Ok. Here’s the gig. Rich and I (and others I know) are genuinely puzzled/baffled at the mo. This is a bit of a lengthy post but worth a careful read. If you have time, I’d also recommend reading today’s #107days post where Sally Donavon talks about related issues. The question is at the end and it would be great if professionals could try to set aside their bureaucratic goggles and think about this in purely human terms.

First, a summary of issues and actions:

1. Abuse at Winterbourne View exposed in 2011. Action: fancy (concordat) talk, no real action
2. In Oxfordshire, learning disability services provided by Sloven, jointly commissioned by the Clinical Commissioning Group (CCG) and Local Authority (LA), are known to be poor since 2011. Action: ineffectual meithering, cosying down together 
3. LB drowned unsupervised in the bath. Action: (attempted) carpet sweeping
4. Independent report by Verita concludes there was opportunity and knowledge to prevent LB’s death. Action: unclear 
5. Three failed CQC inspections in Oxon. Cherry picking lowlights; denial of basic healthcare standards, patients forced to shower without shower curtains and use a mobile toilet in staff view; illegal deprivations of liberty; lack of basic staff training/therapeutic environment/hygiene/battery in defibrillator/record keeping; out of date medication and oxygen; inadequate staffing levels;  inadequate (dangerous) premises. Action: enforcement warnings
6. Monitor investigate and find various potential breaches of Slovens licence including due diligence around their takeover of the Ridgeway Partnership in November 2012, knowing there were issues and not addressing them. Action: enforcement action

Now I ain’t no rocket scientist but it seems pretty obvious to me that 2. and 6. directly contributed to LB’s death and I’m not sure how the Sloves can repair this breach in due diligence eighteen months on. It also seems glaringly obvious that there’s no proportionate relationship between what happened and what’s been done in the 10 months since LB died.

Yesterday, Sloven Chief Exec (of the Year/Health Services Journal (HSJ) inspirational leader), Katrina Percy, spoke on local television/radio. She seems to have swallowed a brand new chapter from the Sloven jargon manual (probably inspired by Bill Mumford’s new involvement in sorting out Oxon provision) which focuses on a shift to community based services. The problem (now), other than the ‘buildings’ (?), is that ‘the right staff’ are working ‘in the wrong place’ (inpatient rather than community settings). Worryingly, the new line seems to be that all problems will be solved by shutting the units and ditching the patients in the community where staff, who couldn’t give a fuck before, will transform into engaged, informed, motivated and caring workers.

Her response to 2-6 above is; ‘it’s not about [staff] neglecting patients but about not operating in the most modern way that they need to‘. Eh?  Oh my giddy aunt. Not neglect? The most modern way?? What definition of ‘inspirational’ were you using at HSJ Towers??

She insists she wants to listen to the people of Oxon (cue Dambusters again) and hear what they have to say about services…

Climbing back down from the glitzy and glamorous world of awards and inspirational leadership, and sidestepping the whole modern/neglect thorny issue, here’s a tiny glimpse of current life for a few dudes/families in Oxfordshire:

1. One of LB’s classmates has been living outside of Oxfordshire for over two years since he was sectioned at the age of 15. His parents travel to see him every other weekend in Newcastle.
2. A second classmate’s first ‘adult/transition’ appointment with the Sloves a month or so ago was so poorly handled/ill prepared for by a Sloven psychiatrist (who was involved with LB) that his family made an official complaint.
3. The family of a third young man who died in August 2012 have not been given a copy of the Sloven internal investigation into his death. Allegedly it would be too distressing. The inquest into his death has been delayed to allow more evidence to be gathered.

So, what we’d like to genuinely ask the Slovens, the CCG, the local authority, the CQC, NHS England, the Department of Health, Monitor (anyone really) is:

Given 1-6 above, can someone tell us clearly and precisely what would have to happen within health and social care provision to generate a response that is proportionate, swift and meaningful?