Down but not out…

Levels of incredulity at the continuing unfoldings down Sloven way – apparently supported and endorsed by NHS Improvement – have reached crisis point. Even our brilliant, informal, campaign media archivist, is flailing…


Behind this battering is a peculiar situation which seems to be baffling pretty much everyone apart from the Sloven exec (plus Katrina Percy), NHS Improvement and Jeremy Hunt. Even Simon Stevens, CEO of NHS England, has publicly said Sloven have let down patients and families…


There is sensible and widespread condemnation of the recent sidestepping of the CEO into a new (or old depending on who and when you ask), part time role at the same salary and perks as a CEO (on top of the other, well documented failings). Including this statement from Philippa Russell on behalf of the National Valuing Families Forum.

The story of Smart’s stint as Interim Board Chair which only started in May is that he apparently commissioned two (yes two) so far mysterious reviews which found that the Sloven board are fit to practice. This was announced on June 30 without any engagement with families (other than an ‘accidental’ meeting with My Life My Choice who have since decided to no longer engage with Smart). The annual board meeting held last week demonstrated woeful engagement with families and patients (forced, as always, to sit through interminable presentations/talk with public question time compressed to barely any time at the end). This seems to last as long as Smart’s patience (if you can bear to listen to the audio recording). Appalling senior action still from a trust who have been in the public spotlight relentlessly for failing to engage with patients and families.

Strangely, Smart has agreed to the secondment of two directors (including the Chief Operating Officer).  Chris Gordon to NHS Improvement and Sandra Grant to another trust or commissioning group. And unilaterally (it appears with NHS Improvement dove from above agreement) agreed Percy’s new or old position.

Just a few questions. [No answers expected…]

  • Why would you insist a board is fine and then allow the secondment of (key) execs when the terrain is rocky?
  • Is there now no Chief Operating Officer or Communications Director alongside an interim Board Chair and CEO?
  • Is anyone at the highest levels of the NHS, in this foul and grotesque tale of abuse, deceit and pantomime, going to find it in themselves to stand up and act with integrity?

I suppose, if nothing else, a necessary light is being shone with a bloody big torch not on only Sloven murkiness but also the gaps, limitations, failings, impotence, pointlessness, corruptness and fatcattery that exist within and among senior NHS spaces. I dunno how you sleep at night.


Walking back from the original gingerbread protest at Jubilee House earlier this summer.

22 thoughts on “Down but not out…

  1. Your final paragraph summarises up the situation nicely. But wasn’t a big torch supposed to have illuminated such things in the aftermath of mid-Staffs? I would like a similarly big torch shone on the shenanigans in the NHS in north Wales although judging from your experience at Southern it would make very little difference – we saw the failing CEO of the former North West Wales NHS Trust moved sideways in a Percyesque move a few years ago, with his salary level kept intact. He still has that position in the Health Board that replaced the NW Wales Trust – a Health Board that is now in special measures. It is clearly the way things are done in the NHS…

  2. Why is KP protected in such a way? What does she know in a way of knowledge and suitability for the the job she has now that others don’t Who is behind her The untouchable KP? What connections she has to be bulletproof getting away with murder literally. Is that how NHS works? Protecting the guilty?
    creating jobs for them re-employing them and rewarding them with totally unjustifiable salary. People with learning disabilities are living on 120/week! experiencing substandard care…and abuse

    • Sadly Suzanne that is indeed just how the NHS works. I gained documentary evidence of the most appalling abuses in the mental health services in north Wales – yet most of those involved are still in their jobs and the Health Board is in special measures because of admitted ‘institutional abuse’ in the mental health services. I asked the same questions as you for ages ie. who is behind these people, why are they untouchable, what connections do they have to enable them to be protected etc. I discovered that the ‘service’ had a dreadful workplace bullying problem, that some members of staff had tried to whistleblow but had suffered such severe repurcussions they had left the area and that there was indeed great concern at Welsh Govt level about events in north Wales. I’m sure that the Welsh Govt don’t actually want loads of mentally ill people dying but they also feared a big scandal if it became public – they knew that Tories in Westminster would have a field day with a Welsh Labour Govt. The people involved in the abuses – including Board members, psychiatrists and mental health staff – were phenomenally aggressive, notoriously difficult to deal with and had the backing of lawyers and powerful unions. (The patients had limited legal aid and were struggling with serious illness.) The abusers certainly all networked together which undoubtedly afforded them protection, but I concluded that there was no one person protecting them – most people were desperate to see the back of them. The NHS is a sclerotic organisation which, despite all its ‘learning’ rhetoric, does not learn and cannot embrace change – and like all institutions it is highly defensive and protects its own interests. People in the system who do try to implement change are routinely obstructed and often end up simply leaving the NHS. And on this blog Sara has shown quite clearly how bodies established to hold the NHS to account are beset with their own institutional failures. So patients carry on dying, NHS scandals keep re-emerging with exactly the same themes and features as previous scandals and politicians remain terrified of standing accused of’ attacking that national treasure the NHS…

      • Thank you for your detailed answer Dr Baker. I know you have these horrific experiences with NHS in North Wales as a professional who dared to whistle blow and suffered the consequences. I am a parent of adult daughter who will need care once I am not able to care for her. I have resisted all my life to let her go into residential home or even into a respite unit for a short stay, because I know what would have happened to her. I have learned a great deal from Sara’s blog and I am shocked and speechless hearing and reading what is going on out there. I feel, that tragedy is almost unpreventable in our circumstances once I am not in charge of my daughter’s care.

    • Suzanne – careful with the word “murder”, which implies intent. KP will be looking for someone to sue for defamation and I wouldn’t to take the risk. It would be difficult to prove in Court that she killed anyone deliberately – and in defamation cases the burden of proof is reversed. You would have to prove that she had murdered someone deliberately: impossible (I suspect) without a police investigation. Please take this comment in the spirit in which it is intended. If you wish to see my view of KP, visit and other posts on my blog.

    • £6.000.000….easy..where do ‘I’ sign..(Ms Percy) ?

      The most vulnerable of learning disabled people – perhaps the people most exposed to poor health – through disability and much reduced social care….are put on a waiting list for access – to any health care….at all.

      Because not enough learning disability nurses in the Trust to support their access ?

      Did this dichotomy … touch the Board (in any sense?)

  3. The care of and support of people with Learning Disability and or Autism is now provided in an integrated way between NHS and LA’s; What in fact is happening is that the worst of poor Governance in each organisation has been integrated

    I am at presently (wearily) engaged in my 6th go at a Judical Review of the failed promises of a LA. Where each time the slow legal process of ‘letters before action; have been stalled by same promises – not delivered. (This time it has been 4 long years) Long wasted years of doing all and protecting all – complaining in vain and obtaining (rare as hens teeth) legal aid.

    And I am just about too done now to care.

    The LA uses contractors for all services bar care management. The contractors put people with agreed support needs on a waiting list for an assessment to see if they (contractor) can meet the needs. If not – on waiting list again for another contractor etc. This uses up years. The NHS (in our case Southern Health till recently) has its own waiting list for LD nurse support for access to any form of health care. In our case – been on waiting list for coming up two years. I did all before integrated/onlist …and still mainly do.

    The LA has cut its staffing of SW’s to the bare minimum and uses care assistants as care managers..caring people who have no authority and little if any influence. Everything has to be pushed up the line to SW first then to manager. If any of the two or their manager are on leave or ill – every thing is suspended till they communication to or from any one. This can go one for months and months. The vulnerable person(s) and exhausted family left swinging in the wind.

    Out of yet another ‘letters before action’ legal letter and complaint by me (another one) …we had another review in June this year where all was promised ..again …care plans and assessments to be sent to me within 14 days.. All the agreed (for years) services to be in place by first days of September.

    We had the meeting as a few days ago..No care plans or the assessment reports yet provided (for my son or his flatmate for whom I also advocate) and no/nil/zilch/zero.. services….just an update on the waiting lists and some extraordinary reasons for no care plans etc ..yet.

    Integrated NHS/LA support for example…means…. vulnerable person gets very ill .gets ntegrated response….’not my responsibility’ ‘ from LA and is ‘on waiting list’ from NHS ….as did my sons flat mate last year..and flatmate nearly died.

    All mainly is still down to me ….. I come free (of cost) at point of delivery.

    Integrated care in the community…my a….
    (just too tired)

    • Above written out of a bad day.

      It is important to add that all the above is also having similarly huge impact on the NHS – LA – and agency people – employed in the care of our sons and daughters.

      Before care agencies replaced direct labour in LA’s – people with learning disabilities in community were mainly supported by one or two people – sometimes same – for years. (Most were excellent – there was rare bad apple.) This person could have
      had a close relationship of years with the person supported – and this could ensure consistent coordinated and safe support.

      Now a number of agencies can be involved in support for same person. Because LA’s have had to reduce number/cost of SW’s etc…(I understand this can vary from LA to LA) there can be little or no monitoring apart from that done by family. And there can be no one at all to co-ordinate the roles and duties of these separate agencies. For example one agency can do shopping – another provide the PA role where support is needed for money management and correspondence – and another the advocate – if provided. And then of course – NHS now responsible for health care support where ongoing issues put yet more pressure on hard pressed LA staff

      Some agencies will have to be re-engaged by a care manager each time – however short term the engagement. Thus communication issues and role over load etc can increase potential for crises and stress and illness in LA staff.

      Excellent agency staff will use their own time to contact family to discuss issues – most are on Zero hours – and they do this out of caring.

      SW’s agree that getting rid of LA rehab officers has caused much of this current distress. Plus – the removal of day care from many vulnerable people – and their families.

      And we now have LA and NHS commissioning machines which must cost a lot of cash?

      It surely cannot be much cheaper to be continuously dealing with crises – firefighting – seeing people suffer neglect – as the hard pressed and caring staff of LA’s do every day.

      Surely time for LA’s to re- consider the humanity and cost efficiency – consistency – experience – and relationship – provided by their former employees – the ‘rehab’ officers.

    • I’m not in your situation but wanted to acknowledge the unpaid advocacy that you and Weary mother are contributing – things should change.

  4. The poor care in LD happens more than in other groups, as it’s not in the public eye.
    We don’t see the low quality care of adults, which is much worse than children’s services, until too late.
    Compare experiences with classroom assistants versus careworkers – paid similar money – they just don’t compare.
    What happens in so many (many, not all) adult health and social care placements, to maintain poor standards?
    As soon as education disappears, this happens. Because parents often disappear too.
    The sudden plunge to almost total neglect, but not total as they want most people to stay alive to feed the service world.
    Because many managers and (many, but not all) social workers and community nurses want easy lives, with no work ethic or conscience. The excessive greed for money.
    Because parents and families are like CQC inspectors – as soon as they speak they are resented.
    Families who are involved by the better services have happier adult children – so we must keep up the pressure. We must change this.
    I’m so sorry that any parent in their 80s is experiencing this – I’m so sorry. An ugly side of Britain that pretends to care.

  5. NHS has a very odd way of dealing with it’s managers. Maybe they should apply the rules of recycling. Failed managers should go out with the black bin guys, never to be seen in a position where they are responsible for people’s safety ever again, not the green bin to be recycled into the first available new management role that comes up.

      • To be more accurate, the ‘Fit and proper person’s test’ was stipulated by CQC for people running care homes, or institutions like Winterbourne View.
        But obviously the same principle applies in the NHS, where the impact is much wider and affects many more people.

  6. very familiar with the scenario of parents in their 60s managing with very real and personal support from the family GP and some familiar agency staff, SW not in the picture scant communications only. More recently witnessing adults alone coping again with GP support , network manager support instigated at the request of GP and any informal support that exists. No SW visiting , no support worker from community mental health and no independent advocate. OTs not informing people they have a right to apply for adaptions, advising instead that it would be a waste of time. It is abandonment and incarceration in the community.

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