Petitions Committee : Tuesday 16 October 2012

P-04-400 : NICE Quality Standard in Mental Health

Dear Bill Powell

Yesterday I received an email from Annette Millett attaching the letter (dated the 15th July) from Lesley Griffiths to you regarding the Petition we submitted earlier this year.

I am very pleased that - FINALLY - the Welsh Government have recognised that the NICE standards for service users in the mental health system have not been adopted in Wales.

While the Minster has indicated that "in principle" - "future" NICE guidelines will apply to the NHS in Wales - this would seem to evade the issue of the adoption and implementation of existing NICE guidelines relating to Mental Health service users.

From my reading of the letter, while admitting that Quality Standards are not Mandatory, the Minister does not seem to be able to confirm that there will be any accountability or requirement to meet standards under the Welsh Measure.

For instance, while there is now a statutory requirement for service users in secondary services to have a Care and Treatment Plan (very worthy and much appreciated) I can not find any indication of what measures or standards apply to the implementation - of failure to implement that particular care plan.  I am also aware from conversations with others, that not all users (mainly those receiving care in the community rather than in hospital) have been involved in developing their own Care Plans and agreeing them with the appropriate key worker, psychiatric nurse etc.

In addition - the support of an independent health advocate is only available upon request and there are very few people employed in this capacity.  I also wonder how an "in-patient" can be in "the community" - my belief was that the right to advocacy was for those receiving in-patient care whether in a "normal" hospital or in a psychiatric unit.  Perhaps the Minister could be asked to clarify this issue.

Regarding the draft policy "Together for Mental Health" - I, amongst many other service users and professional service providers attended one of the Consultation events. (At which, for the second time, we were informed by a senior adviser to the Minister that the NICE guidelines were applicable in Wales!

The Strategy is a wonderful aspirational document - but as the last Mental Health review failed to meet many of the proposed outcomes - I can not see that this new strategy will be any different.  Aspirational, uncosted with no mention of delivery or accountability.

I can not see how the Delivery Plan can "support" the Strategy solely by providing "effective and (sic) measurements of the strategy outcomes" unless it also includes specific targets, standards and levels of accountability.

Unfortunately my response to the letter from Lesley Griffiths is that I feel that despite the fine words, the Minister has failed to address the issues we raised in our petition - and her response has been somewhat evasive.

I hope that you will be able to include this email and this Ministers letter in the discussion of the proposed Strategy and Delivery Plan. Personally I think the response from Lesley Griffiths is somewhat disingenuous.

We also aim to provide - by the Monday midday deadline - some additional supporting evidence from service users and carers illustrating their experiences of treatment within the mental health system in Wales over the last ten years (right up today).

Kind regards

Jane Miller Smith

p.p. Mental Health Petition Action Group