Dear Ms Caulfield

BULLYING AND ORGANISATIONAL ABUSE UNDER MENTAL HEALTH – MY RESPONSE TO YOUR LETTER DATED 21 May 2024

Paragraph 2:    “I was sorry to read of Ms Bevis’s mental health issues”   No, you have got this wrong!   This should read:  I was sorry to read of Ms Bevis’s physical health issues that have been ignored by the mental health trust upon our arrival to new area since September 2021 when they insisted on relying on a supposedly “normal” scan done as far back as 2015 which prompted me to have private scans done. 

Para 3:  “I would like to assure Ms Bevis the Government is committed to expanding and transforming NHS mental health care so more people can get the MH support they need.”    I am not assured. What exactly is meant by so more people can get the support they need as this is only drugs people are told they have to take for the rest of their lives which goes against Manufacturer’s instructions.

Para 4. “Our ambition is to increasingly shift mental healthcare towards early intervention and prevention with treatment primarily delivered in the community rather than inpatient units.”  also stated is “focus on MH and LD services” BUT what about those without such diagnoses classed as having MH problems when in fact they could have any number of underlying physical health issues yet refused pathological tests like Elizabeth?

Para 5.  “Where not possible it is essential that inpatient MH settings meet patients physical as well as mental healthcare needs.”   THEY DO NOT!   The majority of inpatient settings were not fit for purpose.   This is completely the wrong environment for someone with sensory issues.  No psychological input is given. Pathological tests such as MRI refused.

Para 6.  “The Department recognises those who require inpatient care are treated close to home as possible.”    I know of many cases sent a long distance away from home and Elizabeth was sent to Durham.    She has just been moved to a 6^th institution.    This is terrible since she was not even sectioned before we came to this area.  She was living peacefully in the community and being slowly reduced off the Clopixol every six weeks since all her conditions were physical which in this “new” area they choose to overlook plus the fact she was compliant with the depot which we could not get up and running since moving here.

Ms Caulfield goes on to excuse targets being missed on Covid.   Moving patients out of area had been going on for a long time BEFORE Covid and Elizabeth was sent from London to Wales for 18 months in 2014 so I cannot accept Covid as an excuse.

Para 7:“I would like to assure Ms Bevis we remain committed to eliminating all inappropriate acute out of area placements for adults aged 18 years and over.”   I am not assured and also what about out of area community care placements.  From one prison to another – DoLs/CTOs being used to bully residents. Carers, parents.

Para 8:  Re NR –  the system is an absolute joke and something needs to be done about it as Trusts and Councils turn to bullying tactics using threat of costs in secret courts that should be public as this is public money being used in order to achieve their own ends.  The MCA and MHA is being abused and so are the most vulnerable patients and their families/carers.    The system is not fit for purpose.   How can the system be fit for purpose when vulnerable people are held for a lifetime under MH care, detained like restricted prisoners.

Para 9.  PALS is recommended by Ms Caulfield.    I have featured some of the dismissive responses received through Pals devoid of compassion and empathy.  How can Trusts respond to complaints when those at the top are “executive reviewers and specialist advisors for the CQC.”  Others are on the Boards of the ICB –  talk about conflict of interest.    Complaints need to be done completely independently and not by the Trust themselves.   There needs to be accountability but there is non.  

Para 10:   Bullying we have encountered has occurred in both previous and current Trust – the minute you challenge and question this is what you get and it is not just myself – bullying is widespread under NHS and I am in touch with other shocking cases so I know full well the bullying is aimed at any carer who dares to disagree and as for the professional bodies who are supposed to regulate healthcare professionals –  their responses have been dismissive and above them Professional Standards Agency have no powers to intervene.  Absolutely pointless turning to such organisations who appear to protect their own though I have to say the NMC are supposed to be investigating one or two serious matters brought to their attention.   A Doctor’s first priority should be the care of his/her patient but often it is not. When a doctor goes down the legal route powers are used against you as a parent. They try to instigate taking the POA and NR status.

When you get nowhere with the complaints procedures and Ombudsmen try getting legal backing – this virtually impossible and where you come up against a brick wall.   Not even advice or backing for high court cases is available.  Charities just signpost you and solicitors will say “we do not have capacity for new cases”.  Ms Caulfield then goes on in Paragraph 11 to state re “concerns about access to justice and availability of legal aid –I am unable to comment as these are matters for the Ministry of Justice (MoJ)  contact-moj.service.justice.gov.uk.

Conclusion:  Something needs to be done about the MHA and MCA being abused and the professional standards agency have no power to intervene.  Complaints need to be dealt with externally NOT by PALS.   System and in-house as this is not working.

.                              

                                 VICTORIA ATKINS

                                    Member of Parliament for Louth and Horncastle             VA18567

22 May 2024

Dear Ms Bevis

Thank you for taking the time to contact me about mental health services.

Please see the enclosed correspondence which I have received from Maria Caulfield MP, Parliamentary Under-Secretary of State for Mental Health and Women’s Health Strategy, in response to enquiries which I have made on your behalf.

I hope you find the response from the Minister helpful.

Yours sincerely

Victoria Atkins

The Rt Hon Victoria Atkins MP

Member of Parliament for Louth & Horncastle

House of Commons London  SW1A 9AA

Tel 020 7219 5897  Email: Victoria@victoriaatkins.org.uk

From Maria Caulfield MP

Parliamentary Under-Secretary of State for

Mental Health and Women’s Health Strategy

39 Victoria Street

London

SW1H 0EU

21 May 2024

Your Ref:  VA1508940                                                                               

PO-1508940

The Rt Hon Victoria Atkins MP

By email to: Victoria@victoriaatkins.org.uk

Dear Victoria

Thank you for your correspondence of 25 April on behalf of your constituent Ms Susan Bevis about mental health services

I was sorry to read of Ms Bevis’s daughter’s mental health issues and of the experience she describes.  I appreciate her concerns about the support available to her daughter and others who have mental health issues.  As I am sure she will appreciate, it would be inappropriate for me to comment on individual cases, however I understand how distressing this must be for her and her family.

I would like to assure Ms Bevis that the Government is committed to expanding and transforming NHS mental health services so that more people can get the mental health support that they need, when they need it.

Our ambition is to increasingly shift mental healthcare towards early intervention and prevention, with treatment primarily delivered in the community rather than in inpatient units.  This includes increasing the number of personalised care roles, such as peer support workers, with expansion focused on mental health and learning disability services where need is greatest.

Where this is not possible, it is essential that inpatient mental health services meet patients’ physical as well as mental healthcare needs, either through their own appropriately qualified and experienced staff or in partnership with other providers.  This requires mental health inpatient staff to be provided with adequate training and guidance on monitoring physical health, and importantly how to escalate and respond to concerns as needed.

The Department recognises that it is important that those who require inpatient care are treated as close to home as possible, which is why we publicly committed to eliminating all inappropriate acute out of area placements by 2020/21. Unfortunately, COVID 19 – related pressures contributed to services missing that target.  These pressures were caused by a number of factors, including:

• Bed closures due to the need for infection control;
• Reduced community networks;
• Staff absences; and
• Higher levels of demand for NHS mental health services

However, I would like to assure Ms Bevis that we remain committed to eliminating all inappropriate acute out of area placements for adults aged 18 years and over.

All local health systems that still have inappropriate out of area placements have been required to refresh their plans to ensure these placements are eliminated everywhere as soon as reasonably possible.  NHS England continues to work with the worst performing areas in order to support them to improve and we are working with NHS England to ensure that systems prioritise this, including a focus on the discharge process.

If Ms Beviss’ daughter is being detained under the Mental Health Act 1983, her approved mental health professional has to choose who her nearest relative should be as they have certain rights in relation to her care and treatment under the Act.  These are set out in the information leaflet, which is available at assets.nhs.uk/prod/documents/mh-cop-nearest-relative.pdf.

The bullying of patients, parents and carers by healthcare professionals is unacceptable.  I realise that some people will find reporting such behaviour difficult, but all NHS organisations hve complaints procedures in place.  Each Trust has a patient advice and liaison service (PALS) that can help people to raise such issues within the Trust.  The contact details for all relevant PALS can be found at www.nhs.uk by searching for PALS.

Bullying behaviour can also be reported to the relevant professional body for regulated healthcare professionals such as doctors, psychiatrists and nursing staff.

I am afraid that I am unable to comment on Ms Bevis’ concerns about access to justice and the availability of legal aid as these are matters for the Ministry of Justice (MoJ.)  Contact details for MoJ can be found at contact-moj.service.justice.gov.uk.  

I hope this reply is helpful.

Yours sincerely

Maria

MARIA CAULFIELD MP

“Wish not allowed” by HEALTHCARE ASSISTANT Rachel.

Healthcare Assistants have mainly been put in charge of supervising and making notes during my highly restricted visits to see Elizabeth only allowed once a week for one hour only, dependent on staff availability to supervise; it has often been mentioned there are staff shortages on the ward and that can dictate whether you get a call back or whether Elizabeth can go to the hospital shop.

I have not spoken to Elizabeth for several days. I do not phone every day. The phone has confiscated from Elizabeth and put either in her locker or office. This is done to limit and deprive family contact and isolate her from the outside world and aimed primarily at me but affects the entire family. The last two phone calls were not returned and it has been said that “I will see if she wants to speak to me” and it has also been said that it is up to her if she wants to ask for her phone. Today I have contacted the ward as a transaction appeared on her Revolut Card for a new pin number. All orders of food and all orders of takeaways are done with assistance of staff. Elizabeth is never alone with her phone and it is most concerning when no calls are returned and no answer from the only email address with regard to a visit and I have just written a fourth time. Elizabeth has been deemed to have no capacity but what the team are doing is to facilitate that view by not allowing her contact with anyone from the outside world. Elizabeth is 37 and it is a disgrace on LPFT they treat her little more than a vegetable and did 3 capacity assessments to state “no capacity” just to get rid of me as the nearest relative. I telephoned the ward as I wanted to see if she was OK, to update her on a few things and to ask whether she received the shopping I brought to Castle Ward, Peter Hodgkinson Centre, Lincoln County Hospital, Lincoln LN2 5QY following my last visit on Wednesday last week since I did not have time to do the shopping prior to my visit.

I did not get the name of the person I spoke to previously but that person said she would pass the message on to my daughter but I did not receive a call back and then yesterday I spoke to Rachel who used the words in the title of my blog. This kind of approach has been relayed by others too.

Today I spoke to this same HCA who has previously supervised my visits on a 2-1 basis, taking notes. I am treated like a criminal and differently to other carers and rest of the family. This is discrimination under the Equality Act 2010. It is also highly intrusive, degrading and undignified. Rachel, like the majority is doing her job as instructed. It is not just HCAs but nursing staff and other doctors who are expected to do as instructed by certain Officials desperate to keep rigid, restrictive control in place for the most disturbing reasons, against the law and guidelines, own code of conduct and human rights done no doubt to protect themselves right now. Her response replicates others who entirely forget their training and code of conduct and do not raise a voice of concern. Even the Trust’s own values as follows are ignored and disregarded in their conduct:

• Compassion: Acting with kindness
• Pride: Being passionate about what we do
• Integrity: Leading by example​​​​​​​
• Valuing everybody: Using an inclusive approach​​​​​​​
• Innovation: Aspiring for excellence in all we do
• Collaboration: Listening to each other and working together

“I will see if she wants to speak to you“. A typical response with disregard to any carer who is treated like dirt under LPFT who have dared to raise concerns. It is like a ‘slap in the face‘ for a parent/carer to be told this by a Healthcare Assistant or member of nursing staff following orders. This approach is not emphatic or compassionate in any way whatsoever, which appears to be the overall nature of this Trust from our experience. It is obvious what this ward is doing and that is to discourage, distance and isolate a vulnerable patient from having contact with her mother, impacting on all the family and the outside world. Whilst certain Psychiatrists may disapprove of her mother they have acted against their Code of Conduct to go down the legal route rather than medical, their priority to try to take the POA for Health and Welfare as well as the role of nearest relative at County Court level in which they enlisted the help of Lincolnshire County Council. Dr Shahpasandy even said “I am displacing you as NR”. I was cut out of all meetings and Tribunals and eventually the same heavy restrictions were put in place with 2-1 supervision and phone taken away by Ash Villa.

The question is why?

I leave it to you to keep an open mind but my treatment is commonplace to anyone who dares to challenge these “professionals” even if totally justified.

My response to those comments of yesterday was total despair. I cannot think of a greater punishment by “professionals” who act in this way using their enormous power to destroy people’s lives. There is no accountability to such individuals. It is insensitive the way this Trust deals with parents and carers who have every justification to question matters right now. To leave a vulnerable patient to go downhill to such an extent is abuse and yesterday I played back the many recordings I have kept of Elizabeth, some of which are quite disturbing and point to abuse – Organisational Abuse. I have seen how things work at the very best of standards as I have for the past three years worked as a Carers Rep and been involved in reviews of MH services for accreditation purposes but I cannot see any quality or standards in this area where bullying and threats are used by those at Executive Board Level. In this respect I would comment there is/has been/gross conflict of interest and therefore what can you expect but insensitive, dismissive responses to complaints and concerns by Pals and of course the CQC who they are well in with – others are on the Board of the ICB.

There are Carers Champions who clearly work within a system not fit for purpose that splits and divides families, isolates the most weak and vulnerable people in society, their vulnerable families subject to abuse and the knock-on effect of deprival of contact too. In this area alone they are doing a good job of that. When I moved I was keen to get on with people and not complain but was subject to severe bullying from the very beginning.

When each and every person under the so-called MDT is reliant on backing from one another and instructed to act ultra vires against Code of Conduct this shows a culture of bullying with staff just going along with things for the sake of their jobs, without raising concerns.

It is not just Rachel but each and every one of the staff involved in my vulnerable daughters “care” are all instructed to act accordingly.

The person with overall control is Psychiatrist Dr W K (one of ten) but you need to look further because at the top of the Trust Executive Board there is conflict of interest and it is no wonder that you get nowhere if you raise concerns, especially when certain people have held the role as “Executive Reviewer for the CQC and Specialist Advisor”. With this power and backing each and every one of the staff are fully protected because the agencies concerned ie NMC, especially GMC, Social Work England and CQC do nothing to protect the public and it is rare that you can win an Ombudsman complaint. Having said that the NMC is looking into an incident at the former hospital where a nurse shouted “you have just assaulted a member of staff, Ms Bevis” whilst I was standing under CCTV which would have captured everything if at all true!. As regards Ombudsman I did win a past complaint on safeguarding under the former area of Enfield when Elizabeth picked up the minutes and gave them to me of a S42 meeting going on behind my back. They had no choice but to apologise then (Both Council and Trust), The PHSO completely evaded/dismissed answering my complaint. The CQC described themselves as a “business” and even sent a threatening letter.

There is total unaccountability and bullying under the NHS especially under this area LPFT.

The patient, carers/mothers, fathers, other family members are not protected. I am not alone to encounter a wall of silence, culture of bullying but firmly believe this needs to be exposed. This is a complete and utter waste of public money when so many agencies concerned do NOTHING in terms of protection to the public and vulnerable patients. There needs to be external safeguarding audits of multi-agencies with a view to protecting the public and vulnerable patients.

So where do you turn to when all avenues have been exhausted – I believe all safeguarding should be done externally, just as I think all capacity assessments should be done independently and NOT arranged by Trusts/Councils themselves. There needs to be more scrutiny with regard to capacity assessments to ensure Principle 4 is taken into account. There should be more scrutiny about the way social services conduct themselves under the ‘secret court’ of County Court where hearings can take place behind your back and you do not get a fair trial due to redacted copies, certain decisions reached in hearings that take place behind your back without proper regard to circumstances.

“My Idea by Elizabeth Bevis”

FRIDAY 10TH NOVEMBER 2023

“I want to eventually come home to live with my Mum through the COURT OF PROTECTION. This is a court who has helped us in the past when Enfield wanted to send her back to a care home in Northampton where she had no food at the weekend. I have nothing but respect for the Ct of Protection.

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

Here is Rachel’s Response which was witnessed by a family friend:

“Wish not allowed“.

The question is why are HCAs given the task of supervising 2-1 during visits writing notes all the time which most certainly will not be nice in content. It is BULLYING AND INTIMIDATION TO THE EXTREME AND THIS IS IMPOSED BY THE RESPONSIBLE CLINICIAN WHO HAS OVERALL CONTROL, DR W K but could also be extended to Executive Board who have ties with the CQC. You are made to feel like you stand alone, you are made to feel like nothing and outnumbered by many professionals of the MDT who all agree with the Responsible Clinician ie “Why do you think everyone …….………………….” You are made to feel guilty with accusations that you are responsible for the cause of the seizures for instance even in part or that you are unfit to be a mother and carer and disregarded like nothing. You are intimidated and bullied with threat of indefinite ban on not seeing your relative and Police have been used several times to intimidate however the Police in this area have been highly professional in their approach.

I am not expecting a call back from my daughter today because staff have been instructed NOT to allow calls. I wrote to my only avenue of communication ie email address: lpft.careconcerns@nhs.net. You have to request your visit through this email address in good time. So today (21.05) I requested my visit to see Elizabeth. Today I have written again to Care Concerns to see if my visit to Elizabeth can go ahead on Wednesday.

I was previously banned by Dr K for months on end with so many “banning letters” that I took out a Judicial Review myself, doing all the paperwork because I had a decision in writing of further ban and was told verbally I was banned indefinitely. I got nowhere with this even though I did the paperwork correctly and it went before the Judge. It was dismissed as being the wrong course of legal action. It was only then that LPFT slightly backed down and allowed 1 hour’s 2-1 supervised visits but I kept the case going as restrictions were still very much in place contrary to LPFT’s claims in their statement before the court. I had hoped I would get some justice in the High Court bearing in mind this is a human rights issue but sadly this case was dismissed. It is impossible to get a solicitor so I did it myself but many people miss out on such justice because they may not have the facility or may be ill and cannot find a solicitor to represent them. I decided not to challenge the Judge on this outcome but all along you get threatened with costs if you try to pursue justice.

When I visited Elizabeth last Wednesday I always take he some shopping. On this occasion I had to take my car in for repair it so I requested a later appointment and there was not time to do the usual shopping so I had to visit first, then shop afterwards and go back to the ward to drop the shopping in. I just wanted to check Elizabeth had received the shopping OK. When I took in Birthday cake twice it was thrown in the bin by staff and Elizabeth did not even know about the cake. This shows no-one cares.

When I visited last I was shocked at Elizabeth’s appearance.

She was covered in red marks all over her face. She had red raw knuckles where she had been hitting her hands on hard surfaces. When I asked her why she said she was distressed in there as it was “so noisy and unbearable”. None of the agencies involved or the MDT is doing anything about this situation and are disregarding Elizabeth’s wishes to come home and to see her cat. It has been practically three years of hell on earth under LPFT of a restrictive never-ending imprisonment where my daughter is declining in her physical health tremendously. My last visit was supervised 2-1 by a carers rep and HCA. None of them question whether what they are doing is right. They just go along with things and I suppose this is because otherwise they would be subject to extreme bullying like I have encountered.

With all staff sticking together as they are doing they probably feel very secure and protected – it is all of them against 1 (enhanced power), however this might not be the case in a court of law where individuals can be held responsible for their own actions. I have nothing but praise for the Ct of Protection I know not everyone feels this way but when I was previously bullied so badly in Enfield, Enfield CMHT deprived medication for 4 days putting life at risk to force return her back to a care home where she had no food at the weekend rated good by CQC. They were slated in court.

Anyway, that was back in 2014. In 2009 the diagnosis as a result of an MRI scan was not normal ie “Anterior Region Medial Temporol Compromise“. Now you will understand why the NHS religiously are being defensive, backing their psychiatrists in their claims of “mental disorder” who have stood in the way/obstructed/denied prior arranged appointments/referrals made to see a Neurologist arranged by Enfield and when we first moved to Lincolnshire these appointments were cancelled as “unnecessary” and they even tried to comment on their observations being not of a physical health nature but purely MH without proper pathological tests. Well I have evidence to the CONTRARY. It is therefore highly negligent of any doctors to stand in the way of proper pathological tests, especially when a patient is having regular seizures that are life threatening. A Tesla 3 scan alone is not enough. What they are doing is denying contact and trying to put blame on me as a mother for being responsible for the seizures and having a detrimental effect on Elizabeth who I hardly see now. Like a religious cult, LPFT is desperately protective/defensive towards ALL their professionals and guarded when it comes to anyone daring to challenge whether something is right or not and unfortunately the majority just go along with matters for the sake of convenience and for the sake of agreeing and solidarity by way of protection to their colleagues.

An example of this is a Neurologist who on the one hand agrees that Elizabeth should have proper tests that could only be done under a Neurological ward yet is quite happy to go along with filming of the seizures of a vulnerable patient against her wishes by a nurse instructed by the RC under LPFT and for them to comment on in order to justify their beliefs of a MENTAL DISORDER whilst preventing proper pathological tests by experts in Sheffield who have apparently been told not to disclose any information to me. This is highly negligent and gross breach of confidentiality/medical ethics but they are treating Elizabeth as though she has no capacity. They are also obstructing proper tests which need to be done in order that a fresh capacity assessment can properly be carried out to include Principle 4 and causative nexus.

The staff I spoke to in Sheffield were highly professional and highly sympathetic and even commented that is was very wrong to film a patient in distress who explicitly said “NO”.

I am up against several doctors right now. What chance do you have against “professionals” who stick together and agree with one another all acting against the wellbeing of my daughter when they have not properly read the files or looked at the past MRI scans or reports.

From the start, on moving to Lincolnshire I requested pathological tests to be carried out because of the Discharge Note stating “abnormal findings on a scan twice” and I was advised by the GP to take her back to London for the neurological appointments but this was refused by more than one psychiatrist under LPFT. It was as if they were afraid of any potential findings that might point to another diagnosis of a physical nature. The private scans I took Elizabeth for last year showed what looked like a cavernoma, lesions and inflammation but all that has been arranged is a Tesla 3 scan but that is not enough as there are other related extensive tests that need to be carried out in order to determine the correct diagnosis. In the meantime, my daughter is having fits that end always with an injection of benzodiazepam which is highly neglectful. All I ever wanted as a mother was for her to be treated fairly and when scans going back to 2009 revealed abnormality how can they just push this aside and deny my daughter the right to have proper pathological tests.

The above is why I am being treated like a criminal and denied meaningful contact with my daughter and also all calls are supervised and notes taken every visit and that alone is a breach of human rights. Filming a patient against her wishes backed by everyone is gross breach of medical ethics and against GMC Guidelines. Other family members are not treated the same way.

What I would like to see:

I would like my daughter to have her phone back that we her family pay a contract for (though now someone is trying to change the sim card). That would save us all the inconvenience of having to go through the office and holding on for a long time before you finally get through only to be told “I’ll see if she wants to speak to you” when you as a parent might have something important to say in terms of news. What would be better was for a member of staff to say “I will give her the phone to call you back in due course” or even “we are short staffed on the ward at the moment so I will give her the phone back to call you as and when the supervisors are available” – at least that would be an honest response.

A while back Elizabeth was missing meals and isolating in her room for most of the day because she could not stand the noise and chaos of the ward with alarms going off frequently. This has been ongoing but then staff will say “we cannot force her to eat” or “it is up to her” – where is the duty of care towards someone they say has no capacity? Who is spending a fortune of taxpayer’s money on such wrong facilities? When I have written to the ICB they are quick to distance themselves but I am sure they have played a major part in providing/spending a fortune of public money in the wrong direction when it would have been much cheaper to provide in the community. The Local Authority just want what is convenient ie keep someone locked up so they do not have to pay. They do this by making out you are an unsuitable, inadequate person incapable of providing care to your relative.

Practically every code of conduct has been breached, MHAS, MCA HRA Guidelines – everything by professionals acting “ultra vires” and these professionals are not only damaging my daughter’s health but impacting upon my health too and they have failed to carry out an Impact Assessment according to NHS Guidelines.

I have now contacted all the Neurologists and hospitals from former area where clearly scans were NOT NORMAL.

Now with high Prolactin levels of concern (mentioned by Elizabeth) and tremors, self-harming, seizures my daughter is going downhill both physically and mentally thanks to LPFT. Sadly this is not just one doctor alone but practically all of them and the only one who really seemed to care was Dr Memons of Cygnet Durham who bothered to ring me. He cared to tell me that Elizabeth was being taken to A&E after suffering a seizure for which I am now being blamed for. At the very least the doctors should be looking into the correct cause of the seizures and not standing in the way of full and thorough tests. I am only allowed to see Elizabeth once a week for just 1 hr heavily supervised whereas rest of family are unrestricted which is DISCRIMINATION. However now they appear to be standing in the way of phone calls, at least that is how it appears as well as stopping me from visiting by ignoring the emails that I am sending to request a visit. To not even get a response to three emails is concerning.

I would like a multi agency safeguarding review because I am questioning how can this section even be legally valid because the MHA should be the least restrictive care.

If anyone can advise on how to go about the above I would be most grateful.

STANDING IN THE WAY OF CONTACT, MAKING PHONE CONTACT DIFFICULT, TAKING THE PHONE AWAY, ISOLATING A VULNERABLE PATIENT AND IGNORING EMAILS UNDER LPFT

I have written three times now to the only address I am supposed to correspond to as per below. I have had no response whatsoever just a wall of silence.

From: susan bevis

Sent: 21 May 2024 16:12

To: CARECONCERNS (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) <lpft.careconcerns@nhs.net>

Subject: Visit to see E*** tomorrow (22.05.2024) between 6.00 pm and 8.00 pm

I have just phoned the ward and nothing has been put in their diary for me to visit my daughter.

Please confirm I can visit her in the evening tomorrow 22 May 2022.

I have also not been able to speak to my daughter over the phone.

Yours sincerely 

Susan bevis 

From: susan bevis

Sent: 21 May 2024 09:56

To: CARECONCERNS (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) <lpft.careconcerns@nhs.net>

Subject: Visit to see EB tomorrow (22.05.2024) between 6.00 pm and 8.00 pm

 Please can you confirm if the above visit has been booked in.

Please can you confirm what level of prolactin E has as I understand there is concern regarding elevated prolactin levels.

150-200 ng/ml

Prolactin level in prolactinoma is persistently elevated above the normal range1234. A prolactin level of over 150-200 ng/ml is almost always due to a prolactinoma, which is a type of tumor of the pituitary gland that secretes excess prolactin12. Prolactin levels can be much higher in some cases, up to 50,000 ng/ml2. A decrease in tumor size in response to drug treatment may confirm the diagnosis when prolactin levels are in an equivocal range4.

Please can you look into the Voting by Proxy form I left during my last visit to be signed and completed by the ward for the forthcoming local elections on behalf of E.

Look forward to hearing from you regarding the visit tomorrow evening.

Yours sincerely

Susan A Bevis

Mother, POA and Litigation Friend

From: susan bevis <susanb255

Sent: 20 May 2024 13:37

To: CARECONCERNS (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) <lpft.careconcerns@nhs.net>

Subject: E Bevis – request for visit Wednesday evening 22 May 2024

 Please can I book to see E on Wednesday evening between the evening visiting hours of 6.00 pm – 8.00 pm.  

Please comment as per below:

Regulation 9A: Visiting and accompanying in care homes, hospitals and hospices – Care Quality Commission (cqc.org.uk)

Regulation 9A: Visiting and accompanying in care homes, hospitals and hospices

Page last updated:    26 April 2024

Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 9A

This regulation aims to make sure:   people staying in a care home, hospital or hospice can receive visits from people they want to see

people living in a care home are not discouraged from taking visits outside the home

People attending appointments in a hospital or hospice, that do not require an overnight stay, can be accompanied by a family member, friend or advocate if they want someone with them

The regulation explains what providers must do to make sure they respect the right of each person to receive visits and to be accompanied, following an assessment of their needs and preferences.

Everyone should work on the assumption that in-person visiting and accompaniment to appointments are possible. Providers must put in place any measures or precautions necessary and proportionate to ensure that visiting and accompaniment can continue to happen safely. These must be the least restrictive options and must be decided with the person using the service, and their family, friends or advocates where appropriate.   If providers already have contractual arrangements that involve paying for additional staff to support care home residents to go out, this regulation does not change these arrangements.

Yours sincerely

Susan Bevis

Mother, POA and Litigation Friend

No response received to any of the emails I sent requesting to visit my daughter. Totally ignored as a parent/carer, no Care Act Assessment ever done, bullied left right and centre and treated like rubbish. Pushing aside my treatment there is a vulnerable person being abused in there and noone wishes to take any responsibility. None of the Agencies are properly investigating what is going on. I am chasing them up for response.

I also want a FULL ADULTS MULTI AGENCY SAFEGUARDING REVIEW as doctors are standing in the way of Elizabeth having pathological tests and I have gone out of my way to obtain past file records relating to MRI scans that WERE NOT NORMAL.

From: susan bevis
Sent: 22 May 2024 07:33
To: CARECONCERNS (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) lpft.careconcerns@nhs.net

Subject: Visit to See E this Evening between 6-8 pm (22.05.2024)?
Dear Ms Munro

This is the fourth time of writing but I am getting no response. Please advise if  the evening request can go ahead as I am in the area and I have given good notice and yet received no acknowledgement or even a response.

Also please can you explain why not one single call has been returned and the response from all members of staff is “I’ll see if she wants to speak to you”.   It would appear that contact is being obstructed when E needs to be informed as to the latest developments.  

Article 5 (3) deals with the rights of a person who are been detained.   Then there is 5 (4)  Storck v Germany (Application No. 610603/00  16 June 2005.     

It would appear that someone is trying to change E’s sim card for her mobile  which would therefore prevent contact for us all.  I know that E is not alone when making any phone calls and that staff are helping with the ordering of food for her and shopping.  LPFT have rated E as having no capacity and treating her as such with the rigid controls you have put in place.  I can only therefore conclude that a member of staff has tried to change E’s phone number by ordering a new sim card via Smartey especially since E has told us that staff assist her with everything.  We are most concerned that someone is trying to change E’s phone number completely by ordering a new sim card via Smartey when there is a contract attached to that phone.   Please can you explain this.  This would affect everyone in the family and whilst certain people on the ward might wish for me not to have any contact with my daughter so it would appear,  this is very disturbing that this new sim card through Smartey is being arranged by whoever is assisting.

Looking forward to hearing from you regarding today’s visit.    I am copying in everyone in this respect.

I have bought shopping for E which I would like to hand to her at the very least if you have once again banned me from seeing my daughter. 

Yours sincerely

Susan A Bevis
Mother, POA and Litigation Friend

I have been regularly visiting my daughter on Sundays recently at around 2.30 pm. This week due to my error in typing April instead of May in my email and only realising this too late to rectify, sadly I am not allowed to see my daughter this Bank Holiday weekend. It is bad enough having heavy restrictions in place infringing on human rights on telephone and visiting than to be deprived of seeing her altogther as her only regular visitor this weekend. I had promised to bring some things that she requested to the ward and will still make the journey to bring her the shopping I would normally do even though I will not be allowed to see her.

I have just tried to ring the ward. I did not argue that it was protected meal-time but you cannot just ring her mobile phone number as the phone is clearly not with her and has been taken away and the team then have to organise someone to sit in and listen to all phone calls and make notes when it is me who makes contact. Others in the family not treated quite as bad but still cannot get through. It is normally a Healthcare Assistant who is put in charge of the supervision and note taking and God knows what they are writing behind my back. I am sure it is not nice.

This kind of treatment has been going on for a long time now with all staff loyally sticking together regardless of their own Code of Conduct which portrays a culture of bullying and one of non-accountability. There is only one person in charge overall imposing these rules as only a Responsible Clinician can, namely Dr W K.

From: susan bevis
Sent: Thursday, May 2, 2024 2:01:30 PM
To: CARECONCERNS (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) lpft.careconcerns@nhs.net
Subject: Elizabeth BEVIS 12.02.1987 Visit to see Elizabeth
 

For the Attention of Ms A Munro

Is Sunday 5th April OK to visit Elizabeth?   Has there been any change in the restrictions on leave?

Please can you respond to the queries mentioned in my former email.

Yours sincerely

Susan A Bevis
Mother POA and Litigation Friend

No answer whatsoever to the above email from the Management.

So tonight I will ensure that I phone Elizabeth to let her know what is going on. I will reassure her that I will come all the way to Lincoln which is an hour there and back just for the purpose of dropping in a few bits of shopping as I would normally do and was doing throughout the many weeks I was banned completely from visiting.

It is sad the way patients under the MH in this area of Lincolnshire are treated but then again most are treated differently to Elizabeth who is being deprived of meaningful family contact and leave and this has been going on for quite some time by a Responsible Clinician who will not budge and says “I am concerned for my patient” Carers too can be subject to severe bullying also if they dare to complain and it is a waste of time complaining when they are all well-in with the CQC.

Elizabeth says she is autistic which they choose to ignore completely. They say they cannot assess her on a ward but how comes Huntercombe could? For all the criticism some of the private sector institutions get, the very worst experience I have ever encountered has to be the current and this is NHS not private. Even Huntercombe all diagnosed her with high functioning Aspergers but now all of this is in question with the MRI scan results done privately and the constant seizures that can be life threatening as well as frequent rapid tranquilisations with benzodiazepam which should never be given in respect of epileptic fits.

Elizabeth has definitely deteriorated under LPFT’s appalling treatment and her hands could not stop shaking when I visited last. I have been told there is no management on duty during the long weekend. The Manager of this ward is Kashmir Moon and not once have I ever spoken with her. I have only one point of contact now and that is the email address of care concerns and I have featured already what kind of response you get from them. Normally, it is either a wall of silence or else it is a heartless letter devoid of any compassion by a designated member of staff – mostly unsigned completely as no-one wishes to take the slightest bit of responsibility.

Here are extracts of an email I sent today to Care Concerns:

From: susan bevis
Sent: 03 May 2024 11:15
To: CARECONCERNS (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) lpft.careconcerns@nhs.net

Subject: Paralegal’s Visit
 
For the Attention of Ms Ann Munro and LA Voiceability

 A paralegal came to see Elizabeth on 02.05.2024 accompanied by LA. Please explain.

The paralegal did all of the talking according to Elizabeth and it was all about her going into supported living.

Elizabeth was promised she could have her cat there in the supported living scheme but was not told where it is.

Please can you inform Nearest Relative C and S, other Attorney who need to know.

 Who arranged the paralegal?   How could Elizabeth have done this with her phone locked away still.

Elizabeth said very clearly she does not wish to go into supported living and that she wants to come home.

Elizabeth has made it very clear to all of us that she wishes to be close to her family not move out of area.

Elizabeth’s capacity is heavily disputed and as someone with capacity, Elizabeth’s wishes need to be heard.

Since LPFT rely on three “flawed” capacity assessments for displacement of me as NR a fresh capacity assessment is in need.

A fresh capacity assessment cannot be done unless the causative nexus is determined via Sheffield.

The cause of seizures is vital as Elizabeth’s life is at risk

What risk assessments are being done re supported living in regard to the seizures when full pathological tests not conducted

30th July has been arranged for MRI scan under Tesla 3 scanner.  Elizabeth needs to go for a few days to have proper EEG tests done.

If Elizabeth has epilepsy she should not be treated with prn benzos for rapid tranquilisation.

Prolonged and repeated use of benzodiaepines can increase the risk of rebound seizures or interictal epileptiform discharges (IEDs) in some individuals. Schizophrenia-like symptoms are observed in some patients and are associated with epileptiform discharges but not overt seizures. The good response to antiepileptic treatment could be interpreted in the context of a (para)epileptic pathomechanism.

“The EEG alterations might be due to a polygenetic effect due to different genes”.

This is why accurate diagnosis is so important. You will see in the case below that a patient with schizophrenia like symptoms had epilepsy and recovered when taken off antipsychotics and treated with anti-convulsants.

The idea that schizophrenia is ‘confirmed’ by daily observations conducted by unqualified staff is absurd. Care assistants cannot possibly know how to differentiate between IEDs and psychosis induced by other causes. This is why PANSS and associated physiological testing is crucial.  LPFT are in the dark ages when it comes to diagnosing and treating psychiatric patients. They neglect proper investigation of genetic markers in psychosis, they neglect EEG examination, they neglect genetic testing for treatment refractivity, they neglect investigation the potential inflammatory causes of brain disturbances and the ignore ADRs.

This indicates an ideological approach to diagnosing and treating psychosis rather than a medical one. Belief based medicine, not evidence based medicine.

Clozapine can actually induce epilepsy in some patients due to a genetic polymorphism. LPFT do not test for that either.

Schizophrenia Associated with Epileptiform Discharges without Seizures Successfully Treated with Levetiracetam

Dominique Endres1 Evgeniy Perlov1 Bernd Feige1 Dirk-Matthias Altenmüller2 Nils Venhoff3 Ludger Tebartz van Elst1*

1Section for Experimental Neuropsychiatry, Department of Psychiatry, Faculty of Medicine, University of Freiburg, Freiburg, Germany

2Freiburg Epilepsy Center, Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Freiburg, Germany

3Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg, Freiburg, Germany

Background: Schizophrenia-like disorders can be divided into endogenic or primary, idiopathic, polygenetic forms, and different secondary, organic subgroups [e.g., (para)epileptic, immunological, degenerative]. Epileptic and paraepileptic explanatory approaches have a long tradition due to the high rate of electroencephalography (EEG) alterations in patients with schizophrenia.

Case presentation: We present the case of a 23-year-old female patient suffering, since the age of 14 years, from a fluctuating paranoid hallucinatory syndrome with formal thought disorder, fear, delusions of persecution, auditory, visual, and tactile hallucinations, as well as negative and cognitive symptoms. Laboratory measurements showed increased titers of antinuclear antibodies (ANAs) in the context of ulcerative colitis. While there was no clear history or evidence of epileptic seizures, the EEG showed generalized 3 Hz polyspike wave complexes. Under treatment with levetiracetam, the symptoms disappeared and the patient was able to complete vocational training.

Conclusion: The schizophrenia-like symptoms associated with epileptiform discharges but not overt seizures and the good response to antiepileptic treatment could be interpreted in the context of a (para)epileptic pathomechanism. The EEG alterations might be due to a  polygenetic effect due to different genes. Mild immunological mechanisms in the framework of ulcerative colitis and increased ANA titers might have supported the network instability. This case report illustrates (1) the importance of EEG screenings in schizophrenia, (2) a potential pathogenetic role of epileptiform discharges in a subgroup of patients with schizophrenia-like symptoms, and (3) that antiepileptic medication with levetiracetam could be a successful treatment alternative in schizophrenia-like disorders with EEG alterations.

Background

Schizophrenia-like disorders are characterized by delusional perception and delusions of control, hallucinations (e.g., commenting or discussing voices), thought insertion or withdrawal, cognitive impairment, thought disorders, or social withdrawal.1 In addition to primary, endogenic or idiopathic, polygenetic forms, different secondary pathophysiological mechanisms [e.g., (para)epileptic, immunological, degenerative] can be assumed. Because of the high rates of electroencephalography (EEG) alterations, ranging from 7 to 60% in patients with schizophreniform syndromes, epileptic and paraepileptic explanatory approaches have a long tradition (1–3). In line with this assumption, we reported the first case of a young patient with a schizophrenia-like disorder, generalized spike-and-slow-wave complexes without epileptic seizures but with remission under treatment with valproate (4, 5). Immunological reasons might be due to autoantibody-associated autoimmune encephalitis, cerebral vasculitis, or collagenosis e.g., systemic lupus erythematosus (SLE). Immunological effects might lead to network instability and therefore cause (para)epileptic phenomena (7). The detection of a (para)epileptic or immunological mechanism opens new treatment perspectives, in that antiepileptics or immunomodulators may be helpful (4, 5, 7–10).

Case Presentation

Clinical Presentation

We present the case of a 23-year-old female office clerk suffering from fluctuating paranoid-hallucinatory symptoms since the age of 14 years (2007). Therefore, the diagnosis of paranoid schizophrenia was made by different psychiatrists. Although taking neuroleptics, in the course of the disease, the patient developed five episodes (for several weeks) with paranoid-hallucinatory exacerbation. In these episodes, the patient suffered from formal thought disorder, fear, delusions of persecution, auditory hallucinations with commenting, discussing, and commanding voices, visual hallucinations with seeing maggots in her room, and tactile hallucinations with the feeling of being touched from behind. In parallel to these exacerbations, the patient developed severe negative and cognitive symptoms including attention and memory deficits, fatigue, depressive mood, and sleep disturbances thus completing the psychopathological features of comprehensive schizophrenia. Neurological and medical examinations were normal.

Family History

There was a positive family history for unipolar depression, which was diagnosed earlier in two sisters, both parents, and both grandmothers. There was no history for schizophrenia-like psychopathology, bipolar disorder, or epilepsy.

Somatic and Developmental History

Symptoms started 6 weeks after pain of the large joints. Therefore, a rheumatological disease was discussed. During an external work-up of repeated diarrhea, a chronic inflammation gut disease (ulcerative colitis) was diagnosed in 2014 and treated with mesalazine. No birth complications or in utero abnormalities were remembered; the birth was performed by cesarean section. The early childhood development was normal. No febrile convulsions or inflammatory brain diseases were remembered. The patient suffered mild cerebral contusions at the age of 4 and 12 years.

Diagnostic Findings

The diagnostic findings are summarized in Table 1. Taken together, the immunological alterations were compatible with the previously known ulcerative colitis (11). The electrophysiological findings (Figure 1) would be compatible with primary (idiopathic) generalized epilepsy; however, the history for epileptic seizures including absences and myoclonic jerks was negative.

Table 1

On 08 February 2024 16:42 LPFT Mental Health Act Team sent an email regarding a question the NR (Elizabeth’s sister) put to them about Elizabeth’s PANSS score.

The PANSS score is a long established test approved by the Royal College of Psychiatrists and used by NHS Mental Health Teams in many of the trusts to determine the severity of the schizophrenia the patient is suffering from. Its purpose is to confirm diagnosis, to guide the treatment regimen and to determine suitability for matters such as section 17 leave, suitability of the patient for post-discharge accommodation and eventual discharge from mental health care.

This was the reply the NR received:

“LPFT does not use the PANSS scale for various reasons but does use the Glasgow Antipsychotic side effect scale (GASS). This measures the side effects of antipsychotics rather than the efficacy of antipsychotics”.

This is totally unsatisfactory for the following reasons. To begin with to quote their own words “for various reasons” gives no explanation at all why this scale is not used by LPFT and is a cursory and unhelpful excuse.

The PANSS scale as mentioned above is crucial in determining not only treatment but deprivation of liberty and the ability of Elizabeth to enjoy leave and to have quality time off the ward. Her stifling detention without hope of even the chance to have a day out or to spend time with her family on important occasions like Christmas and her birthday are a contribution to her state of mind and a detriment to her eventual recovery.

The scale is also used to determine an appropriate treatment regimen which goes beyond the simple use or rapid tranquillisation and isolation preferred by the staff of the hospital in which she is detained. The hospital has obstructed all attempts to have Elizabeth’s mental health condition based on a determination that their ‘diagnosis ‘ of schizophrenia would be the only option. Elizabeth is now seeing a neurologist but that has only happened because that intervention was sought by her mother and was indeed actively discouraged and obstructed by the Responsible Clinician and the Clinical Lead on the ward.

The Glasgow Antipsychotic Side effect (GASS) scale that they refer to in their email has an entirely different purpose to the PANSS scale and they are well aware of that. The GASS effect scale is for detecting adverse drug reactions and it has to be said if they are indeed using this they have ignored a number of these over the last two and a half years in spite of them being pointed out to them.

LPFT are fully aware that the GASS scale is not a substitute for PANSS but an entirely different test and the reply to the NR was disingenuous and unhelpful. To date no detailed explanation of why PANSS is not being used has been given and the Mental Health Act Team (notably the email does not identify its author) have failed to help once again.

In the absence of proper monitoring by the people entrusted with Elizabeth’s care is it hardly surprising that after two and a half years subjected to a deprivation of liberty regime more restrictive than a section 37/41 order and constant prn rapid tranquillisation that she has made no improvement and is as far away from discharge as she very has been.

The improvement and recovery of patients is higher with PANSS than with the informant based observation that LPFT use.

That, along with random selection of medication, failure to carry out tests and the ignoring of test results already established, failure to involve other healthcare professionals and even to obstruct Elizabeth from seeing them, oppressive deprivation of liberty including denial of her human rights and repeated use of rapid tranquillisation for their benefit and not hers has resulted in absolutely no improvement in 30 months of being held under the Mental Health Act in an acute admission setting.

LPFT have totally failed Elizabeth and tried to blame me for their failures. Dr K has even said I am contributive towards the seizures. Their admission that they don’t effectively observe patients but still continue oppressive deprivation of liberty just about sums up their failure.

Yours sincerely

Susan Bevis

Making and using
visual and audio
recordings of patients

https://www.gmc-uk.org/professional-standards/professional-standards-for-doctors/making-and-using-visual-and-audio-recordings-of-patients/principles

The above link may be of interest to those who like myself am not happy at hearing from Elizabeth that her thoughts and wishes have been ignored as regards being filmed. LPFT have assessed Elizabeth as having no capacity in capacity assessments that are highly contested, just like the MRI scans they did (United Lincolnshire Hospital Trust that came out normal) under their 1.5 Tesla Scanner that failed to pick up on details shown in the private scans I had done by S G Radiology. The Neurology department suggested the filming by the MH team but after all these years and neglect for the past 2.5 years under Lincolnshire I now want proper assessments on a properly equipped Neurological Ward carried out, particularly since Elizabeth is suffering from life threatening fits that end with her being rapidly tranquilised on every occasion. I have also questioned why it is necessary to inject her every time following a fit. Is this what is done for everyone that has epilepsy? What I would like to see is that she is sent to Sheffield not just for the Tesla 3 MRI scans but under THEIR observation for at least a week to undergo extensive tests. I am going to suggest this to my MP as I have not yet had a reply by the Neurology department I have just written to. I am far from happy at the filming as the MH do not have correct monitoring equipment, unlike a specialist neurological ward would in Sheffield. I also would like the cancer scans re-done, having seen an article where a woman died because nothing was picked up under a Tesla 1.5 scanner. I have been asking over and over again for Elizabeth to be referred to an Endocrinologist as again, I have proven by way of private tests there is Endocrine dysfunction. I have suggested patch tests which I explain later in this blog.

On the subject of filming patients there is disturbing technology to do this which is very controversial and I am not in favour of this as it infringes on a patient’s privacy. Elizabeth clearly said no to filming by the MH team and this was not respected by LPFT. She has capacity to decide. The disturbing technology to film patients is provided by https://www.oxehealth.com/ – It should be up to the patient to decide surely on whether this is OK with them. Not everyone will be in favour of such technology being used but once again unfortunately if someone like Elizabeth is deemed not to have capacity and everything decided upon as Best Interest once again a vulnerable person’s human rights are being abused. I believe only as a last resort should the new technology be used.

Turning to Mental Capacity and the flawed assessments – I totally dispute the these three capacity assessments done for Elizabeth to try to coerce her into my displacement as the nearest relative but Elizabeth did not wish to engage and said things like “no comment” – “it is nice weather today” and “my mother is the nearest relative”. For anyone also questioning their son’s/daughter’s capacity, a very good book to read is none other than what the Trusts’ currently use as their Guidance, especially when it would appear that Trusts and councils are abusing their powers in a dishonest manner. That Guidance comes in the form of “Demystifying Mental Capaity Guide for Health and Social Care Professionals which I have just ordered a copy of. What is so very wrong is that some Trusts, when carrying out capacity assessments deliberately to exclude everyone, especially mothers who happen to be the nearest relative who should have been invited to the capacity assessment and not excluded. I am now a BI assessor myself so I know that things have been done wrongly. Elizabeth’s Neurologist should also have been included. Details of these facts are contained in this guide which I intend to read indepth.

Demystifying Mental Capacity: A guide for health and …

Amazon UKhttps://www.amazon.co.uk › Demystifying-Mental-Cap…

Keith Brown. Editor. Demystifying Mental Capacity: A guide for health and social care professionals (Post-Qualifying Social Work Practice Series). First …

 Rating: 4.1 · ‎ 7 reviews · ‎ £26.99 · ‎ In stock  

I am Professor Keith Brown, the Founding Director of The National Centre for Post-Qualifying Social Work and Professional Practice at Bournemouth University (NCPQSW). Currently I am an Emeritus Professor at Bournemouth University 

The National Centre for Post Qualifying Social Work was awarded the Chartered Institute for Personnel and Development prize for the Best Example of a Continuous Professional Development programme in the UK. In 2010, the Centre was winner of the National Training Award for the Best Provider of Education/Training in the UK. In 2017, we received the first ever Chartered Trading Standards Institute (CTSI) ‘Institutional Hero Award’ for service and research into preventing financial scams. In 2020 the social work department at Bournemouth University was the Number 1 department in the Guardian League Table for the UK. 

I have been a recipient of the Linda Ammon Memorial Prize, which was awarded to the individual making the greatest contribution to Learning and Education in the UK, by the former department of education and science.

Currently I am the Chair of the NHS Safeguarding Adults National Network and a member of the National Mental Capacity Leadership Forum. I am also the chair of the Worcestershire and West of Berkshire Safeguarding Adults Boards 

I am the series editor for the Sage post qualifying social work series and have published over 35 texts in the social work field 

I continue to work with the National Trading Standards Scams Team in the area of fraud research and development and I am a member of the Financial Vulnerability Taskforce 

I am the series editor for the Sage/Learning Matters ‘Post-Qualifying Social Work’ series of text books, which has sales of over 75,000 copies in the past 5 years. I have written over 35 text books and published numerous research reports in the field of Social Work. I regularly speak at national and international conferences and am currently leading the national research into financial scamming on behalf of The National Scams team and CTSI. We are working together to not only reduce the risk of financial scamming but to raise awareness to organisations and the public so that they too can join the fight against scamming.

Perhaps he can be invited to LPFT to speak in light of their flawed capacity assessments. I have today tried to contact Professor Keith Brown as I am keen to discuss further the 3 flawed capacity assessments with such a renowned leading expert. Just like human rights being ignored, I am astonished at the lack of knowledge under Lincolnshire Partnership Trust and feel that wrong capacity assessments could also affect all the patients, not just Elizabeth. The book above is the Guidance that the Professionals concerned with assessing capacity should be using in any case and I will advice Lincolnshire County Council too of this fact. Anyway as a BI assessor myself I cannot possibly accept Elizabeth’s capacity assessments for two reasons:

1. In the context of mental capacity, causative nexus looks at whether an individual’s mental incapacity was a direct and significant cause for a particular action or decision. The aim is to determine whether the mental incapacity had a material influence on the outcome in question. Once you have identified an impairment or disturbance in the functioning of the mind or brain, it is important to decide whether the inability to make the decision is because of this impairment. This is known as the “causative nexus” (PC and NC v City of York Council [2013] EWCA Civ 478).

2.Mental Capacity Act 2005 :

(Section 4):  Requires that patient to be regarded as having capacity until evidence ascertained as to how that capacity is impaired.

(Section 4) (1) (a) and (b): “The Prohibited Step” Decision maker should not draw conclusion on capacity from patient’s age, appearance or on a condition of his/hers or an aspect of behaviour which might lead others to make unjustified assumptions on what might be in his/her best interests.

(Section 4) (2): Decision maker should try to identify all issues most relevant to the individual relating to particular decision (para 3, Main Code of Practice).

(Section D): inconsistencies of witness statements on capacity.  Capacity assessments not conducted as required by S1 MCA 2005

Masterman-Lister v Brutton & Co [2003] 1WLR 151 

“a party to legal proceedings is capable of understanding, with the assistance of such proper explanation (in broad terms and simple language) from legal advisers and other experts as the case may require, the matters on which their consent or decision was likely to be necessary in the course of those proceedings.”

The flawed capacity assessments all three of them (2 done by doctors, another by a social worker) were simply done to get rid of me as Nearest Relative but not just that, but to take complete control of everything, taking away Elizabeth’s autonomy and I do not like that one bit. I am having no other choice but to challenge all this right now and everyone should be aware of this which is why I am sharing all this information as it is important that vulnerable people and their families are treated with the utmost integrity and fairly which is surely what the MCA and MHA was intended for but unfortunately, some professionals are abusing this. Therefore everyone should look into matters thoroughly as regards capacity as I have done and get a copy of the wonderful guidance by Professor Keith Brown to show to their Trusts and Councils who will not be able to argue with their own guidance they are supposed to follow.

EASTER WITHOUT ELIZABETH:

Easter was once a joyous occasion, just like Xmas in the past but not any more thanks to Lincolnshire Partnership Trust who have stolen Elizabeth holding her a virtual prisoner without leave. I therefore cannot celebrate any of these occasions any more and even feel guilty going out places. I constantly think of Elizabeth held a virtual prisoner on a never ending section and deprived of a life of her own in what is supposed to be “appropriate care”. It is NOT appropriate as she is going downhill through lack of exercise and fresh air and contact with her family especially with the uncertainty of what will happen to her and threat of being sent a very long distance away from home and family to for example W Sussex and Yorkshire. I have written to Mr John Turner of the ICB about this.

I did not visit Elizabeth over Easter. I had hoped that others in the family would as I knew they were being treated differently to myself. Elizabeth’s Sister had asked to take her out to the Carlton Centre where Elizabeth thoroughly enjoyed herself during the only bit of leave ever given under Dr Waqqas Khokhar before be banned all leave and visits and imposed restrictions on phone calls which are still ongoing because you cannot just get through and this is affecting the entire family and a contract is paid on the mobile phone by the family. Elizabeth’s request to take her sister out was refused.

Elizabeth’s sister was disappointed she could not take her to the Carlton Centre which is just around the corner from the hospital. Elizabeth sister was staying with me over Easter but it was not a family occasion without Elizabeth. It is the ultimate punishment to take her away and imprison her, when it is entirely unnecessary. Plus she has a home of her own now which I provided.

LPFT should have carried out an impact assessment on myself, Elizabeth and copy given to the Nearest Relative, her sister who was found to be more suitable under NHS Guidelines but nothing was ever done about this.

Elizabeth was not well when her sister visited and it was described to me her appearance which was not good and the fact that she could barely keep her eyes open. She has started to miss meals again and will not leave her room just like at Ash Villa. They do not seem to understand she hates noise, she cant stand bright lights and does not like crowds either. The alarms are constantly going off on the ward and this is supposed to be “appropriate” care. It is most certainly not the appropriate environment to get well but I think they are deliberately letting her go downhill physically and mentally so she becomes a ‘vegetable’ because they want to put her into a care home out of area under DoLs for the rest of her life, restricting contact forever to her family for convenience purposes because the ICB is doing nothing about providing anything at all in the local community – not that they would have to provide much. She has a lovely home – a bungalow and where it would be much cheaper and she could make a recovery in the correct environment. It is not my local area (voted one of the best nationwide to live in) that is the problem it is LINCOLNSHIRE PARTNERSHIP TRUST AND THE ICB AND LINCOLNSHIRE COUNTY COUNCIL. It was never my intention to not want to work with professionals but it is the professionals who have behaved in such a way that they have abused the law and human rights. There is no accountability as the Executives on the Board have conflicts of interest that extend to the CQC.

I later found out that the reason Elizabeth was so tired was because she had been injected following an episode on the ward yet again. I dont know why staff feel the need to inject her after ‘an episode’ as I see this as being totally unnecessary and Elizabeth has said this is not what she wants.

My visit to see Elizabeth took place Wednesday. Elizabeth said she had missed my visit over the past week and that it was a long time since she saw me but I told her that I thought it would be nice for her to see her sister alone and had hoped that she could take her out as the punishment is not extended to other family members, just me.

I usually get a list of things that Elizabeth wants me to bring her. I had a dentist appointment that day so fitted in shopping in the Sleaford area before driving to Lincoln.

Elizabeth has started to scratch and rub her face like once before. This she was not doing before we moved to this area. I assume she does this out of sheer stress and she told me that Dr Khokhar was trying to encourage her to come out of her room but she did not want to and explained her reasons. I then turned to the young HCA making notes. I mentioned that it was very bad that Elizabeth had no breakfast, no lunch and that this problem was reoccurring. All I heard was that she had tried to encourage her to get up for meals. It would appear frequent injections are being given which I feel is the reason she cannot get up for any meals and just stays isolating in her room just like at Ash Villa to avoid people, noise, bright lights. I notified Adults Safeguarding again out of concern. It is after all risky for her to miss meals which makes her susceptible to infection, strain on her heart and liver when she restarts eating. Monocytes responsible for fighting off infectious pathogens retreat back into bone marrow if too many meals are missed. Just like the lack of oxygen during sleep this will combine to make her ill. Monocytes protect against cancer and heart disease by stopping pathogens getting access to the heart. When I asked if they put aside meals that she missed to re-heat I was told this was not done.

I have just written the following emails about this and included the CEO of the Integrated Care Board, John Turner.

It is a bad the way Lincolnshire Partnership Trust cancelled all physical health tests upon moving as being unnecessary, despite the discharge note pointing to “abnormal findings on scans”. It is even worse that they have also refused Endocrinology referrals as the skin irritation and sebaceous cyst reveal there could be Endocrine problems and besides I already proved this in private tests years ago.

 Dermatologic manifestations of endocrine disorders – PMC

National Institutes of Health (NIH) (.gov)
https://www.ncbi.nlm.nih.gov › articles › PMC5682371
by M Lause · 2017 · Cited by 160 — The first diagnostic step includes measurement of serum thyroid-stimulating hormone (TSH) and free thyroxine (FT4). If laboratory

I am going to write to my MP Victoria Atkins about this and also no sign of the Sheffield appointment – I feel this should be at least a week on a Neurological ward and also to carry out Endocrinology tests – all could be done at Sheffield who have the up to date scanners and equipment, unlike Lincolnshire. I have heard of some patch tests that can be done as I am concerned regarding the state of Elizabeth’s face which in parts is red raw due to scratching. There is obviously either allergy or related to the Endocrine system just as the sebaceous cyst and I am keen now for her to see an Endocrinologist – how many times do I have to request for this referral. I cannot even trust the cancer tests done last year as they do not have the right scanners.

Anyway I am now going to see what is going on by contacting Sheffield.

Royal Hallamshire Hospital

Endocrinology and Metabolic Medicine

0114 226 8680

I wrote to my MP only yesterday but definitely more than just the scans are required here in light of the neglect of essential appointments over the past 2.5 years.

I will let you all know how I get on with this.

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

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

Christopher Reid

<Chris.Reid@parliament.uk>;

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

Dear Mr Reid

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

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

Yours sincerely

Susan A Bevis   POA and Litigation Friend.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Out of sight out of Mind:   

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

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

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

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

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

Featuring LPFT, ICB, ULHT

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

Wed 13/03/2024 02:19

Good morning,

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

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

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

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

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

Dear Ms Ellis

Of course they are conflicts.

Please see attached regarding the CQC 

If the NHS purchase from Nemaura is a conflict.

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

Sent: 12 March 2024 08:54

To: susan bevis <susanb255@outlook.com>

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

Subject: RE: Conflict of Interest – ICB Board

 Good morning

 Thank you for your recent email.

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

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

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

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

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

Jules Ellis-Fenwick

NHS Lincolnshire ICB Board Secretary and

Head of Corporate Governance

Email: julieellis1@nhs.net

Please see below:

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

 Sources

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

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

 Reference list

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

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

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

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

Julie Pomeroy also has connections to Nemaura Pharma Ltd.

Trust Board Members :: Lincolnshire Community Health Services NHS Trust 

Sam Wilde – director of finance and business intelligence

Astra Zeneca.

Jim Connolly

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