Care Clustering in the NHS, haven’t got a clue? Well neither do I!

Today I saw an article in the Guardian. http://www.guardian.co.uk/society/2012/jan/31/reorganising-mental-health-clusters-madness Reorganising mental health services into clusters doesn't make sense

Thought What the...! And went and read it....sadly despite the impassioned voice of this article I was none the wiser as to what the exact problem with clustering was. That some people with have to change their doctor does not, for me, seem a huge deal, particularly if I would be seeing someone more specialised in the problems that I am suffering. However I am not OCD. As read it seems that clustering could give a better idea of what my actual problems are and less and broad overall diagnosis which most people see as irrelevant. I found this which is a suggestion by a nurse that actually having specialism’s in mental health would be a good idea.

http://www.mentalhealthforum.net/forum/showthread.php?3617-Specialism-in-mental-health-a-good-idea-or-not

Sadly it wasn’t commented on and the originating page does not exist anymore.

I investigated further and though the guardian has several related articles (so it claims) about this I am none the wiser...a few more places on the net and yet again the explanations are lacking. I have not yet found a clear explanation that shows why this would be so detrimental. It actually doesn’t sound that much different to what we have already.

Horrifically underfunded Chaos with a postcode lottery in quality of patient care!

Realistically there may be severe problems with accessing treatments and social care with some more troublesome patients getting sidelined; however I’m still lost as to how it is that different from what we have already.

So I’ll have a cluster and a diagnosis...that this will be related to my actual symptoms at present and not necessarily to my diagnosis per sea seems quite good to me, but then I am bipolar. I could be manic or I could be depressed and I require different care for each phase. Seems fine to me; but clearly it isn’t as the people writing some of this are having to face implementing it and they have grave concerns. http://www.guardian.co.uk/social-care-network/2012/jan/05/mental-health-cannot-be-shoehorned-clusters

So having tracked down this site http://www.dh.gov.uk/en/Managingyourorganisation/NHSFinancialReforms/DH_4137762 where there are several documents about the history of the proposed changes I looked particularly at this one.

Payment by Results in Mental Health:

A Review of the International Literature

and an Economic Assessment of the

Approach in the English NHS

To see if it would shed any light on what and why this was being done. As predicted it was complicated and long winded however it did highlight several things for me.

·         That the country is trying to be creative in finding answers to the problems of poor mental health services

·         That no other country has implemented the system this country intends to

·         That many abandoned implementation of a system like this

·         Those that have implanted something, have either limited it to in-patient care or have severely restricted its’ impact on the overall care package.

There was also an overwhelming lack of knowledge and understanding and an awful lot of looking at the economics of providing care and it does seem to me that gathering more information by phasing in the assessments and looking at the possible consequences of it to the patients before actually changing the system would be the best option.

It seems strange to me that having been in the system for 20 years, having had therapy and a CPN and various other drug treatments, and am currently signed off for mental ill health that I have not heard anything about the proposed changes.

There is a lot of chatter about the economics and efficiency, however given some of the fiascos in the benefit reform and changes in patient care practises I would have thought that that was the least of the governments’ worries. I get that we need to save money, but I don’t see why patient care should be compromised to achieve it. Unfortunately I have no real idea whether that is what will happen and sadly I don’t believe that they do either. My only hope is that as they review its’ implementation if they see it not working well that it will be aborted.