring coherence to diverse provision. This led to theAdvocacy Charter in 2002, then to the Code of Practice for Advocates in 2006. We trained thousands of advocates and managers, built the capacity of a diverse sector, and lobbied government to put into law a duty to make people's voices. In eight years, advocacy had gone from dangerous purists to having legally defined roles in protecting people's rights (through the Mental Capacity Act and the Mental Health Act).

We developed a quality mark (QPM) that was rated ISO equivalent, cited in commissioning guidance by Social care Institute for Excellence. It was designed to ensure that advocacy services retain their empowering, independent and challenging nature; ensuring that the skills, views and rights of those they support remain paramount. Thankfully, it appears that the QPM will continue beyond A4a.

Unfortunately, people still do not have a strong and equal voice. Funding and access for advocacy services are falling while demand is rising. More than 12,000 people are being denied their legal right to access an independent mental health advocate (IMHA). Despite recommendations from the Care and Support Alliance, the Joint Committee on Human Rights and the Law Commission, the care bill gives no right of access to advocacy.

It has been said that the right to advocacy is implied through the duty to provide advice and information. However, at a time when explicit legal rights to advocacy such as IMHA are ignored, the idea that an implied right to advocacy will suffice is at best fanciful, at worst cynical. Information and advice are not sufficient when you are simply not being listened to, when your dignity is compromised continually, or when choice is being managed out of your life.

A4a leaves a legacy of accountability and quality in the advocacy sector. It helped to create legal rights to advocacy. However, its absence means that advocacy has no coherent voice to lobby for people's access to rights. There is now no place to bring trends and themes in advocacy together, to highlight how we need to change society if we are to ensure a strong and equal voice for all citizens. That challenge can't be left unmet.

Martin Coyle is director of True Voice and a former chief executive of Action for Advocacy

Universal credit: Flagship welfare reform 'poor value' says watchdog

The government's flagship welfare reform has been badly managed, is "overambitious" and poor value for money, the spending watchdog has said.

The National Audit Office said risks were taken with the universal credit to hit targets, IT systems had "limited functionality" and an unfamiliar project management approach was used.

A national rollout of the new benefit has been delayed following IT glitches.......

http://www.bbc.co.uk/news/uk-politics-23963867