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27 March 2023

New study maps out links between psychosis and our immune system

In the largest study of its kind, research led by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London has identified some of the elements in our immune response that influence our risk for developing psychosis.

brain graphic psychosis

Published in Brain, Behaviour and Immunity, the study analysed blood samples from 325 people to assess the levels of 20 proteins which are known to be involved in our immune response.

Researchers found an association between the levels of certain proteins – cytokines – involved in inflammation and the risk of developing psychosis. Other proteins that are thought to affect the barrier between the blood and the brain were linked to whether those at risk later developed psychosis.

The research was part of the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) Project and supported by the NIHR Maudsley Biomedical Research Centre.

This is the largest study of its kind to explore in depth how the patterns of the different proteins involved in our immune response might be connected to the risk of developing psychosis. Our analysis has highlighted some interesting relationships between individual proteins that are released by our immune system and the likelihood of whether someone at risk of psychosis will go on to develop the condition.Professor Valeria Mondelli, Clinical Professor of Psychoneuroimmunology at King’s IoPPN and lead author on the study

Detecting risk of psychosis early

Psychosis is when people lose contact with external reality, often causing considerable distress for the person and their family or carers. People with psychosis can, and do, recover and the likelihood of this happening increases the sooner treatment is started.

To enable early treatment, researchers and clinicians have developed methods to identify those who are more likely to develop psychosis and studies show that 1.7 per cent of the general population are at risk. However, around one fifth of those people at risk will develop psychosis which presents a key challenge in predicting whether someone will or will not go on to experience the symptoms of psychosis.

The identification of specific biological markers or signs in the blood that are linked to psychosis could help overcome this challenge. There has been increasing evidence that the immune system plays a role in psychotic disorders and the study aimed to assess whether levels of certain proteins and chemicals that are part of the immune response are different in those who at high clinical risk compared to the general population. Researchers also explored whether those who went on to develop psychosis had a distinct profile in their immune markers compared to those who remained at risk but did not experience symptoms.

Linking immune response to psychosis

Researchers assessed levels of 20 proteins involved in our immune response in the blood of 325 participants from nine different countries. At the beginning of the study 270 of these were assessed to be at high risk for developing psychosis and 56 were not. Participants were assessed over the next two years and during this time 50 of those people who were at risk went on to develop psychosis.

Analysis of blood samples showed that those at risk of psychosis had higher levels of two proteins or cytokines involved in inflammation compared to those not at risk. These cytokines are called interleukin (IL)-6 and IL-4. Within the at-risk group subsequent onset of psychosis was associated with higher levels of vascular endothelial growth factor (VEGF) and an increased ratio of IL-10 cytokine to IL-6 cytokine. VEGF is involved in regulating the porosity of the membrane between the blood system and our brain and this is the first time it has been identified as a possible indicator of whether people will move from risk of psychosis to development of the disorder.

AI prediction techniques

In order to explore the potential for using immune-related markers as a way to predict the onset of psychosis, researchers tested a machine learning approach on the data collected on all 20 immune system markers. The approach did not provide an accurate prediction of whether people at risk of psychosis would go on to develop the disorder but represents an innovative step forward in new techniques to inform our understanding of psychosis.

Professor Mondelli, theme lead for Mood Disorders and Psychosis at the NIHR Maudsley Biomedical Research Centre commented: “Although it would have been fantastic to have identified a way to predict whether people will develop psychosis based on markers in their immune response, it is not surprising that AI techniques are unable to do this using this data alone. The path to psychosis involves many other factors in both an individual’s psychology and biology as well as from society and it is likely that data from these aspects of people’s lives would also have to be incorporated into any machine learning approach to enable a prediction of whether they will develop the condition.”

The study ‘Serum immune markers and transition to psychosis in individuals at clinical high risk’ by Mondelli, V. et al. was published in Brain, Behaviour and Immunity.

For more information please contact Franca Davenport (Communications and Engagement Manager (part-time), NIHR Maudsley Biomedical Research Centre).

In this story

Professor Valeria Mondelli

Clinical Professor of Psychoneuroimmunology

PRESENT RESTRICTIONS

Just now I had a call from Elizabeth and we were on the phone talking when a member of staff was nearby named Harry. He is a Healthcare Assistant and I could hear every word said. I have written the following to: CARECONCERNS (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) lpft.careconcerns@nhs.net copying in the CQC. Deprival of S17 leave (not that ground leave is actually S17 leave has been threatened today 23.11.2023 by someone who I have been told is a nurse on the ward namely Lucy. S17 leave is a right not a privilege. I was told to write to the email address mentioned above however I see this as bullying and if such leave is deprived it would be ultra vires.

Dear All

I had a call  from my daughter around 19:00 hrs 23.11.2023.  At one point she was speaking to Harry, (HCA).  I overheard Harry say Elizabeth’s leave off the ward has been cancelled altogether.   He mentioned this was down to Lucy and because she was  “hostile”.  I  phoned the office (call witnessed) and spoke to Harry.  I asked what he meant by “hostile” and said that I had heard nothing to suggest she was hostile.  He said this related to a previous incident so I pointed out that in certain papers there were no previous incidents of hostility and he said that Lucy was behind the cancellation of all leave.

Call witnessed in entirety so I cannot be accused of being hostile/aggressive myself and neither can Elizabeth but the discussion was loud and clear plus was witnessed.

I note there are two Lucys on the MDT list.  I will leave that to you to find out but I want to hear back about the leave situation.  It is only right that you copy in the rest of the family and those included in this email.

CAMSELL, Lucy (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST);

Waby, Lucieann (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST);

I have no idea which one might be responsible for taking away the only tiny bit of enjoyment she has.   She has no quality of life whatsoever since being held on a virtual DoLs.   This is clearly being done as punishment.  

I am most concerned for my daughter’s health and wellbeing on Castle Ward.

I went to see my GP yesterday and I explained the current situation to them and how my daughter misses home and family and I am copying the GP in to this email as I informed them that I was concerned for her wellbeing and they are advised about the scan results also.

It is unbelievable cruelty to take away her small leave allowance and it is within NHS Guidelines to do an Impact Assessment on us both and send a copy of this to the Nearest Relative who is copied in.  I am wondering if the GP can do an Impact assessment on me and then Elizabeth’s advocate be involved in doing one for her as per NHS  guidelines.

Regards

Susan Bevis 

I presently have 2-1 visiting restrictions and am not allowed to see Elizabeth off the ward. This has only been allowed on one occasion and have been discontinued on the grounds that apparently according to the RC “you are a bad influence”. It was then said it was an MDT decision because of negative effect I have on Elizabeth but this is hardly true as I have no end of text messages from Elizabeth. I am the only visitor and one who comes on a weekly basis bringing her food and things she runs short of. She is allowed out only with 2 members of staff present to the main hospital to the shop and to the restaurant. Just been informed that someone called Lucy is rescinding her leave tomorrow – she works in the office.

She has seen nothing at all of Lincoln which is quite sad after all this time.

I was not included in ward rounds to begin with but now am once a week. Elizabeth does not like to attend and sometimes flatly refuses to go as there are so many people at these meetings. She does not like meetings or crowds of people.

Visits from friends and relatives are considered crucial in the recovery and welfare of patients and research carried out on the severe restrictions imposed during the Covid pandemic indicates a clear detrimental effect on patients who missed visits from loved ones and friends. The impact on visitors has also resulted in an increased incidence of depression and anxiety being recorded. 

Excluding or restricting visits should therefore be imposed only in exceptional circumstances where there are reasonable ground for believing that a visitor may have a detrimental effect on the patients therapy.   

A decision to exclude visitors on the grounds of his or her behaviour or propensities must be fully documented and explained to the patient and where possible the appropriate person concerned.  In the case of psychiatric patients the nearest relative should be informed of any visitor exclusions and supervision decision and if it is they who are excluded or supervised an explanation in writing is to be provided to them. 

A visitor may be excluded or restricted to visits under supervision if the visit is considered to be anti-therapeutic (in the short or long term) to an extent that a discernible arrest of progress or even deterioration of the patient’s mental state is evident or can reasonably be anticipated if contact is not restricted.

An impact assessment should be carried out in consultation with the patient to assess the impact of any denial or restriction of visits on the patient’s welfare.  Where a patient lacks capacity or is impaired as to their capacity an assessment by a suitably qualified best interests assessor should be carried out to assess any negative impact that denial or restriction of visits may have on the patient.

An Impact assessment has not been done on either of us in line with Guidelines.  

What is bad about the above is that Elizabeth has not had an Impact Assessment. Elizabeth is being treated as though she has no capacity and deprived meaningful contact with family. I am the only visitor on a weekly basis and she has mentioned she is not happy with current arrangements.

Today Elizabeth has told me to pass on:

“Hello readers”

Today I have seen the therapy dog called “Cookie” on the ward. This was very nice. She is a “female angel dog”.

I miss my cat and constantly think about him.

I was not well yesterday. I have very bad autism. My eyes are affected and I think this is the medication. It sounds strange but the sensation I get is that my eyes are not connected to my head and I get this weird feeling and sometimes pain to my eyes and hands. I have been shaky on my feet today but have been doing some dancing on the ward. I want to do some more cooking. I get headaches too.

I hope I can come home for Christmas.

The ward is very noisy. Cant stand the noise.

I have tried to ring my solicitor again to see when she is coming to see me.

The impact on me as well as others in my position of not being able to have quality time with their relative is detrimental. At 5.00 am this morning I could not sleep and was in contact with another mother who has a son trapped in a prison environment. It affects you sleeping. It affects you wanting to eat and can impact on your health in a serious way such as stroke and heart attack. Elizabeth is being held for the sake of it not because she is a risk to others but because for convenience they want to put her into a care home.

Elizabeth’s views have not been taken into account because of three flawed capacity assessments. Elizabeth has her own separate living accommodation.

There is lots to do in the small local community and it is friendly where there are art groups, music groups, we are surrounded by wildlife reserves, the sea, beach and people are very nice here and kind. There are all the basic shops you could wish for within walking distance. You can hire mobility scooters if disabled. You can go for miles along the promenade. Another interest of Elizabeth is gardening and cooking. There is a college nearby and wellbeing groups. There are sensory cafes and I chose this area because it is so different to London and now they do not want her to come home and are trying to sever contact by sending her away against her wishes and that of her family out of area when there is everything here in this area I could not provide before.

When you as a parent have tried everything and know what works because Elizabeth was able to travel to Australia for wonderful care and had psychotherapy there is a sense of guilt that it is your fault as if I had not moved we would not be in this position now and what chance do you have against over 30 people at MDTs, many not known to us and some have been involved in previous reports and safeguarding not of a nice nature. I knew the London flat was no longer any good and not once scrap of care provide by Enfield and there were experienced carers who wanted to work with Elizabeth. There was no bathing facility Elizabeth could use and my attempts to get this in place were to no avail.

I cant think which area is worse so many bad things happened in Enfield that made me decide to move. I do think in Lincolnshire it is more rigid and this is not how things should be for people under the MHA – it should be least restrictive. It is as though she is on a DoLs. However the minute we did move we were subject to investigations and allegations of abuse and all sorts to discredit you which in a way has backfired. I would not be writing this blog if we were treated fairly but also I am not alone in Lincolnshire – constituency of the Health Secretary herself the Rt Hon Victoria Atkins who I have approached to look into the problem of what could be termed as “Medical Kidnapping” of vulnerable people going on nationwide and there are other cases in my new area and the most remarkable case of a 90 year old lady who is fighting for her son which I would love to feature. The effect it all has on you is that some days you feel like giving up on everything. It feels like someone has died and I know some of my contacts are going through even worse. Elizabeth is 36 and to a certain extent can speak up for herself but there are those who cannot speak yet know what they want and none want to be far away from their families.

I have seen on Twitter response to what I put about the Oliver McGowan mandatory training when I said I could see nothing of the sort in this area and I am very pleased it has been mentioned. The training may have only been given to a select few but should be given not just to NHS employees but management as well as social services and their safeguarding teams – EVERYONE INCLUDING THE DOCTORS need to have this training as they should respect when a patient constantly says “I am autistic”. It is not me saying that as I think otherwise but nevertheless if these medical professionals were taking part in the Oliver McGowan training then people like me with their sons and daughters trapped on never ending sections might be treated more fairly and not have to endure years of punishment.

PAST RESTRICTIONS

From: Blake, Zoe
Sent: 11 March 2022 09:59
To: susan bevis
Subject: Sundays leave request

Good morning Susan

I hope this email finds you well.

With regards to your request for section 17 leave on Sunday to visit Sleaford church.

On this occasion Section 17 leave for Sleaford church has not been granted.

If you would still like to Visit Elizabeth on Sunday Please let us know what time you would like us to book the family room from for a 1 hour slot.

Please book as soon as possible to save disappointment as we must insist the room is booked in advance.

Kind regards

Zoe Blake

Carer Champion

Ash Villa

Sleaford

NG34 8QA

Working hours Monday to Friday

From: Blake, Zoe
Sent: Friday, March 11, 2022 2:41:58 PM
To: susan bevis
Subject: RE: RELIGIOUS LEAVE FOR CHURCH NOT AGREED – WHO IS ACTING RESPONSIBLE CLINICIAN IN ABSENCE OF DR KUMAR AND DR SHAPASENDY

Good afternoon susan

I do apologise for any miscommunication Doctor Shahpesandy is the RC for ash villa and is acting as such today.

What time would you like to book the room for , Visiting is a 1 hour slot ( I have confirmed this prior to reply)  you are welcome to spend some or all of that time in the grounds but this would still require being booked in.

Two members of Staff would still be supporting the contact but will be at a distance to allow some privacy.

For any Medical concerns or questions please use the 15 Minutes exclusive allocated time given weekly to yourself to address the doctors.

For any Complaints please Contact Pals lpft.pals@nhs.net

Anything else please don’t hesitate to contact me as your point of contact.

Emails to Multiple people within the LPFT organisation will not be answered.

If Emails are sent to myself please allow 72 hours for me to respond, responses will be given within working hours of 09.00-17.00pm

My emails, Direct line and Mobile numbers are:

Warm regards

Zoe Blake

Carer Champion

Ash Villa

Sleaford

NG34 8QA

Working hours Monday to Friday 09.00-17.00 pm

From: susan bevis
Sent: Friday, March 11, 2022 2:49:00 PM
To: Blake, Zoe
Subject: Re: RELIGIOUS LEAVE FOR CHURCH NOT AGREED – WHO IS ACTING RESPONSIBLE CLINICIAN IN ABSENCE OF DR KUMAR AND DR SHAPASENDY

Dear Zoe 

As I have said before the church service is at 10.00 am.  I have notified the church that my daughter is being deprived her religious rights by dr shapasendy 


Sent: 28 March 2022 22:39
To: susanb
Subject: Re: Limbic system update

Susan

Elizabeth does have capacity to consent to those tests.  I am a senior lecturer in medical ethics and law and since this study is to determine possible treatments for Elizabeth it is perfectly OK to carry them out.

I would have hoped that medical practitioners would have known that. 

—–Original Message—–
From: susan bevis
To: BLAKE, Zoe (

Sent: Mon, 28 Mar 2022 19:05
Subject: Limbic system update

Hi Zoe

Are you trying to say that my daughter has no capacity?

Where is the study being done and who do I contact to get the necessary forms?

Elizabeth has agreed witnessed by more than one family member.

I look forward to receiving the necessary forms.  The tests are very important I am sure you will agree and this has already been agreed by Dr Shahpesandy in any case.  His important research needs to be widely publicised and I have proof she has already agreed.  The more people who know about his research the better as this could widely benefit more than my daughter.

The entire family are witnesses to this consent in any case.  

Regards

Susan Bevis

NEAREST RELATIVE, POA, MCKENZIE FRIEND AND MOTHER

Sent from Mail for Windows

From: Blake, Zoe
Sent: 28 March 2022 17:35
To: susan bevis
Subject: Limbic system update

Afternoon susan

I have spoken with Dr Shahpesandy and the bloods that need to be taken for the Limbic system are not able to be Done as it’s as part of a study, and the study requirements stipulate that the patient must have capacity to consent to have those particular bloods taken.

Kind regards

Zoe Blake

Carer Champion

Ash Villa

Sleaford

NG34 8QA

Working hours Monday to Friday 09.00-17.00 pm

From: susan bevis
Sent: 28 March 2022 09:41
To: Jackson, S (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); s.jackson@lpft.mha.net; s.twist@lpft.mha.net
BLAKE, Zoe
Subject: Manager’s Hearing for Elizabeth 12.2.1987

Dear ********

As Nearest Relative for Elizabeth Bevis I would like to call a Hospital Manager’s Hearing as soon as possible.

Please inform everyone above of the date of this Manager’s Hearing.

Thank you.

Kind regards

Susan A Bevis

Mother, Nearest Relative, POA and McKenzie Friend for Elizabeth

From: Blake, Zoe
Sent: 22 March 2022 11:37
To: susan bevis
Subject: RE: ELIZABETH’S PHONE

Good morning susan

I have been down to see Elizabeth and her phone is in her locker.

I have been to Elizabeth and asked if she would like it and she asked that I Leave it in the locker.

If you need anything else don’t hesitate to let me know.

From: susan bevis
Sent: Tuesday, March 22, 2022 1:16:48 PM
To: Blake, Zoe Bevis
Subject: Re: ELIZABETH’S PHONE Re: MP/2022/03502

I can see right through everything zoe please don’t bother to excuse matters.  

You most certainly do not appreciate anything to do with how I feel.   

I did not ask Elizabeth to phone me but there are other family members who might wish to call so please just give her back the phone anyway ok.  What is the problem with that?

Regards 

Susan

From: Blake, Zoe
Sent: Tuesday, March 22, 2022 1:12:09 PM
To: susan bevis
Subject: RE: ELIZABETH’S PHONE Re: MP/2022/03502

Hi Susan

I am sorry you are finding this Distressing  and I apricate you are paying for a phone contract.

I popped into see Elizabeth and expressed you had called and asked if she would like her phone to call you back and she declined.

It would not be Professional of me to force the phone onto Elizabeth if she has requested to have it placed in the locker.

Elizabeth has section 17 ground leave which you both used on Sunday when you visited.

Feel free to call me should you wish to talk further.

Kind regards

Zoe Blake

Carer Champion

Ash Villa

Sleaford

NG34 8QA

To: Blake, Zoe s.twist>; Jackson, s.jackson
safeguarding@cqc.org.uk; CONNERY, Sarah PALS(LPT) (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) ;mhtcorrespondence@justice.gov.uk>
Subject: RE: ELIZABETH’S PHONE Re: MP/2022/03502

Dear Zoe

Yes there is one more thing you need to tell Elizabeth that her Family wish to talk to her.  We are paying a contract on the phone and want to wish her all the best for her T******* and where is the link I requested?

I know it is up to the J****and P**** but as I am not even mentioned as the NR I have contacted the T.O to let them know and also the fact that Elizabeth requested me to be present.

I have had no response from either S Twist or S Jackson who is in charge of the MHA Office.  

Elizabeth said she wanted me to attend on Sunday so if it is Lincolnshire Partnership Trust Ash Villa who do not wish for me to attend then I am not given a reason why Elizabeth cannot attend church either on Sunday or have the slightest bit of S17 leave.   These questions remain unanswered from the last ward round as despite the further meeting arranged at 2.00 pm no section 17 leave was granted.   This is constantly being disregarded why is that Zoe?

What exactly was your wording to my daughter when you asked her if she would like her phone or not?  Did you say that her family would like to speak to her.

Why did no one tell her on her Birthday that I waited all day long and no one even informed her that her Birthday presents were in a storage room.

Please therefore pass the phone to my daughter right now thank you so that her family can wish her good luck for today.  We are after all paying for the contract on the phone which should be with her at all times not charging or locked away in a locker room.    I heard a very different story when I spoke to my daughter after several days following her Birthday.  She had no idea I had left a card or presents.  What on earth is going on under Ash Villa?    The supervised restrictive visits akin to prison, the lack of contact.  I’ve been through all this before and my daughter’s words are “I will never get better in here”

Just to remind you further these are her actual words from her messages.

I do not think you have any idea how awful and upsetting this is and my daughter also told me that words are being put in her head.  That she is being put under pressure to sign papers and she has not even got her care plan.   

Thank you.

Regards

Susan Bevis

From: Blake, Zoe
Sent: 11 April 2022 12:30
To: susan bevis
Subject: RE: Elizabeth

Good morning susan

Thank you for your email.

I will of course report the shoulder scratching you are concerned about to the Nurse in charge today , thank you for Highlighting this to us.

To be clear the 2 x 30 Minutes is not your entitlement but the leave that The doctor is happy to give Elizabeth.

2 x 30 Minutes ground leave is E’s entitlement to walk round the grounds, with that said E is not restricted to use the ward garden for fresh air and enjoy the flowers and wildlife. But not without two members of staff escorting her for the most part and treated very differently to others. Was told by a HCA she was on a “different kind of section”. On my visits the two members of staff would follow if we got up to have a walk or to sit in the shade.

As you are aware when you visited Sunday you continued your visit with Elizabeth in the family room, this is because we are no longer closed to visits.

You are welcome to arrange a chiropodist to visit Elizabeth however I would suggest this takes place in our treatment room, you would not be granted access to this area of the ward. I had to pay for this privately as she was in pain and agony with her feet.

The only access to the ward for yourself is the family room and this has been agreed is NOT the right place for the appointment.

With that said maybe you would be willing to wait until the appointment had finished and visit Elizabeth after the appointment.

In order to have access to any recording or CCTV footage you would need to send relevant paperwork to Subject to access request form. Done this but despite standing directly under the CCTV for which I once had a licence to operate no footage was recoverable.

Please find attached.

Any health concerns you have we can raise with the doctors on Friday.

Kind regards

Zoe Blake

Carer Champion

Ash Villa

Sleaford

NG34 8QA

Working hours Monday to Friday 09.00-17.00 pm

From: susan bevis
Sent: 11 April 2022 11:21
<Anita.heera@publicguardian
Subject: Elizabeth

Dear Zoe

I visited Elizabeth on Sunday and quite frankly was shocked by her appearance.   She is starting to self harm by scratching herself and had a nasty looking red wound on her shoulder.

In addition I understand that she was still in pain with her feet.   I spoke to J about this and I tried to cut the toe nails myself but I could not.    My entitlement to see my daughter is just half an hour twice a week in line with Ash Villa’s Policy and I am wondering if it is OK for me to get a private chiropodist to visit Elizabeth in the grounds in addition?  I would like you to confirm this is OK for me to be there for just an additional half an hour as I do not want to run the risk of certain staff calling the police yet again.

As the recent allegations against me are ruining my character and also as I am being investigated as an unfit attorney by Public Guardian Office, I have had to tell my employers about all of this and will need to prove to them that none of these serious allegations are true so who do I contact within the Trust to get all recordings and CCTV footage of the alleged incidents for which A Bartlett has accused me of in her letter and especially for last Sunday.

I also received a message from my daughter which is very distressing.  Whilst lying in bed a lot during the day and not getting any exercise, held a virtual prisoner she is clearly going downhill physically and the doctor who visited her today has said he has muscle weakness to whole body which is no wonder why.   She constantly claims she is autistic also but no one is listening.

I would also like to know how many additional injections of Lorazepam are being administered to my daughter per week?    I am still the Nearest Relative and so am entitled to such information.

Also, what is Ash Villa doing about the i************ previously denied but recognised by Lincoln Hospital Charlesworth Ward?

I look forward to hearing from you.  In the meantime I will look for a private mobile chiropodist.

Regards

Susan Bevis  

From: Blake, Zoe
Sent: Friday, April 8, 2022 4:49:43 PM
To: susan bevis
Subject: Sundays leave

Good afternoon Susan

It has been raised that you wish for 1 hour ground leave on Sunday

This will not be granted.

The Section 17 leave that is in place is for 30 Minutes twice a week.

30 minutes has been taken today the reminder can be taken on Sunday.

To be clear you have 30 Minutes ground leave booked in for Sunday at 14.00pm

Kind regards

Zoe Blake

Carer Champion

Ash Villa

Sleaford

NG34 8QA

Mobile: 07518294826

From: PALS(LPT) (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST)
Sent: 31 March 2022 10:57
To: susan bevis
Subject: RE: HOSPITAL MANAGERS Ward Round Today Please can Elizabeth have her phone back if charging fao ALISON WHITING

Hi Mrs bevis

I have checked with the MHA team. They are aware that you are delegating your nearest relative responsibility. But I had not exactly agreed to do so and besides Elizabeth did not want me to. Please be assured that the hospital managers hearing is being scheduled in accordance with the code of practice and relevant people will be informed in due course. I was excluded from the Manager’s Hearing but knew all about it thanks to Elizabeth’s invitation but was refused a link to attend.

kind regards

Ann Munro

Patient Experience Lead

From: susan bevis
Sent: 30 March 2022 21:01
To: PALS(LPT) (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) <lpft.pals@nhs.net>; safeguarding@cqc.org.uk; Enquiries <Enquiries@cqc.org.uk>; Blake, Zoe
Subject: Re: HOSPITAL MANAGERS Ward Round Today Please can Elizabeth have her phone back if charging fao ALISON WHITING

Dear Ann

I have written to S Jackson and S Swift of the MHA office.  I have not had any response.  I wanted to discuss matters with the Associate Managers at a Manager’s Hearing.  As Nearest Relative I am entitled to call a Manager’s Hearing so please can you look into this as to the reasons why I am getting no response.  

Regards

Susan Bevis. 07498299069

From: susan bevis
Sent: 18 March 2022 12:13
To: PALS(LPT) (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) <lpft.pals@nhs.net>
Subject: HOSPITAL MANAGERS Ward Round Today Please can Elizabeth have her phone back if charging fao: ALISON WHITING

Dear Alison

Today’s ward round made me feel slightly happier in that Dr Shapasendy offered to look at S17 leave and that the abnormalities on the scan will be investigated hopefully.

It is sad though that I am finding myself in exactly the same position as I was back in the former area and I see it as bullying and absolutely horrible.   There is no way that Elizabeth would have knowingly signed anything against me being NR as she has been constantly sharing information.  She was given papers to sign but says she did not read them.  They were given to her whilst she was recovering from covid and not feeling well at the time and she felt under pressure to sign. 

Anyway I hope you can help me in that I would like to know who the Hospital Managers of Ash Villa are please.     I am still the nearest relative and would like to contact the managers.   As you can see Mr H has added his voice to the complaint you have in response to the letter from A Bartlett Ward Manager.

Regards

Susan Bevis

From: GH
Date: 14 March 2022 at 11:27:58 GMT
To: aB
Cc: lpft.patientexperience@nhs.net
Subject: Letter from Alison Bartle to Susan Bevis

I have read the letter from yourself to Susan Bevis and would totally refute the allegations of rudeness or threatening behaviour by Susan Bevis.

I myself have witnessed such calls as I have been in the same room as Susan makes the calls.
I am also aware of the awful occasion on E’s birthday and having spoken to her direct how she was looking forward to receiving her birthday cake. Several friends and family in addition to myself spoke to E prior to her birthday and were given the same impression. It seems to have been out of character for her to not want contact.

I am witness to E’s care over many years and have to say this has been the most restrictive to date.
In every ward round interview E has been asked where she wants to live. She constantly says she wants to come home. We are working on providing her own safe self contained and peaceful accommodation. No way should she still be kept at Ash Villa but staff should be working towards providing care in the community.

I wish this email to be included in any complaints procedures as I would back Susan Bevis in stating that no threats have been made against members of staff, and that current restrictions are wrong, unhelpful and a backward step in E’s care. Indeed I would say that both myself and family members have stated that it has been staff that have been rude and dismissive. Have staff been told not to give information, perhaps they are bullied by senior staff.

On moving to Lincolnshire, Susan did all in her power to put medication injections ongoing in place for her care to continue. This included notifying the new GP and a trip to Urgent Care. The injections she was being reduced slowly and gradually no doubt because of the discharge note pointing to only physical health concerns.

The ward round recently appeared to be a deliberate attempt to stop attendance.

A reply to this email is not required but please ensure it is included in any complaints procedure.

Sent from my iPhone

If there are abnormal readings on a scan they have an absolute duty of care to investigate them and a psychiatrist is not qualified to do that.  If there is a lesion it needs treating as such.  Psycopharmaceutical interventions are not suitable to do that.

If that abnormal reading is in the pre-frontal cortex it could account for some of her behaviour and non-responsiveness to drugs.  

She needs that scan and a proper investigation of anything found, not just references to ‘abnormalities’

Sent from Mail for Windows

From: susan bevis
Sent: 06 April 2022 12:00
To: Blake, Zoe
Cc: safeguarding@cqc.org.uk; OPG Safeguarding Unit; OPG Customer Services;
Subject: Re: Ground visit

Dear Zoe

It was ********, witnessed by my daughter and  others who accused me of assaulting a staff member and I have a reference number from the police regarding this as they called police on me.  My daughter reacted to the accusations from ********** that I assaulted a member of staff and these allegations and/or my alleged threatening behaviour led to police being called.   

Everything is now on police records and I do not lie.    Oh no my Mum did not assault a member of staff”.

Anyway,I am now in touch with Adult safeguarding regarding my daughter’s discriminatory treatment at Ash Villa in accordance with Lincolnshire Partnership Trust’s Policy so I was told. No doubt they will examine all in this connection.    Why did dr Shahpasandy say there was concerns regarding me and safeguarding.   Perhaps he can explain all to Adults Social services and CQC.    Elizabeth tells me Dr RM and one other has left all of a sudden.  So if there is no safeguarding one member of staff has said E is on “a different kind of section” that warrants such restrictions?  Which section?

Also please give E her letters back.  She told me they were taken and held in the office.

In addition why are staff supervising visits from the chaplain and advocate?

Surely you must know that it is unlawful for any member of staff to be present when a patient sees an advocate?

Anything like allegations of my threatening violent intimidating behaviour as alleged will be clearly captured on CCTV and should be examined before any more letters are produced by A Bartlett accusing me of such.   I used to operate CCTV so I would know.

Why is J questioning my daughter on the subject of me being nearest relative?  This is a legal matter and NOT a clinical matter?

As regards the Limbic tests which incidentally require a scan first –  these were agreed last ward round but no blood test or scans have been done and Dr RM did not come and see Elizabeth as planned now she is leaving apparently.  It is not a matter of discussing what had already been agreed but when will scan and blood test be carried out?

Also please keep me informed and rest of the family re the cancer tests for E plus MRI.

I will be having an advocate of very high standing soon by the way.

Regards

Susan Bevis

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From: Blake, Zoe
Sent: Wednesday, April 6, 2022 11:33:31 AM
To: susan bevis
Subject: RE: Ground visit

Good morning susan

If you don’t mind I will reply to both emails in one.

With regards to you requesting visits to E both Friday 8th of April and  10th of April  at 14.00pm this has been agreed.

E currently has 2 x 30 Minutes S17 ground leave a week, 30 minutes has been agreed for Friday and 30 minutes for Sunday, the Visits will be supported by 2 x staff members.

To address some of your raised concerns below.

  1. There has been no mention from any member of staff that you have physically assaulted anyone, The nurse on duty has not made this allegation in any documented notes recorded for the day.
  2. J is the wards clinical lead for the ash villa unit
  3. As for the Limbic tests we can discuss this will Dr Shahpesandy at the meeting 10.00 on Friday.

Should you wish to discuss anything else further please don’t hesitate to call or email.

Warm regards

Zoe Blake

Carer Champion

Ash Villa

Sleaford

NG34 8QA

From: Tammy Waby
Sent: Wednesday, April 6, 2022 10:41:24 AM
To: susan bevis
Subject: RE: safeguarding referral outcome for Elizabeth

Morning Susan

I can confirm that from LCC there is no active safeguarding against yourself.

The only active safeguarding is the one that you have raised against Ash Villa

Regards

Tammy Waby

Principal Practitioner

Safeguarding Vulnerable Adults Team

Adult Care and Community Wellbeing Directorate

Sleaford Area Office,

105 Eastgate,

Sleaford

NG34 7EN

From: Blake, Zoe
Sent: 23 March 2022 09:59
To: susan bevis
Subject: limbic encephalitis

Good morning Susan

Doctor Shahpesandy has asked I make contact and advised you regarding your request to have limbic encephalitis looked into for Elizabeth

Doctor Shahpesandy has advised that he cannot justify an open scanner But if Elizabeth agreed to a blood sample being taken he will send it to the lab to test for limbic encephalitis. Do not know if this was carried out as Elizabeth told me no-one came to give her the blood test for the Limbic System and was expecting a Dr R to come. Even if this is not done – an MRI was not carried out and should have been immediately by the other ward under Dr Ismail where they tried to carry out safeguarding against me so I found out. At Ash villa the episodes started. There was an accident where she hit her head. It is only now a scan has been carried out and it is not reassuring it said normal as things have been identified from the private scan.

If you have any more questions regarding the above please raise it on Friday when you have your meeting with Dr Shahpesandy.

Kind regards

Zoe Blake

Carer Champion

Ash Villa

Sleaford

NG34 8QA

Working hours Monday to Friday 09.00-17.00 pm

From: Blake, Zoe
Sent: 07 June 2022 12:17
To: susan bevis
Subject: RE: Visit Tomorrow to Elizabeth

Hi Susan

I do hope it will be a nice day for you, as today is.

Scan update is Elizabeth is still refusing to go, and I will need to ask about the endocrinology for you. She would have gone if I had been allowed to take her but she was on restrictions as though in prison and I was on supervised 2-1 supervision. She would have gone if under an open scanner.

As far as I am aware other family members are aware we are monitoring phone use for a period of time.

Phone calls as well as phone use will be monitored for the agreed period of time.   You have no right to do this under law.

Our new RC  at ash villa is still Dr Kumar but may change in the near future, I will advise when this happens.

Kind regards

Zoe Blake

Carer Champion

Ash Villa

Sleaford

NG34 8QA

DEPRIVATION OF LIBERTY – DO YOU HAVE A CASE?

May 3rd, 2016

This is an area of law which is undergoing significant change yet which is of profound significance for vulnerable individuals. The following provides a brief overview of the current position.

Human Rights Act 1998

Article 5 of the Human Rights Act 1998 enshrines an individual’s right to liberty.

However those deemed to be ‘unsound of mind’ can be deprived of their liberty by the state as long as this follows a lawful process. The phrase ‘unsound of mind’ would apply to individuals who don’t have capacity to make decisions and who are subject to the provisions of the Mental Capacity Act 2005.    GJ has done a best interest assessment and did not even tell Elizabeth –  she is I understand a nurse but from this assessment Zoe Blake stated that Elizabeth had no capacity regarding me attending a Manager’s Hearing when Elizabeth had invited me and told me the exact time of this meeting but disturbingly I as NR had been asking for a Manager’s Hearing for months only to be totally ignored by the MHA Office S Jackson Manager on every occasion.   This is most suspicious I am sure you will agree.  So the phone has been taken away from Elizabeth as a means of punishment to stop her from speaking to her family, a hospital run by the NHS under Lincolnshire Partnership Trust that has total unaccountability and rife with bullying as we have encountered.

Mental Capacity Act 2005:

The legislation sets out two separate processes for a person lacking capacity to be deprived of their liberty, depending upon the location where their care is received.

  • Deprivation within the community:
    An authorisation can only be provided in relation to a deprivation within a community setting (eg the person’s own home or a supported living placement) by making an application to the Court of Protection.
  • Deprivation within a care home or hospital:      YES trying to do that now behind our backs OOA.
    To authorise a deprivation of liberty within a care home or hospital, there must be compliance with the Deprivation of Liberty Safeguards (DoLS), detailed at schedule A1 Mental Capacity Act 2005    – SINCE FEB 2022???? to date  Please look into this CQC as when I checked no DoLs was in place for such restrictions to be lawful.

What is a Deprivation of Liberty?

In the leading case of P v Cheshire West & Chester Council (March 2014) the Supreme Court provided an acid test to decide if someone without capacity had been deprived of their liberty.

A person can now be said to be deprived of their liberty if:
1. they are subject to continuous supervision and control; and
2. they are not free to leave (with the focus being not on whether a person seems to be wanting to leave, but on how those who support them would react if they did want to leave.)   Exactly!  

Elizabeth is welcome back at home saving £3800 of public money wasted on imprisonment of the highest degree we have never thought possible under the NHS especially since she was not on a section CTO in the former area and was entitled to CTRs and at last was starting to be treated more fairly. 

An architecturally designed separate living accommodation within the back garden has been provided and had no objection to MH professionals visiting her.  She was previously being taken off the depot as her discharge note pointed only to physical health concerns relating to central nervous system – abnormal findings on scans..  We have had nothing but bullying under Lincolnshire Partnership Trust since our arrival.

You can be sure I have contacted social services to check to see if DoLs are in place and was clearly told “no” which makes all of this unlawful surely.    

The Position After P v Cheshire West

This truly was a watershed judgment which confirmed that many more people were deprived of their liberty than had previously been thought. The decision has now triggered a ten-fold increase in applications for authorisation and it is estimated that in the year 2015/2016 there will be:

  • 176,000 standard authorisations by Local Authorities
  • 30,000 authorisations by the Court of Protection

The increase in necessary authorisations has brought with it a consensus that the DoLS authorisation process for care home and hospital placements which is supervised by Local Authorities is no longer fit for purpose.

On this basis the Law Commission has been invited to review the safeguards and come up with proposals for an improved system. The Law Commission will produce their final proposals later this year.

In the meantime the Court of Protection has been seeking to produce a streamlined procedure to ensure that authorisations for deprivations within the community can be conducted efficiently and fairly given the increased workload.

A stalemate has unfortunately been reached in relation to individuals who do not have a friend or family member to participate in these court proceedings. A suitable representative for the individual is a required minimum procedural safeguard, but if a willing volunteer is not available then a paid professional must undertake this role. Unsurprisingly no public body has the resource available to meet this expense on the large scale anticipated.

In March 2016, Mr Justice Charles addressed this stalemate in the case of Re JM & Ors. He commented;

“I am sorry to have to record that in my view the stance of the Secretary of State (through officials at the MoJ and DoH) in these proceedings has been one in which they have failed to face up to and constructively address the availability in practice of such…representatives”

Judicial pressure has now been firmly applied to Central Government to come up with some solution to enable lawful process to be followed. Watch this space.

Unlawful Deprivations of Liberty & Damages Awards

It is a little known fact that an individual who has been unlawfully deprived of their liberty has a right to compensation.

Compensation should be awarded to an individual if the relevant deprivation of liberty process was not followed and, as a result, the individual was wrongly deprived or was excessively restricted.

Recent cases have attracted compensation in the region of £3000 – £5000 per month of unlawful deprivation, although this is guidance only and not binding.

It is widely believed that there are countless incidences of unlawful deprivations of liberty and that the potential liability for compensation claims could be highly significant.

Finally

The following are all signs that a deprivation of liberty may be unlawful:

  • Local Authority forcing a person into a care home without consent or against their will
  • The person or their family/friends not being happy with their care
  • The person or their family/friends not being involved in the authorisation process
  • The person or their family/friends not being told how to challenge or complain about their care
  • Care which is overly restrictive/protective/risk averse

If you have concerns that someone you know may be subject to an unlawful or overly restrictive deprivation of liberty, please contact us to discuss whether we can help.

YES I DO UNDER LINCOLNSHIRE PARTNERSHIP TRUST FROM FEBRUARY 2022 TO DATE AND I ALSO CONSIDER THIS TO BE OF HUGE PUBLIC INTEREST CONSIDERING THE WASTAGE OF PUBLIC MONEY WHEN ELIZABETH COULD BE AT HOME RIGHT NOW AND WE ASKED FOR NOTHING APART FROM THE DEPOT TO BE CONTINUED IN NEW AREA WITH THE REDUCTION PLAN WE SHOWD FROM THE FORMER AREA.  WHY WAS THIS SO DIFFICULT LINCOLNSHIRE PARTNERSHIP TRUST AND BEHMHTNHS?

Please further see below as it is not just me who is unhappy about the treatment of my daughter whose life is being put at risk and it is recorded has low blood oxygen levels which could be life threatening.

Email below from Elizabeth’s father:

From: SB
Sent: 07 June 2022 16:55
To: susan bevis
Subject: Re: Yesterday’s Visit

When I arrived Elizabeth was in bed and didn’t want to see me as she didn’t want to see me at first She eventually came and saw me and we had a nice afternoon but she said she didn’t want to see me in her state. To be honest she was unresponsive but we did have a couple of laughs together don’t know how her oncology appointment went Elizabeth said it was up to her if she went but I tried to encourage her to go. I tried my hardest to get an update from doctors but they wouldn’t give me one as her condition when I saw her last to now hasn’t improved As for her flat I’ve sought advice as I cannot just remove her possessions I need her permission and she was in no fit state as of yesterday to give it as it has to be in writing Also where is her stuff going? I’m trying really hard to resolve but hitting too many obstacles Any advice gratefully received I also left Elizabeth some money which has been put in her locker for safe keeping!


Subject: Re: stress induced psychosis

They recognise that Elizabeth has stress induced psychosis but signally fail to recognise that they are the cause of much of the stress.  Do they not realise that being deprived of liberty is about as stressful as it gets.

Oh, and nasty tastes are an effect of the anticholinergic effects of the drugs.  Odd they don’t recognise that either.

Ask for a detailed explanation of why Elizabeth cannot be given s.17 leave.  Including a full appraisal of her current state of mind, not some utterly inadequate reference to outdated diagnostic criteria.  Section 17 leave is part of the rehabilitation programme and patients do not get better permanently locked up in a bizarre setting with hostile staff.

It is patently obvious that if Elizabeth does not want to engage with the staff in Ash Villa that they need to make better arrangements.  She clearly needs one to one psychotherapy with someone she can trust and who can break through the barrier that these mental health professionals themselves create.

No amount of incarceration in a locked ‘rehabilitation’ ward will improve her quality of life and all it will do is make her more determined to reject their interventions.  The idea that rehabilitation can be achieved in a lock-up is bloody ridiculous in any case.

As for schizophrenia I would suggest that the nurse needs to do some CME training.  Virtually no-one considers this an organic condition anymore and even where it is recognised as a disorder it is syndromal and not a condition with either aetiology or prognosis.  Thousands of those accused of being schizophrenics recover if properly treated.  Millions of others are simply drugged and locked up for convenience.  

I think that Elizabeth would show signs of recovery if she was given seven days leave and later attended as a voluntary patient.  If they cannot see that her defiance will not subside after this length of time they need to reconsider their chosen professions.

From: susan bevis
Sent: 06 April 2022 10:32
To: Tammy Waby
Subject: Re: safeguarding referral outcome for E (3500795)

Dear Ms Waby

It was Dr Shahpasandy who told me that concerns had been raised about me personally but I do not know by whom so because of the restrictions put in place whereby I have only supervised visiting rights I thought it has got to be either safeguarding or DoLs.  I was told my daughter could not even come out in the garden alone with me due to safeguarding concerns and her being on a different type of section.   At Xmas my daughter came home for a few days but became unsettled on her return from leave.  My daughter claims to be autistic.  She sees it as punishment and says she is injected sometimes because of her i***** and that certain staff are putting pressure or have done to get her to sign paperwork and also in relation to her nearest relative.  I was told they were doing everything in line with their policy and my daughter has complained that staff are behaving in an intrusive manner on the ward towards her.

I was told by dr Shahpasandy he is getting rid of me as nearest relative and that the POA investigation is an entirely separate matter.  

Safeguarding was commenced under Lincoln Hospital Charlesworth Ward but I thought this had been stopped.     

Regards

Susan Bevis.

From: susan bevis
Sent: 09 May 2022 12:01
To: Kumar, Praveen
Cc: BLAKE, Zoe
Subject: Main Points of Concern

Dear Dr Kumar

  • My main concern is the very lengthy detention of my daughter now around 8 months who is suffering from comorbidity illnesses and deprived of exercise and fresh air under section, physically not benefitting from treatment that is so very restrictive and is declining physically.   It is about time she was released back home in accordance with her wishes because already she has developed what could well be breast cancer as a result of lack of vit D and exercise.
  • I brought in a bird table that could be fixed to her window but still this has not been done.  This was suggested by a member of your staff.
  • The environment is traumatic and distressing to my daughter of being locked up and what evidence is there that she has got well after so very long when it is clear from her messages to the family she is not gaining benefit.   She misses the home environment and her cat and everything she needs can be provided in the community.
  • It has been suggested by **********, world leading expert on complex PTSD be involved in helping Elizabeth and I am quite prepared to pay for this.

Perhaps these issues can be discussed above all others at the forthcoming manager’s hearing and hopefully even sooner at a weekly meeting I am normally invited to attend.

Yours sincerely

Susan Bevis


Sent: Tuesday, May 24, 2022 1:28 pm
To: <susanb
Subject: Re: Managers hearing

You might be interested in the contents of this lecture, especially from slide 38 which explains the duties of Health Informatics Professionals.

As NR and with Elizabeth’s written consent you are entitled view the capacity report which must give full reasons for the decision on capacity.

Capacity is a legal construct and not a medical one.  As Elizabeth’s NR you can challenge the capacity report.  See the Bournewood case (also attached).

From: Blake, Zoe
Sent: 24 May 2022 10:12
To: susan bevis
Subject: RE: Managers hearing

Good morning Susan

I hope your well.

As advised on many occasions I am your single point of access, others will not reply but I will seek to gain the relevant answers and feed them back to you.

You will not be sent the link to the managers meeting today, Elizabeth has not given verbal consent to any member of staff although we have tried to gain this on many occasions.

Elizabeth has not been deemed to have Capacity to consent to your request on this occasion.

Kind regards

Zoe Blake

Carer Champion

Ash Villa

Sleaford

NG34 8QA

There is no tangible reason why Elizabeth cannot be given s.17 leave and the refusal to allow her some respite form permanent confinement is positively detrimental to her mental health.

In a nutshell they are institutionalising her by stealth.  This is a human rights issue and not one for half-assed tribunals.  

This circumvents the institutional bias of the tribunals and involved decisions based on well establish law rather than the convenience of the staff at AV.  It is utterly absurd that she has not had some home leave in eight months. Even a restricted patient would have been allowed some leave.

From: Blake, Zoe
Sent: Friday, June 10, 2022 11:32 am
To: susan bevis
Subject: Unlawful Deprival of Liberty

Hi Susan

I do not best placed to answer about Dr Kumar but have asked the questions and will reply when I have the answers for you.

Our mental health nurses are qualified to undertake capacity assessments.

Informal capacity assessments can be done by anyone, for example if a patent needs help in finding something to wear we would assess what level of support is needed and help, this is a capacity assessment.

Formal Capacity assessment is for things more in-depth such as understanding rights under the section they are held at this point someone who is best placed  can undertake the capacity assessment. In most cases this will be done by mental health professionals from consultant to nurses.

I have received a message from GH and I will call him back when I have availability which should be this morning.

You have every right to call me based on me being your point of contact.

Elizabeth does not have set times in which she has her phone.

Elizabeth is offered the phone intermittently thought the day, when she accepts her hour starts, Elizabeth is permitted 2 hours per day.

When Elizabeth sees her phone she will see any missed calls and messages you have sent and she will reply as she wishes.

Kind regards

Zoe Blake

Carer Champion

Ash Villa

Sleaford

NG34 8QA 

From: Blake, Zoe
Sent: 07 June 2022 12:17
To: susan bevis
Subject: RE: Visit Tomorrow to Elizabeth

Hi Susan

I do hope it will be a nice day for you, as today is.

Scan update is Elizabeth is still refusing to go, and I will need to ask about the endocrinology for you.

As far as I am aware other family members are aware we are monitoring phone use for a period of time.

Phone calls as well as phone use will be monitored for the agreed period of time.   You have no right to do this under law.

Our new RC  at ash villa is still Dr Kumar but may change in the near future, I will advise when this happens.

Kind regards

Zoe Blake

Carer Champion

Ash Villa

Sleaford

NG34 8QA

From: susan bevis
Sent: 07 June 2022 13:15
To: BLAKE, Zoe
Cc: CONNERY, Sarah
Subject: FW: Visit Tomorrow to Elizabeth

This was done at Cambian.  Her phone taken away, kept charging in the office continuously, given a time slot for when I was allowed to phone.  The outcome was the phone had to be handed back immediately to Elizabeth because it was found that legally Cambian were in breach of human rights and the law as is Ash Villa. The phone is Elizabeth’s phone and the contract is paid for by the family and therefore Ash Villa and the MDT are in breach of human rights law and I can forward you the letter from previous solicitors in this respect as it went straight to the CEO for court purposes.

Thanks for confirming that Dr Kumar is still the RC with overall responsibility for everything that goes on under Ash Villa.

Elizabeth would not be refusing appointments for the scan if her family were taking her and so I would like some Section 17 leave to take my daughter for this essential appointment. 

Endocrinology is also an essential appointment and referral to a hormone clinic was recommended at a previous tribunal.   We want to know what the abnormal findings on the scan were so therefore when is the next MRI appointment in an open scanner which we dont mind paying the difference for so that we can be present.

Please forward a copy of the capacity assessment done by GJ that prompted you to say Elizabeth had no capacity as well as a copy of the minutes of the manager’s hearing that I was invited to by way of text message from Elizabeth and that I had been requesting for months on end as my right as the NR but then now it would appear that everything has changed in this respect.

Thank you

Regards

Susan Bevis

Ash Villa

Sleaford

NG34 8QA

Working hours Monday to Friday 09.00-17.00 pm

From: Blake, Zoe
Sent: 07 June 2022 14:02
To: susan bevis
Subject: RE: Visit Tomorrow to Elizabeth

Hi Susan

I have spoken to the Doctor today and unfortunately he does not have any room in his diary to meet with you tomorrow.

The Doctor and myself will revisit this for you at the end of the week and allocate some time where possible.

I am not authorised to send paperwork you would need to go through the correct channels.

Please find attached the document you would need to fill in and send off to be able to gain access to the information.

I have spoken with the doctors regarding ****** Celebrations and this will not be permitted on this occasion Elizabeth’s S17 leave will remain the same  which is 2 x 30 minutes ground leave escorted by 2 members of staff.

Kind regards

Zoe Blake

Carer Champion

Ash Villa

Sleaford

NG34 8QA

From: Blake, Zoe
Sent: 07 June 2022 11:47
To: susan bevis
Subject: RE: Visit Tomorrow to Elizabeth

Good morning Susan

It has been recently discussed in Elizabeth’s MDT That phone access be monitored for a period of time.

It has been reported that the phone works fine and Elizabeth has not mentioned it needs to be repaired.    There is a cracked screen which Elizabeth agreed for me to get repaired but because I used to visit on a Sunday no shops were open.

Elizabeth has her phone twice a day 1 hour in a morning and 1 hour in the evening, at these times Elizabeth is able to call and text who she wishes. Elizabeth is just lying in bed in the mornings and in fact according to one nurse has spent much of her time in her room isolated from everyone and refuses to join in.

The phone will not be permitted to leave the ward however her clothing will be ready for you to collect. 

I will speak to the RC and see if he has any room to see you tomorrow at 3pm however I cant commit to this as yet, I will feed back to you as soon as I can on this.

I will book your visit in for 15.00pm Wednesday.

For your information Elizabeth went to her breast screening appointment yesterday and it has been reported that No Lump has been found, Elizabeth was visibility pleased by this and commented how pleased you would be able this also.  

Kind regards

Zoe Blake

Carer Champion


Sent: Friday, June 17, 2022 7:04:38 PM
To: susanb
Subject: Evidence

The best interest assessor will need to give evidence if they are relying on this to justify their actions.  A best interests assessor is a legal role, not a medical one.  

Sent: Wednesday, June 15, 2022 9:26 am
To: susanb
Subject: Re: Costs

Until the question of capacity is settled this will continue to go around in circles.  I do not believe a proper capacity assessment has been carried out and that this is simply a ploy to keep control on the ward.  If they can maintain this the issue of consent is basically sidelined.

It is absolutely essential that this is determined one way or the other.  If best interests assessor has made a professional decision here all they have to do is provide you with a copy of that assessment.  Since doing that would settle the matter and they haven’t done so I can only assume that this process has not been carried out under the provisions of the MCA2005.  

As for threats of costs that is an ‘occupational hazard’ in litigation and is an obvious weapon to be waved about if you threaten to take them to court.  



It is very risky for Elizabeth to miss meals.  It will make her susceptible to infection and can be a strain on her heart and liver when she restarts eating.

Monocytes responsible for fighting off infectious pathogens retreat back into bone marrow if the person misses too many meals.  This is measurable even after one day.  Just like the lack of oxygen she suffers during sleep these effects will combine to make her ill, possibly seriously ill.  Monocytes protect against cancer and heart disease by stopping pathogens getting access to the heart.  

They should know that.  It will also affect the metabolism of the drugs as fasting shuts down P450 cytochromes.  Letting her go without food is neglect.

See attached paper:  

Skipping meals can trigger a negative effect on immune cells:

Fasting may be detrimental to fighting off infection, and could lead to an

increased risk of heart disease, according to a new study by the Icahn School of Medicine at Mount Sinai. The research, which focused on mouse models, is among the first to show that skipping meals triggers a response in the brain that negatively affects immune cells. The results that focus on breakfast were published in the February 23 issue of Immunity, and could lead to a better understanding of how chronic fasting may affect the body long term.

Researchers aimed to better understand how fasting -; from a relatively short fast of only a few hours to a more severe fast of 24 hours -; affects the immune system. They analyzed two groups of mice. One group ate breakfast right after waking up (breakfast is their largest meal of the day), and the other group had no breakfast. Researchers collected blood samples in both groups when mice woke up (baseline), then four hours later, and eight hours later.

When examining the blood work, researchers noticed a distinct difference in the fasting group. Specifically, the researchers saw a difference in the number of monocytes, which are white blood cells that are made in the bone marrow and travel through the body, where they play many critical roles, from fighting infections, to heart disease, to cancer.

Reviewed by Emily Henderson, B.Sc. Feb 23 2023

There is a growing awareness that fasting is healthy, and there is indeed abundant evidence for the benefits of fasting. Our study provides a word of caution as it suggests that there may also be a cost to fasting that carries a health risk. This is a mechanistic study delving into some of the fundamental biology relevant to fasting. The study shows that there is a conversation between the nervous and immune systems.”

Filip Swirski, PhD, Lead Author, Director of the Cardiovascular

Research Institute at Icahn Mount Sinai

Skipping meals can trigger a negative effect on immune cells

Saved from URL: https://www.news-medical.net/news/20230223/Skipping-meals-can-trigger-a-negative-effect-on-immune-cells.as

At baseline, all mice had the same amount of monocytes. But after four hours,monocytes in mice from the fasting group were dramatically affected.

Researchers found 90 percent of these cells disappeared from the bloodstream,and the number further declined at eight hours. Meanwhile monocytes in the non-fasting group were unaffected.

In fasting mice, researchers discovered the monocytes traveled back to the bone marrow to hibernate. Concurrently, production of new cells in the bone marrow diminished. The monocytes in the bone marrow-;which typically have a short lifespan-;significantly changed. They survived longer as a consequence of staying in the bone marrow, and aged differently than the monocytes that stayed in the blood.

The researchers continued to fast mice for up to 24 hours, and then reintroduced food. The cells hiding in the bone marrow surged back into the bloodstream within a few hours. This surge led to heightened level of inflammation. Instead of protecting against infection, these altered monocytes were more inflammatory, making the body less resistant to fighting infection.

This study is among the first to make the connection between the brain and these immune cells during fasting. Researchers found that specific regions in the brain controlled the monocyte response during fasting. This study demonstrated that fasting elicits a stress response in the brain-;that’s what makes people “hangry” (feeling hungry and angry) -;and this instantly triggers a large-scale migration of these white blood cells from the blood to the bone marrow, and then back to the bloodstream shortly after food is reintroduced.

Dr. Swirski emphasized that while there is also evidence of the metabolic

benefits of fasting, this new study is a useful advance in the full understanding of the body’s mechanisms.

“The study shows that, on the one hand, fasting reduces the number of circulating monocytes, which one might think is a good thing, as these cells are important components of inflammation. On the other hand, reintroduction of food creates a surge of monocytes flooding back to the blood, which can be problematic. Fasting, therefore regulates this pool in ways that are not always beneficial to the body’s capacity to respond to a challenge such as an infection,”

Skipping meals can trigger a negative effect on immune cells

Saved from URL: https://www.news-medical.net/news/20230223/Skipping-meals-can-trigger-a-negative-effect-on-immune-cells.as

explains Dr. Swirski. “Because these cells are so important to other diseases like heart disease or cancer, understanding how their function is controlled is critical.”

This study was funded by grants from the National Institutes of Health and the Cure Alzheimer”s Fund.

Source:

Mount Sinai Health System

Journal reference:

Janssen, H., et al. (2023) Monocytes re-enter the bone marrow during fasting and alter the host response to infection. Immunity. doi.org/10.1016/j.im

muni.2023.01.024.

Skipping meals can trigger a negative effect on immune cells

Saved from URL: https://www.news-medical.net/news/20230223/Skipping-meals-can-trigger-a-negative-effect-on-immune-cells.as

Castle Ward, Peter Hodgkinson Unit Lincoln County Hospital have not examined whether any of its ‘treatments’ have disrupted Elizabeth’s immune system.  There is close association with inflammatory cytokines such as interleukin-6 and worsening psychosis. I have asked for these tests to be done.

It is all very well saying that they are complying with the BNF dosing regimen but that is a waste of time where a patient is a poor or non-metaboliser or where inflammatory cytokines are interfering with the drug in getting to target.

It is more than possible that their defective interventions have disrupted these inflammatory markers and induced a worsening of the psychotic symptoms as a result.   They simply do not understand the interaction of the immune system with the CNS and how immune dysfunction can affect neurotransmitters such as dopamine.   They should have done immunological tests, brains scans and cytochrome tests to determine any immunological/inflammatory conditions that might affect the metabolism and therapeutic effect of any medication.  Where these issues are not taken into account psychosis can get worse with treatment, not better.

Professor Valeria Mondelli, Clinical Professor of Psychoneuroimmunology at King’s Institute of Psychiatry, Psychology and Neuroscience is the most influential neuroscientist working on immune response, inflammation and psychosis.

She has identified 20 cytokines (proteins) involved in inflammation inducing psychosis and that these can be triggered by acute trauma.  That is probably what happened to Elizabeth during serious past incidents in London and every time they mistreat her in hospital by restraint and forced medication it triggers the response again making her mental illness even worse.  She needs to be out of a DoLs restrictive/coercive environment if she has any chance at all of a recovery at all. 

It is abusive for male nurses to administer depot injections. Today she has had nothing to eat and there has been more than one occasion such as this. Yesterday I brought food in and I have tried to call the ward several times just now. Only once a week patients are allowed to have takeaways but I now want to order something because something is better that nothing and there are healthy alternatives.

It is important for Elizabeth to be tested for multi -drug resistance associated protein 1 (MRP1).   If transport proteins are not correctly expressed she could have serious adverse effects caused by inability to efflux drug substrates from brain tissue and this can lead to neurotovicity, another organic brain disorder.  This is the transport proten for Clopixol P-GTLYCOPROTEIN (p)-GP).

TESTS TO SEE IF C-REACTIVE PROTEIN (CRP) AND INTERLEUKIN – 6  (IL-6)  Are present

SEBACEOUS CYST

THIS IS WELL ASSOCIATED WITH LONG TERM USE OF NEUROLPTIC MEDICATIONS.  IT IS A POTENTIAL ENDOCRINE DISORDER LINKED TO INABILITY TO METABOLISE DRUGS  (Both endocrine tests and P450 liver enzyme tests) have proven this.  THE CYST IS NOT BENIGN.   THE CYST NEEDS REMOVING AND ELIZABETH NEEDS TO BE GIVEN ADVICE ON THIS UNDER THE INFORMED CONSENT ACT AND HER MOTHER SHOULD BE INCLUDED IN ASSISTING IE TAKING HER TO A NECESSARY APPOINTMENT.

RESTRICTIONS ON HER MOTHER VISITING AND BEING SUPERVISED 2-1 SHOULD BE LIFTED AND IN ANY CASE AS PER NHS GUIDELINES AN IMPACT ASSESSMENT HAS NEVER BEEN CARRIED OUT ON ELIZABETH OR HER MOTHER AND NO NOTIFICATION TO THE NEAREST RELATIVE

It is suspected that Elizabeth has a dysfunctional glymphatic system after years of neuroleptic medication.  If these tests have not been done then they need doing urgently.

27 March 2023

New study maps out links between psychosis and our immune system

In the largest study of its kind, research led by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London has identified some of the elements in our immune response that influence our risk for developing psychosis.

brain graphic psychosis

Published in Brain, Behaviour and Immunity, the study analysed blood samples from 325 people to assess the levels of 20 proteins which are known to be involved in our immune response.

Researchers found an association between the levels of certain proteins – cytokines – involved in inflammation and the risk of developing psychosis. Other proteins that are thought to affect the barrier between the blood and the brain were linked to whether those at risk later developed psychosis.

The research was part of the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) Project and supported by the NIHR Maudsley Biomedical Research Centre.

This is the largest study of its kind to explore in depth how the patterns of the different proteins involved in our immune response might be connected to the risk of developing psychosis. Our analysis has highlighted some interesting relationships between individual proteins that are released by our immune system and the likelihood of whether someone at risk of psychosis will go on to develop the condition.Professor Valeria Mondelli, Clinical Professor of Psychoneuroimmunology at King’s IoPPN and lead author on the study

Detecting risk of psychosis early

Psychosis is when people lose contact with external reality, often causing considerable distress for the person and their family or carers. People with psychosis can, and do, recover and the likelihood of this happening increases the sooner treatment is started.

To enable early treatment, researchers and clinicians have developed methods to identify those who are more likely to develop psychosis and studies show that 1.7 per cent of the general population are at risk. However, around one fifth of those people at risk will develop psychosis which presents a key challenge in predicting whether someone will or will not go on to experience the symptoms of psychosis.

The identification of specific biological markers or signs in the blood that are linked to psychosis could help overcome this challenge. There has been increasing evidence that the immune system plays a role in psychotic disorders and the study aimed to assess whether levels of certain proteins and chemicals that are part of the immune response are different in those who at high clinical risk compared to the general population. Researchers also explored whether those who went on to develop psychosis had a distinct profile in their immune markers compared to those who remained at risk but did not experience symptoms.

Linking immune response to psychosis

Researchers assessed levels of 20 proteins involved in our immune response in the blood of 325 participants from nine different countries. At the beginning of the study 270 of these were assessed to be at high risk for developing psychosis and 56 were not. Participants were assessed over the next two years and during this time 50 of those people who were at risk went on to develop psychosis.

Analysis of blood samples showed that those at risk of psychosis had higher levels of two proteins or cytokines involved in inflammation compared to those not at risk. These cytokines are called interleukin (IL)-6 and IL-4. Within the at-risk group subsequent onset of psychosis was associated with higher levels of vascular endothelial growth factor (VEGF) and an increased ratio of IL-10 cytokine to IL-6 cytokine. VEGF is involved in regulating the porosity of the membrane between the blood system and our brain and this is the first time it has been identified as a possible indicator of whether people will move from risk of psychosis to development of the disorder.

AI prediction techniques

In order to explore the potential for using immune-related markers as a way to predict the onset of psychosis, researchers tested a machine learning approach on the data collected on all 20 immune system markers. The approach did not provide an accurate prediction of whether people at risk of psychosis would go on to develop the disorder but represents an innovative step forward in new techniques to inform our understanding of psychosis.

Professor Mondelli, theme lead for Mood Disorders and Psychosis at the NIHR Maudsley Biomedical Research Centre commented: “Although it would have been fantastic to have identified a way to predict whether people will develop psychosis based on markers in their immune response, it is not surprising that AI techniques are unable to do this using this data alone. The path to psychosis involves many other factors in both an individual’s psychology and biology as well as from society and it is likely that data from these aspects of people’s lives would also have to be incorporated into any machine learning approach to enable a prediction of whether they will develop the condition.”

The study ‘Serum immune markers and transition to psychosis in individuals at clinical high risk’ by Mondelli, V. et al. was published in Brain, Behaviour and Immunity.

For more information please contact Franca Davenport (Communications and Engagement Manager (part-time), NIHR Maudsley Biomedical Research Centre).

In this story

Professor Valeria Mondelli

Clinical Professor of Psychoneuroimmunology

I am going to send you my entire email just written to the Rt Hon Victoria Atkins (Health Secretary) MP about Lincolnshire Partnership Trust and Council – her own area. The Rt Hon Victoria Atkins has tried to help us by sending emails to and from the Trust to the likes of Sarah Connery CEO but unfortunately the only positive thing I have had so far is a meeting with the Director of Nursing of LPFT – newly appointed Sharon Harvey and Director of Nursing Martin Fahy ICB. Here is what has been promised:

A FRESH CAPACITY ASSESSMENT TOTALLY INDEPENDENT OF THE TRUST – AS WITNESSED – BY SHARON HARVEY

A CTR (COMMUNITY TREATMENT REVIEW) with independent Chair by Martin Fahy Director of Nursing ICB

I saw the above-named Directors of Nursing on the 2nd October in a private meeting witnessed by a friend. At the same time, Elizabeth was being rushed to A&E suffering from an ‘episode’ lasting hours and hours on end from 2.00 pm to 7.30 pm as an emergency case. That is a long time to be in such a state with massively high BP levels and low oxygen levels – a very dangerous condition that prompted LPFT to refer her to A&E. Her body felt cold and clammy. I was allowed onto the ward despite Covid by the team as I had hoped to visit Elizabeth before this important meeting. I witnessed everything that I had seen months ago, well known to Ash Villa where she had countless episodes prior to Castle Ward and Ash Villa is where she had the accident that appears to have been covered up. Noone informed the family like they should have done under Sch 20 HSCA Reg 14. I have only just found out about this accident as Elizabeth has told me. Elizabeth not only shares information with me but other family members so it is pointless banning me from contact isn’t it but this is what Castle Ward tried to do altogether but now impose highly restricted supervised visits in breach of human rights.

Anyway, here is that email which exposes the area where Health Secretary Victoria Atkins is responsible for her constituents, me being one of them. To be fair, she has only just been appointed as Health Secretary but naturally I as a mother am not going to stay silent about the abuse my daughter is suffering and her family. The fact is she is said to have ‘no capacity’ yet was capable of making numerous phone calls today so she told me to solicitors on human rights, solicitors who previously represented her in her failed tribunal where she was too unwell to attend and also to capacity assessors to endeavour to appoint privately in order to overturn several flawed capacity assessments by Dr Adaeze Bradshaw, Dr Tahir Suleman and AMHP Kirsty Findlay, evidence supported by a best interest qualified and legal representative (Cilex qualified), KB. Elizabeth has herself contacted a firm of capacity assessors but Ms Sharon Harvey of LPFT offered to arrange for a completely independent assessment and therefore she needs to take Elizbeth’s instructions or else and ensure that the assessors of Elizabeth’s choice are allowed on the ward especially in light of visiting restrictions against me. I am very proud that Elizabeth has tried to help herself by making such phone calls, inspired by the influence of other patients who have said she must speak up for herself. Too right! I can do nothing for her right now except come and see her once a week for 2 hours of restricted contact.

I am glad to read the RC cannot pinpoint anything against Elizabeth in terms of risk to self/others from certain papers. In other words there is no risk to self or others but a hospital is far more risky than home when the flooring is hard and there has already been an accident where she hit her head following RT.

This is of public interest as it is public funds that are providing this so called care and treatment involving frequent and practically daily injections over and above what is “treatment” recommended under MHA for a condition now in grave doubt. Elizabeth and I both wish to go completely public for the sake of so many others and would welcome press attention:

Here is my email to the Rt Hon Victoria Atkins who Elizabeth advised she contacted today:

Dear Rt Hon Victoria Atkins

As you know we have suffered a catalogue of abuse since moving to Lincolnshire on 15 September 2021 when all we tried to do was provide the right environment and living accommodation and bring Elizabeth closer to her family.

We have been accused of psychological abuse and taking away of power of Attorney but this went in our favour.

I was stripped of my title of NR in County Court for not being suitable. 

I wish to congratulate you on your appointment as Health Secretary and want you to know how bad things are in your own area for vulnerable people with disabilities such as LD, autism and those yet to be properly diagnosed who are being denied pathological tests stuck under MH acute wards, who have something entirely different wrong with them such as my daughter as proven by scans below. I sincerely hope you can help us stop Elizabeth being sent far away.  I am taking out a full human rights case right now as my daughter’s human rights are being abused.   Elizabeth had all her neurology appointments cancelled as being ‘unnecessary’ the moment we arrived in this area. She was refused the research of Dr Shahpasandy into the Limbic system and scans going back to 2015 “normal” were being relied upon by various doctors.   Elizabeth has been treated just like a restricted prisoner practically all along and I am currently subject to 2-1 visiting restrictions – total breach of human rights.   I have also been denied visits.   Today I have had countless calls from my daughter keen to see me tomorrow.   She has told me on her own accord thanks to advice from another patient about speaking up she has phoned human rights solicitors, she has contacted your office and more than one firm of solicitors and even tried to get a fresh capacity assessment done herself.   I am not allowed to see my daughter apart from 2-1 visiting rights and besides Elizabeth will not do as I say so how on earth can I be portrayed as a bad influence?  

She is on a never-ending section and wishes to come home but various other doctors under LPFT  namely Dr Adaeze Bradshaw, Dr Tahir Suleman, AMHP Kirsty Findlay all did reports pointing to “no capacity” that are completely flawed that are being relied upon in order that a team of so many can decide what THEY think is best interest.

So Elizabeth has had the following doctors:

Dr Ismail – Charlesworth Ward who was talking about Lynsey needing nursing care in the first instance.
Dr Shahpasandy – refused his own research into the Limbic System – treated Lynsey as a restricted prisoner
Dr Ismail again
Dr Kumar
Dr Islam
Dr Suleyman – carried out flawed capacity assessment and left shortly afterwards
Dr Greenall – gave a bit of leave then stopped leave following an ‘episode’
Dr Memon  Cygnet – a doctor who I truly respected because of his brilliant communication skills and caring attitude when Elizabeth had another episode on his ward at Cygnet and was taken to A&E.
Dr Mohammed – Ward 12 – again another episode where she was rapidly tranquilised
Dr Khokhar – Castle Ward who has had to allow fresh scan and neurologist referral but who has imposed enormous restrictions Elizabeth calls “punishment”.

5 Institutions since moving to LPFT:
Charlesworth Ward PHU – a dormitory ward which could not be worse re sensory issues
Ash Villa Sleaford – held a virtual prisoner for months on end under Dr Shahpasandy and where the “fits” began and accident occurred
Cygnet Durham
Ward 12 – another dormitory ward
Castle Ward – the only ward where they have better facilities however it is incredibly noisy with alarms going off all the time.

Proposed care home Ashton House – looks like in West Sussex hundreds of miles away from home and family but it has been mentioned about East Yorkshire with regard to her moving to. So the question is why not Lincolnshire or if the plan is to keep her away from me why not Norfolk where other family members live?

All this is going on behind our backs right now yet Elizabeth who is said not to have any capacity has given me all this information, shared the most recent correspondence and also shared her Neurologist appointment letter with me and her appointment is on 3 January 2024.  I reckon they are trying to send her away before the Neurologist appointment far away from home and family because of what this could reveal especially now there are two sets of scans and “normal” means nothing because these words do not incorporate what has been identified by certain other experts who have the scans. All these years l suspect there has been historic injury in fact this is not a figment of my imagination because it actually says so on one of the images. Elizabeth does not want to go away to a care home so far away from home and family. She apparently said to the assessor yesterday from Ashton House “go away please”.

I have just spoken to Elizabeth who says she has tried to ring yourself just now and she has also tried to ring several solicitors.

The only treatment she is getting is constant injections right now, a Parkinsons drug is forcibly given yet not really part of her treatment as well as RT on nearly a daily basis – she said the injections hurt her and have been given by male nurses. This is absolute abuse- no psychological input whatsoever. It is apalling since Elizabeth is an abuse victim herself.  Having said that she has engaged with the OTs who she likes.  It is therefore very disturbing that Dr Khokhar has mistakenly said that Elizabeth is not engaging with activities when she is, as she has told the family she likes cooking and art. On a Saturday this is the only day Elizabeth can order a takeaway but some of the time she misses meals because she claims to feel constantly cold and stays in bed trying to keep warm and away from the never ending noise which is disturbing to her.

Elizabeth apparently had a bad accident whilst at Ash Villa which we have only just found out about. Her account of this was she was coming out of the bathroom in the seclusion room when she felt dizzy and fell hitting her head on the floor. No doubt she had been rapidly tranquilised, a frequent occurrence under Ash Villa that other patients felt necessary to report and they said they were doing the safeguarding. Even before moving to Lincolnshire her discharge note clearly stated “abnormal findings on a scan”  yet a wall of silence when I have tried to find out what this implied. Various doctors including Dr Greenall, Dr Afolabi and the vast majority except for Dr Memons have said a fresh scan and Neurologist appointment was not necessary but only now after so many episodes it has been deemed necessary. Totally negligent of any professional to be dismissive of underlying conditions or try to ignore possibilities of such especially when it clearly states on the discharge note “abnormal findings”.   Back in Enfield she was transferred from Chase Farm Hospital to Edgware because she was constantly hit around the head by another patient so a member of staff told me. I doubt she was sent for an MRI scan as a result.   There would appear to be injury on the private scans I paid for which are with another team of professionals right now who happen to be researching inflammation of the brain, lesions and also Alzheimers.  The scans have also been forwarded to various neurological experts.   Elizabeth has advised that a further set of scans were done on 10 November whilst under Castle Ward, again said to be normal but cannot possibly be normal when they would show exactly the same as the private scans also done recent that reveal a possible cavernoma, lesions and inflammation of the brain. Anyway, since there are so many episodes upon moving to Lincolnshire something is clearly wrong and all this time up until now nothing has been done about it.  Elizabeth has an appointment to see Dr C Solinas Consultant Neurologist on 3 January 2024 and it is very disturbing that right now they are trying to move her far away from home and family which should not be before this very important appointment.   There are wider implications here of my daughter being deprived of pathological tests, she has countless ‘episodes’ where her life is put at risk lasting for hours and hours and ending up in A&E so the pathological tests are of great importance.

I am also concerned that reading certain papers attached it states “low blood oxygen levels” and this can be fatal and the cause of it could be the overdrugging and frequent rapid tranquilisations without proper monitoring throughout the night.  During one ‘episode’ never experienced before we moved here BP soared enormously high. This combined with low blood oxygen levels can be fatal.  The episode on 2nd October lasted for hours and hours from 2.00 pm until 7.30 pm.   THERE IS SOMETHING ELSE WRONG WITH MY DAUGHTER AND THIS IS MENTIONED WAY BACK IN THE FILES and none of the psychiatrists involved know what it is as this is what is recorded. Therefore it is an MDT decision for the current referral to Dr Solinas. I should not be desperately trying to fight for proper tests all this length of time and neither should my daughter on her own accord be trying to ring numbers to get representation as she does not wish to be sent far away from home and family. 

You are Health Secretary and I am just a mother but I can assure you that I will do everything I can to publicise and bring to the attention of everyone worldwide the abuse going on – abuse of power and process by public authorities such as Lincolnshire Partnership Trust and Lincolnshire County Council – not forgetting Enfield – former area BEHMHT and Enfield Council and their legal dept.  Unfortunately, I am in touch with so many other heart breaking cases nationwide. I hope that you can do something about this. Martha’s Rule brings a great deal of hope.

Elizabeth today said something remarkable “God is stronger than them”.  It should not be a case of them and us should it, as all we wanted to do was work together with the professionals.   All over this country thousands of disabled vulnerable people are being held for years and years on end in acute ward setting and taken far away from their families and placed into care home settings where many lose their lives and are abused.  I can most certainly provide you with many other cases I am in touch with.  Imagine being a 90 year old lady fighting for her disabled son in desperation and feeling suicidal.  I am disgusted with this Country that this can go on but to be fair to you you are newly appointed and have tried to help us.  Now you have more power and more authority to help many others similarly suffering right now nationwide.    

I am copying in another mother/carer who together with me (as we are supporting one another right now) would very much like to meet with you personally whether it be in the local area that applies to both of us or in London.  Please supply me with a date when we can visit you personally preferably in the New Year.

I am worried Elizabeth’s appointment to see a Dr C Solinas Consultant Neurologist at Lincolnshire United Hospitals Partnership Trust (separate trust from Lincolnshire Partnership Trust which is MH) will be cancelled.  This is on 3 January 2024.  Now they are talking about moving her.   I am worried that she will miss out on her appointments when there is clearly underlying causes for the constant fits she is suffering that is of a neurological nature not psychiatric yet she is lumped together with others.  I am curious at how many others likewise are affected and never getting better because they are not being pathologically assessed in terms of underlying physical health problems which may present with symptoms mistaken as being mental illness.

I am also trying to get hold of the Rapid Tranquilisation log as every time Elizabeth has an “episode” which looks like a fit this treatment and this can affect blood oxygen levels.  

Whilst I have only 2-1 supervised visits we see this as punishment. My daughter’s life is at risk as per the attached which mentions blood oxygen levels to be low.  There is a big meeting planned about moving Elizabeth into care coming up soon but I am not sure whether this is a proper CTR or whether family will be included as they were previously in Enfield. Elizabeth is not being properly supported for this ‘CTR’ and has been given a piece of paper to write on her comments. She has written, witnessed by a friend “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.  My blog below goes right back to Enfield and features all of the institutions involved.  Enfield are responsible for paying for S117 aftercare.

No way should anything be covered up that is under public expense and disgusting abuse of a vulnerable person’s rights and this needs exposing.  All courts should be open and transparent. Elizabeth wishes to waive anonymity because all along she has capacity to decide on important matters such as where she wants to live.  I am training to be a BI assessor so I also know what I am talking about here.

This is your local area so I do sincerely hope you can do something about this abuse.  I intend to go to any lengths to change such a rotten abusive system and am happy to feature the many other cases on my website who are affected until there is a law in place to prevent such abuse from happening.  Martha’s law is a good start and also Helen Whately and Will Quince are working on a paper to ensure parents and carers are allowed to visit care homes and hospitals in a dignified manner. There are many people still restricted/ banned from visiting their relatives in care homes and hospitals.

I trust you will give this your due consideration as I am far from daunted in taking on what appears to be a completely corrupt system the UK currently has in place and will go to any lengths necessary as all I want is for my daughter to be treated in an honest and fair manner.  

Kind regards

Susan Bevis  POA

MRI SCANS – CAN A NEUROLOGIST PLEASE CONFIRM PLUS CARE QUALITY COMMISSION COMPLAINT

Since moving to Lincolnshire Partnership Trust Elizabeth’s physical health has not been taken seriously by any of 10 doctors apart from Dr Memons from Cygnet Durham who has not had the usual …

revelationsuk.com

GO AWAY PLEASE I DO NOT WANT TO GO TO ASHTON HOUSE WRITTEN BY ELIZABETH “IT’S NOT SET IN STONE”
Yesterday I had a lady come to see me at Castle Ward (Peter Hodgkinson Centre) Lincoln County Hospital. She said she was assessing me for Ashton House. I got my Mum to look up Ashton House and it a…
revelationsuk.com

LETTER FROM MENTAL HEALTH ACT TEAM and LEGAL TEAM

NHS LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST &nb…

revelationsuk.com

BULLYING/ABUSE OF POWER AND PROCESS BY LINCOLNSHIRE PARTNERSHIP TRUST – AND THE ROLE OF THE RC

Mental Health Act Administration Office &…

revelationsuk.com

REGULATION 20 – The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

Regulation 20 requires the healthcare provider (in this case LPFT) to notify patients and their families of any unintended consequences caused by a regulated activity such as rapid tranquilisation.…

revelationsuk.com

Yesterday I had a lady come to see me at Castle Ward (Peter Hodgkinson Centre) Lincoln County Hospital.

She said she was assessing me for Ashton House. I got my Mum to look up Ashton House and it appears to be a care home in West Sussex. I told this lady (dont know her name but trying to find out) that I did not want to go to Ashton House and I wanted to come home. She said “it is not set in concrete”.

I feel I am being abused at Castle Ward. I am very unhappy here. It is so noisy. Another patient has told me I need to speak up for myself.

I find it difficult to speak up as they have put me on so much drugs. I find it easier to write and I have asked my Mum to put my words on her blog. My Mum is only allowed to visit with two members of staff present. I feel my human rights are being abused. Today I have tried to appoint a human rights lawyer. I have also tried to appoint another lawyer for the court of protection. My mum has explained about the capacity assessments to me and why I need a fresh one. I understand this has been promised by Sharon Harvey.

I have just phoned a human rights lawyer and was told “all sorted the solicitor will ring me back”.

I miss you lots. I am looking forward to my next visit.

I can see what is happening they have control or they think they do. 14.59 15.11.2023 I have missed you greatly today – they say it wont be long before come bk home 00:23 15.11.2023.

I have agreed for all the scans to be shared. 15:12 13.11.23.

ASHTON HOUSE WRITTEN BY SUSAN BEVIS

Crawley Nursing Homes, Dementia Nursing Home Haywards Heath, Nursing Homes in Crawley West Sussex, Brighton & Burgess Hill Nursing Home – Nursing Home Haywards Heath – Ashton House Residential and Nursing Home (ashtonhousehaywardsheath.co.uk)

This is the only Ashton House information I could find on line and it is a very long distance from home and family as if they could not find anywhere nearer since the rest of family live in Norfolk! So if they, the MDT are intent on keeping my daughter away from me as said by Dr W Khokhar RC “you are a bad influence” why not think of others in the family. Why punish us all? Talk was of East Yorkshire originally but now this place is in W Sussex and all the time Elizabeth has capacity. How dishonest is that for LPft rated Good by the CQC?

Only got to hear the shocking news this morning from Elizabeth who apparently told the lady trying to carry out an assessment to “go away”. Elizabeth has asked me to share the above which I am doing. I could only find one Ashton House which is situated hundreds of miles away and it is a Care Home in West Sussex. Elizabeth is trying to find out the name of the lady concerned who visited her yesterday who she said smiled at her but Elizabeth clearly does not want to be sent so far away from home. Rest of family are in Norfolk. The way this is being done is highly deceitful of Lincolnshire Partnership Trust who know full well she has a Neurologist appointment on the 3rd January with Dr C Solinas and they appear to be trying to move her far away from home and family against her wishes.

Elizabeth has made several phone calls herself to try and book a fresh capacity assessment because three flawed in-house assessments have been carried out by the following:

Dr Adaeze Bradshaw

Dr Tahir Suleman

Kirsty Findlay AMHP

All in-house and all severely flawed.

Under this appalling Trust rife with bullying where human rights are non existent, where no regard is given to carers or vulnerable patients, they are clearly desperate to get Elizabeth far away from home and family regardless of human rights and are restricting visits 2-1 against human rights Art 8 HRA.

Elizabeth was given a pen and notepaper to write on because she finds it difficult sometimes to talk to people especially in meetings. She has an advocate from Voiceability but not sure how often she sees this advocate and not sure she is always included in meetings. She was present at the ward round last Wednesday though and I was actually let into the Teams meeting on this occasion but have been cut out of several left waiting endlessly but they are no doubt stepping up sending Elizabeth to either hospital or care home outside of the area as in this area there is nothing nearby according to Hannah Kajue which is nonsense and besides this other area who provided nothing by way of support and care in the community themselves are not the decision makers here now.

The two Directors of Nursing are Sharon Harvey LPFT newly appointed

and

Martin Fahy Director of Nursing Lincolnshire ICB.

Following a culmination of endless complaints never properly answered and some responses of the most horrific threatening nature finally an appointment was arranged by Pals to see Sharon Harvey and Martin Fahy on the 2 October. The meeting was witnessed with a friend present.

It was offered – FRESH CAPACITY ASSESSMENT INDEPENDENTLY DONE BY SHARON HARVEY

It was offered – CTR INDEPENDENTLY CHAIRED previously refused BY MARTIN FAHY

So far Elizabeth has not been supported at all for the CTR. She has not idea when this will take place but a meeting is planned and I feel the CQC need to be present for this meeting as I can see my daughter and noone in her family is being treated fairly at all.

All we have seen so far since moving to Lincolnshire is abuse of power and process by council and NHS Trust.

It is, and has been for some time clear that ‘capacity’ is being used as a firewall to prevent Elizabeth exercising her rights and to exclude me from decision making processes.

This is a textbook ‘Catch 22’ position and is entirely disingenuous. Elizabeth does not lack capacity to decide who is acting in her best interests.  Her attenuated capacity does not go that far at all.

The LPFT and LCC have abused the MCA2005 simply to get their own way.  They are so obsessed with keeping you out of the picture that they are quite prepared to put Elizabeth’s welfare in jeopardy.

Capacity need to be continually assessed as it is time and situation specific.  I dare bet there is no record of any ongoing capacity assessment and they are abusing the process simply to get their own way.

This is a major violation of Elizabeth’s and your human rights and not simply a minor violation of the MCA2005 (it is of course that as well)     

I agree fully that this needs publicity, especially with regard to the HRA issues.  You will of course need Elizabeth’s consent for that. which I do most certainly have. No-one without a bit of capacity could pick up the phone and call a solicitor for help and then try to get human rights lawyers involved.

How many times does my daughter have to say “I WANT TO GO HOME” “I MISS MY CAT” LINCOLNSHIRE PARTNERSHIP TRUST AND COUNCIL YOU ARE A DISGRACE AND WE HAVE HAD NOTHING BUT BULLYING SINCE WE ARRIVED. You should not be entitled to a Good Rating by CQC until you take on board human rights of vulnerable people and you should all undergo the Oliver McGowan Training SHAME ON YOU LINCOLNSHIRE PARTNERSHIP TRUST AND COUNCIL WHO BACKED YOU, ESPECIALLY THE AMHP DEPARTMENT.

Last of all I want all CCTV footage and written evidence of my alleged threatening behaviour when it is you yourselves responsible for that in my opinion and I want all allegations taken out against me unless you can provide me with proof which I want to share with all my readers.

It is disgraceful how doctors torment a patient refusing to listen and labelling her with a stigmatic label refusing to carry out the necessary pathological investigations, depriving her of the support she needs and family contact. It is utterly inhumane to fail to emphasise with a patient and total abrogation of medical ethics. To insist on isolating her from anyone who can offer her real support is an appalling and egregious abuse of their power. By transferring her far away from home and family they clearly do not want her to develop long term friendships because of their insistence on providing her with personal support.

They are not even honest enough to give the full reasons to your face except that “you are a bad influence“. The two doctors who are very much involved are Dr Toby Greenall and Dr Khokhar RC who appears to be registered with Leicestership Partnership Trust but has two email addresses.

The other doctors involved have carried out flawed capacity assessments and the legal department backing them all the way yet the person concerned a Kyla Bailey Cilex Qualified is a Best Interest Assessor herself and would have known full well that capacity assessments were not fit for purpose and completely and utterly flawed.

Since moving to Lincolnshire Partnership Trust Elizabeth’s physical health has not been taken seriously by any of 10 doctors apart from Dr Memons from Cygnet Durham who has not had the usual arrogant dismissive response towards me as a mother.

I am not alone in desperately trying to get to the bottom of the truth when it is difficult to have faith in the medical profession who have gone to lengths to cover up underlying causes and Elizabeth is suffering life threatening “episodes” where her BP is sky high and her blood oxygen levels very low.

When you have scans done privately it is very disturbing when professionals such as Radiologists and psychiatrists pass these off as being “normal”. I now want everyone to know that just because they say “normal” does not mean normal at all. I am bitterly disappointed and feel let down that some doctors do not look into things properly. There have been ten doctors and five institutions under Lincolnshire Partnership Trust in a period of two years.

It is only now after countless “episodes” lasting hours on end have they referred Elizabeth to a Consultant Neurologist, a specialist in his field and thank God this is with another Trust though under Lincolnshire.

When scans from Barnet Enfield and Haringey MH Trust come back as “abnormal findings on a scan” as a mother and carer I have gone out of my way to ask what that has meant. It does say in the files that going way back to around 2008 “Anterior Region Medial Temporal Compromise“. I contacted Headway about this. The former MH nurse of Headway said “well done Ms Bevis“. This is not a mental illness.

The reason I am posting this for all my readers to hear is because I am concerned that there may be other people under the MH all over the County who are being denied proper pathological tests when they may have underlying physical health problems or injury that is being completely ignored and I do not think this is right at all. With Martha’s Rule coming up this gives hope to people like myself but it is a completely nightmare getting a second opinion on a medical condition when you are misfortunate to have a relative under the MH stuck on a never-ending section but why should such people be deprived of the correct diagnosis and treatment? It surely is imperative they get the right treatment for the underlying correct physical health diagnosis as all schizophrenia is, is a catch all label and physical health conditions or injuries are not pathologically investigated leading to incorrect diagnosis and treatment for many years on end.

I have had to pay privately for the scans when given a small amount of leave whilst under Ash Villa but they have revealed a great deal.

I am prepared also to pay for a private neurologist report and by posting this publicly I am hoping that someone can help me urgently in case Elizabeth gets moved on the spur of the moment as has been done before.

Whilst finally after all this length of time Lincolnshire Partnership Trust have referred Elizabeth to a Consultant Neurologist her appointment is not until 3rd January 2024. Now all of a sudden Lincolnshire Partnership Trust are talking of moving Elizabeth far away from her family to East Yorkshire. She does not want to go however I am worried that the Neurologist appointment with Lincolnshire United Hospitals Trust will be cancelled and then once trapped in another prison like setting (talk is of yet another hospital) or even a care home so when will there be the opportunity for Elizabeth to see the Consultant Neurologist. I have every faith in the Consultant Neurologist who is called Dr C Solinas but because everything has been covered up by two Trusts which include BEHMHT it is very hard to have faith in the majority of all the doctors involved under the MH who have flatly refused a scan as being unnecessary and here below is a prime example of a doctor who has done research into the Limbic system that everyone should be aware of.

Do you agree that ‘upregulation’ and ‘downregulation’ of dopamine might affect presentation of psychotic symptoms?”  

If there are abnormal readings on a scan they have an absolute duty of care to investigate them and a psychiatrist is not qualified to do that.  If there is a lesion it needs treating as such.  Psycopharmaceutical interventions are not suitable to do that.

If that abnormal reading is in the pre-frontal cortex it could account for some of her behaviour and non-responsiveness to drugs.  I am working on a paper at this very moment on psychophysiological causes of anxiety and depression.  

She needs that scan and a proper investigation of anything found, not just references to ‘abnormalities’

IMG-0003-00001jpeg. (their reference Im: 7/24) shows the curious straight line going from the right temple radiating backwards at about 60 degrees to the lateral line of the skull. On the opposite side you will see a dark area corresponding to just behind the left ear.  

On IMG-0004-00001jpeg. (their reference Im: 11/24) there is another curious dark line behind the right eye.  You need to ask what they think these images are showing. Are they potential lesions? 

On IMG-0005-00001jpeg. (their reference Im: 26/96) the scan refers to >55 years old trauma.  What are they referring to here?

These images should be visible on your computer software without the Dicom download since jpeg. is a standard picture file format”

From: MHA Enquiries <MHAEnquiries@cqc.org.uk>
Sent: 16 November 2023 11:25

To: susanb255@outlook.com <susanb255@outlook.com>
Subject: CQC MHA Complaint Ref: ENQ1-17716124293

Dear Ms Bevis

We are writing to you from the Mental Health Act complaints team at the Care Quality Commission (CQC).

We have now received a copy of the letter summarising the outcome of the investigation into your complaints. We believe that a copy of this letter dated 14 November 2023 and signed by Dr Toby Greenall the Consultant Psychiatrist at Peter Hodgkinson Centre has already been sent to you, but please let us know if this is not so.

The Mental Health Act grants the CQC a discretionary power to investigate complaints where they are about the use of the powers and duties in the Act. If you are not satisfied with the response provided to you by the service, you could request that the CQC consider reviewing your unresolved concerns.

We do sometimes receive complaints about matters that we are not able to investigate because they are not within these powers. The CQC complaints process cannot make any recommendation about matters that can only be decided by a court of law. For example, we cannot rule on whether a detention is lawful, nor would we be able to provide any clinical opinion re diagnosis.

Before we could decide if there is a role for us, we would need a clear statement from you outlining what you are unhappy with in the provider response, any outstanding issues and your desired outcome.

Alternatively, you can contact the Parliamentary and Health Service Ombudsman Office (PHSO) within the next twelve months, saying why you are not satisfied. Their address is: –

The Parliamentary and Health Service Ombudsman for England

Citygate

Mosley Street

Manchester

M2 3HQ

www.ombudsman.org.uk/making-complaint

Telephone: 0345 015 4033

The PHSO can consider whether to investigate complaints that the NHS (and NHS funded care) in England have failed to act properly or fairly or provided a poor service. If the Ombudsman feels that it is more appropriate for the CQC to consider the outstanding concerns, they may refer you to our organisation.

The PHSO is the final arbiter in any complaint matter and therefore the CQC cannot consider any request for investigation once the Ombudsman has either completed or declined an investigation into your complaints.

Could I please request that you use the above reference number on any correspondence in relation to this case. If we do not hear from you within 15 working days of the date of this letter, we will assume that you have received satisfactory answers to the issues you have raised through Local Resolution and your enquiry will be closed.

Yours sincerely

Mark

Mental Health Act Complaints Team

LPFT have also treated my daughter like a restricted prisoner under Dols and tried to sever contact by taking the phone away whilst at Ash Villa and right now on Castle Ward Elizabeth is subject to restricted visiting, no leave after 2 years – treated like a prisoner with no rights as though on dols to this day. Even in former shocking area of Enfield she was not treated like a restricted prisoner.

The doctors responsible for that non-compliant capacity examination also need asking why they did not consider the criteria form the MCA 2005.  Elizabeth is perfectly capable of making a decision as to who represents her in any litigation.  They have not come anywhere near the required standard of proof that she lacks capacity to the extent that she is incapable of determining who she wants as next friend.

I was told by dr Shahpasandy he is getting rid of me as nearest relative and that the POA investigation is an entirely separate matter.   The bullying started the minute we moved. The first “best interest assessor” was Margaret Biddles followed by Andrew Morrans AMHP under the shocking department run by Heidi Merrikin – Manager.

As NR and with Elizabeth’s written consent you are entitled view the capacity report which must give full reasons for the decision on capacity. I am sure I have requested these before but in case my correspondence has been lost I will certainly re-request these and I will post right here what response I get.

The doctors responsible for that non-compliant capacity examination also need asking why they did not consider the criteria form the MCA 2005.  Elizabeth is perfectly capable of making a decision as to who represents her in any litigation.  They have not come anywhere near the required standard of proof that she lacks capacity to the extent that she is incapable of determining who she wants as next friend. Too right! If Elizabeth is capable of contacting a solicitor herself and contacting a firm who do capacity assessments to request a fresh one done this rubbishes all the capacity assessments currently being used as an excuse to take away her autonomy and decide upon everything this team below see as “Best Interest which is a total disgrace in my opinion.

I am now training to be a Best Interest Assessor and so therefore can comment on what is right and wrong and all of these below apart from myself have got things very wrong. I have sought expert opinions and Elizabeth has contacted a firm of capacity assessors herself only recently so the team below should welcome the capacity assessors that are completely independent and appointed by Elizabeth onto the ward and I will let you know their response. I had no influence in this as Elizabeth chose to ring them herself so how comes I am being labelled as a bad influence when Elizabeth has a mind of her own. I am looking forward to hearing this explanation but I suspect just like the CCTV footage I am also waiting for nothing will appear in terms of explanation or evidence.

CASTLE WARD

To: KHOKHAR, Waqqas (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); TANIMOWO, Adekiite (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); KHOKHAR, Waqqas (LEICESTERSHIRE PARTNERSHIP NHS TRUST); CALDERONCARHUARICRA, Katteryne (BARNET, ENFIELD AND HARINGEY MENTAL HEALTH NHS TRUST); BARFORD-COWLEY, Amelia (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) Cc: AITKENHEAD, Angela (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Barker, Robert (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Barlow, Diane (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); BELLAMY, Charlotte (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); CAMSELL, Lucy (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); FISHER, Bridgette (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Fitzpatrick, Brenda (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); FLETCHER, Sue (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); GOSTELOW, Joby (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); JAQUES, Anthony (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Keogh, Sophie (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); LAKE, James (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); MARABADA, Ngonidzashe (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); MOONS, Kashmir (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); POPOOLA, Tomilayo (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); SCOTT, Emily (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); SENDALL, Jackie (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Skelton, Alice (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); SUNDAR, Siddharth (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Tarling, Paul (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Waby, Lucieann (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); WALLACE, Sarah (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); White, Jocelyne (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Woodlock, Emma (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST);

CQC COMPLAINT IS ABOUT 2-1 VISITING RESTRICTIONS BASED UPON ME BEING A BAD INFLUENCE TO ELIZABETH WHEN ALL ALONG SHE HAS FULL CAPACITY TO DECIDE THINGS FOR HERSELF AND ALSO THE CORRUPT MANNER IN WHICH THE MCA AND MHA HAVE BEEN USURPED TO THE BEST INTEREST OF THE INSTITUTION AND PROFESSIONALS INSTEAD OF A VULNERABLE PATIENT’S WISHES.

First of all Elizabeth wishes everyone to know how she feels and what she wants:

Friday 10 November 2023 witnessed by friend:

“I want to eventually come home to live with my Mum in the annex through the CoP.

I miss my Mum greatly and want to go home to her”

Elizabeth has her own little bungalow and there is no intention on my part to stop professionals visiting.

Care Coordinator from BEHMHTNHS Hannah Kajue commented “I do not think the annex is suitable” well for a start she has not even seen it and has NO SAY because all they will be doing is paying for S117 aftercare which they previously failed to prompting us to move. They have also failed consistently to provide anything fit for purpose which again I can well and truly prove. So it is all of the above but most of all Dr Khokhar who has the final word but tries to make out it is an MDT decision which is why I do not agree with MDTs because they allow certain professionals to hide and make out it is not them.

A CTR was promised by Martin FahyDirector of Nursing ICB with independent Chair like in Enfield where the Independent Chair said “the whole thing stinks”.

Director of Nursing Sharon Harvey from LPFT promised a fresh capacity assessment independent of LPFT but Elizabeth’s wishes should be taken into consideration and Elizabeth has chosen a firm to carry out this. It is only fair that LPFT should pay for it as nothing has been done correctly by two doctors and 1 AMHP. NO CAPACITY ASSESSMENTS SHOULD EVER BE CARRIED OUT IN-HOUSE AND AS LPFT HAVE MADE A HUGE MISTAKE BY APPOINTING IN-HOUSE ASSESSORS THIS NEEDS TO BE RECTIFIED.

I would also like the CQC to be invited to this multi-agency panel and the wonderful Access Charity who have previously given wonderful support until Elizabeth’s phone was taken away and to be fair to them made matters impossible for them to stay in contact however I have contacted them again today to let them know about the CTR.

The second diagnosis on the care plan is “Autism” but Dr Khokhar keeps saying “you have got schizophrenia, you have got schizophrenia” – this is extremely wrong and I want to clear up any confusion which is why I have turned to X to obtain expert opinions on the scan and Elizabeth has already given written consent for the scans to be shared with the wonderful Cavernoma Alliance and other experts.

It is extremely wearing to have to fight for another expert opinion and very quickly now I am so alarmed by LPFT wishing to send Elizabeth away to a 6th institution far away in East Yorkshire which could occur any time now that I therefore have had no option but to see if I can get as many opinions by Neurologists or even Neuro surgeons as possible and that is not because I do not trust Dr C Solinas but because I am afraid of the team’s next move and that Elizabeth could be whisked away so quickly that she misses out on any second opinions when it has already been highlighted the very valid concerns.

The CQC should look at how LPFT have behaved in the past also at former hospital Ash Villa:

From: Blake, Zoe LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST)
Sent: 24 May 2022 10:12
To: susan bevis
Subject: RE: Managers hearing

Good morning Susan

I hope your well.

As advised on many occasions I am your single point of access, others will not reply but I will seek to gain the relevant answers and feed them back to you.

You will not be sent the link to the managers meeting today, Elizabeth has not given verbal consent to any member of staff although we have tried to gain this on many occasions.

Elizabeth has not been deemed to have Capacity to consent to your request on this occasion. Oh yes she has as I have her text messages inviting me to prove and knew exactly what time it took place. Ash Villa were well aware of this too as I phoned on the day asking for the link.

 Kind regards

Zoe Blake

Carer Champion

Ash Villa

Sleaford

NG34 8QA


Subject: Managers hearing

As NR and with Elizabeth’s written consent you are entitled view the capacity report which must give full reasons for the decision on capacity.

Zoe Blake

Carer Champion

Ash Villa

Sleaford

NG34 8QA

From: susan bevis
Sent: 24 May 2022 09:39
To: Blake, Zoe (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST)
Cc: MHA (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) <lpft.mha@nhs.net>
Subject: Managers hearing

Please can you give me a reason why Sophie Jackson and Sarah Twist of the MHA office have continually ignored me as nearest relative and today is the managers hearing which Elizabeth has invited me to.   So where is the link for this?   I have asked for a managers hearing many times only to be ignored by the MHA office.   What on earth is going on under that office as nearest relative I am surely entitled to call a managers hearing.

 I look forward to receiving the link

 Regards

Susan Bevis. 

So with the above examples you can see that I was cut out completely at the time of Dr Shahpasandy being RC.

Elizabeth’s medication was raised to enormous levels from just 300mg per fortnight to circa 400mg weekly with 10mg on top:

I can make no sense of that. A depot and pro re nata medication by tablet.

The drugs raised from 300mg per fortnight to 400mg weekly of clopixol PLUS 10mg clopixol tablet prn”

“After 24 months it should obvious that she is treatment refractive vis-a-vis Clopixol. They do not appear to have taken any notice of the fact that she is a poor metaboliser and that she may have inflammatory and endocrine disorders causing the drugs to be poorly or not metabolised.”

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

Interrogative Suggestibility. Gudjonnson (1984)

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

“whether the party to the 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.”

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 you as far away from the treatment regimen as possible.

“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”.

So getting back to my complaint re CQC a thorough investigation needs to be carried out to look into breaches of code of conduct and policy to achieve results stated as being “best interest” – how on earth can it be best interest to send a vulnerable person far away from home and family making out she has no capacity. THIS IS TOTAL ABUSE OF POWER AND PROCESS AND COULD WELL AFFECT OTHERS. IN FACT BEFORE THE CQC SAYS THEY CANNOT INVESTIGATE INDIVIDUAL COMPLAINTS I KNOW OF OTHERS AFFECTED.

This is undoubtedly a matter for The Rt Hon Victoria Atkins to look into as it concerns Lincolnshire but also a much wider picture that affects the entire UK because there are many other parents fighting right now that I know of.

I am also aware of others whose relatives have been sent far away and there must be some sort of deal with Yorkshire?

A while back in Enfield I asked for Elizabeth to be considered for The Retreat in York or Amitola Community that offer an entirely different approach. However I moved to benefit Elizabeth to the right environment and do not see why she should be moved at all since there is a wonderful organisation called Shared Lives whose offices are in Sleaford. I have also seen an example of a parent asking the LA in Surrey I believe to provide the land where disable people can have their own community and parents can be involved unlike at Lincolnshire Partnership Trust. I would be happy to be involved with any project of this nature and know of others seeking similar solutions. Imagine what it must be like to be 90 and fighting to be near to your relative – a son who is in a wheelchair stuck on a MH ward – this is so sad and I know of other cases in this area too who could be actively involved alongside care workers and professionals working together and not having to challenge decisions of a MDT involving about 30 strangers and deciding on which institution next all of which are the wrong environment. But in this new area there is a wealth of land and farming communities where the correct provision can be made and money saved by this.

I also think that if there was Open Dialogue there would be no complaints from parents and carers such as myself who are on the receiving end of heartbreaking messages and phone calls from their relatives who would not be fighting if they were included rather than excluded in decision making.

I hope that the Rt Hon Victoria Atkins takes this on board as I am in touch with the most shocking cases throughout the UK and would like to see something done about it

I wish to share with you some of the emails I have today been writing in sheer desperation on behalf of my vulnerable daughter and I also wish to share with you her most recent comments and wishes which are being totally ignored by these people:

CASTLE WARD

To: KHOKHAR, Waqqas (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); TANIMOWO, Adekiite (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); KHOKHAR, Waqqas (LEICESTERSHIRE PARTNERSHIP NHS TRUST); CALDERONCARHUARICRA, Katteryne (BARNET, ENFIELD AND HARINGEY MENTAL HEALTH NHS TRUST); BARFORD-COWLEY, Amelia (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) Cc: AITKENHEAD, Angela (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Barker, Robert (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Barlow, Diane (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); BELLAMY, Charlotte (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); CAMSELL, Lucy (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); FISHER, Bridgette (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Fitzpatrick, Brenda (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); FLETCHER, Sue (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); GOSTELOW, Joby (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); JAQUES, Anthony (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Keogh, Sophie (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); LAKE, James (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); MARABADA, Ngonidzashe (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); MOONS, Kashmir (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); POPOOLA, Tomilayo (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); SCOTT, Emily (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); SENDALL, Jackie (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Skelton, Alice (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); SUNDAR, Siddharth (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Tarling, Paul (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Waby, Lucieann (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); WALLACE, Sarah (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); White, Jocelyne (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Woodlock, Emma (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST);

These people above are what is known as the MDT (Multi-disciplinary Team) and personally I think there are far too many strangers amongst them to be involved in making decisions on behalf of a vulnerable person who should have been offered a CTR (Community Treatment Review) in the first place but this was denied to Elizabeth under LPFT. At least a CTR with independent Chair is a fairer option. What chance of fairness could ever be found from these people above under LPFT where there would appear to be a culture of bullying and as such who would even dare to challenge because when you do like I have you become a target of bullying and punishment dished out to you and that greatest punishment of all is to deprive you of contact with your vulnerable relative. Elizabeth used the word “punishment” today and said that she is being punished. She has made it clear to so many her wishes to come home, to see her cat and be closer to the family but instead this team of strangers have come up with East Yorks and yet another hospital. What a shambles.

On the other hand it could be because they want to take her away from this area because it has come to light there has been an accident at Ash Villa where Elizabeth hit her head on the floor in the seclusion room whilst on God knows how much drugs causing her to feel dizzy and lose her balance and to think they tried to cover it all up. What a disgrace.

Amongst the attendees above are my former shocking area of Enfield namely BEHMHTNHS equally as bad and still involved because of S117 aftercare.

During my visit to Castle Ward supervised 2-1 by HCAs and witnessed by a horrified friend Elizabeth wrote on a piece of paper her wishes:

“I want to come home to live with my Mum in the annex through the Court of Protection. I miss my Mum greatly and want to go home to her.”

How very cruel that Elizabeth’s wishes are ignored by so many but I supposed if any of them dared to challenge it is more than their job is worth. I have even heard this said previously at a shocking good for nothing care home in Northampton by an RMN rated good by CQC yet she had no food at weekends in the files and I can share proof of that with all of you too.

I am still awaiting the CCTV footage of my alleged aggressive behaviour but will be waiting a very long time as there is nothing of course. It is just bullying because I turned up at Trust HQ and dared to complain about Dr Khokhar’s decision to cut all leave which was only granted on one occasion after months of imprisonment and total abuse of human rights. That leave was only 2 hours in grounds outside and extended to local area of Lincoln where Elizabeth thoroughly enjoyed going to a shopping centre called Carlton.

Since that one time things have gone from bad to worse. The entire family know about the accident now which happened some months ago and during the time at Ash Villa a bit more leave was granted up to 6 hours which worked well as I could take her out and show her the wildlife parks and a few nice things in the local area. During this time as a surprise I booked for Elizabeth an MRI scan which is what she always wanted and she did very well and lasted most of the duration for images to be taken in the mobile unit in Sleaford, Lincs.

I sent the scans to experts working on research of various kinds and a team of colleagues looked at the scans and identified several things in need of further investigation despite the scan amazingly stating “normal”. I wrote back to the organisation conducting the scan to the Radiologist and have not had any reply when I questioned why the scans said normal. They clearly are NOT normal. I was told at the time by various doctors/clinicians that no MRI was needed and that scans done in 2015 were normal. So I want all my readers to know that you cannot go by NORMAL! One of the images was even marked as “historic trauma” – the fact is they were all denying her the appointments with a neurologist and it is only because I made such a fuss about it and shows them the scans plus the comments made by an expert that finally LPFT have provided a scan and referral to a neurologist however today I contacted the care quality commission as it was also mentioned at Ward Round that a SOAD should be appointed. I wrote to the care quality commission and told them that Elizabeth should NOT be moved to another facility far away when she has been referred to a Consultant Neurologist and no way on earth should their SOAD look at the current treatment until Elizabeth has seen the Consultant Neurologist as how can a SOAD give any opinion if the diagnosis of schizophrenia is totally completely and utterly wrong.

Here is why Martha’s Rule is so very important and needed in that certain doctors wish to stick with out of date questionable diagnoses completely overlooking physical health concerns and file content that goes way back stating “Anterior Region Medial Temporal Compromise” plus the discharge note stating “abnormal findings on a scan”. Who can you trust except your instincts as a mother/relative in providing privately what was needed all along – an MRI scan which simply cannot be argued about as this is fact not assumptions.

Only one of ten doctors so far and from Cygnet in Durham really showed an interest in physical health and most probably would not have refused to do a scan.

So here are some of the emails I have written today which show what lengths I have had to go to to try and get the right care and treatment despite being cut out of everything and simply based on fact by way of the MRI scan I had done privately:

From: susan bevis
Sent: 15 November 2023 19:15
To: CARECONCERNS (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) lpft.careconcerns@nhs.net; victoria@victoriaatkins.org.uk victoria@victoriaatkins.org.uk; Christopher Reid Chris.Reid@parliament.uk; Enquiries Enquiries@cqc.org.uk;

Subject: Ward Round and Proposed Move to East Yorkshire
 
Dear All

I was talking with Elizabeth earlier today who did not feel very well unsurprisingly.  She has been treated like a restricted prisoner for c 2 years now, not allowed leave and now with the threat of being sent to East Yorkshire to yet another institution right now.  Great damage is being done to my daughter being held on various acute wards after all this time when she would be better off at home in the right environment.

Elizabeth now suffers from fits lasting hours and a hospital is completely unsafe as the floors are hard and she has hurt her back and she has hit her head badly on the floor of the seclusion room.  The annex is far more suitable and in a peaceful environment.   We should have been notified of this accident under Regulation 20 H&SCA Regulation 14 and that goes for every time she is rapidly tranquilised and now I have the CP11 Policy document which I intend to read thoroughly as I am concerned to read about blood oxygen levels being low and that is harmful to my daughter. 

Not only has no-one stopped to consider her feelings or that of any family members but they have treated Elizabeth like a vegetable on account of three flawed capacity assessments (not fit for purpose) but what of the CoP assessments?  they were done at the same time (2 of them) by assessors who came to Ash Villa and they did not state ‘no capacity’ did they!  Now that I myself am training to be a Best Interest Assessor I can see that nothing is being done correctly under LPFT. Elizabeth clearly has capacity and this matter needs to go before the Court of Protection in accordance with Elizabeth’s wishes.     I have a note witnessed by CM during her recent visit that states “I want to come home to live with my Mum in the annexe and through the Court of Protection.  I miss my Mum greatly and want to go home to her”.  Elizabeth has also tried to arrange a capacity assessment herself which I was prepared to pay for however Ms Sharon Harvey, Director of Nursing has offered to provide an independent capacity assessment and Mr Fahy a CTR independently chaired.

I do not like the way LPFT are ignoring my daughter’s wishes.   LPFT failed taking away the POA despite attempts trying to label myself and Mr Bevis as abusive yet again.  You succeeded in the closed- door county court to get rid of me behind my back and Elizabeth in the most deceitful manner backed by the council and their legal department.   That is another matter because clearly there is a culture of bullying under LPFT but yet 1 person retains overall control and yet sending Elizabeth away, so far away from home and family it is made out to be an MDT team decision.   In the middle of all of this is my vulnerable daughter who has phoned me today stating she feels she is being abused and she is correct.

The words “you have schizophrenia” are constantly expressed to her when Elizabeth (not me) states she is autistic and YES YOU CAN provide an assessment on that.  Nothing has been done properly there either. 

We came here to Lincolnshire to provide a more suitable home which is now built and completely independent.  We came here with the intention of working with professionals rather than against them but now LPFT have gone too far in ignoring my daughter’s wishes and I do not intend to stay silent about this or do nothing.

If LPFT are intent on severing contact between myself and my daughter then where is the consideration to the rest of the family.  If noone thinks I am suitable to be near my daughter what about the rest of the family who reside in Norfolk?   Why send her to East Yorks when she could either be nearer home so she can see her cat who she misses or else be moved to Norfolk?   You can be sure of this I intend to challenge this in the Highest Court which will reveal a lot about this area and how human rights, MCA and MHA law have been abused/ignored and the shocking way they treat vulnerable people and their families, breach of law re MCA and MHA also and breach of LPFT Policy.  

If Elizabeth was allowed to come home and said she did not like the annex and wanted to go elsewhere then that would be her decision.  There also should be a choice of three placements but because of the flawed capacity assessments this is being prevented as she has been stripped of her autonomy in the most dishonest and disturbing manner that warrants a full external investigation. 

Because of the private scans I have had cause to question the diagnosis with good clear evidence.  Scans said to be “normal”  however when questioned the radiologist remains silent with no response to my emails. 

The scans I had done are with various experts in the field of neurology right now and Elizabeth has written a letter of consent to share the opinions with the Cavernoma Alliance 

Since moving to this area LPFT have cancelled all pre-arranged neurologist appointments stating they are unnecessary which is very strange since the discharge note points to abnormal findings on a scan.     

IMG-0003-00001jpeg. (their reference Im: 7/24) shows the curious straight line going from the right temple radiating backwards at about 60 degrees to the lateral line of the skull. On the opposite side you will see a dark area corresponding to just behind the left ear.  

On IMG-0004-00001jpeg. (their reference Im: 11/24) there is another curious dark line behind the right eye.  You need to ask what they think these images are showing. Are they potential lesions? 

 On IMG-0005-00001jpeg. (their reference Im: 26/96) the scan refers to >55 years old trauma.  What are they referring to here?

Cavernomas

 Cavernomas are vascular malformations that have been associated with psychosis as well, especially in the setting of hemorrhagic transformation.

 That dark patch on Elizabeth’s temporal lobe looks suspiciously like one.

 
The article is about a young man presenting with psychosis and aggression.  He was found to have two cavernomas and you can see them on the scans in the article.

 It is possible that the reason why cavernomas are relatively rare is that the misdiagnosis of schizophrenia is masking the actual incidence in the population.  Since psychiatrists are so reluctant to allow patients to have brain scans many of these may be going undetected.

Clearly you need to get Elizabeth properly examined by a neurologist to determine if that indication on her brain is indeed a cavernoma or any other type of lesion. 

Neuroleptic medication will not treat these lesions and could potentially make them worse since it can cause inflammation.  

I took note that you mentioned that Elizabeth has a large sebaceous cyst on her head.  This is well associated with the long-term use of neuroleptic medications.

That also needs a medical appraisal done.  This is not simply a cosmetic ADR but indicates a potential endocrine disorder linked to her inability to metabolise drugs.

Incidentally this has also been known about for years.  Sebaceous cysts are NOT benign.  For one thing they may mask subdural lesions and inflammation making them difficult to define. I am told that nothing will be done about the sebaceous cyst and am really unhappy about the slapdash way they go about things refusing to look into pathological causes.

 It is rather odd that the scans are referred to as ‘normal’.  Decreases in grey matter are associated with neuroleptic use and certain areas of the brain are more affected than others. Most of the literature refers to severity of psychotic symptoms and dosage of neuroleptics to be directly associated with brain grey matter loss.  Since those with the most pronounced psychotic symptoms are given the highest doses of drugs and often dangerous concomitant medication it is not surprising that both contribute to brain atrophy.

The psychiatrists have classed Elizabeth as being towards the most severe degree of psychosis and have heavily and concomitantly prescribed neuroleptics to address this.  There is in fact little evidence that correlates dose with severity of psychotic symptoms.  Many patients with severe psychosis have responded to low doses of neuroleptics and the difference in response is more likely to be associated with the patients ability to metabolise than the dose volume.  It is here of course to be noted that the medics have been ignoring that for many years and have only just (reluctantly) accepted it. Very strange indeed as in Australia no sign of psychosis mentioned.

Elizabeth has of course now been subjected to many years of medication and structural changes in the brain resulting from it are likely to be irreversible along with the other long term ADRs associated with neuroleptic medication.  Her reduced capacity, which they put down to a low baseline IQ is far more likely caused by the long term structural changes to her brain, in particular grey matter atrophy.  Baseline IQ is in any case an anachronistic measure of a patients capacity and is highly inaccurate and riddled with confounding variables.  

 I have attached a set of scans that show where brain atrophy occurs as a result of neuroleptic medication (green spots) 

 There is also the mater of inflammatory complications. The inflammation can come and go and is likely to be pronounced in psychotic episodes.  They have not over the years seemed to consider this at all in spite of the large amount of studies published in the medical literature.  It is firmly established that inflammation can cause psychosis and that it can interfere with the uptake and metabolism of the drugs.  Personally I am astonished that this is in the main simply disregarded, just like to P450s were for decades.  So am I astonished.

I was fascinated with Dr Shahpesandy’s bizarre doublethink on inflammation.  On the one hand in his publications he fully acknowledges it it but when treating patients he completely disregards the findings of his own research.  

The orthodox medical obsession with so called chemical imbalances ‘treated’ with neuroleptics completely blocks out numerous pathophysiological contributing factors and possibly even causes of psychosis.  It is virtually medieval in its approach and shares more in common with cult beliefs than with science.  
 
Ignoring pathophysiological symptoms and markers is utterly absurd in any diagnostic system let alone the potential for consequences of ignoring them when administering medication. 

Refusing Elizabeth and other patients access to properly conducted tests and analysis is a scandal on a huge scale.  But of course they find it much easier to label people with catch-all and non -specific stigmatising terms like schizophrenia.   The reason I am being bullied by this team is because I have dared to request the real diagnosis now that I have significant proof by way of scans and it has been a nightmare to find that second opinion I need urgently before Elizabeth is moved on by Dr Khokhar and team which I hope will not be prior to Xmas depriving her of being with her family as well as depriving her once again of pathological tests and seeing her Consultant Neurologist who Elizabeth has shared with me is a Doctor C Solinas who holds clinics at Lincoln County Hospital. Elizabeth has also shared the date and time of the appointment which is on 3 January. I have just written to Dr Solinas to share the private scans and now there are more said to be normal when they cannot possibly be normal – it is as though the NHS is deliberately trying to cover up things like cavernomas and lesions as well as inflammation of the brain under the label of “normal” but luckily I am not so easily taken in and look well and truly beyond this as something must be wrong if Elizabeth is having fits that last for hours and hours on end and result in dangerously high blood pressure and low blood oxygen levels that could be fatal.

I wish to congratulate Victoria Atkins on her appointment as Health Secretary and am copying her in to this email.  I hope this example can be studied in terms of improving a system not fit for purpose and devoid of human rights.  

I do not know when you are going to send my daughter away yet again to another facility where it is noisy and hope it is not before Xmas as she wants to see her family and nothing is being mentioned about that.   She is suffering the effects of headaches, pain to her eyes and dizziness which led to an accident at Ash Villa.  She suffers anxiousness because of the uncertainty of her life which has been turned upside down as ours has.  She is subject to frequent rapid tranquilisation and I would question with the CQC to check the RT log and whether procedures are carried out correctly.

I have now proven that there is something else wrong with my daughter of a physical nature that needs further investigation but what is so bad are the lengths I have had to go to in respect of even getting her a referral to a Consultant Neurologist because I am not against treatment of the right kind but can see my daughter is suffering right now on a massive dose of drugs being treated for schizophrenia when it is likely she has a cavernoma and lesions plus inflammation of the brain.  She has also been denied endocrine test and immunologist tests.   She has sensory issues and is held in a most noisy acute facility and is being injected on a frequent practically daily basis despite the fact that MRI scans point to certain images being suspect of cavernoma, lesions and past trauma.

Last of all Elizabeth should NOT be sent anywhere until she has seen the Consultant Neurologist Dr C Solinas and it is not a case of the SOAD just checking on her medicine treatment as how can they do so until she has seen Consultant Neurologist Dr Solinas on the 3rd January.  Elizabeth has shared her appointment letter so I know all about it.

I would like confirmation from someone that my daughter will not be sent far away before Xmas and prior to her Neurology appointment with Dr Solinas against her wishes.

Yours sincerely

Susan Bevis   

I wish to share with you some of my concerns and why I have been copying in the CQC and why everyone with similar concerns should obtain their Trusts CP11 Policy on RT where applicable.

“Lowered oxygen availability (hypoxia) is theoretically important in the consideration of pharmacology because 

(1) hypoxia can alter cellular function and thereby the therapeutic effectiveness of the agent, 

(2) therapeutic agents may potentiate or protect against hypoxia-induced pathology, 

(3) hypoxic conditions may potentiate or mitigate drug-induced toxicity, 

(4) hypoxia may alter drug metabolism and thereby therapeutic effectiveness, and 

(5) therapeutic agents might alter the relative coupling of blood flow and energy metabolism in an organ. 

The prototypic biochemical effect of hypoxia is related to its known role as a cofactor in a number of enzymatic reactions, e.g., oxidases and oxygenases, which are affected independently from the bioenergetic effect of low oxygen on energetic functions. 

The cytochrome P-450 family of enzymes is another example. Here, there is a direct effect of oxygen availability on the conformation of the enzyme, thereby altering the metabolism of drug substrates. 

From: Hypoxia—implications for pharmaceutical developments.  Sleep Breath. 2010 Dec; 14(4): 291–298. Published online 2010 Jul 14. doi: 10.1007/s11325-010-0368-x

Psychosis Due to a Medical Condition
This diagnosis is made when a patient’s medical history, physical examination, or laboratory test results suggest that one or more medical conditions have caused brain changes that might create psychotic symptoms*, and those psychotic symptoms (e.g., hallucinations, delusions) are in fact present since the medical condition has occurred. 

A surprisingly large number of different medical conditions are capable of creating psychosis. Neurological conditions that may cause psychosis include brain tumors, cerebrovascular disease, Huntington’s disease, multiple sclerosis, epilepsy, auditory or visual nerve injury or impairment, deafness, migraine, and infections of the central nervous system. 

Endocrine disturbances include increases or decreases in the activity of the thyroid, parathyroid, or adrenocortical system. 

A decrease in blood gases such as oxygen or carbon dioxide or imbalances in blood sugar or electrolytes are some metabolic causes of psychosis. Finally, autoimmune disorders with central nervous system involvement such as systemic lupus erythematosus have also been known to cause psychosis.

Psychosis caused by a medical condition may be a single isolated incident1 or may be recurrent, cycling with the status of the underlying medical condition2. Although treating the medical condition often results in the remission of the psychosis, this is not always the case. Psychotic symptoms may persist long after the medical conditions that have caused them are cured.

*Single doses of psychotropic medications can cause brain plasticity changes.

1 Such as those causing PTSD.

2 Caused by incorrect titration of psychotropic and neuroleptic medication

The other thing I have done is give one month’s notice under a GDPR request since I am being labelled in a defamatory manner made out to be aggressive hostile and threatening. I will let you know the result in due course but I am once again still waiting for the CCTV footage which could not be produced in the first instance so in that case I will want alterations done to the file records and for this I have written to both areas, both Enfield and LPFT Trust and Councils.

I will finish by saying it is the ultimate punishment to deny contact and impose restrictions such as 2-1 supervised visits. It is an infringement of human rights. Unless there are concerns of harm towards a vulnerable person by violence then there is no cause to impose such restrictions and any safeguarding should be done in an open and transparent manner. It would appear that such punishment is being dished out to cover up failings and try to protect certain professionals and to isolate a vulnerable person denying her with the sort of emotional support she needs. It is inhumane to emphasise with a patient – total abrogation of medical ethics. What LPFT are dong is isolating Elizabeth from anyone who can offer her real support, an appalling and egregious abuse of power. I would accuse LPFT of not wanting Elizabeth to develop long term friendships because they give her personal support. For instance she has made a new friend who is helping her on the ward right now.

It is not that I am a danger to Elizabeth they wish to move her far away as yet more punishment it is because Dr K thinks I am a bad influence when they try to play on no capacity so if Elizabeth is considered to have no capacity to the point the team have to decide everything they think in terms of their own best interest abusing their power and control stating she has no capacity yet how then can I be of any influence if she has no capacity. Utterly ridiculous.

Elizabeth’s request for another RC has been ignored and it is most disturbing at reading more file paperwork today that something needs to be done to stop this abuse right now.

When I suggested too high a dosage this is being ignored and so is the sebaceous cyst that needs to be removed.

If it comes to anyone’s attention that medical file notes/records are incorrect and full of errors like I have come across it should most definitely be challenged and today I phoned the ICO in this respect but they said certain comments could not be deleted and only a reference put against them that you do not agree. I do not think this is very good since some of the comments are defamatory but now I want to see what they have written because I can only visit Elizabeth with 2-1 supervision just like in prison though I suspect in prison people are treated better.

Anyway, I have written the email below and as you can see I have had to include two areas but I thought it would save time by doing one email as you can see below. As for the errors there are so many I do not know where to begin. It is disgraceful to put comments that you have acted in an aggressive manner, threatening, hostile, intimidating and swearing and yet where is the CCTV and recordings. I have had to chase them up again as I wish to feature this but the fact is as you can well understand there is no evidence so why write like this and because of what I have read by chance I want to see ALL the records now especially since I have found out I am not under safeguarding.

From: susan bevis

Sent: Monday, November 13, 2023 1:08 PM

To: CARECONCERNS (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) lpft.careconcerns@nhs.net  Cc: lpft.lpftrecords@nhs.net ; beh-tr.records@nhs.net; Enfield.Data.Protection.Officer@enfield.gov.uk

Dear Sir/Madam

I wish to exercise my rights under the GDPR 2018 to obtain from LPFT and BEHMHTNHS as well as Enfield and Lincolnshire County council all records of what they have been saying about me over the last few years in the form of notes, memos and any recordings and in Enfield’s case back to 2019.  I have a right to see all records and a right to correct errors in any of them. 

I am hereby making a formal Data Subject Access Request to LPFT, LCC, BEHMHTNHS and Enfield Council who I believe have records where I am the subject.  

Since I am currently on 2 on 1 supervision there will certainly be extensive records of this from discussions between medical and social services teams that will extend to former area Enfield.  

Other material will undoubtedly be making very adverse observations about me and I am entitled to set the record straight under GDPR and therefore require sight of this and necessary corrections to be  made.

There should not any legitimate reason why I cannot have such material in which I am discussed as it is my  legal right.  

In your letter attached you have suggested going to the ICO’s office which I will do.

 I have checked there is no safeguarding mentioned against me despite this being mentioned verbally during a ward round.

You have one month to provide this information from today’s date plus I have already requested alongside CM the CCTV footage from the Trust HQ and all the notes regarding the 2-1 supervision currently in place also.  

I have just phoned the ICO and confirmed this fact and they are waiting to hear from me and said to give one month for receipt of all data.

 Look forward to receiving this in due course.

Yours sincerely

Susan Bevis   

Here is another email I wrote to my designated email address as I am most concerned about all the rapid tranquilisation and high dosage of drugs.

“Lack of oxygen in the blood results in cold intolerance because it regulates vasodilation.  Hypothyroidism and disorders in the hypothalamus cause an intolerance to perceived cold, even if the room temperature is warm.

Lack of blood oxygen cause confusion, disorientation and even psychosis.  If it drops below 90% the patients life is at risk.  It is time this received more urgent attention.   “

“If a patient has low blood oxygen levels that too will interfere with metabolism and receptor uptake.  Apart from the rather obvious fact that low blood oxygen can damage the very organs employed in drug metabolisation and excretion.  

I very much doubt that these people can be trusted to carry out proper monitoring of Elizabeth’s blood oxygen levels especially through the night. “

I wish to clarify the term “treatment resistant schizophrenia”

 “There is no such thing as treatment resistant schizophrenia.  If a patient is not responding to medication it is because they cannot metabolise it properly, not because they are ‘resistant’.”

“2nd opinions would be very valuable because they will undoubtedly come from those trained in neurology.”

“The drug treatment for ‘schizophrenia’ involves dopamine and serotonin receptors (D2 & 5-HT) In order for an antagonist to work on those receptors it must be metabolised by P450s.”

I understand it is alleged Elizabeth does not join in but I would totally contradict this as she loves cooking and art group. Having said this all of this is available in the community.

Elizabeth has at last had a referral to a Consultant Neurologist but she told me she just had a further scan done through referral from Castle Ward. I thought this was strange as the team knew I had paid for a private MRI scan. It has taken two years for such a referral to be made and this is not until the New Year that she goes to the Neurology clinic and by the way I would definitely say to anyone that has an MRI scan not to trust the results of “normal” if they happen to be under the MH as normal might be quite the opposite as I have discovered if the scans are shown to the right people. This is unbelievable when even I could see things wrong and it is clearly marked “trauma” on one of the images.

Thank God for that after two years when at last former area of Enfield were taking her physical health seriously now LPFT have had to do the Neurology referral they refused a while back. Now I have joined the Cavernoma Alliance that give fantastic advice and it is good to take part in their zoom meetings.

I have heard it said Elizabeth could not be managed safely in the community and that it is not in her best interest to come home. This is totally contradictory to what I have read in important recent papers. So in that case whose best interest is it really? It strikes me that it is the best interest of Castle Ward/LPFT and as for best interest I am now training to be a best interest assessor myself and cannot think of a good word to say about their flawed capacity assessments. Elizabeth herself has telephoned a company who do capacity assessments and has requested a fresh one. Now that shows capacity doesn’t it. Back in Enfield Elizabeth was not even on a section and this is the fault of two areas as to how difficult was it to get the treatment up and running instead of neglecting the necessity to continue the highly unsatisfactory treatment of a depot but without it being titrated down slowly and gradually this meant withdrawal syndrome and most certainly not relapse of a so called mental illness especially when Elizabeth keeps having to repeat she has autism whereas I have actual proof of other underlying conditions of a physical nature.

The current drug combination of Clopixol and Procylidine needs very close supervision because it can affect blood oxygen levels and on top rapid tranquilisations are given frequently. Practically every day Elizabeth is injected and she sees this as a punishment.

Back in Enfield Elizabeth was previously on 300mg per fortnight in the community and compliant.

I have been accused of demanding a bespoke package from Enfield. Chance would be a fine thing as  absolutely nothing was ever provided under Enfield. I had moved to become her full time carer and provide a nice safe living accommodation in the form of a little bungalow.

There was never behavioural problems or what resembles a fit prior to moving, the drugs were being reduced and she was on 300mg per fortnight.  My complaints have been about the level of the drugs prescribed which are affecting her eyesight, making her very tired and unsteady on her feet  If Elizabeth wasn’t on such a massive amount of Clopixol she would not need to take the procyclidine.

I am waiting to hear when the CTR will go ahead.

It is much safer for Elizabeth to be home because at least there are carpets rather than hard floors.  I am not phased about the fits in any case having witnessed this twice. It is much safer at home in the annex.   

It is very wrong that so many flawed capacity assessments have been done but I feel this never did have anything to do with displacement but more on where Elizabeth should live and to choose because they regarded her as not having capacity and want to distance her from her family who she clearly misses greatly and has been able to express this in writing.

It is not true that 2 hours leave is granted and that was only granted once.  Elizabeth is being treated in a disgusting manner against the Code Practice, against Policy of LPFT, against John’s Campaign and most of all against both Equality Act and Human Rights Act.

As for holistic care.  You can hardly call anything holistic under LPFT who have denied physical health pathological tests which even Enfield were giving after so very long and only because it has suddenly been deemed necessary because I have scan results.

I wrote I look forward to the next ward round where hopefully I will be let into the meeting but if not I may have to come in person but should this not have been held in the main room with everyone else present on the screens?

Anyway, one session of two hours unsupervised leave was the only leave Elizabeth was given in a long while which was a huge success but perhaps next time it can be considered that staff are needed on the ward and not having to listen to every word of conversation –  it is clearly not necessary at all and an infringement of Elizabeth’s human rights.

Side effects of the drugs:

Incontinence

blurred vision – affecting her eyesight and pain to her eyes

Dizziness – which led to accident at Ash Villa

Fits that last for many hours they do not know the cause of.

Extreme tiredness

Headaches

Feeling extremely cold

The above is what Elizabeth has told us are side effects on this huge dosage currently being prescribed.

Regards

Susan Bevis

Glad it has been acknowledged in this highly inaccurate report that Elizabeth was not “hostile or agitated”.  Not surprising she would present as “detached“.   She clearly DOES NOT LACK CAPACITY otherwise she would not be writing in such a clear concise manner to everyone. She keeps asking to come home as she misses her cat and I would say that is most certainly BEST INTEREST.

I am pleased to read our local MP Victoria Atkins is now Health Secretary and I hope she can improve things in this area and ensure provision in the community.

https://www.independent.co.uk/news/health/victoria-atkins-health-secretary-sunak-reshuffle-nhs-b2446502.html 

Mental Health Act Administration Office

                                                                                                                Trust Headquarters

                                                                                                                St Georges

                                                                                                                Long Leys Road

                                                                                                                LINCOLN    LN1 1FS

                                                                                                                20 October 2023

In Confidence

Mrs Susan Bevis

Dear Mrs Bevis

We have been informed about an incident that took place in Reception at Trust Headquarters, St Georges Site on Wednesday 18th October 20233, in which you presented as hostile and aggressive, demanding immediate access to a senior manager

As an employer LPFT has a duty of care for the health,  safety and wellbeing of its staff.   We also have a legal responsibility to provide a safe and secure working environment for staff.  Staff mental health is as important as their physical health.  Any incident in which an employee is abused, threatened or assaulted in circumstances relating to their work is unacceptable and not tolerated.  This includes the serious or persistent use of verbal abuse, aggressive tone or language and swearing.

In accordance with NHS guidance, such behaviour is not acceptable and you are now formally warned that if there is a repeat of this or similar behaviour again in the future at any LPFT site the Police will be called to escort you from Trust premises.

Going forward please ensure that you only attend Castle Ward for your pre-booked appointment times once a week.  This will allow ward staff to facilitate the visits as directed by Elizabeth’s Responsible Clinician as part of the plan for her care and treatment;  please be assured that these decisions have not been made by staff in Trust Headquarters or other teams and will be reviewed regularly.  Unannounced visits to Castle Ward to see Elizabeth will not be able to be facilitated.

Yours sincerely

THE MENTAL HEALTH ACT AND LEGAL TEAM

CHAIR  KEVIN LOCKYER

CHIEF EXECUTIVE:  SARAH CONNERY 

VISIT TO ELIZABETH ON 30 OCTOBER 2023

There is no greater bullying and abuse of power than to deprive contact with your vulnerable relative. LPFT have most certainly achieved this. Threats and defamation of character are another way to bully one person and then to carry out safeguarding behind your back. This was already done under Enfield and both Trust and Council were forced to apologise. Here under LPFT this is going on against me because it only takes one complaint and then everyone gangs up yet when I asked for safeguarding this was dismissed and ignored especially when so many other patients had come up to me in the grounds to tell me about my daughter’s shocking treatment and frequent rapid tranquilisations that led to a bad accident that we the family have only just got to hear about via Elizabeth.

I had to sit outside on the floor for the entire visit whilst only a friend was allowed to visit unescorted who actually booked the visit and made it clear it was for both of us but I did not argue as they would have called security or Police once again. I could only see Elizabeth for about 5 minutes because apparently it was ordered that I needed to have 2-1 supervision. Nurse Paul Tarling told me to leave the ward and I did so immediately when ordered. The reason was there was nothing written down in their books about me coming and they were short staffed and could not provide 2-1 supervision. The staff on Castle Ward point to Trust HQ but it is very clear who is behind this decision. The unsigned letter from Trust HQ explains in the last paragraph. I am still waiting for the CCTV footage requested under GDPR Rules and nothing previously has ever been produced despite similar comments alleging threatening abusive behaviour on my part. I have written to the records department of LPFT and requested CCTV footage along with an accompanying friend.

Email dated 31.10.23 regarding visit 30.10.23 by accompanying friend the following was written:

“I arranged this meeting myself to accompany Susan Bevis to Castle Ward on the above date.  I clearly pointed out that the visit would be both of us verbally.

We arrived yesterday at 6.00 pm and were allowed onto the ward and Elizabeth was with us in the visiting room unescorted.    However, a male nurse, I understand his name is Paul Tarling appeared in the visitors room and announced that only 1 visitor had been agreed and this was myself to which I responded that I had requested Susan Bevis to visit alongside me and was advised this was noted in the visitor’s book.

Anyway Susan Bevis was told to leave the ward and sat outside where she remained seated on the floor just outside the ward whilst my visit continued unescorted.

I am concerned at the effect this may all be having on Elizabeth and her care.  It is clear there is personal vendetta from Dr Waqqas Khokhar towards Susan Bevis and I understand he has described her as being “a bad influence”.   I am also aware that previously there were incidents not substantiated by CCTV or recordings and that it is awaited proof of alleged threatening behaviour on the part of Susan Bevis during her visit to Trust HQ with CM (another friend).

Whilst the nurse (Paul Tarling) said it was not a ward decision I can see quite clearly from the letter Susan Bevis shared with me attached that it is clearly a decision made by you, Dr Khokhar.   I therefore would like to understand further why such restrictions are in place and to understand Trust Policy on banning visitors and restricting contact.

Perhaps you or Ms Munro can send me the Trust Guidelines and Policy in this respect.

I would also like to know the time of the meeting on the 3rd November I have heard all about.  Perhaps you can send me the link to this meeting so we can all take part.”  

Yours sincerely

My email to Ms Ann Munro

From: susan bevis
Sent: 31 October 2023 21:18
To: CARECONCERNS (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST)
Cc: Enquiries; Parliamentary Health Ombudsman
Subject: FAO ANN MUNRO ENQ 17716124293

Dear Ms Munro

Thank you for your letter of 30 October.

CP11 Policy has been requested under FOI on 8 October 2023.  I am also aware Elizabeth has been shown on screen the information she told me she had requested in written form.

I receive an invitation to attend Teams Meetings automatically but on two occasions have not been admitted. I have even phoned to advise of this.  This is why I came in person on the 18th October and this had been prior arranged.   Elizabeth was well aware and happy for me to attend and was looking forward to a repeat of the two hour leave granted.  This was no ward round as it was held in the visitor’s room instead.  I am also aware that Elizabeth absolutely hates these meetings where so many strangers attend, without any family members invited. She often chooses not to attend and quite often no advocate present.

I have another invitation for Teams ward round for the 1st November but am aware that there is a family meeting on the 3rd November and  have not received the invitation to that?   Am I going to be cut out of both meetings as has been the case for the most part? 

To: KHOKHAR, Waqqas (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); TANIMOWO, Adekiite (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); KHOKHAR, Waqqas (LEICESTERSHIRE PARTNERSHIP NHS TRUST); CALDERONCARHUARICRA, Katteryne (BARNET, ENFIELD AND HARINGEY MENTAL HEALTH NHS TRUST); BARFORD-COWLEY, Amelia (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) Cc: AITKENHEAD, Angela (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Barker, Robert (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Barlow, Diane (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); BELLAMY, Charlotte (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); CAMSELL, Lucy (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); FISHER, Bridgette (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Fitzpatrick, Brenda (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); FLETCHER, Sue (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); GOSTELOW, Joby (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); JAQUES, Anthony (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Keogh, Sophie (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); LAKE, James (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); MARABADA, Ngonidzashe (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); MOONS, Kashmir (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); POPOOLA, Tomilayo (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); SCOTT, Emily (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); SENDALL, Jackie (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Skelton, Alice (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); SUNDAR, Siddharth (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Tarling, Paul (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Waby, Lucieann (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); WALLACE, Sarah (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); White, Jocelyne (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Woodlock, Emma (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); KAJUE, Hannah (BARNET, ENFIELD AND HARINGEY MENTAL HEALTH NHS TRUST); Lisa Anderson; susanb255@outlook.com; THORNTON, Andrea (NHS LINCOLNSHIRE ICB – 71E); PANDURANGI, Disha (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST)

Microsoft Teams Meeting

01 November 2023 10:40 – 11:00 (was 25 October 2023)

As you can see I am automatically included in Teams Meetings so it is not an excuse to say the Team would not have been aware of my invitation.  See above – my email address is clearly on the list and would be seen as who is waiting to be let in for the meeting.

I am aware that there is another meeting on the 3rd November and have not received the link for that and neither has ****

No, your explanations have not reassured me in the slightest bit.

Whilst writing I have been reading with interest LPFT’s Policy

Just to reflect LPFT had three capacity assessments done each and every one of them flawed. They launched a campaign on bullying against me trying to take away POA for Health and Welfare then displacing me as NR and have had these 3 capacity assessments done in-house – two by doctors, one completely redacted and the other by an AMHP. They wanted them to show “no capacity” so that they could take over the life of my daughter who was not even sectioned before under the former area of Enfield. They have abused her rights and treated her like a restricted prisoner for over two years. There have been 10 doctors and 5 institutions and now they are looking for a 6th option and former area of Enfield cannot find any nearby option apparently. There has been no regard to Elizabeth’s feelings whatsoever and no regard to her family. There is a culture of bullying under LPFT as there was with Enfield and zero accountability. No consideration to human rights whatsoever and the wishes of my vulnerable daughter and she is not alone as there are countless others trapped in institutions such as this and treated as prisoners. She was not even on a section before we moved to Lincolnshire for the purpose of providing a nice home in the form of a small bungalow in our back garden. I moved to bring her closer to other family members. LPFT are not only in breach of human rights law but their only Policy and code of conduct and under the MHA too and should apply the least restrictive care but it has been the complete opposite.

“If an individual lacks the capacity to consent to admission and the admission is completed using the best interest framework then this should be recorded as per policy 6b and an urgent authorisation for a Deprivation of Liberty should be submitted to the Supervisory Body as per the MCA Policy 6b.  

Is/was 6b applicable from Ash Villa to date?  This being in addition to MHA (s3) detention. Surely LPFT would not have applied DoLs on account of the three flawed capacity assessments?  If Dols in place is this the reason that Elizabeth has been treated like a restricted prisoner all along and denied leave and family contact for the most part?  I did not think you could apply DoLs whilst held under S3 MHA or has anything changed?

LPFT POLICY

8.7 Visitors to LPFT Premises LPFT considers the safety and dignity of all visitors to its premises as extremely important. The link below provides guidance and procedures regarding the management of all visitors to Trust premises and includes process for managing visits by children: Please refer to visitors process within safeguarding policy 11

Was the reason for my “treatment” yesterday because safeguarding has been applied against me?  Or was it simply a matter of being short staffed in order to accommodate 2-1 supervision as would apply in prison. If there are no staff to supervise 2-1 then this could leave problems with future visits and result in a similar scenario when I was told to leave the ward in front of Elizabeth, having just arrived, when the visit was booked including myself yet disputed  and on account of staff shortages not permitted so it would seem.    Please explain the reasons why 2-1 supervision applied against me and surely Elizabeth would be entitled to see family members in privacy as stated within your own Policy.

In November 2006 the Department of Health launched a ‘Dignity in Care’ campaign with an aim to put dignity and respect at the heart of care services, which extended into Mental health Services in 2007; and is now applicable in all health and social care settings. This campaign, led by the National Dignity Council, identified a 10 point Dignity Challenge to organisations which remains fully applicable today as follows:

6. Respect people’s right to privacy

8. Engage with family members and carers as care partners

9.4.1 Privacy refers to freedom from intrusion and relates to all information and practice that is personal or sensitive in nature to an individual.

9.4.2 Dignity refers to how people feel, think and behave in relation to the worth or value of themselves and others. To treat someone with dignity is to treat them as being of worth, in a way that is respectful of them as a valued individual. In care situations, dignity may be promoted or diminished by the physical environment, the organisational culture, by the attitudes and behaviour of the care team and others; and by the way in which activities are carried out.

Dignity applies equally to those service users (patients) who have capacity and to those who lack capacity.

9.4.3 Maintaining a service user’s (patient’s) privacy, dignity and respect is central to the delivery of effective health and social care, working in partnership with service users (patients) and where appropriate their carers / families.

OR

Do the above points not apply when the Trust sees someone as having no capacity and invoke their own measures of Best Interest regardless of any consideration towards Lynsey or her visitors/family?

9.4.4 Since July 2016 all organisations that provide NHS care or adult social care are legally required to follow the Accessible Information Standard. Meeting the standard requires workers across the Trust to ensure people who have a disability, impairment or sensory loss are provided with information that they can easily read or understand with support, so they can communicate effectively with health and social care services.

9.4.5 The following are examples of how to maintain a service user’s (patient’s) privacy and dignity:

9.9.2 Divisional Managers, Quality Assurance Leads and Team Leaders for in-patient services Divisional Managers, Quality Assurance Leads and Team Leaders for in-patient services are responsible for:

Monitoring compliance with this policy

Ensuring timely reporting of any non-compliance of this policy through the DATIX incident reporting system.

Investigating any reported non-compliance with this policy

Implementing any actions required following audits, incidents or patient / carer / worker feedback relating to Privacy, dignity and mixed sex accommodation. This may include individual worker development where there is evidence of failure in respect of related practice.

Ensuring workers are aware of this policy, its content, where to access it; and their individual related responsibilities.

Ensuring timely reporting of any non-compliance of this policy through the DATIX incident reporting system.

Ensuring service user/s (patient/s) and their carers (where appropriate) receive an apology and an explanation of the reason for the breach.

Investigating any reported non-compliance with this policy, including taking corrective action to prevent any recurrence.

• Actively promoting the service user’s (patient’s) privacy and dignity at all times.

Staff must acknowledge that the carer is frequently the person who knows the service user best, often having regular contact over many years throughout many changes in mental health well-being, social networks and professional support.

The carer is often the person who has to offer support during out-of-hours crises, which can be stressful. By involving the carer in the development of the care plan and crisis plan where appropriate, or ensuring they have a copy of it, the carer can feel supported in assisting the service user to follow it.

An exchange of appropriate information with all relevant people, including carers

Service users, families and carers are actively involved in, and remain informed of discharge plans.

So, bearing in mind the above – just some of the points raised in  LPFT Trust Policy:

  • Trust Policy clearly states right to privacy and dignity and yesterday’s visit and that of the 18th was far from dignified and most certainly upsetting for Elizabeth.  
  • What exactly are the concerns on behalf of Dr Khokhar who is clearly the person behind the restrictions as stated in Trust HQ letter?
  • Is it not breach of privacy and dignity for Elizabeth to have 2 members of staff sitting in and listening to every word?  Is this acceptable in terms of privacy and dignity?  This does not seem to be in line with LPFT Policy.
  • Is safeguarding going on again behind my back and at what stage is this at?  
  • Is DoLs in place and LPFT gone behind our backs to court to apply this under 6b MCA?  Surely this cannot be the case when Elizabeth is already held under the MHA in which case the less restrictive practice should be made surely unless I have misread LPFT’s Policy in that respect.  Please confirm?
  • Finally within Equality Act and HRA 1998 it is clearly stated consideration as per below.
  • Elizabeth made a valid point at the only ward round I was present –  “why do members of staff push me up against a wall and inject me when I was doing nothing at the time?  
  • Public sector Equality Duty

The public sector Equality Duty came into force across Great Britain on 5 April 2011. It means that public bodies have to consider all individuals when carrying out their day-to-day work – in shaping policy, in delivering services and in relation to their own employees.

It also requires that public bodies have due regard to the need to:

  • eliminate discrimination
  • advance equality of opportunity
  • foster good relations between different people when carrying out their activities

he Act sets out your human rights in a series of ‘Articles’. Each Article deals with a different right. These are all taken from the ECHR and are commonly known as ‘the Convention Rights’:

Hope the above is given consideration.   After two years+ of incarceration and held on an ongoing indefinite section, when Elizabeth was released from Section 3 under Enfield she was living in the community peacefully, before we moved to Lincolnshire where I provided a small bungalow for her to live independently and bring her closer to rest of family.   She had no care or support in the previous community Under S117 apart from the depot which she was compliant with.  Why is she still held and treated like a restricted prisoner after all this length of time under LPFT?

Elizabeth should not be treated as though on DoLs when held under S3 MHA as this kind of treatment does not seem to be in line with your own Policy and would appear unlawful.  

As somebody who has been responsible for records and H&S for many years and who has also seen at first hand NHS staff working towards accreditations I do not see any regard for Human Rights or the Equality Act or LPFT Policy. 

I would like to know the reasons for this degrading, restrictive practise on the part of LPFT and how long will these restrictions of 2-1 supervision be in place for?

Yours sincerely

Susan Bevis

Mother and POA

TEAMS MEETING 01.11.2023

Unfortunately technical problems my end so I could only write my comments but at least my comments are recorded to all attending on the massive list above. No-one else from the family on that list and many strangers. I could see and hear what they were saying at least. Former Area of Enfield care coordinator Hannah Kajue well known to us as a family was present. They are responsible for S117 which was something I was not aware of prior to moving. Only depot injection provided- no care or support whatsoever.

My first question was about the restrictions which are of course against Elizabeth’s wishes and human rights.

Dr Waqqas Khokhar who is the Responsible Clinician of Castle Ward, PHU Lincolnshire County Hospital (LPFT) said that the restrictions would continue on me visiting my daughter – he had already mentioned about concerns regarding me being a “bad influence” on Elizabeth. However Elizabeth has full capacity as far as we are concerned and wants to come home. Because of three in house capacity assessments all flawed a whole team are deciding what they think is best interest on behalf of my daughter. Surely nothing should ever be done in-house and during a meeting before Sharon Harvey Director of Nursing and Quality LPFT it was verbally offered another completely independent capacity assessment but what about those done by the CoP at the same time? I have already heard the result of one of them that did not show Elizabeth to have no capacity. It is disgraceful that this LPFT are going along with the flawed capacity assessments to decide on their OWN intentions together with former area of Enfield involved. I believe they are also doing safeguarding once again behind my back.

The safeguarding should be solely done on LINCOLNSHIRE PARTNERSHIP TRUST RATED GOOD BY THE CQC. That is because we are all now aware of the serious accident at Ash Villa where Elizabeth banged her head badly on the floor of the seclusion room. Since then she has been suffering from what looks like fits. All her existing appointments were cancelled as unnecessary by LPFT who were happy to rely on scans going back to 2015 stating “NORMAL”.

Dr Khokhar mentioned about the EEG that everything was normal however none of this is of any consolation now Elizabeth has these frequent episodes since Ash Villa.

Dr Khokhar mentioned about another MRI scan which THEY LPFT would arrange. However I told him that a private scan had already been done and was with other experts. I also told him that these scans had been sent to the Consultant Neurologist directly based by another team under Lincolnshire. Hopefully another team concerned with physical health expertise under neurology will look into all the abnormalities seen on the MRI scan.

All I have ever wanted was for my daughter to be listened to and to have fair treatment. This has not been the case under LPFT where no laws are abided by and they are even in breach of their own code of conduct and Policy. Her physical health has been totally ignored reliant on a previous scan in 2015 and ignoring all the other scans that showed abnormality on the discharge note.

The Ombudsman too need to look into everything as a vulnerable person’s life and wellbeing is at stake here.

The CQC need to look into how many times my daughter is being frequently rapidly tranquilised and she is being forced to take Procyclidine. She is being deprived family visiting rights and leave after over two years. There has been abuse of power and process.

Elizabeth has requested another doctor because this particular doctor will not listen and you can barely get a word in edgeways. Dr Khokhar said this would not be facilitated as there was noone to act as such however now things have changed in terms of appointment which I will quote later.

Promises given by Directors of Nursing for LPFT (Sharon Harvey) and the ICB (Martin Fahey) was a CTR (Community Treatment Review) – originally denied but was promised that the CTR would be independently chaired like in Enfield where the independent chair said “the whole thing stinks”. Yes it most certainly does when a vulnerable person is not getting the correct care and denied human rights to see their family.

The other matter that was briefly discussed was the displacement of yet another NR appointed in my place but this NR has recovered now from illness and it is clearly a conflict of interest to appoint the LA who have failed in every way to do their job in safeguarding under the role of NR for so long. She was living in squalid conditions and on a faulty bed, so many health and safety issues plus under what would appear a DoLs yet nothing properly set up as I checked. Treated like a restricted prisoner, denied S17 leave and constantly injected to the point other patients complained. Appalling treatment of a vulnerable person and family.

I would like a FULL ENQUIRY by the CQC into the conduct of the MHA office under Ash Villa and to date what is going on behind my back under safeguarding once again. If they are using safeguarding to protect themselves because I have found out about the accident and injury to my daughter and so have other family members then this needs proper examination as to where concerns lie. As mother and POA I have a duty to speak up against such cover-ups when certain trusted professionals do not go by their own code of conduct and breach of Trust Policy and MHA and MCA re the 3 flawed capacity assessments.

 WWW.LPFT.NHS.UK 

THE RESPONSIBLE CLINICIAN

The functions of the RC are no longer restricted to medical practitioners.

It may be undertaken by practitioners from other professions, comprising nursing, psychology,

occupational therapy and social work, this by virtue of the fact that Directions specify.

The professions whose members may be approved and the type of skill and experience required have been set out in the Mental Health Act 1983 Approved Clinician Directions 2008 are:

a registered medical practitioner

· or a chartered psychologist

· or a first level nurse whose field of practice is mental health or learning

disabilities nursing

· or an occupational therapist

· or a registered social worker.

Approval under the Directions also requires an individual to demonstrate a comprehensive understanding of the role of the AC, the role of the RC, legal responsibilities and key functions.

The categories of competencies required include:

· role of the approved clinician

· assessment

· leadership and multi disciplinary team working

· care planning

· treatment

· equality and cultural diversity

· mental health legislation and policy

· communication

Appointment of the responsible clinician

Where a patient becomes subject to compulsion, the hospital managers have a

responsibility to ensure that the patient is allocated an appropriate RC. [see Chapter 11of the Code]

The hospital managers must ensure that the RC for each patient is clearly identified.

Other ACs who are involved in the delivery of aspects of the patient’s care should also be clearly identified

The day to day responsibility for appointing or changing the RC will normally be

delegated to staff or other officers of the hospital. Nevertheless, overall accountability will remain with the hospital managers.

The decisions on who to appoint as the RC will be based on the individual needs of the patient concerned.

It is also possible that a patient may request for an alternative RC to be appointed. Where this is appropriate or practical, such a request may be accommodated. This has been denied to Elizabeth as Dr Khokhar refuses to step down and Elizabeth has said this in front of him too.

Approved Clinicians and Responsible Clinicians Workbook

Version 1 11 They arrange and co-ordinate the assessment, taking into account all factors to determine if detention in hospital is the best option for a patient or if there is a less restrictive alternative.

Point to note

A registered medical practitioner is specifically prohibited from being approved to act as an AMHP. This means that there will be a mix of professional perspectives at the point in time when a decision is being made regarding a patient’s detention.

This does not prevent all those involved from being employed by the NHS, but the skills and training required of AMHPs are intended to ensure that they provide an

independent social perspective.

Part 2 – Compulsory Treatment

· Section 20(3) – (5) Review of detention for treatment

The duty of the RC to examine a patient who is compulsorily detained for treatment within the two months before the period of detention expires, to determine whether they continue to meet the criteria for detention. If the criteria are met and the RC considers that it is appropriate to renew the detention, the RC must make a report to the hospital managers , in order that the period of detention will be renewed.

Before making their report the RC has a duty to consult at least one other person

who has been professionally concerned with the patient’s medical treatment and

who belongs to a profession other than that of the RC and that person has

confirmed in writing that he or she agrees that the grounds are met.

Section 17(1) – (4) Leave of absence from hospital

The RC may grant leave to be absent from the hospital to a patient who is

compulsorily detained, subject to such conditions (if any) as are considered

necessary in the interests of the patient or for the protection of other persons. She is of no risk to others. 

Section 23 – Discharge of patients

The RC may make an order in writing discharging a patient absolutely from

detention, community treatment or guardianship.

Approved Clinicians and Responsible Clinicians Workbook

You will be aware that certain treatments require a second opinion (either as well as or in place of the patient’s consent) and that in some circumstances treatment can be

imposed without the patient’s consent.

In all these situations, the AC or other person in charge of the treatment now has the

functions previously held by the RMO. A typical example of this would be signing a

certificate to say that a patient is capable and willing to consent to the treatment.

An AC can visit and examine the patient for the purposes of a reference or application to the Tribunal under those provisions. It is no longer necessary for this duty to be performed by a registered medical practitioner.

In all cases the RC will be the AC with overall responsibility for the patient’s case. This is set out in section 34(1) of the 1983 Act.

ONGOING DETENTION

The RC who is assessing has a statutory duty to consult with one or more

professionals who have been involved with the patient’s medical treatment. Before

furnishing a renewal report, the RC must secure the written agreement of one such

professional.

The professional(s) consulted in this way must be members of a different professional grouping from that to which the RC belongs.

In addition, it would be good practice, wherever possible, for the RC to consult with

others who have been involved with the patient’s care. This could include members of the statutory, voluntary or independent services. However, there is no specific duty to do so.

Criteria on which Elizabeth’s continued detention would be judged are essentially the

same as those that had to be satisfied before she became subject to compulsory

measures in the first place.

These are that:

· She is suffering from a mental disorder of a nature or degree which makes it

appropriate for her to receive medical treatment in hospital, and  physical Now that is in doubt. Medical treatment might have to be of a different kind following the private MRI scans the MH department did not want her to have.

· It is necessary for her own health or safety or for the protection of other persons that she should receive such treatment and it cannot be provided unless she is detained,  and  not met The only risk is towards my daughter who has been denied MRI scan and Neurologist appointments already arranged by Enfield leaving me to pay for this myself privately.

· Appropriate medical treatment is available for her.   Not met – totally wrong what they are doing.

If Elizabeth is to continue to be detained for treatment under section 3, the RC must be

satisfied that all three of the above criteria are met.

All clinically recognised mental illnesses such as schizophrenia, bipolar disorder,

anxiety or depression would fall under this definition. So too would personality

disorders, eating disorders, and autistic spectrum disorders.  I do not see Cavernomas, epilepsy and tumours listed

The purpose of medical treatment is to “alleviate or prevent a worsening of the disorder or one or more of its symptoms” (section 145).  They are making her worse re her physical health than ever.  She has an injury.

In Elizabeth’s case, her diagnosis is in severe dispute. Pathological tests have been denied under LPFT for over 2 years now and it is only now she has been referred to a Neurologist under Lincolnshire United Partnership Trust – that deals with primary care and thank goodness for that.

treatment for her. The fact that this treatment is currently unavailable in Elizabeth’s local

psychiatric hospital does not necessarily mean that she cannot be detained there,

provided that an appropriate alternative treatment is available at this hospital. Then this is all wrong as there is no alternative treatment of a physical kind and how many more people in this position?

The second of the criteria for detention is that “it is necessary for their own health or

safety or for the protection of other persons that he or she should receive such

treatment”. Again if the diagnosis is completely different to mental illness and is of a physical nature a different kind of treatment clearly needs to be given. Why is that so unreasonable to ask for as a caring relative and why cant the NHS offer that especially when one of Elizabeth’s Doctor’s – Dr Shahpasandy did research on the Limbic System and found that a different kind of treatment worked to deal with the inflammation of the brain. Elizabeth also has a sebaceous cyst they say is benign but it is NOT BENIGN and they are just leaving it. Elizabeth should be entitled to have a family member with them if she is being taken for any surgery or appointments. When staff fail to get a patient under the MRI scanner I had no problems and therefore it is BEST INTEREST for the sake of physical health that carers are included and that is after all mentioned in LPFT Trust Policy.

If the RC is satisfied that the statutory grounds for continued detention are met, there is a statutory obligation for him/her to make a report to the hospital managers that this should happen, provided that he/she believes that this would be appropriate in all the circumstances of Elizabeth’s case. No idea who the Hospital Managers are but previously even when I was NR I was excluded from everything and Dr Shahpasandy said he was getting rid of me as NR. I had dared to ask for the research on my daughter that he was involved in when he found a patient did not have schizophrenia but inflammation of the brain and a different kind of treatment led to his recovery.

Thus, once the RC has come to a decision that continued detention is appropriate, a

report should be made on the appropriate statutory form which is used for this purpose.

This form is set out in Regulations. This will also require the written agreement of the

second professional whom the RC has been under a duty to consult. This written

agreement is provided on the statutory form.

How should the RC proceed if he/she comes to the conclusion that Elizabeth does

not meet the criteria for her detention to be continued?

If Elizabeth does not meet the criteria for continued detention, section 23(2)(a) of the Act

gives her RC the power to discharge her from detention.

This discharge served on the managers of the hospital in which Elizabeth has been detained.  Note that, as always in respect of the Act, discharge refers to discharge from detention and does not refer to discharge from hospital.

Section 20 of the Act provides the legislative framework for all these actions, and the basic process for making this decision remains much as it was before.

The RC should also consult wherever possible with others who have been involved with the patient’s care, including the statutory, voluntary or independent services. Yes there have been plenty involved including Access Charity and NAS, private endocrinologist and neurologist

The value of involving carers and family in the decision making process is well

recognised because it provides a particular perspective of the patient’s circumstances and experiences. NO WAY HAS THIS EVER BEEN DONE.

The RC is, in fact, the only person who has the authority to renew the detention of a patient under section 3 of the 1983 Act. YES AND TO DENY FAMILY VISITING IN BREACH OF ART 8 HRA AND IN BREACH OF TRUST POLICY.

Definition of mental disorder:

The legislation now defines mental disorder as ‘any disorder or disability of the

mind’. This new definition provides a single, simple definition rather than specifying

categories of disorder. This is disturbing because the former RC Dr Shahpasandy did research into the Limbic system and with a different kind of treatment his patient recovered. Pathological tests are denied to patients under MH so underlying physical health conditions are simply covered up and that patient is not getting the right treatment. Notably Dr Shahpasandy’s patient got better when taken off the same drug that Elizabeth was on and if someone has inflammation of the brain then they need anti-inflammatory drugs surely. The other reason I am being denied contact with my daughter is that Rapid Tranquilisations are given frequently and often without any reason. No correct procedures are being carried out before the injection is given. Absolutely appalling! I have requested under FOI lPFT RT log and Policy which I am still waiting for.

Grounds for detention:

If patients are to be detained for treatment under section 3 and related sections of

Part 3 there is an important addition to the criteria that ‘appropriate medical How inappropriate is it for a vulnerable patient to have frequent rapid tranquilisations and even be forced to take Procyclydine which is not part of the treatment. It is affecting Elizbeth’s eyesight and walking ability they are desperately trying to play down.

treatment’ is available for the patient. As a result, it will not be possible for patients to be compulsorily detained or their detention renewed unless medical treatment is available for them which is appropriate taking into account the nature and degree of their mental disorder and all the other circumstances of their case. The previously used ‘treatability test’ (as it was called) has now been abolished.

Disabilities of the brain would not be classified as mental disorders unless they give rise to a disability or disorder of the mind as well. The extent of injury they are treating as a mental disorder needs further examination by experts in the field of Neurology only.

Treatability test required the decision-makers to determine whether medical

treatment was ‘likely to alleviate or prevent deterioration in the patient’s condition’. This requirement no longer applies. If someone has epilepsy are they physically restrained and injected whilst having a fit. Why on earth is this being done under MH?

“’Medical treatment’ includes nursing, psychological intervention and specialist mentalhealth habilitation, rehabilitation and care”. [section 145 of the Act]

Purpose of treatment

The Act also stipulates that the purpose of medical treatment “is to alleviate, or prevent a worsening of, the disorder or one or more of its symptoms or manifestations”. A ‘disorder’ when in fact an injury that needs further investigation????? Why were we not informed of the accident??

Point to note

An important factor here is that this is about the purpose of the treatment, rather than

being about its likely outcome (as was the case in the previous ‘treatability’ test).

Point to note

The overall effect then is that these conditions cannot be met unless medical treatment:

· is available to the patient in question

· is appropriate IT CLEARLY IS NOT APPROPRIATE WHAT THEY ARE DOING AND AGAINST THE LAW.

· takes account of the nature and degree of the patient’s mental disorder, and

· takes account of all other circumstances of the case.

The Mental Health Act 1983 sets out the legal framework that underpins the detention and treatment of patients under compulsion. THE MENTAL HEALTH ACT IS NOT FIT FOR PURPOSE AND FAILING TO PROTECT THE VULNERABLE PATIENTS HELD ON NEVER ENDING SECTIONS DEPRIVED OF PATHOLOGICAL TESTS SUCH AS NEUROLOGY/MRI

The Mental Health Act 1983 Code of Practice provides guidance, including

good practice, as to how the Act should be applied. It also sets out principles which

should inform decisions under the Act.

The Code of Practice highlights, where relevant, the connections between the 1983 Act and other legislation, such as the Mental Capacity Act 2005.

The 1983 Act provides that practitioners must have regard to the Code in relation to

admitting persons to hospital or guardianship, community patients and in providing

medical treatment to patients.

Failure to do so could give rise to legal challenge. A court, in reviewing any departures from the Code, will scrutinise the reasons for the divergence to ensure there is sufficient and convincing justification in such circumstances. Nothing against medical treatment following full investigation by the Consultant Neurologist. The scans are with the Consultant Neurologist and several other experts as all I want is for my daughter to be treated fairly and correctly.

To put it simply, the Code of Practice is designed to guide practitioners in discharging their powers and duties under the 1983 Act. It provides practical guidance on all aspects of such matters.

Chapter 1 of the Code of Practice provides a set of nine guiding principles which should be considered whenever a decision has to be made about a course of action under the Act. The principles work together to form a balanced set of considerations which should inform all decision-making

Chapter 14 of the Code emphasises the importance of a holistic approach to providing care and treatment, and of involving users and carers in creating and reviewing the care plan. It also sets out that those who should be involved in preparing the care plan to meet the patient’s needs include: Holistic approach – this is laughable as her medication raised to enormous levels.

– the patient, if he or she wishes and/or a nominated

– the patient’s responsible clinician

– the patient’s care coordinator

– the patient’s carer (where they will be providing care that is identified in the care plan)

– members of the inpatient care team (if the patient is in hospital).

Chapter 4 of the Code makes it clear that the test requires a judgement about whether, in all the circumstances, medical treatment is available to the patient which is appropriate. This needs consideration of the nature and degree of the patient’s mental disorder and all other circumstances of the patient’s case. These other circumstance might, for example, include the patient’s physical health – how it might impact on the effectiveness of the available medical treatment for mental disorder and the impact that treatment might have in return:

· any physical difficulties that the patient has

· the patient’s culture and ethnicity

· the patient’s age

· the patient’s gender, gender-identity and sexual orientation

· the location of the available treatment

The treatment to be offered must be an appropriate response to the patient’s condition and situation.

But that needs to be properly determined by an expert in the field of Neurology.

RCs cannot grant leave of absence under section 17 for part 2 or unrestricted part 3

patients for longer than 7 consecutive days without first considering whether the patient should be discharged onto SCT. In effect, RCs will have to demonstrate that SCT has been considered and show why section 17 was more appropriate. No S17 granted and visits highly restricted – breach of Art 8 HRA

DEPRIVATION OF LIBERTY NOTES

Deprivation or restriction of a person’s liberty

The principal question that is likely to concern you in your role is whether a particular

set of circumstances amounts to actual deprivation of someone’s liberty or whether it is a restriction of liberty.

The European Court of Human Rights has said that the difference between restriction and deprivation of liberty is one of degree or intensity rather than of nature or substance.

To determine whether a person is being deprived of liberty, there must be an

assessment of the specific factors in each individual case. Every case must be

assessed on its own terms, and every possible instance has to be taken on a ‘case by case’ basis.

Based on existing case law, the following factors might well be considered by the courts to be relevant when considering whether or not deprivation of liberty is occurring:

· The person is not allowed to leave the facility Yes

  • The person has no, or very limited, choice about their life within the care home or Hospital Yes
  • The person is prevented from maintaining contact with the world outside the care Yes
  • home or hospital Yes

Standard authorisations Requesting authorisation

The managing authority must request authorisation from the supervisory body for a

person to be detained as a resident in a hospital or care home in circumstances which amount to deprivation of their liberty.

Qualifying requirements

Before a managing authority applies to the supervisory body for a standard

authorisation to detain a person as a resident in a hospital or care home in

circumstances which amount to deprivation of their liberty, it must be satisfied that the individual appears to meet the qualifying requirements.

There are six qualifying requirements against which the case will be assessed by the supervisory body:

1. age requirement

– the person must be aged 18 or over.

2. mental health requirement

– the person must be suffering from a mental disorder within the meaning of the

1983 Act.

3. mental capacity requirement 3 completely flawed assessments so they can take control – total abuse

– the person must lack capacity to decide whether or not they should be a

resident in the hospital or care home.

4. best interests requirement should be abolished and any assessments done independently.

– the deprivation of liberty authorised must be in the best interests of the person. in their own interests without consideration to anyone else in the family.

5. eligibility requirement

– a person is ineligible if they are already actually detained in hospital under the

1983 Act, or if they are on leave of absence from such detention or subject to

guardianship, SCT or conditional discharge and in connection with that are

subject to a measure which would be inconsistent with the authorisation if

granted.

6. no refusals requirement

– if there is a conflict, with another existing authority for decision-making for the

person, a standard authorisation for deprivation of liberty may not be given.

Urgent Authorisations

The managing authority can itself give an urgent authorisation for deprivation of liberty where it:

· is required to make a request to the supervisory body for a standard

authorisation, but believes that the need for a person to be deprived of liberty is

so urgent that it is appropriate to begin the deprivation before the request is

made, or

· has made a request for a standard authorisation but believes that the need for a

person to be deprived of liberty has now become so urgent that it is appropriate

to begin the deprivation before the request is dealt with by the supervisory body.

This means that an urgent authorisation can never be issued without a request for a

standard authorisation being made.

An urgent authorisation can only last for a maximum of 7 days unless in exceptional

circumstances it is extended to 14 days by the supervisory body.

CONCLUSION

“THE WHOLE THING STINKS!” SO MANY VULNERABLE PEOPLE BEING ABUSED BY A SYSTEM NOT FIT FOR PURPOSE AND IT IS NOT JUST LPFT OR BEHMHTNHS THIS IS NHS CARE AT ITS WORST THAT ALLOWS SYSTEMATIC ABUSE OF THE WEAK AND VULNERABLE AND SOMETHING NEEDS TO BE DONE ABOUT IT AND THE PEOPLE WHO NEED TO BE INVOLVED IN CHANGING THE MHA ARE NONE OTHER THAN THE PATIENTS AND CARERS THEMSELVES.