FIRST, THE POST OFFICE SCANDAL, THEN WASPI BUT THE GREATEST SCANDAL STILL TO BE EXPOSED ARE THE THOUSANDS OF VULNERABLE PEOPLE TRAPPED MH FOR MANY YEARS ON END IN UNSUITABLE SETTINGS, DEPRIVED OF MEANINGFUL CONTACT WITH THEIR FAMILIES , DENIAL OF PHYSICAL HEALTHCARE REFERRALS, HELD WITHOUT LEAVE ON NEVER-ENDING SECTIONS.  

There is also the matter of conflict of interest at Board level with those at the top working for CQC which is conflict of interest.

Christopher Reid

<Chris.Reid@parliament.uk>;

victoria@victoriaatkins.org.uk victoria@victoriaatkins.org.uk

Dear Mr Reid

It is a disgrace that senior people within the ICB and LPFT and even ULHT are working for Care Quality Commission. It is no wonder why no complaints are dealt with properly.

I am most concerned about this and something should be done about it.

Yours sincerely

Susan A Bevis   POA and Litigation Friend.

It is now 2.5 years since the imprisonment of my 37 year old daughter under Lincolnshire Partnership Trust.  When I first moved in 2021, I cared about what they thought and was keen to get on with professionals, working together and to have a fresh start in the right environment – this is what I hoped for but that was never Lincolnshire Partnership’s Trust intention or that of Lincolnshire County Council.   The area where I live has just been voted one of the best areas in the Country to reside. There is a blue flag beach status with nature reserves surrounding my home.  Such natural environment had proved beneficial to Elizabeth before when she had wonderful care privately provided on the Isle of Lewis.  Elizabeth adores animals particularly birds (pigeons). She has a home of her own which was my first priority to provide. I moved because Elizabeth was just left to go downhill under Barnet Enfield and Haringey MH Trust, another dreadful area whose CEO is Jinjer Kandola.   

However moving was disastrous. I could not get her treatment continued in the community then came the bullying from certain professionals under “safeguarding”, whose priority was to get rid of me as the Nearest Relative. I was falsely accused of buying too many takeaways, when Elizabeth had turned to others; I was accused of being neglectful towards her physical health and being incapable of caring for her when in fact I had been her only carer in the community for six months prior to moving to the new area without any support in place.

The Team that had failed to provide anything in the community was (Enfield Community Rehab Team). We had a meeting with them prior to moving but could not give a definite decision as Elizabeth had not seen the new area. She was not on a section prior to moving but when we did move and confirmed she wanted to stay, they were advised she was not coming back and was immediately registered with a new GP.

It was someone called Hannah (former area)  from Enfield Community Rehab Team who spoke with the new area and recommended a MHA assessment. The followed all the files full of nasty comments and inaccuracy from Enfield who unfortunately remained responsible for s117 aftercare when they never provided any care within an independent council flat despite promises.   I had tried unsuccessfully to get adaptions done in that flat because Elizabeth could utilise her bath but this proved impossible.   All that was supplied was the fortnightly depot but they were reducing it every six weeks.

It was upon trying to get treatment continued then followed interaction with a new new social services team and we found ourselves in an even worse position. All sorts of allegations were levied mainly regarding the medication, then towards taking the POA putting me under investigation for months on end and then worse was to following with assumptions on “no capacity”, Elizabeth assessed for one section after another, then court papers produced. With no services up and running and boxes everywhere having just moved, the last thing we wanted was yet more challenges but having acquired former files, where all sorts of nasty things had been written, these file papers were simply taken on board and we had two areas to deal with. Despite registering with a new GP they failed to refer her correctly to MH services within the new area. Again little did we know that most of the services were the other side of the County. Despite being given details of everything the treatment was not continued despite all efforts and I was advised to take Elizabeth to urgent care where I thought she would see a doctor and could come home with the treatment arranged but it was not that simple. There followed months leading to years of the most restrictive incarceration ever experienced.  

I was accused of avoiding social services who apparently wanted to extend the section and assumed I would object. I had commented previously that the stress of going through court yet again, having suffered a stroke but this was mocked by more than one of these social workers.   Our treatment previously was ruthless and we are not alone in experiencing what amounts to bullying and blame culture that can effectively destroy families. That is out experience of social services apart from two who worked with the family when I was a carer for my father with Alzheimers. I have come across dishonesty in file papers and that presented to court even. There was mentioned that an attempt on her Elizabeth’s life was made whilst Elizabeth was in my company upon moving. In fact we were staying in a guest house whilst I had to sort out problems left by former tenants as the house was once two flats.  Elizabeth commented more about her distress on a dormitory ward where she could not stand the noise and tried to gouge her eyes out.  She had to be moved into a side room so she explained.

There was safeguarding instigated by various nursing staff against me followed by an investigation from Public Guardian Office for psychological abuse so I was blamed but the Public Guardian office found in our favour, an investigation which took months on end to conclude.

At the same time there was ongoing litigation for displacement of NR ongoing for months on end and all it took was disagreement regarding treatment to be found “unsuitable” but for months on end noone was safeguarding the wellbeing of Elizabeth on a ward where other patients had reported she was being picked on and constantly injected during the night. She would isolate in her room during the day and be awake all night, there came all sorts of allegations against me when heavy restrictions were put in place and threats to displace me as the NR and such allegations were put in letters following two occasions when I have turned up to visit and the visit was refused. The hospital had no end of CCTV yet no evidence could be produced to back up all sorts of nasty comments and when one member of staff yelled out “you have just assaulted a member of staff” whilst standing outside alone under CCTV I had asked for the footage which showed nothing.    Elizabeth had no leave granted for months on end, with visiting supervised 2-1 and phone taken away because she kept calling Police and Emergency Services.    The only people safeguarding Elizabeth were the patients themselves, one of whom said she slept with her door open. Collectively a group of patients reported their concerns to a HCA. that  “night staff were picking on her”.  When asked who I was told “the vast majority”   I was also told “what they are doing is institutionalising her”.   “She is being overdrugged and goes into the seclusion room with a tray full of needles”    “they are picking on  her for the slightest thing such as when she threw some clothes out of her room in the corridor.”   During this time all physical health appointments (to see a Neurologist previously arranged before moving) were cancelled by Dr Shahpasandy and Dr Afolabi as unnecessary.  The new GP recommended I took her back to London for the Neurologist appointments as the waiting list would be very long but I was not allowed to. Three capacity assessments were carried out by two doctors and one social worker that were seriously flawed and failed to take into account Principle 4.   Elizabeth contracted covid twice and family not immediately advised.  Elizabeth was not at all well when put under pressure by management, nursing staff and Mr M to participate in such assessments and the line of questioning was quite shocking all geared to succeed in their goal of displacement and trying to get a vulnerable patient to say negative comments but this tactic backfired in the end.   Eventually another family member was appointed Shame on the doctors who carried out these assessments and noone was ensuring that appropriate care was being provided when conditions were described as squalid.   The doctors under this hospital were reliant on so called “normal scans” going back to 2015 but when it came to my attention her doctor did some brilliant research into the Limbic system I had asked if Elizabeth could have the tests done due to what was written on the discharge note from Enfield but nothing was done about this. Elizabeth was treated like a virtual prisoner and I was in receipt of intimidating letters from the Ward Manager accusing me of being aggressive, intimidating but there is nothing more threatening than calling Police which occurred more than once.   Elizabeth’s treatment was dreadful under this hospital. Denied exercise and meaningful family contact and not treated the same as other patients.   The drugs were raised to double I assume this was whilst the capacity assessments were taking place.    There seemed to be huge conflict of interest at Board Level in regard to their association with CQC.

There followed a succession of other doctors, last of all being Dr TG who did allow some leave which went very well. Elizabeth was then transferred to Cygnet, Durham, then onto Ward 12, which time she was having regular seizures which originated from Ash Villa. There was also a cancer scare and appointment made, the outcome of which was “normal”  –  It is disturbing that people’s lives are put at risk when 1.5 Tesla scanner do not detect everything clearly and Tesla 3 scanners are only within teaching hospitals.

Because Elizabeth could not stand the noise on wards she spent much of her time isolating in her room and lying in bed during the day.  Apparently her room was next to the seclusion room which must have been incredibly noisy and she was clearly being treated very differently to other patients who were allowed more freedom. Other patients described H/C assistants snatching water away when drinking, food away when eating, constant injections and screaming in the seclusion room.

Elizabeth reported she had muscle weakness to entire body due to lack of exercise.  

During a very short period of time unrestricted leave was granted within local area surrounding the hospital then extended to 6 hours which was lovely.   Wherever Elizabeth has been in these dreadful institutions, the surrounding areas have been beautiful and what is so sad is nothing is right about the treatment of my daughter and so many others held as virtual prisoners, deprived of leave and isolated from their families.   During 6 hours I was able to take Elizabeth out to show her the local area and there was never any trouble.    Dr G began to give a bit of leave to come home but the awful thing was it was restricting by having to see the Crisis Team and whenever this was arranged Elizabeth would get worked up and anxious, her fears stemming from previous experience of former area. It was wonderful to be able to spend time with Elizabeth and to have her home.  We would go shopping, she would cook meals at home, we would go out to some nice places and on one occasion I had taken Elizabeth to have a private MRI scan because I was concerned that all her appointments had been cancelled as “unnecessary”. The private scans revealed what looked like a cavernoma and lesions and it was only then that LPFT felt obliged to have more scans done, Finally a referral was apparently been made to see a Neurologist.

Now a prisoner for months on end under Dr W K ,  Elizabeth appears to be really going downhill.  Her face is full of marks where she is self-harming once again, she is denied leave,  she is denied meaningful family contact, she has had her phone taken away, put in the locker and when she does phone she is only allowed supervised calls with 2-1 supervision and the carer’s champion is often called upon to supervise the visits.   She is denied exercise, fresh air on a daily basis. There is not always staff available to take her to the shop or allow her to have the phone in order to supervise. She is missing home, she is missing her cat, she has seen nothing of the beautiful City of Lincoln. It has been like going backwards the way she has been treated.

Elizabeth is of no risk to others and although her face is red raw with marks and what follows seizures is always rapid tranquilisation.

At Ash Villa, she was constantly missing meals going without all day isolating in her room.  Here on Castle Ward same, with at one time virtually daily injections and a new drug introduced namely Procyclidine (for Parkinsons) and then they tried to give Aripiprazole orally to counteract the high prolactin levels but I have found out that Aripiprazole does not counteract high prolactin levels. This is also a drug I previously reported for adverse reaction.

The only hope now is that my daughter will go to Sheffield where they have all the up to date machinery such as Tesla 3 scanner.  I have told the Mental Capacity Lead that until the underlying causes are investigated they could not possibly go down the route of capacity without finding out about the underlying causes that impair capacity because impaired capacity is not the same as having zero capacity and the reasons for the impaired capacity need to be thoroughly documented.    Not once under this hospital or any others provided by Lincolnshire has there been any psychological input.

Going to Sheffield is also my only hope as it has been dreadful watching my daughter going downhill.  . For many years now since 2007 and a report by UCL stating “Anterior Region Medial Temporal Compromise” I have been looking for answers as I have always felt her condition was neurological rather than MH.

Out of sight out of Mind:   

The intentional isolation, degrading treatment like you would expect for a restricted prison has led to Elizabeth going downhill both physically and mentally which has been done deliberately so as to take ultimate control over that person.  Going back to our initial move –  the intention seemed to be to place Elizabeth into care against her wishes and that of her family.

LPFT have left her to go downhill to such an extent she needs assistance in showering, in going out places – unlike other patients not even allowed to the hospital shop.  They are not protecting my daughter by taking the phone away.  Staff are no doubt writing negatively and it is very intrusive to listen to every word of conversation. 

In care plans I have seen no mention of discharge only that she is too unwell to be discharged into the community but the home area is rated as one of the best in the country where she could make recovery but there appear to be other plans for out of area placements restricting contact with family.   There have been assessments taking place for a care home in West Sussex and another hospital. I feel this detention is all about convenience due to non provision of care in the community.

I would like to see a replica of the successful Linden Farm in Surrey  (Simon Trust) in Lincolnshire to allow disabled people to remain within the area close to their families and inclusion rather than exclusion.

More choice is needed such as care farms, more places like Camphill Community Trusts and involving parents/carers like the Simon Trust (Linden Farm).   

Featuring LPFT, ICB, ULHT

COMMUNICATIONS (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) <lpft.communications@nhs.net>

Wed 13/03/2024 02:19

Good morning,

Thank you for your email. We apologise that this information was not showing on the website, there appeared to be a technical issue that we have now resolved. You can now find the register of interests for our Board of Directors using the following link –

How can you have the CEO on the Board plus work as a specialist advisor for CQC or  The Director of Operations (Chris Higgins) for LPFT also work as an Executive Reviewer for CQC???

Click to access Board_of_Directors_Register_of_Interests_2023-24.pdf

BOARD OF DIRECTORS’ REGISTER OF INTERESTS AS AT 29 FEBRUARY 2024 NO. DATE OF ENTRY NAME NATURE OF DECLARATION DISCLOSED DATE OF DECLARATION 1 04/02/19 21/09/22

Sarah Connery 1) Specialist Advisor for the Care Quality Commission (CQC) 2) Partner member of the Lincolnshire Integrated Care Board (ICB) for mental health (wef 01/07/22) 31/01/19 21/09/22 2 21/09/22 04/12/23

Chris Higgins 1) Member of the Lincolnshire Integrated Care Board Finance Committee 2) Executive Reviewer for the Care Quality Commission (CQC) 20/09/22 29/11/23

Dear Ms Ellis

Of course they are conflicts.

Please see attached regarding the CQC 

If the NHS purchase from Nemaura is a conflict.

From: ELLIS-FENWICK, Julie (NHS LINCOLNSHIRE ICB – 71E) <julieellis1@nhs.net>

Sent: 12 March 2024 08:54

To: susan bevis <susanb255@outlook.com>

Cc: BATES, Sarah (NHS LINCOLNSHIRE ICB – 71E) <s.bates@nhs.net>

Subject: RE: Conflict of Interest – ICB Board

 Good morning

 Thank you for your recent email.

 As required by section 14Z30 of the NHS Act 2006 (as amended by the Health and Social Care Act 2022), the ICB has made arrangements to manage any actual and potential conflicts of interest to ensure that decisions made by the ICB will be taken and seen to be taken without being unduly influenced by external or private interest and do not (and do not risk appearing to) affect the integrity of the ICB’s decision-making processes.

The ICB has established a Standards of Business Conduct and Conflicts of Interest Policy, which was approved by the ICB Board at its first meeting held on the 1st July 2022. This policy sets out clear procedures to deal with situations where an officer/member has a conflict of interest and is included in the ICB Governance Handbook available here: http://www.lincolnshire.icb.nhs.uk

In accordance with section 14Z30(2) of the NHS Act 2006 registers of interest are recorded in the ICB Registers of Interests which is published on the ICB website. The Registers are regularly reviewed by the ICB’s Audit and Risk Committee for assurance purposes. They are also subject to a thorough review by the ICB appointed external auditors as part of the year-end audit process.

Further to the above, in accordance with section 14Z25(5) of, and paragraph 1 of Schedule 1B to, the 2006 Act the ICB must have a Constitution, which must comply with the requirements set out in that Schedule. The ICB is required to publish its Constitution (section 14Z29). The ICB Board adopted its Constitution at its first meeting held on the 1st July 2022 and this is published on the ICB website. This includes information on the Eligibility Criteria for Board Membership and the Disqualification Criteria. Neither of the interests declared by Dr Gerry McSorley and Mrs Julie Pomeroy preclude them from being an ICB Board Member.

I trust this responds to your queries but if you have any further concerns to raise, please do contact me.

Jules Ellis-Fenwick

NHS Lincolnshire ICB Board Secretary and

Head of Corporate Governance

Email: julieellis1@nhs.net

Please see below:

Current CQC advisors on trust boards may create conflicts of interest, making it difficult for the CQC to conduct fair and unbiased inspections and reviews. This raises questions about regulatory accuracy and fairness. Dual roles in healthcare regulatory bodies and provider organizations may also raise ethical concerns. People may lose trust in the healthcare system if conflicts of interest arise. It is important to determine if there are rules or guidelines to prevent conflicts of interest in different healthcare organizations.

 Sources

 According to NHS Providers (2023, 1), the Health and Care Act 2022 has introduced a new NHS landscape, allowing directors of NHS Foundation Trusts (FT) and Trusts (Trust) to have multiple roles. For instance, a director of an FT or Trust may also be a partner member of an Integrated Care Board (ICB). In most cases, the director’s duties to the FT or Trust align with those owed to the ICB, but in theory, these duties may conflict.

 The CQC’s Declaration of Interest and Resolution of Conflicts policy, ratified in April 2015, requires all staff members to recognise and disclose activities that may lead to conflicts of interest or perceptions of conflicts and ensure proper management or avoidance to protect the credibility of the CQC’s work and its individuals. The policy applies to all levels of CQC staff, including employees, specialist advisors, contractors, temporary workers, experts by experience, second-opinion appointed doctors, and Mental Health Act reviewers. A parallel policy applies to CQC commissioners and independent members of CQC committees (CQC Board, 2015, 1).

 Reference list

 1.      CQC Board (2015). Declaration of Interest and Resolution of Conflicts policy. [online] Available at: https://www.cqc.org.uk/sites/default/files/20180305_spa_declaration_of_interest.pdf %5BAccessed 8 Mar. 2024].

2.      NHS Providers (2023). Commentary for NHS providers:conflicts of Interests for Foundation Trust and Nhs Trust Directors on Integrated Care Boards. [online] Available at: https://nhsproviders.org/media/695915/conflicts-of-interest-nhsp-advice-from-mwe-jun23.pdf %5BAccessed 8 Mar. 2024].

https://lincolnshire.icb.nhs.uk/documents/declaration-of-interests-register/nhs-lincolnshire-icb-declaration-of-interests-register/?layout=default

Meet the Board

 McSorley, Gerry (Board Member)     Non-Executive Member and Deputy ICB Chair     CQC                                          

Julie Pomeroy also has connections to Nemaura Pharma Ltd.

Trust Board Members :: Lincolnshire Community Health Services NHS Trust 

Sam Wilde – director of finance and business intelligence

Astra Zeneca.

Jim Connolly

Jim has a had a varied career in the NHS as a nurse, working in a range of clinical, managerial and executive roles. He worked as a Director of Nursing and was the National Director for Continuing Healthcare with NHS England. In addition he works with the Care Quality Commission as a specialist advisor on governance. Prior to joining LCHS he was a Non Executive Director at Lincolnshire Clinical Commissioning Group and is supporting the vaccination programme as a vaccinator at the Meres Clinic in Grantham.

I visited Elizabeth on Wednesday 6 March. There was a capacity lead (Tony Mansfield) there together with Dr Khokhar who was questioning Elizabeth’s capacity. There is no doubt she has capacity but does not want to go in a van to Sheffield where they have the Tesla 3 scanner but said she did not want to be filmed on the ward. I said that it would be best for everything necessary to be done under the Neurology Department. I had written to my MP (Victoria Atkin) questioning why ULHT did not have a Tesla 3 scanner but anyway it is most promising she can go to Sheffield and this was promised would definitely be happening hopefully soon. Once and for all finally after all this time Elizabeth will get proper pathological tests but no way should this have been made so difficult. Elizabeth’s visit was late, following this meeting and again she showed massive capacity by knowing what the date was and checking what the time was. She presented me with some sweets for Mothers Day and as usual asked questions about her cat. She had telephoned me prior to my visit saying how much she missed the sunshine and her cat.

Elizabeth has capacity, there is no doubt of that but when faced with meetings that have over 9 people it is no wonder she is put under pressure. Here is something useful to remember if anyone is put under duress to sign documents for instance:

“agreements signed under duress are voidable and not enforceable. Forcing a relative to sign an agreement on the consequences of not being able to visit loved ones is not only being obtained under duress but is simultaneously the exercise of undue influence:

Williams v Bailey (1866) LR 1 hl 200, Dent v Bennett (1839 4 My & CR 269 (Doctor patient undue influence).

This goes to anyone put under pressure to sign schedules: NO SCHEDULE SHOULD BE SIGNED WITHOUT INDEPENDENT LEGAL ADVICE EVER.

It is wrong when certain professionals do this in order to get decisions and this can amount to bullying. I attach an interesting article on research into brain injury below:

A New Biomarker of Brain Injury?

Pauline Anderson

March 05, 2024

Posttraumatic headache (PTH) is associated with an increase in iron accumulation in certain brain regions , notably those involved in the pain network, early research shows.

Investigators found positive correlations between iron accumulation and headache frequency, number of lifetime mild traumatic brain injuries (mTBIs), and time since last mTBI.

The findings come on the heels of previous research showing patients with iron accumulation in certain brain regions don’t respond as well to treatment, study investigator, Simona Nikolova, PhD, assistant professor of neurology, Mayo Clinic, Phoenix, Arizona, told Medscape Medical News.

“This is really important, and doctors need to be aware of it. If you have a patient who is not responding to treatment, then you know what to look at,” she said. 

The findings (Abstract #3379) will be presented on April 15 at the American Academy of Neurology (AAN) 2024 Annual Meeting. 

Dose Effect
The study included 60 people with acute PTH due to mTBI. Most were White, and almost half had sustained a concussion due to a fall, with about 30% injured in a vehicle accident and a smaller number injured during a fight.

The mean number of lifetime mTBIs was 2.4, although participants had sustained as many as five or six and as few as one. The mean time from the most recent mTBI was 25 days, and the mean score on the Sport Concussion Assessment Tool (SCAT), which measures postconcussion symptom severity, was 29.

Most in the mTBI group (43) had migraine or probable migraine, and 14 had tension-type headaches. Mean headache frequency was 81%.

Researchers matched these patients with 60 controls without concussion or headache. Because iron accumulation is age-related, they tried to eliminate this covariant by pairing each participant with mTBI with an age- and sex-matched control.

All participants underwent a type of brain MRI known as T2* weighted sequence that can identify brain iron accumulation, a marker of neural injury. 

Investigators found that the PTH group had significantly higher levels of iron accumulation in several areas of the brain, most of which are part of a “pain network” that includes about 63 areas of the brain, Nikolova said.

The study wasn’t designed to determine how much more iron accumulation mTBI patients had vs controls. 

“We can’t say it was twice as much or three times as much; we can only say it was significant. Measuring concentrations in PTH patients and comparing that with controls is something we haven’t don’t yet,” said Nikolova

Areas of the brain with increased iron accumulation, included the periaqueductal gray (PAG), anterior cingulated cortex, and supramarginal gyrus. 

Research suggests patients with migraine who have elevated levels of iron in the PAG have a poorer response to botulinum toxin treatment. An earlier study by the same team showed a poorer response to the calcitonin gene-related peptide inhibitor erenumab in migraine patients with elevated iron in the PAG.

Researchers discovered that those with more lifetime TBIs had higher iron accumulation in the right gyrus rectus and right putamen vs those with fewer injuries and that headache frequency was associated with iron accumulation in the posterior corona radiata, bilateral temporal, right frontal, bilateral supplemental motor area, left fusiform, right hippocampus, sagittal striatum, and left cerebellum.

Surprising Result
The investigators also found a link between time since the most recent mTBI and iron accumulation in the bilateral temporal, right hippocampus, posterior and superior corona radiata, bilateral thalamus, right precuneus and cuneus, right lingual, and right cerebellum. 

“The more time that passed since the concussion occurred, the more likely that people had higher iron levels,” said Nikolova.

It’s perhaps to be expected that the length of time since injury is linked to iron accumulation in the brain as iron accumulates over time. But even those whose injury was relatively recent had higher amounts of iron, which Nikolova said was “surprising.”

“We thought iron accumulates over time so we were thinking maybe we should be doing a longitudinal study to see what happens, but we see definite iron accumulation due to injury shortly after the injury,” she said.

There was no association between iron accumulation and symptom severity as measured by SCAT scores.

Questions Remain
It’s unclear why iron accumulates after an injury or what the ramifications are of this accumulation, Nikolova noted. 

The imaging used in the study doesn’t distinguish between “bound” iron found after a hemorrhage and “free” iron in the brain. The free iron type has been shown to be increased after TBI and is “the stuff you should be afraid of,” Nikolova said.

Iron’s role in the metabolic process is important, but must be closely regulated, she said. Even a small accumulation can lead to oxidative stress.

Researchers are investigating whether the findings would be similar in mTBI but no headache and want to increase the number of study participants. A larger, more diverse sample would allow them to probe other questions, including whether iron accumulation is different in men and women. More data could also eventually lead to iron accumulation becoming a biomarker for concussion and PTH, Nikolova said.

“If you know a certain person has that biomarker, you might be able to administer a drug or some therapeutic procedure to prevent that iron from continuing to accumulate in the brain.”

Chelation drugs and other therapies may clear iron from the body but not necessarily from the brain. 

Commenting on the study for Medscape Medical News, Frank Conidi, MD, director, Florida Center for Headache and Sports Neurology, Port St. Lucie , said that the study supports the hypothesis that concussion “is not a benign process for the brain, and the cumulative effect of repetitive head injury can result in permanent brain injury.”

He said that he found the accumulation of iron in cortical structures particularly interesting. This, he said, differs from most current research that suggests head trauma mainly results in damage to white matter tracts.

He prefers the term “concussion” over “mild traumatic brain injury” which was used in the study. “Recent guidelines, including some that I’ve been involved with, have defined mild traumatic brain injury as a more permanent process,” he said.

The study was supported by the US Department of Defence and National Institutes of Health. No relevant conflicts of interest were disclosed. 

Talking of conflicts of interest, this is something else I am looking into with the Trust Board of Executives as I have discovered with UHLT that there are two conflicts on interest on their Board. I then turned to the Board of Executives for the ICB and found the same. I am yet to thoroughly go through the Board of LPFT and have instead written to Care Concerns to speed matters up. I will let you know when I get a response.

Meanwhile I am waiting for the date for Sheffield for the once in a lifetime tests I have been trying to get for years and years.

It is very bad there is such a battle to get such tests that are needed in order to determine anything.

I told the capacity lead that nothing had been done properly and now I was a BI assessor myself and I pointed out that the cause of the “impairment” needs to be ascertained before any assumptions are made and also Principle 4 of the MCA 2005 had not been applied correctly – therefore the three capacity assessments were completely flawed so until Sheffield looks at everything properly under their Tesla 3 scanner no further assumptions could be made. I pointed out that it was quite shocking the way the MCA had been manipulated by LPFT in order to get a decision they wanted ie to get rid of me as the nearest relative. Everything they have done has been done incorrectly and needs to be rectified. I will keep you informed how everything goes.

This below is my latest email I have received via Care Concerns inviting me to a meeting by LPFT to discuss capacity which is something LPFT have totally abused when 3 flawed in-house capacity assessments were done a year ago to achieve their ends. I am featuring my response how the MCA has been abused. I am now a BI assessor myself and I am quite appalled by this abuse. People have a right to know what is going on.

MY RESPONSE TO “CAPACITY” MEETING ON 6.03.2024 WITH DR WAQQAS KHOKHAR AND MENTAL CAPACITY LEAD TONY MANSFIELD

From: susan bevis
To: CARECONCERNS (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) <lpft.careconcerns@nhs.net>
Subject: Fw: Wednesday 6th March 2024

Dear Ms Munro

Thank you for your email below.

I spoke to my daughter today and she told me about another accident that happened on the ward.  Under Reg 14 HSCA The family should be informed of any accidents, especially ones where she hit her head in light of the fits she is suffering.

I am now a Best Interest assessor myself so I would know that the assessments done on my daughter are completely flawed and that goes for the Tesla 1.5.   I am waiting to  hear as regards Sharon Harvey’s promise to get done a completely independent capacity assessment as promised in our meeting on 2 October 2023. (HOWEVER HOW ANYTHING BE INDEPENDENT WHEN LPFT ARRANGE IT)

There is no doubt my daughter has capacity as she is able to relay to me exactly what is happening including the assessments/suggestions of her going into supported living against her wishes and that of the family out of area.  Perhaps you can inform the family and nearest relative who I am copying in herewith.

Elizabeth does not agree to being filmed by the MH team on the ward re her fits.   

Elizabeth did not have an advocate present at ward round today but was able to relay everything and the only reason she mentioned she did not wish to go to Sheffield was because of the transport.   Elizabeth did not want to go in a van and she still remembers and is traumatised by the previous caged vehicle used to transport her from Lincoln Hospital to Ash Villa to this day.   Elizabeth said she will be happy if family were present at Sheffield and I have written to Dame Pamela Shaw at Sheffield.  

As regards Elizabeth’s Capacity she told me personally she did not wish to engage and that was because AM (AMHP) and certain shameful doctors were deliberately trying to coerce her into displacing myself as Nearest Relative.   That has been the main objective focussed on and not the wellbeing and care of my vulnerable daughter.   

LPFT’s abuse on capacity:

Case study: The diagnostic step and the causative nexus · 12 June 2023 Case Study, Mental Capacity in Practice

The diagnostic step is a simple but often misunderstood part of the Mental Capacity Assessment. One of the most common errors is to simply list a medical diagnosis without any explanation of how the diagnosis impacts upon decision-making. However, this link – also known as the causative nexus – is the vital point on which the rest of the assessment is based. It is therefore important to understand exactly why the diagnostic step is important and how to document it properly.

LPFT have ‘determined’ via faulty processes that Elizabeth lacks capacity.  She frequently missed meals at Ash Villa and spent much of the day isolating in her room situated right next to the Seclusion Room knowing full well she had sensory issues.  Her treatment was befitting of Panorama and Dispatches and several patients approached me in the grounds outside asking if I was Elizabeth’s Mum and stating they were doing the safeguarding and sleeping with their doors open at night.  This is where the fits started and where the cancer scare originated but the tests for cancer will need re-doing as you do not have a decent scanner in Lincolnshire and this is about to be headline news hopefully and totally inadequate response below.  The 1.5 scanner did not pick up what the Tesla 3 did that I paid for privately and a cancer patient has died in this area.  I now want all the scans done properly under a Tesla 3 in Sheffield.

Julie Frake-Harris, Chief Operating Officer at United Lincolnshire Hospitals NHS Trust, said:

“Our hospitals offer the correct and appropriate equipment for medical imaging, including 1.5 Tesla MRI scanners, which allow our experienced clinical teams to scan all our patients to a high diagnostic quality. 3 Tesla MRI scanners would usually only be in place at specialist tertiary centres, where they have a specific need for neurosurgery or research. ULHT does not provide this type of specialist service. 
“We are commissioning four new state-of-the-art 1.5 Tesla MRI scanners in Lincolnshire this year, which is more appropriate for the wide variety of patients we care for, is safer for their clinical needs and offers a more comfortable experience during a scan. The new software allows comparative image quality and speed to a 3T without the additional risk.

“If any patients or carers have any questions about their care, we would encourage them to discuss them with us so we can address any concerns they may have.”

That is totally wrong!

The acuity and resolution of the scanner is determined by the strength of the magnets measured in Teslas not by imaging software.  

No amount of software can resolve an image that has not been picked up in the first place.

The analogy is the James Webb telescope.  Its acuity and resolution come from it mirrors.  They ‘find’ the image the software only cleans it up.

If you use sophisticated software with a low resolution image it will not allow you to see something the ‘lens, mirror or magnet did not see in the first place. 

This is why Elizabeth was being referred by Dr S to Sheffield because my private scans showed much more detail and as my daughter’s “episodes” have ended up in A&E on more than one occasion with low blood oxygen levels and enormously high blood pressure – this could be life threatening ad someone has died as a result which makes this whole matter public interest.

Getting back to Capacity ………...  

Why has a vulnerable patient such as Elizabeth, who by LPFT’s assessment lacks capacity being left unfed for large parts of the day?  It was certainly negligent to leave anyone who lacked capacity to be not properly nourished.

Why was Elizabeth only fed when I called, in emergency to ensure that she was properly nourished?

Why was/is a patient  judged as lacking capacity not properly monitored in respect of her sleep, especially as it is clear she suffers from sleep apnoea, most likely as a result of the overuse of neuroleptic medications administered via depot and prn?

Why was Elizabeth, who by LPFT’s evaluation (faulty) lacking capacity not given appropriate tests to determine what might be causing this lack of capacity?

If Elizabeth lacks capacity, as LPFT suggests, LPFT’s duty of care/standard of care in medical negligence is at a higher level.  Why has/had she been neglected on the ward and prior to this Ash Villa to the extent that no one checked that she was being properly nourished?

The LPFT and LCC have abused the capacity assessment process to restrict/deny Elizabeth’s fundamental rights to patient autonomy to facilitate their own interests or convenience. This includes/ has included denying her rights to privacy and a family life by subjecting her to oppressive supervised visits.

The LPFT have/are abusing their powers under the Mental Health Act 1983 to deny Elizabeth and her family fundamental human rights, not in order to prevent or control risk but simply to benefit themselves and to obtain control to abrogate their actual responsibilities.

These are matters that will be referred to judicial review as ultra vires.  The MHA 1983 was designed to protect the interest of the mentally ill, not provide a convenient set of excuses for clinicians, nurses and social workers.   

Elizabeth was judged to lack capacity but the common law test as determined in Masterman-Lister v Brutton & Co [2003] 1WLR 1511 was not applied.

“whether the party to legal proceedings is capable of understanding, with the assistance of proper explanation from legal advisers and experts in other disciplines as the case may require, the issues on which his consent or decision is likely to be necessary in the course of those proceedings… the threshold for capacity to provide instructions is not high, and people severely affected by a mental disorder may still be able to provide instructions if you explain matters simply and clearly.”

I contacted Dr Bob Johnson (former Expert Witness) regarding the capacity assessment and he said:

“I tend to agree with you about issues of capacity centring on the doc!”

Bob informed me that the ‘no comment’ interview makes no sense in terms of determining capacity.

“Either you don’t understand the question, in which case you say so, and your “micro-expressions” confirm it, or you do, and you’re dodging. The latter is rather too clever for no capacity”.

Bob of course has had enormous experience dealing with this kind of interview. 

The decision that Elizabeth lacks capacity is contrived in the face of obviously conflicting evidence. In criminal law a ‘no comment’ interview can be put to the jury as an inference of guilt, i.e. that the suspect is evading the question while knowing the answer.

Elizabeth is using it as a defence mechanism against people she considers hostile. She is carefully calculating when it is in her interest to ‘cooperate with them and when it is not. That is not indicative of those who lack capacity.

What does happen with those who lack capacity is that they either confabulate or talk nonsense or that they are ‘interview suggestible’*, meaning that they say what they perceive the interviewer to want them to. That is why in police station interviews that need a responsible adult present.

Elizabeth was/is being evasive and dodging questions she is uncomfortable with. A classic evasion strategy that is quite the opposite of what would be expected from someone who really lacked capacity.

A proper examination applying the proper methods and following the Code of Practice correctly, instead of manipulating it would show that Elizabeth has capacity, albeit impaired. That is why they want to get me as far away from the treatment regimen as possible.

Research indicates that attitudes assuming guilt (or lack of capacity) actually reduces the effectiveness of interviews1

Interrogative Suggestibility. Gudjonnson (1984)

1. Baldwin (1993); Moston (1995), Pearse and Gudjonsson (1996), Shepherd (1993)

If it was/has been really concluded that Elizabeth lacks capacity then LPFT must have radically altered her care plan and her detention must now be under the deprivation of liberty criteria from the MCA 2005 rather than the MHA 1983.  My suspicions are that no such variation has been made.   This was possibly designed to do an end run around the section 3 review system just as much as it was to displace me as  the NR.  

Elizabeth used evasive answers that are logically selected and timed. She even used distraction techniques to what she perceived as her advantage. Refusal to engage and interrogation evasion techniques indicate complex insight, even if the patient is in other ways cognitively impaired. Elizabeth perceived the interrogator as a threat or even as an oppressor. No comment and noncommittal answers are exactly what one would expect in that situation. I would not expect a patient who truly lacked capacity to use ‘no comment’ answers. 

She was being defensive and that is not a sign of lacking capacity.

The doctors describe choosing an interrogation technique that assumes in advance that Elizabeth lacks capacity in spite of that being contrary to section 4(1) MCA 2005 and the Code of Practice. Elizabeth is assumed to be educationally sub-normal and of low IQ (another discredited system of evaluating capacity) but Huntercombe – an entire team assessed her properly as being “High Spectrum Aspergers”.

The doctors talked of asking short simple questions but her answers indicate she is fully cognisant of what they are saying. They even interpreted her desire to go home as being delusional instead of a perfectly understandable aspiration.

This process was totally flawed and designed with a ‘no capacity’ outcome built in. It even assumed, again contrary to section 4 that she was not capable of regaining capacity. That, combined with the retractions was designed as an obstacle to any form of appeal or genuine objective second opinion.

The MCA2005 is used to take control from patients and their families. In most cases this really is in the best interest of the patient but is open to abuse as is everything else. The best interest of the institution are often ‘factored in’ even though that is entirely contradictory to the spirit of the legislation and code of practice.

Inadmissibility of Capacity Assessments

The capacity assessments carried out at Ash Villa are inadmissible as evidence.

Applicable Principles and Requirements

The capacity assessments are all seriously flawed in terms of the requirements and principles of the Mental Capacity Act 2005, the Code of Practice, and indeed in the very philosophy underpinning the legislation.

The concept of best interests is founded on the most fundamental principles of human rights. Those principles are centred entirely around the welfare of the patient and never in the interests or expediency of ward management or those carrying out assessments.

The Mental Capacity Act 2005 at Section 4 requires that the patient is to be regarded as having capacity until evidence is ascertained as to how that capacity is impaired.  

No Proper Capacity Evidence

It is evident from the statements regarding Elizabeth’s capacity that:

(a)  No proper, full, objective and admissible evaluation of capacity has been made at Ash Villa; and/or

(b)  there was an over-emphasis of the goal of displacing myself as NR, which created a bias in  assessment so materially affecting validity that none of the evidence on capacity is admissible.  

Capacity Evidence Has No Relevance

There is in any event no relevance of any evidence, on capacity of the Elizabeth, to any aspect of the Claim, which is that her mother is unsuitable to continue to act as Nearest Relative.

It was not asserted why capacity evidence has been produced, nor shown – anywhere –  any relevance of such evidence.

The very slight admissible evidence in the capacity assessments is not on capacity itself, but is only that which reinforces the evidence of the her mother that the position of the Elizabeth is very simple: she wishes to go home to live next to her mother, and that her mother is her Nearest Relative.

The Context for Elizabeth’s Responses

What is startling is that no account is taken of Elizabeth’s reaction to being, as she sees it, in an oppressive institutionalised situation in which she has virtually no right to privacy, family life or psychological and spiritual enrichment.  

It is hardly surprising that any person so deprived of the most fundamental of human aspirations is not so much lacking capacity but is self evidently being deprived of it.   

All of this is in breach of the letter and spirit of section 4, MCA 2005.  

The Prohibited Step

It is never allowed that the decision maker on best interest draws conclusions on capacity from a patient’s age or appearance on a condition of his/hers or an aspect of his behaviour which might lead others to make unjustified assumptions about what might be in his/her best interests by section 4(1)(a) & (b).  This is known generically as The Prohibited Step.     

Failures: Identification of Issues

Section 4(2) MCA 2005 requires that the decision maker should try to identify all the issues that would be most relevant to the individual who is asserted to lack capacity relating to the particular decision (para 3, Main Code of Practice)

Failures: Framing of questions/suggestions

The framing of questions/suggestions in closed form gave Elizabeth no opportunity to explain or include detail in her answers.  

It is a disturbing oversight on the part of those carrying out those interviews that the nature and framing of questions and suggestions, and their leading nature, made it impossible for her to express herself.  

Failures: Elizabeth’s Clear Responses

There is no evidence from the interviews that there was any attempt to determine the actual meaning of Elizabeth’s clear responses to questions/suggestions made by the interviewer.  

Failures to comply with Requirements

The content of the Section D witness statements on capacity is riddled with inconsistencies. The capacity assessments were not conducted as required by section 1 of the Mental Capacity Act 2005.  

It is submitted that the capacity evidence is inadmissible as evidence of lack of capacity not only because of logical and factual inaccuracies in the statements, but also for failure to apply the meaning of the statute, and the failures to follow the required steps:

Submissions on the Required s.4 Steps

The required steps, in summary, in s.4 of the Mental Capacity Act 2005, and appropriate related submissions, are:

To consider the likelihood of the person gaining capacity. There is no evidence that this was even considered by either first or 2nd opinion assessor or in the ‘off record’ intervention by KS, and thus never taken into account at all.

To promote and encourage the participation of the patient so far as possible.  There is no evidence that Elizabeth’s participation via appropriate dialogue was encouraged or ever taken into account at all. Indeed the first and second assessor treated her as someone with a severe learning disability rather than an educated woman with a chronic mental health condition.  They make reference to talking to her in “little chunks of three sentences”.  Nothing in Elizabeth’s diagnosis suggests that she is mentally retarded or incompetent and this approach is in clear violation of  The ‘Prohibited Step’ described in section 4(1) of the Act. 

To consider the persons wishes, beliefs and other factors the person would be likely to consider were they able to do so.  Once again this is not taken into account at all by either of the first and second opinion assessors.  None of Elizabeth’s wishes were considered in those interviews or were simply disregarded with scant attention.  This is evident in the perfunctory treatment of her observations regarding the litigation.  No attempt was made to understand why she may have taken those positions, including of course that the oppressive nature of the interview with no independent observer present may have seriously deprived of any ability to explain in detail.  All contrary to section 4(2) and the main Code.

To take account of the views of named others.  This is perhaps the most obvious complete failing of all the assessment interviews and is a cause for serious concern.  The views of neither Susan Bevis, Elizabeth’s mother, or her sister, or her father were taken into consideration or even sought.  

Conclusion:

The individual and accumulative effects of all of these failings make the statements by the assessors incapable of being relied upon at all.  

Comments on the Section D Assessments of the 1st assessor and second opinion assessor in red. 

Question 1. UNDERSTANDING: Does the person understand the information relevant to the decision?

Answer: No

She was happy to see me, and we (along with S/N GJ) used family rooms in order to promote her privacy. I explained that I would like to talk with her so that I can complete an assessment on her mental capacity to make decision in order to displace her mother as her NR. She asked me what that meant. I explained in simple language the rights and duties of the NR as summarised above in the salient information section, using slow and steady speech. I ensured I gave her the information in little chunks of three sentences and would go over it, if it seemed that she was not following. I explained that her mum is her NR and that there are steps to identifying a NR. I explained that her mum (NR) will be expected to fulfil those roles as above and also to act in her best interests – such as supporting her in staying well and making services aware should she start relapsing or stop taking her medications. I explained that there are times either the patient can ask to displace their NR or professionals can apply to do so. I added that usually it is when professionals do not believe that the NR is acting in the patient’s interest. In this case, that her mum is not acting in her best interest. Elizabeth frowned and stared at me. I added that according to her records,

Her mum does not believe that she suffers from the diagnoses listed. I explained that she believed that she had ‘autism’. She asked me what was going to happen about that diagnosis and I explained that she has been (or is going to be soon as we have agreed in last ward round) to be referred for a diagnostic interview but unfortunately, there was a long waiting time and when her turn comes up she would be assessed for it.  I mentioned the pros and cons of not having her mum as her NR. I recapped my explanation above regarding the issue at hand of her capacity to displace the NR. I am of the reasonable belief that Elizabeth did not demonstrate understanding of the functions of the NR, pros and cons of the decision and the implications of displacing her mum as her NR.

She did not seem interested in NR displacement issue. Although, she said that she understood, she was not able to relay it back to me as if she did not want to discuss this issue anymore.

‘as if’ is entirely speculative and inconclusive of Elizabeth’s lack of capacity.  It is also contradicted by Elizabeth’s response to the suggestion that her mother is displaced.  “Elizabeth frowned and stared at me”.  Such a response is self-evidently disapproval and indicates the capacity to make decision on this.  If indeed Elizabeth was expressing a refusal to discuss the matter further that cannot be ‘reasonably’ regarded as a lack of understanding of the issues and would just as likely show an objection to the suggestion her mother was displaced as NR.

The erroneous beliefs of Elizabeth’s mother regarding the diagnosis is irrelevant to a capacity assessment.  Elizabeth’s mother’s beliefs are not evidence of Elizabeth’s capacity or lack of it.  

“I am of the reasonable belief that Elizabeth did not demonstrate understanding of the functions of the NR, pros and cons of the decision and the implications of displacing her mum as her NR”.  This is indeed not a reasonable belief in the light of Elizabeth’s obvious disapproval of her mother being displaced.  

“I mentioned the pros and cons of not having her mum as her NR. I recapped my explanation above regarding the issue at hand of her capacity to displace the NR”.  This is a logical fallacy. It is effectively asking Elizabeth to acknowledge her lack of capacity.  Logic clearly dictates that if she does not understand the information ‘given in little chunks’ she is not going to be able to determine her own lack of capacity. 

Question 2. RETENTION: Can the person retain the relevant information long enough for the decision to be made?

Answer: No

I asked her if she had any questions to ask and she said “no questions”. It is my reasonable belief that Elizabeth was not able to recall the salient points given to her to enable her to make a decision on whether to displace her mum as her NR or not. It seems like she was able to retain the information for some time but she was not able to relay it back to me as if she did not want to discuss this issue anymore.

“I asked her if she had any questions to ask and she said “no questions”.”

“she was not able to relay it back to me as if she did not want to discuss this issue anymore”.

It is not a reasonable basis of belief that this indicates a lack of capacity and could just as easily represent defiance or resistance to a suggestion that Elizabeth found threatening or disagreeable.   It is also logically inconsistent.  If Elizabeth says “no questions” there is no reason at all why she would wish to relay back the discussion.   

2^nd Opinion Comments

1. UNDERSTANDING: Does the person understand the information relevant to the decision?

Answer: No

When I asked Elizabeth if she was aware that there was an ongoing court case she said “yes” but when I asked her if she knew what it was about, she said “not sure”. I explained to Elizabeth the purpose of court proceedings, stating that this was because LPFT were asking a judge to decide if her mum should be her nearest relative or whether someone else should act in this role. Elizabeth stated that she could not be involved in court proceedings because “my back is broken and I have got autism”. I did challenge Elizabeth on this stating that just because a person has autism (noting this is not a formal diagnosis for Elizabeth) does not mean that they do not have opinions or views about what they want to happen, and this includes who they want to be nearest relative or represent them in court. Elizabeth was still adamant that she could not be involved. I asked Elizabeth if she knew who her litigation friend is currently and she said no. When I told her it is her sister, she said “she can’t help me” but was unable to expand on why she felt this was the case, when I asked her why she thinks that, she said “not sure”. I have checked with the care team and have been informed that although there is a likelihood that Elizabeth had injured her back when in periods of high distress and volatility, this has not been to a significant degree beyond strain or sprain and she is not known to have ever broken her back or sustained a similar level of injury.

On the balance of probabilities, I consider that Elizabeth does not understand all the salient information needed to be able to make this decision. When I tried to explain to Elizabeth that she could instruct a solicitor or tell the judge what she wants, she was fixed in her view that she could not do this because of having autism. This evidences that Elizabeth does not understand all the options available to allow her to participate in the legal process regarding displacement of her nearest relative.

Elizabeth stated that she could not be involved in court proceedings because “my back is broken and I have got autism”.  However Elizabeth asked to attend court but this was denied through a phone call from Solicitors to the Ward.

That is not conclusive or even persuasive evidence of a lack of capacity.  Elizabeth’s erroneous belief in her condition is not indicative of an inability to choose her mother as NR or a failure to understand the questions put to her.  As for the injury to her back, she has been subjected to numerous physical restraints including pinning her face down on the floor according to witnesses .  It is entirely understandable that she may use hyperbole to describe her pain from injuries sustained by this restraint. That is not evidence of a lack of capacity.

2. RETENTION: Can the person retain the relevant information long enough for the decision to be made?

Answer: No

Elizabeth has demonstrated that she does retain some information relating to the court proceedings to displace her nearest relative. Having reviewed her notes, I can see there have been occasions when she has been emotionally distressed that she has expressed anger about the application to displace her mother as nearest relative without prompting and has stated that LFPT does not have a right to stop her mother being her nearest relative. She was also able to recall today that her mother is her nearest relative.

Although there is clearly a level of retention regarding this decision, I do not consider that Elizabeth is able to retain all the pertinent information required to be able to litigate in these proceedings. For example, after explaining to Elizabeth that her sister is her litigation friend and that she is representing her in the current proceedings, when I revisited this later in the conversation and asked Elizabeth if she could remember who I said was acting as her litigation friend, she was unable to recall that it is her sister.

After I finished my discussion with Elizabeth, deputy ward manager KS went to speak to her independently in her bedspace to see if she was willing to discuss this decision in more detail without me being present. Elizabeth asked K if I was going to be going to court. Elizabeth had asked me the same question approx. 10 mins earlier when I was talking to her and I explained to her that I was not a solicitor and was not going to be in the court hearing, but that I would be writing about our discussion today and the court would see it. As Elizabeth had asked K the same question 10 minutes after I had given her this information, this evidences difficulties with retaining all relevant information relating to the court proceedings.

“I can see there have been occasions when she has been emotionally distressed that she has expressed anger about the application to displace her mother as nearest relative without prompting and has stated that LFPT does not have a right to stop her mother being her nearest relative. She was also able to recall today that her mother is her nearest relative”.

All of that is indicative of a functioning capacity to understand the issues, not only at that point but on reflection of earlier events.  This is fully supportive of her ability not only to recall but to maintain a position on the NR.  In the light of this is cannot be stated that “on the balance of probabilities” Elizabeth lacks capacity.  The MCA 2005 principles found at are at section 1  quite explicit that the capacity assessor should work on the basis that a patient has capacity ‘on the balance of probabilities”  Those principles are as follows:

·         Principle 1: A presumption of capacity. … 

·         Principle 2: Individuals being supported to make their own decisions. … 

·         Principle 3: Unwise decisions. … 

·         Principle 4: Best interests. … 

·         Principle 5: Less restrictive option.

Violations of principle 1: Elizabeth is presumed in the negative contrary to the principle of presumed capacity.  Clear evidence in Elizabeth’s answers and  attitude to the capacity assessment indicates a presumption of capacity and not the contrary.

Violation of Principle 2: Elizabeth has received no support to make her own decisions and was not supported at this capacity interview by an independent advocate.  The clinical staff are seen by Elizabeth as intimidatory.  Her responses to these capacity interviews show clear evidence of resistance to the questions and objections to the purposes of it.

Violations of Principle 3:  Section 1 of the MCA 2005 and the Code of Practice are quite explicit that unwise decisions cannot be used as evidence of lack of capacity.  Emphasis is placed in the interviews on irrelevant interpretations of Elizabeth’s mistaken beliefs in her diagnosis.  It is very often that case, probably more often than not that a psychiatric patient will deny their illness.  This is not evidence in itself of either delusion or lack of capacity.  Elizabeth’s complaints about the back injury are quite explainable since she has been subjected to maximum physical restraint on several occasions.  The use of restraint has been described as a method of dealing with “distressed” patients at Ash Villa and that is quite disturbing.

Violation of Principle 4:  It was in Elizabeth’s best interest that this interview was conducted in the presence of an independent advocate or her NR.  Neither was present and Elizabeth had no support.  Elizabeth is used to being physically restrained and in the light of that far better safeguarding of her best interest should have been applied at these interviews.    

Violation of Principle 5. Elizabeth is currently being held under a regime of restraint and it is difficult to see how she could be subjected to a more restrictive option.  The two on one surveillance that has been employed at Ash Villa and the intrusive surveillance of family visits is more severe than many s.37/41 patients would encounter.  There is every reason to believe that should Elizabeth be given a less institutionalised and restraint based treatment regime that she would display a much better degree of capacity than the current regime allows.   

“I do not consider that Elizabeth is able to retain all the pertinent information required to be able to litigate in these proceedings”

Elizabeth is not required to litigate these proceedings she is represented by a litigation friend and has a right to a solicitor.

“As Elizabeth had asked K the same question 10 minutes after I had given her this information, this evidences difficulties with retaining all relevant information relating to the court proceedings”.

That presumption is fallacious.  Elizabeth could just as likely have been seeking verification from someone she was more familiar with and it does not necessarily indicate she did not understand or retain the information.  It is also indicative of a lack of trust, especially in the light of the stated reason for K S wanting to speak to Elizabeth independently.    The suggestion that the capacity assessor was being mistaken for a solicitor is not made out.  Elizabeth’s question regarding whether the capacity assessor was going to be in court is perfectly sensible since this person was discussing the litigation with her.  

“Elizabeth demonstrates an ability to communicate her views to the extent that she chooses and is able to do so. She did offer a view regarding her involvement in the current legal application, stating “I don’t want any part in it”. Further to this, she has at times of distress spontaneously expressed her unhappiness that LPFT have instigated these court proceedings. Additionally, when deputy ward manager K S went to speak to Elizabeth alone 10 minutes after my assessment with her, she was able to express to K that she did not want me (meaning K F) to have anything to do with the court case”.

Although Elizabeth is guarded and refused to discuss her capacity to litigate in any great detail with me, I do not consider that a refusal to communicate a decision equates to an inability to do so and therefore on the balance of probabilities, I consider that L does have the ability to communicate in relation to this aspect of the capacity assessment”.

This element of the statement is riddled with contradictions when considered against the principles defined in section 1 of the MCA 2005. Elizabeth appears to have a full appreciation of the nature and purpose of the litigation and expresses strong and clear views on it and the NR process as currently conducted by LCC Adult Social Care.  As stated a refusal to communicate is hardly any evidence of an ability to do so and is in realty much more likely to indicate a good range of capacity.  Once again concluding otherwise falls foul of principle one of the Mental Capacity Act 2005.  The entire process seems faulty and as such should not be admissible as evidence in these proceedings.   

 Subject: End runs and abuses of process

“The capacity red herring is being used solely to facilitate the LCC (acting as proxy) for the health trust being effectively unopposed in their application and represents a violation of article 6. ECHR.

The county court is unlikely to be able to deal with an argument on this level due to their perfunctory approach to this case to date. They have so far accepted evidence of questionable provenance and accuracy and failed to see the procedural errors and self-evident abuses of process.

So far no human rights issues have been put before the court for consideration and they are operating on process alone.  This is giving them the advantage.  The human rights matters will put a spanner in that works.

Unless a truly independent capacity report is presented Ash Villa is being allowed to act as a judge in their own cause and that is contrary to natural justice.  The capacity report is obstructing everything here and while the county court is accepting it as justification for displacement in the most absurd and contradictory manner possible no progress will be made there.

It is utterly preposterous to suggest on the one hand that Elizabeth wants her mother to be displaced and on the other that she cannot decide where she might want to live.  It is nonsense to suggest that capacity could be that selective.  If Elizabeth wants to go to home that is an entirely separate issue to the NR case.  

It strikes me the council are deliberately conflating these two separate issues to achieve a single aim.  It is obviously not based on any fear of Susan applying for discharge.  That is no threat in any case.  This procedure is being used to ensure that discharge is to sheltered accommodation (out of area).  What is ridiculous about this is that once discharged Elizabeth can leave any such accommodation unless a separate injunction is applied preventing it.  There has been a case where the mother was injuncted from taking her son home for more than two days a week.  Note that even in those extreme circumstances the son was still allowed to stay with his mother for part of the week.

The LCC and LPFT are trying to do an end run around the MHA 1983, the MCA 2005 and the very recent common law cases is order to have it all their own way. They should not be allowed to do an end run around the ECHR and Human Rights Act provisions on privacy and the family, the right to a fair hearing and the right to freedom expression.  This is a blatant and quite startling disregard for human rights and the law right down to the most fundamental maxims of English law. Everyone knows that final decisions of any court cannot be made in secret or ex-parte and at the very best only interim orders can be made. 

Once again these abuses of process are trying to do an end run even around that principle. 

Two court of protection assessors visited Elizabeth at Ash Villa.  According to the court papers she had fluctuating capacity.  Her medication was increased from 400mg fortnightly to 400mg weekly plus 10 mg table form.    This huge increase in “medication” was the cause of fluctuating capacity but still she was not deemed to have NO CAPACITY which was the result LPFT and Council were looking for.

All the time Elizabeth had to listen to “professionals” running down her mother (myself) using gaslighting and coercion to achieve their ends.  At first it was working because she was approached so she told me during a time she had Covid and was very unwell.  Then she changed her mind.

She has been treated appallingly and left to go downhill – how would anyone like to be treated this way?   We did not ask for anything other than the depot to be provided and my former area are responsible for providing the care in any case.  The former area (Enfield) have neglected my daughter in the community previously which was subjected to Judicial Review and solicitors were successfully appointed but then they sectioned her unlawfully in haste to avoid Judicial Review.

From the minute we moved was the time bullying commenced first with the POA which Public Guardian saw in our favour and then followed months and months on end.

There is no way I would wish to challenge the NR through the court for the role of NR back that is my younger daughter. However to do what they did is most certainly not out of kindness or care in any way. It is pure abuse of power.

All physical health appointments cancelled as unnecessary where former area were taking health very seriously.   

“abnormal findings on scan” mentioned twice was why I had the private scans done under a Tesla 3.

As regards capacity you involved the Court of Protection to take away the POA which there followed months and months of investigation into us as parents for malicious allegations on “psychological abuse” and the Public Guardian Office found in our favour.

If LPFT wanted a decision on forcing my daughter into supported living and housing out of area LPFT chose not to go down the correct route ie Court of Protection –  could this have been because the last Court of Protection case went in my daughter’s favour?

LPFT have cut me out consistently as a mother, treated me like a criminal, threatened me via the doctor in charge stating “I am banning you indefinitely for inciting your daughter to attack members of staff”  –  you have now concluded your investigation but we (myself and witness completed a section 9 statement even though we did not have to because of these serious threats which once again involved Police.  This is bullying tactics.

Now LPFT wish to talk about capacity and my daughter’s capacity which she has had all along.   LPFT had no advocate at this ward meeting and Elizabeth was able to relay everything in front of the supervising member of staff during my supervised phone call which is an infringement of human rights for a start.   

The issue is:   Does Elizabeth allow for staff on castle ward to film her and I understand she said “no” to that.

However, in the absence of an advocate:   Does Elizabeth want to go to Sheffield?   This question was unfairly sprung on her in the absence of any advocate present to support her.   When Elizabeth told me she did not wish to go it was because she was concerned at the transport.  She still is traumatised by being taken in a van – a caged van from Lincoln County Hospital to Ash Villa.      That was her explanation.  Secondly Elizabeth has made it clear that she wishes a member of her family to be present.  Section 17 leave will therefore need to be facilitated.    I see you are involving a MCA lead namely Tony Mansfield.   It is a conflict of interest to carry out a capacity assessment by staff employed by LPFT as has been done at County Court. 

Why hasn’t any fresh capacity assessment been done as promised by Sharon Harvey?   (Then again if arranged by LPFT how can you trust anything they do. Elizabeth herself phoned to try to arrange this before LPFT took away her phone and locked it away in her locker making it impossible for her to make calls, receive text messages, listen to her music, see pictures of her cat.  Anyway hopefully matters will eventually be resolved as this is all about human rights which LPFT have discounted all along.

The last thing I wanted was to challenge and be in this position of having to defend myself and my daughter.  In the former area she was compliant with medication in the community and the former area were taking her physical health extremely seriously unlike here.

Clearly any capacity assessment needs to be done completely independently and Elizabeth called Mental Capacity Consult  to arrange this herself privately and has tried to appoint solicitors before the phone was taken from her by staff acting against human rights and this is still going on currently when it is stated in Ms Munro’s letter that restrictions had ended which is NOT TRUE.  That shows tremendous capacity for her to phone and try to arrange things herself that was before her phone was taken away.

I was supposed to visit on Tuesday but rather than go two days running I shall have to look to changing this to fit in with them because it is a long distance for me to travel there and back  Instead it is suggested 3.30 pm on Wednesday.

Elizabeth has said she would go to Sheffield as long as she does not have to go in a van and she has asked if I can be present to support her or even her sister although she is working right now.

Yours sincerely

Susan A Bevis   Mother and POA

Going to Sheffield is to be under specialist observation and we are keen for this to go ahead because of the frequent fits Elizabeth now suffers but our concerns are what Elizabeth has relayed a few days ago “I will not be here much longer”. So this meeting is to discuss what exactly??? as the correct procedure would have been for LPFT to seek a capacity assessment completely independently through the CoP or let her family arrange it. The issue at stake now is discharge to supported living once again when Elizabeth wants to be near to her family and come home. They want her to have no capacity so they can control and restrict contact for a lifetime no doubt placing her far away from home and family. There is no way anything can be classed as independent, true and honest if LPFT arrange or carry this out themselves as you can see from the above example of sheer dishonesty. This time, the decision will not be about getting rid of me but where THEY want to send her and so far a care home has visited situated far from home and family in W Sussex and even if it is Yorkshire or another area it will not make family relationships easy to maintain and under Art 8 Elizabeth is entitled to a family life. It is an absolute disgrace what LPFT and Lincolnshire County Council have done/are doing to the Elizabeth and this is affecting the family who have provided a nice independent home for her. There are other cases where sons/daughters have been sent far out of area which makes it difficult for them to see one another. I am in touch with such cases in this area and can see what damage this does to everyone. A total disgrace on the part of LPFT and the Council. It would be my former area of Enfield who would be paying for s117 aftercare and they have always wanted Elizabeth to be institutionalised for the rest of her life. We tried to provide a fresh start only to find even worse here in Lincolnshire. Supported living and housing has been tried and failed before and – this is just lining the pockets of wealthy business people who set up homes that are like an extension of hospital and their rigid prison style rules and restrictions just for the convenience of Lincolnshire Partnership Trust and Council combined so they can wash their hands of all responsibility.

This is going on all over the country and as a family. It is total abuse to send a vulnerable patient away from home and family in this way. This is all done to take control of everything and wash their hands. It has nothing to do with the wellbeing of the vulnerable patient.

From: CARECONCERNS (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) <lpft.careconcerns@nhs.net>
Sent: 01 March 2024 14:51
To: susanb255
Subject: Wednesday 6th March 2024

Dear Mrs Bevis,

A meeting has been organised for you to meet with the Trust Mental Capacity Lead, Tony Mansfield, and Dr Khokhar on Wednesday 6^th March at 3:30pm to discuss Elizabeth’s ongoing care and treatment, and Elizabeth’s capacity for decision making in relation to this.

This meeting will take place face-to-face at Peter Hodgkinson Centre and will last for a duration of 45 minutes.

Kind regards,

The Mental Health Act Team.

HERE ARE ELIZABETH’S WISHES:

FRIDAY 10TH NOVEMBER 2023 IN FRONT OF A HCA SUPERVISING:

“I WANT TO EVENTUALLY COME HOME TO LIVE WITH MY MUM IN THE ANNEX THROUGH COURT OF PROTECTION” “I MISS MY MUM GREATLY AND WANT TO GO HOME TO HER.”

MESSAGE TO LPFT: I WILL NEVER GIVE UP THROUGH THE LEGAL SYSTEM IN FIGHTING FOR MY DAUGHTER TO COME HOME. SHE HAS HAD NOTHING BUT ABUSE SINCE COMING TO THIS AREA AND WE HAVE ENCOUNTERED BULLYING FROM SOCIAL WORKERS. WHILST THE SYSTEM IS ROTTEN TO THE CORE AND YOU BOTH SHOW THIS BY EXAMPLE, THIS DOES NOT GIVE EXCUSE FOR DISHONESTY AND BULLYING. HERE IS WHAT I THINK:

“YOU ARE A DISGRACE AND NEED EDUCATING IN HUMAN RIGHTS”. YOU TREAT VULNERABLE PEOPLE LIKE DIRT AND YOU DO NOT RESPECT CARERS WHO QUITE RIGHTLY HAVE GOOD CAUSE TO CHALLENGE. THAT GOES TO MY FORMER AREA OF ENFIELD TOO BECAUSE WE WOULD NOT HAVE MOVED IF THERE WAS A GLIMMER OF THE BASIC NECESSITY OF CONTINUATION OF THE SO CALLED MEDICATION IN THE COMMUNITY. WE DID NOT EXPECT ANYTHING MORE THAN THAT.

YOU ARE IN BREACH OF THE LAW AND THIS NEEDS TO BE CHALLENGED BECAUSE IT IS OF PUBLIC INTEREST AS IT IS PUBLIC MONEY THAT HAS BEEN WASTED BY TRUST AND COUNCILS IN BOTH AREAS. I AM HAPPY TO FEATURE ALL OF THIS PLUS OTHER AREAS TOO.

MORE THAN THAT THE ISSUE OF THE TESLA SCANNERS NEEDS TO BE ADDRESSED IN EVERY TRUST NATIONWIDE BEFORE MORE LIVES ARE LOST.

REGISTER OF GOVERNORS’ DECLARATION OF INTERESTS 2023-2024 08.01.2024
Date of Disclosure
Constituency/Stakeholder
Organisation Name Political Party
Interests Other Interests
01.10.2023 Staff: Adult Inpatient Services (1) Debbie Judge TBC TBC
01.10.2020 Staff: Adult Inpatient Services (2) Helen Smith Nil Nil
01.10.2023 Staff: Adult Community Services (1) Dan Fleshbourne Nil • Nicola Fleshbourne works as a Peer Support Worker for the LPFT in the Community

Rehabilitation team.

• Currently working with @RAMOSGOMEZ,Carmen around Carers Rights Day ‘23
• Bank HCA (LPFT)
• Member of UNISON
• Co-opted at Unison Lincolnshire BEC as Joint EDI Officer, no affiliation to the funding of any
  specific party.
  
• 01.09.2022 Staff: Adult Community Services (2) Andrew Leaston Member of the
  Labour party
  Nil
  01.10.2020 Staff: Corporate Services Laura Suffield Nil Nil
  
• Staff: Specialist Services (1) VACANT – AWAITING NOMINATION
  15.09.2017 Staff: Specialist Services (2) Lisa Norris Nil
  Updated:
  05.06.2020
  Nil
  Updated: 05.06.2020
  1.3
  2
  Staff: Older Adult Services (1) VACANT – AWAITING
  NOMINATION
  10.10.2016 Staff: Older Adult Services (2) Jacky Tyson Nil Nil
  Updated: 19.01.2022
  01.10.2021 Public: Borough of Boston Marlene Fullwood Nil Nil
  01.10.2023 Public: City of Lincoln Alexandra Chambers Nil • I work for Development and Community
  Development charity and I am founder of project neurotopia. A new neurodivergent support hub.
  01.10.2021 Public: East Lindsey Emma Slack Nil • Ongoing complaint against another NHS
  Trust (outside of Lincolnshire) in relation to the care of a close relative and involving the Health Service Ombudsman.
  Updated: 17.11.2021
• Current complaint with local GP regarding waiting times for medication, advanced through Healthwatch and referred to CCG.
  Updated: 23.05.2022
• Current volunteer at RAF Association
  Connections for Life
  Updated: 19.07.2022
  07.10.2021 Public: North Kesteven Carole Hagan Nil Nil
  01.10.2023 Public: South Holland Reverend Jonathan Sibley
  Nil Nil
  
• 01.10.2021 Public: South Kesteven Debbie Abrams Nil • Trustee Restless Legs Syndrome UK
  (charity)
  Updated: 15.10.2021
• Husband is a volunteer with Healthwatch
  Steering Group 3
  Updated: 21.09.2022
• Virtual ULHT patient improvement panel
• Member of local surgery patient
  participation group and as a representative
  of this group attends Lincolnshire Patient
  Participation group 4 times a year.
  Updated: 24.10.2023
  Public: Rest of England VACANT AWAITING –
  NOMINATION
  01.10.2021 Public: West Lindsey David Docherty Nil • Currently employed with East Midlands
  Ambulance Service to provide NHS Estates advice and assurance. Attends ICS property
  boards for Nottinghamshire, Derbyshire, Leicestershire and Northamptonshire.
  Updated: 01.12.2022
  06.08.2020 Service User (1) Rebecca Mezzo Nil • Suicide Intervention trained by Asist
• Sleaford Dementia Support Trustee
• CEOP Ambassador
• Girlguiding leader- age group 10-14 years
• Dementia Friends Champion
• Sister works Peterborough City Hospital.
  01.02.2020 Service User (2) Michael Regan Nil • Service veterans’ clubs in Sleaford and Lincoln
  Service User (3) VACANT AWAITING –
  NOMINATION
  Service User (4) Alice Barton Nil Nil
  Service User (5) VACANT AWAITING –
  NOMINATION
  4
  Service User (6) VACANT AWAITING –
  NOMINATION
  Service User (7) VACANT AWAITING –
  NOMINATION
  28.09.2022 Carer: General (1) Amanda Whitehead Nil • Owner/ Health and Nutrition Coach –
  Purposefully Nourished
• Health & Wellbeing Director – The Wellness
  Network CIC
  Updated: 07.12.2022
  01.10.2022 Carer: General (2) Sally Spencer Nil • Works in the Business Support department
  at Lincolnshire County Council
• Member of the LPFT Carers Council
• Member of the Carers Education Group
  Updated: 21.12.2022
  28.09.2022 Carer: General (3) Diane Fox Nil • Bank Midwife at Northern Lincolnshire and
  Goole NHS Foundation Trust
• Trainee Neuordevelopment Practitioner for Healios as of 17.10.2022
• Vice Chair of Maternity Autism Research
  Group (MARG) – bringing researchers and health professionals together to improve care for autistic people in Maternity Care
  Carer: Younger People VACANT – AWAITING NOMINATION
  31.05.2023 Stakeholder: Lincolnshire
  Integrated Care Board
  Pete Burnett Nil • Wife is Director of Midwifery and Deputy Chief
  Nurse at University Hospitals Leicester
• Mother-in-law is a Primary Care Commissioning
  Manager in Nottinghamshire ICB
• Sister-in-law employed in a Project Management role for the East Midlands Academic Health Science Network 5
• Sister-in-law’s partner is a Finance Manager for NEMS Nottingham
• Brother-in-law’s partner is a technician in the Nottingham division of East Midlands Ambulance Services (EMAS)
  Stakeholder: Healthwatch VACANT – AWAITING
  NOMINATION
  15.02.2021 Stakeholder: Lincolnshire County Council (LCC) (1)
  Cllr Colin Matthews Member of the Conservative Party
  (Conservative Party Councillor)
• Poplar Farm Caravan site, shop, craft room
  and tea room, Owner and operator.
• Executive Support Councillor for NHS Liaison, Community Engagement,
  Registration and Coroners
• Member of Children and Young People Scrutiny Group
• Member of Corporate Parenting Panel
  Member of Definitive Map and Statement
  of Public Rights of Way sub-committee
• Member of Gibraltar Point National Reserve Joint Advisory Committee.
• Member of Local Government Association – Coastal Special Interest Group.
• Member of Snipe Dales Joint Advisory Committee
  Updated 26.05.2022
  22.07.2022 Stakeholder: Lincolnshire County Council (LCC) (2)
  Cllr Robert Kendrick Member of the Conservative Party
  (Conservative Party Councillor)
• Former employee of LPFT – Voluntary
  Services Manager
  Updated 22.07.2022
  6
  Stakeholder: Lincolnshire
  Partnership NHS Foundation Trust
  Volunteers
  VACANT –
  AWAITING
  NOMINATION
  10.03.2022 Stakeholder: Shine Lincolnshire Rachel Wright Nil • CEO of Shine Lincolnshire who hold a
  contract with LPFT.
  01.10.2023 Stakeholder: University of Lincoln Lesley Gratrix Nil Nil
  31.05.2023 Stakeholder: Lincolnshire Police Chris Davison Nil • Assistant Chief Constable at Lincolnshire Police
  19.07.2022 Director of Corporate Governance Jenna Davies Nil Ni

Trust Board Members

Julie Frake-Harris, Chief Operating Officer at United Lincolnshire Hospitals NHS Trust, said:

 “Our hospitals offer the correct and appropriate equipment for medical imaging, including 1.5 Tesla MRI scanners, which allow our experienced clinical teams to scan all our patients to a high diagnostic quality. 3 Tesla MRI scanners would usually only be in place at specialist tertiary centres, where they have a specific need for neurosurgery or research. ULHT does not provide this type of specialist service. 

“We are commissioning four new state-of-the-art 1.5 Tesla MRI scanners in Lincolnshire this year, which is more appropriate for the wide variety of patients we care for, is safer for their clinical needs and offers a more comfortable experience during a scan. The new software allows comparative image quality and speed to a 3T without the additional risk.

“If any patients or carers have any questions about their care, we would encourage them to discuss them with us so we can address any concerns they may have.”

SCANDAL OF 2ND RATE MRI SCANNERS: “NORMAL?? LIVES CAN BE LOST DUE TO INADEQUATE 1.5 SCANNERS: LINCOLNSHIRE, ENFIELD, WESTON – WHERE ELSE??

Our Trust Board

The overall purpose of the Trust Board is to take responsibility for leading, governing and managing the organisation and all of its services.

Led by an independent chair and composed of a mixture of both executive and independent non-executive directors, the Trust Board shapes the strategic direction, vision and purpose of the trust and ensures it delivers value for money services. The Trust Board is also responsible for assuring that risks to the organisation and the public are managed and mitigated effectively.

Questions from the public at board meetings

Questions are welcomed from members of the public and these can be submitted to the Trust Board by emailing lhnt.lchsecomms@nhs.net or by completing the form below.

Trust Board meetings, whilst held in public, are not public meetings. This means that the public are very welcome to view the broadcast and our Chair will conduct a short item before the start of each public Trust Board meeting to acknowledge and where possible respond to questions from the public which have been submitted in writing in advance of the meeting. Questions can be accepted until the Sunday before each Trust Board meeting.

Subject matter for questions

The Chair reserves the right to refuse any written question that:

• is not within the powers and duties of the Trust to answer;
• is defamatory or offensive, or related to individual members of staff;
• would require the disclosure of confidential or exempt information;
• Is deemed to be overtly political;
• is substantially the same as a question that has been answered before.

The next Trust Board meeting will be held at 10am on:

Tuesday, 12 March

The meeting will be held in person. If you wish to attend, please contact: lhnt.lchsecomms@nhs.net or call the Chief Executive’s Office on 01522 308686.

---

By clicking on the link below, we will have your email address and may contact you to ask about your experience of the meeting.

Meeting date	Venue
Tuesday, 9 January	Click here to watch a recording of the meeting.
Tuesday, 12 March	Virtual (link to be added soon)

Please submit a question for our Trust Board

Name RequiredEmail Address RequiredTelephone Number RequiredPlease submit your question RequiredPlease type the letters and numbers shown in the image. Click the image to see another captcha.

Submit

 Risk Appetite StatementBack to About Us Date Last Modified 19/02/2024

Subject matter for questions

The Chair reserves the right to refuse any written question that:

• is not within the powers and duties of the Trust to answer;
• is defamatory or offensive, or related to individual members of staff;
• would require the disclosure of confidential or exempt information;
• Is deemed to be overtly political;
• is substantially the same as a question that has been answered before.

Meeting date	Venue
Tuesday, 9 January	Click here to watch a recording of the meeting.
Tuesday, 12 March	Virtual (link to be added soon)

Please submit a question for our Trust Board

Name RequiredEmail Address RequiredTelephone Number RequiredPlease submit your question RequiredPlease type the letters and numbers shown in the image. Click the image to see another captcha.

“If any patients or carers have any questions about their care, we would encourage them to discuss them with us so we can address any concerns they may have.”       YES I DO AND I WANT TO DISCUSS THIS IN AN OPEN TRANSPARENT MANNER. I HAVE ENORMOUS CONCERNS REGARDING ELIZABETH AND SCANS AS YOU DO NOT HAVE AN ACCURATE SCANNER. I HAVE HAD A LETTER FOR SCREENING AND WISH FOR BOTH HER AND MYSELF TO BE REFERRED TO SHEFFIELD FOR THE ACCURATE TESLA 3. WHEN YOU TALK ABOUT NEW SOFTWARE – IT IS NOTHING TO DO WITH THE SOFTWARE. WHERE DID YOU GET THIS INFORMATION FROM AS IT IS TOTALLY WRONG AND INACCURATE. WHAT IS YOUR TECHNICAL KNOWLEDGE OF TESLA SCANNERS AND SOFTWARE TO WHICH YOU SPEAK? WHAT IS THE SOURCE OF YOUR INFOMATION AND WHO TOLD YOU?

“The new software allows comparative image quality and speed to a 3T without the additional risk.“

That is totally wrong!

The acuity and resolution of the scanner is determined by the strength of the magnets measured in Teslas not by imaging software.  

No amount of software can resolve an image that has not been picked up in the first place.

The analogy is the James Webb telescope.  Its acuity and resolution come from it mirrors.  They ‘find’ the image the software only cleans it up.

If you use sophisticated software with a low resolution image it will not allow you to see something the ‘lens, mirror or magnet did not see in the first place. 

MY QUESTION ABOVE GOES TO JULIE FRAKE-HARRISON:

Julie Frake-Harris – chief operating officer

Julie joined LCHS as Interim Chief Operating Officer (COO) in July 2023, and recently became Interim Chief Operating Officer at ULHT alongside this role. Julie has worked in the NHS for over 25 years, during this time she has had the privilege to delivery services across London, Cambridge, Peterborough, and Kent. She has a passion for integrated community and mental health services and held COO roles in community and mental health settings and in an acute trust during the COVID-19 pandemic.

She held her first director role championing forensic and integrated prison services before moving to Cambridge and Peterborough to be the architect of the Neighbourhood Team model for Cambridge and Peterborough NHS Foundation Trust (CPFT). She has held system leadership roles and worked to develop with partners services closest to home across Kent and CPFT. She is committed to operational delivery for the communities we serve.

She lives in Cambridgeshire with her family and 4 dogs.

Malcolm Burch – trust board chair

Malcolm has had a career that spans universities, local government, policing and the NHS. Throughout his career, he has been focused on involving the public in service provision and supporting better performance and improved outcomes.

In the NHS, he was a non-executive director in Lincolnshire’s mental health trust for six years and before that spent four years as a commissioner as part of a Primary Care Trust in Peterborough and Cambridgeshire.

He has three degrees, including an MBA from the University of Birmingham, and works as the chief executive to the Lincolnshire Police and Crime Commissioner. He has lived and raised his family in the county for 15 years.

Andrew Morgan – group chief executive for LCHS and ULHT

Andrew has worked for the NHS since 1982. From August 2023 Andrew became the Group Chief Executive for LCHS and ULHT. He joined United Lincolnshire Hospitals NHS Trust as their Chief Executive in June 2019. Prior to this, Andrew was the Chief Executive of Lincolnshire Community Health Services NHS Trust from June 2014 to June 2019.

He has been a Chief Executive since 2004 and has held Chief Executive posts at East of England Ambulance Service NHS Trust, NHS Norfolk and Waveney, NHS Bedfordshire and NHS Harrow. His earlier NHS career included a range of director posts at NHS organisations around the country, including in commissioning, performance management, strategy and service improvement. Andrew is married and has a grown up daughter.

Executive directors

Professor Karen Dunderdale – executive chief nurse

Karen has held board level roles as a Chief Nurse, Chief Operating Officer, Deputy CEO and acting CEO. In addition, she held the role of vice chair of her local hospice for a number of years. Her more recent role as director of nursing was at Walsall Healthcare Trust where her leadership supported the Trust achieve Outstanding for Caring. Karen qualified as a registered nurse in 1991 and her clinical experience has been in cardiology. She became a cardiac nurse specialist developing cardiac rehabilitation and heart failure services. She has a PhD in Health Related Quality of Life in Chronic Heart Failure from York University, has contributed substantially to the development of cardiac nursing, and raised expectations nationally within the nursing profession. In 2017 Karen joined the National nursing team at NHS Improvement working for Dr Ruth May, Chief Nursing Officer for England contributing to the wider nursing and patient experience agenda. Karen is passionate about delivering high quality fundamental nursing care.

Claire Low – director of people

Claire joined the Trust in October 2023 in an interim role alongside her role at United Lincolnshire Hospitals NHS Trust where she has worked as deputy director of people and organisational development since December 2021 before starting work in the director position in October 2022. She has a long career spanning over 20 years of working in people services within the NHS and acute trusts and has worked in operational HR, recruitment, transformational projects and deputy director roles, and more recently acted as Director of People at Northern Lincolnshire and Goole Hospitals NHS Trust for a period of two years. Claire is passionate about the people agenda and investment in training and development of staff, she graduated from her part-time MBA, which she completed under the apprenticeship scheme at her previous Trust. Claire is also a Chartered Fellow of the CIPD and is embedding a ‘just and learning’ as part of the transformation agenda for the People Directorate.

Sam Wilde – director of finance and business intelligence

Sam joined LCHS as interim director of finance and strategy on June 1, 2018, having worked as associate director of finance for Norfolk Community Health and Care NHS Trust.

Sam graduated in 1996 having studied finance and accountancy before going on to complete an MBA at Durham University. He has worked in the NHS for six years interspersed with experience of working in the private sector for Rolls Royce PLC and Astra Zeneca.

 

Dr Anne-Louise Schokker – medical director

Dr Anne-Louise Schokker is the Medical Director and a Consultant Geriatrician. After completing her medical degree and post graduate training in London, she moved to the East Midlands as a consultant in 2007 where she gained extensive clinical experience in general medicine and geriatrics across secondary care and community settings. Her leadership journey began as a junior doctor and she has been passionate about compassionate, clinical leadership since. She has held divisional clinical director and deputy medical director roles where she delivered turn around improvements in nonelective care, successfully transformed integrated services across providers and advanced the quality agenda. She is also a regional clinical associate for the NHSE ECIST team. She lives locally in Lincolnshire with her husband, daughter and extended family.

Julie Frake-Harris – chief operating officer

Julie joined LCHS as Interim Chief Operating Officer (COO) in July 2023, and recently became Interim Chief Operating Officer at ULHT alongside this role. Julie has worked in the NHS for over 25 years, during this time she has had the privilege to delivery services across London, Cambridge, Peterborough, and Kent. She has a passion for integrated community and mental health services and held COO roles in community and mental health settings and in an acute trust during the COVID-19 pandemic.

She held her first director role championing forensic and integrated prison services before moving to Cambridge and Peterborough to be the architect of the Neighbourhood Team model for Cambridge and Peterborough NHS Foundation Trust (CPFT). She has held system leadership roles and worked to develop with partners services closest to home across Kent and CPFT. She is committed to operational delivery for the communities we serve.

She lives in Cambridgeshire with her family and 4 dogs.

Non-executive directors

Ian Orrell

Ian joined LCHS in February 2023, on an interim basis. Ian has a wealth of experience in the public sector, particularly with large and complex councils. He has experience of working within senior corporate leadership teams to help reshape and deliver quality frontline adult and children social care services, as well as delivering professional support services.

Ian also has over 30 years as a qualified accountant and previous experience in non-executive roles where partnership approaches were taken to improve service provision.

Gail Shadlock

Gail is a highly experienced director with a professional background in human resources and organisational development and extensive general and project management experience working in the UK and abroad. Gail has worked both as an executive director and as a non-executive director and has led and contributed to significant transformational change across the following sectors; private sector – FTSE 100 and FTSE 350 (major projects include mergers, acquisitions and flotation of a company on the London Stock Exchange); public sector – NHS, police, local government; third/not for profit sector – charity supporting people with learning disabilities and a housing association with a national footprint.

Murray Macdonald

Murray Macdonald has had a varied career across a number of sectors. He started in the commercial leisure sector managing a number of venues, before moving into regeneration and project management with local authorities.

Currently, Murray is Chief Executive of Boston Mayflower Housing Association, where he is responsible for all operational aspects of the company including housing management, asset management, regeneration, older peoples’ services and development.

Murray is an experienced Non-Executive Director, with posts currently also held with Lincolnshire Community Voluntary Service and Speedwell Homes.

Jim Connolly

Jim has a had a varied career in the NHS as a nurse, working in a range of clinical, managerial and executive roles. He worked as a Director of Nursing and was the National Director for Continuing Healthcare with NHS England. In addition he works with the Care Quality Commission as a specialist advisor on governance. Prior to joining LCHS he was a Non Executive Director at Lincolnshire Clinical Commissioning Group and is supporting the vaccination programme as a vaccinator at the Meres Clinic in Grantham. HOW EXACTLY ARE YOU INDEPENDENT??? IS IT NOT A CONFLICT OF INTEREST WORKING FOR THE CQC?

Rebecca Brown MBE

Rebecca Brown began her career in the NHS as a nurse in 1989.

From 2012 to 2016 Rebecca was Deputy Chief Operating Officer at Northampton General Hospital.  In 2016 Rebecca took on the role of Chief Operating Officer and Deputy Chief Executive at Kettering General Hospital. In 2018 She joined Leicester’s Hospitals as Chief Operating Officer and Deputy Chief Executive. She took on the role of Chief Executive in early 2020. Rebecca successfully lead the Trust during the pandemic, with Leicester Hospitals leading nationally on research and treatment of Covid.

Rebecca has played an integral role in the development of wider system and partnership working within the NHS and latterly with social care, local government and the independent sector.

In 2000, Rebecca was awarded the MBE by Her Majesty the Queen for Services to Nursing.

Rebecca also holds a Non Executive role for ULHT. Date Last Modified 29/02/2024