Wednesday 30 January 2013

Get WithThe Plan!

Take a look at our funky new publication Get with the Plan now available on-line. This is aimed at introducing patients and families to the new holistic Care and Treatment Plans which all users of secondary mental health services should have by June 2013.

The legal right to the Plan kicked in from June last year but if you previously had a CPA plan in place before June then you must get a new-style Plan within a year of that CPA Plan's date - so all old-style CPA Plans should be superseded by June this year. It sounds complicated but this is important stuff and has the potential to improve mental health services in Wales dramatically if (1) the Plans are done well and (2) they are delivered on.

The key to getting your Plan done well is to use our comprehensive Guide launched by the Minister of Health last year - see this link. Incidentally the new "Get with the Plan" leaflet is not a substitute for the comprehensive Guide but is a useful introduction to a necessarily complex personal planning process.

Not that people seem to need much encouragement to look at the full Guide - we have distributed 31,000 copies already - strictly on request not speculatively! And watch this space for some excellent training materials to back up the Guide which we are developing with our friends in the Mental Health Foundation and Bipolar UK.


It's sunny today and not so bad last weekend either when I was putting into action my own holistic life plans for physical health (by going for some vigorous walks) and for hobbies and interests (by taking a camera). This was 9.50am Saturday from the dungeon of Dinefwr Castle...

And it's getting ever so slightly lighter of course: this is 4.20pm the same day...

Thursday 24 January 2013


My "small breakfast" at the excellent Coffee Corner in Colwyn Bay high street this morning, a welcome change from the relentless 200 calorie limit strictly enforced at Blog Towers

I am in the midst of a UK-wide motor tour seeing at first hand the apocalyptic band of unprecedented weather which has invested the country (or, alternatively, a flurry of snow quite unremarkable for the time of year).

On Tuesday I rolled into London to give evidence to an enquiry into the future of mental health services organised by our friends in the Mental Health Foundation. We are invited to imagine how services might look in up to thirty years time - a useful exercise because it makes you think beyond immediate concerns like reform of benefits and the implementation of the new mental health law in Wales, very important though those things obviously are right now.

I find myself sounding quite pessimistic about Wales, making the point that sound legislation and decent-enough policy won't alone lead to excellent services. The focus has moved towards looking at the "culture" of the workforce. Logical I suppose but why should we believe that the culture will change while the service-providers still call the shots in our "take-it-or-leave-it", top-down system?

I don't doubt that mental health professionals in Wales are as decent and well-intentioned as any but the only way to ensure a respectful, listening, and therapeutic service is to allow patients and their families to choose the services they want and to choose who delivers those services. That way you don't have to rely on good will from professionals with monopoly control of what is available, an arrangement which inevitably leads to taking the patient for granted.

Yesterday I drove up from London to our North Wales HQ in Colwyn Bay. This meant motorway (or dual carriage-way equivalent) all the way so no problem with the snow but amazing scenery. Today I've been static, attending our quarterly North Wales meeting for more senior staff and local Trustees, but tomorrow I'm heading to Caernarfon to meet carers and then face the prospect of tacking down south via Dolgellau and Aber - fingers crossed that the roads are clear.


A good day to ask Deputy Chief Exec of Hafal (and full colonel in the "Jack Army") Alun Thomas for a pay rise following Swansea City's draw (and therefore win on aggregate) against Chelsea in the League Cup Semi. Congratulations on a sterling performance by all twelve of them (I include of course the ball boy - see the story here).


I promised more information following the news that Hafal has won Big Lottery funding to develop a groundbreaking Recovery Centre offering in-patient support and treatment for people with a serious mental illness. The Lottery "Innovations" funding will enable Hafal to employ a Development Officer to take forward the initiative.

We are delighted to have won funding to take this exciting venture forward. The Big Lottery has recognised what an original and interesting project this will be for Wales and our Members are very grateful for their backing.

We have spoken to key experts about our Recovery Centre concept including patients and families, NHS commissioners and consultants, and contacts in social services and other Third Sector organisations: there is strong support for taking this forward.

We look forward to developing an innovative service which is ambitious for its clients and which sets new standards of best practice for Wales.

The Recovery Centre will provide a progressive service for people experiencing serious mental illness and in need of hospital treatment. It will be based on the following principles:-

• The Centre will be a not-for-profit service delivered by a Third Sector organisation

• It will be recovery-focused and holistic, empowering patients to live more independently and to overcome the "revolving door" syndrome (a cyclical pattern of short-term readmissions to psychiatric units)

• The Centre will be cost-effective: the recovery focus will ensure patients move on from the service as soon as they are able to, and that they are equipped and supported to continue to work towards recovery

• The service will be patient-led: the Big Lottery was especially keen to fund the service because Hafal is user-led and this would inform the culture of the Centre

• It will provide significant employment opportunities

• The Centre will be developed in close liaison with the NHS to ensure we provide a service that fits with existing NHS services and that it meets the highest clinical governance standards

• The Centre will have a 15 bed capacity and will be located in South Wales

• It will be registered as a hospital with Healthcare Inspectorate Wales

• The service will have a holistic approach strongly in line with the Mental Health (Wales) Measure and the "Together for Health" and "Together for Mental Health" strategies.

Watch out for the job advert in the next few weeks and I'll keep you posted as we move forward with this exciting project.

Sunday 20 January 2013

Stony-Hearted Misanthrope

That was a busy week that was. I hardly noticed the snow. It's been a busy January - all in a good cause and mercifully not so much fire-fighting (though of course there is always some of that in a large organisation) as taking up development opportunities and planning an exciting year ahead, not least in campaigning for delivery, delivery, delivery on the Mental Health Measure and the new strategy "Together for Mental Health" and its Delivery Plan.

Hence my inattention to this Blog which may be a matter of indifference to you but for me this is important therapy!

Early in the week we met funders to report on the first year of Time to Change Wales, the anti-stigma campaign which we are running with our colleagues in Gofal and Mind Cymru.

There have been many initiatives across the world aimed at reducing stigma but the jury is still out on what actually works. However, I'm more than ever convinced that success depends absolutely on ordinary people with a mental illness "coming out" in their communities, work-places, and elsewhere to challenge stigma courteously but assertively.

That's a tough call but we are right to give priority to building a mass movement of people with a mental illness and their families who are prepared to speak up. Hafal's role in the initiative has been to support these courageous champions to deliver formal and informal training to the wider public and so far they've done just that to nearly 2,000 people.

Meanwhile, to be honest, I would have got the Blog done if I had not also been leading a full social life...

On Tuesday I was expecting a night in with my feet up but a friend handed us tickets at the last minute to see the Royal Opera House's production of La Bohème broadcast live from Covent Garden to...Screen 2 of the Apollo Cinema in Carmarthen.

Good fun and well-sung if also a little well-worn. ROH are very pleased with themselves that this production dates from 1975 but I think it shows a bit - although the production is traditional (so ostensibly could be from the 1890s when Puccini knocked it out) somehow it looks dated. Also annoying was a pre-recorded lecture before the performance aimed at inducting the cinema audiences around the country into the mysteries of opera - irritatingly patronising to an audience of what were quite obviously Carmarthenshire opera buffs who knew more about the subject than most of the actual audience at Covent Garden (bored executives sucking up corporate hospitality).

But this is the greatest of operas and the most accessible art-form on the planet contrary to popular belief. A stony-hearted misanthrope could not fail to weep as Mimi consumptively coughs her last.

Before the performance I notice that our tickets are for senior citizens. Mrs Blog is all for just ignoring this and walking in but a combination of honesty and vanity makes me insist on offering to pay up the difference. The kindly box office person smiles, shakes his head and suggests we don't worry - and sure enough the ticket inspector on the door doesn't bat an eyelid. Ah well.

On Thursday we are out again (but this was planned) to see a performance of the National Theatre's current stage hit The Magistrate, a sort of Victorian farce by Sir Arthur Wing Pinero and starring American star John Lithgow whom we saw playing Malvoleo in Twelfth Night a couple of years ago. The live production is beamed across the ether to...Screen 2 of the Apollo Cinema in Carmarthen, now our home from home.

This is slight stuff first produced in 1885 - 10 years before Puccini's masterpiece. Lithgow and the rest of the cast play it in a cartoon-style frenzy padded out with some song-and-dance routines which are unrealistic and don't add anything to the feeble plot and rare jokes. Still, I did enjoy it - it's an interesting period piece and races along fast enough.

The biggest star on both Tuesday and Thursday was...Screen 2 of the Apollo Cinema in Carmarthen. Compared with the agonising discomfort and grotesque cost of West End theatre the plush leatherette seats, drinks-holders, limitless leg-room and fair pricing of modern cinemas are a real bargain and true luxury - and surely the reason cinema attendances have risen three-fold since 1985.

And today we do a massive walk right around St David's peninsula in freezing cold but intermittent sunshine which makes me feel young again and dispels any tendency towards misanthropy...

Friday 11 January 2013

Value Range

A new mural in Bethany Baptist Church created by Hafal Blaenau Gwent

The National Lottery announced this week that it is giving Hafal £280,000 towards development of a Recovery Centre - a pioneering new venture which we have been planning for a while. The idea is to put our money (and the Lottery's) where our mouth is by developing a progressive new facility, registered as a hospital, where patients with high needs can get better quickly and stay better, breaking the cycle of relapse and readmission. Early days but the soundings we have taken with consultants and commissioners have been really positive so we will get started in earnest now. More on this in due course.

Meanwhile Hafal's Members are deeply concerned about changes in the benefits system. The ongoing anxieties about assessment are being compounded by the news that many benefits are being "capped" with just 1% rises over three years - which in reality means a reduction of perhaps 5% over that time.

The bare figures don't look all that dramatic but the problem is worse than it seems. People on low incomes have very limited control over outgoings, seeing most of their cash disappear inexorably and unavoidably on bills for rent, heat, light, etc, leaving a precious few pounds for food and going about their business. So if out of, say, £100 worth of benefits you might have £20 to play with then a 5% reduction means you've got just £15 instead, a very big difference indeed.

I don't know where Iain Duncan Smith does his shopping but I invite him to visit Tesco and fill his basket judiciously with the following:

1 sliced white loaf
1 litre skimmed milk
80 tea bags
1 kilo potatoes
3 cans baked beans
1 tin tomatoes
566g fresh chicken
1 tin cat food

If he has been really careful to choose the "value range" options he will be asked for £4.87 at the till - and then he could reflect that what is in his basket is how much he is taking away for every £100 worth of affected benefits like ESA (the cap doesn't apply to disability-specific benefits). I'm not saying here whether he's right or wrong to reduce benefits but it is right to reflect on what the policy means in real terms.

Incidentally the only item on the shopping list which I wouldn't be quite happy with is the value range tea bags - cheap at 27p but personally I would splash out on Glengettie (the famous Welsh tea grown I believe on the warm, south-facing slopes of the Preseli Mountains) or PG Tips. Cheap tea bags can be disappointing, though certainly preferable to posh teas like Earl Grey, "English Breakfast", etc which just taste like dish-water. Anything on the end of a string is particularly to be avoided.

Friday 4 January 2013


Chichester harbour with the Isle of Wight on the horizon

Happy New Year!

...And it's back to work.

There is a positive mood in the office because development opportunities are springing up in spite of the financial climate. Better to be busy because there is work to do than be wringing your hands because there isn't...

Meanwhile the campaigning challenge in 2013 will be to sustain the interest of Welsh politicians and others in mental health now that the law (the Mental Health Measure) - and the new Welsh strategy ("Together for Mental Health") are in place. The risk is that everybody congratulates themselves on "a job well done" and "moves on", a scenario which would leave mental health patients in the lurch because we haven't yet delivered - and that, of course, is the most difficult bit.

We are presently working with our partners Bipolar UK and the Mental Health Foundation to assist patients and families through this year to test and comment on delivery of the Measure and the strategy - watch this space!


As you can see the weather was fine on New Year's Day on the south coast of England where we cooked and ate sausages en pleine air, in contrast to last year when it bucketed down.