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Steve Turner

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  1. Article Comment
    “Stand-alone units”, so-called “hot homes” and 'zoned accommodation' sound like good ideas. Given the current set up and the lack of a coordinated social care 'system' in England the start point needs to be having a strategy and plan for a radical overhaul of social care. Does this exist? Who leads it ?
  2. Content Article Comment
    Now I have read the full report I'm even more appalled. Three things stand out for me: Firstly, the need for urgent action to promote safe prescribing especially around prescribing competence and use of the Mental Capacity Act. Secondly, the need for an Executive Lead on CCGs for the LeDeR Reviews. I would ask all involved to check if your CCG has implemented this. Thirdly, the apparent inappropriate deference to the coroner's verdict, and they way in which this was used to protect reputations. at the expense of patient safety. In 2019 I gave a talk (see video) to the national NICE Medicines & Prescribing Team. It was based on Oliver's story / #oliverscampaign . I always wondered if I may need to change this talk in the light of new information that comes to light. Did I miss something? Was I being unfair in discussing the possible failings of governance & best practice in prescribing, and failure to follow the Mental Capacity Act? It seems I was not.
  3. Article Comment
    This is really shocking and the full story should not be paywalled in my view.
  4. Content Article
    Oliver McGowan died due to a reaction to a drug he was known to react adversely to. The learning disability mortality review (LeDeR) into his death said that "if Oliver had been assessed correctly on admission to hospital and staff had read his hospital passport, he may never have needed to be intubated and sedated". This is the second report into Oliver's case, following campaigning from Oliver's family. #oliverscampaign I believe all clinicians should read this latest report. There is so much to be learned and so many changes in clinical practice that can be made right away. Since 2018, I have been teaching using Oliver's tragic story to promote reflection on best practice in prescribing and in implementing the Mental Capacity Act. I could write a lot here; however, I believe this is a report all clinicians, and especially all prescribers, need to read in full. A summary of how I see this (or indeed how any individual sees it) it will not be adequate.
  5. Community Post
    It's #SpeakUpMonth in the #NHS so why isn't the National Guardian Office using the word whistleblowing? After all it was the Francis Review into whistleblowing that led to the recommendation for Speak Up Guardians. I believe that if we don't talk about it openly and use the word 'WHISTLEBLOWING' we will be unable to learn and change. Whistleblowing isn’t a problem to be solved or managed, it’s an opportunity to learn and improve. So many genuine healthcare whistleblowers seem to be excluded from contributing to the debate, and yes not all those who claim to be whistleblowers are genuine. The more we move away for labelling and stereotyping, and look at what's happening from all angles, the more we will learn. Regardless of our position, role or perceived status, we all need to address this much more openly and explicitly, in a spirit of truth and with a genuine desire to learn and change.
  6. Content Article
    I first met when Sam when he was a user of mental health services and I was working with an Assertive Team as his nurse. Over time we established a good working relationship and Sam’s condition, and the way he learned to manage it, improved. This was achieved primarily through self-awareness and psychological input, and also through getting the medicines right (that’s medicines optimisation – in jargon). Sam used to be admitted frequently to psychiatric hospitals, sometimes more than once in a year. He has not needed inpatient treatment since 2006. Together, Sam and I learned that medicines are not the only answer to being mentally and physically healthy. Sometimes they are needed. Sometimes less is more. The main component for success is building a relationship of trust and listening to what matters to the 'patient'. Early on we discussed the possibility of teaching together as equals, so we could share what we learned and help break down professional barriers. We’ve now been teaching together at pre and post registration level since 2008. In this video we reflect on a role play we presented to students, of a prescribing assessment. Our conversation focuses on the eight areas that prescribing students are asked to cover.
  7. Community Post
    I've been posting advice to patients advising them to personally follow up on referrals. Good advice I believe, which could save lives. I'm interested in people's views on this. This is the message I'm sharing: **Important message for patients relating to clinical referrals in England** We need a specific effort to ensure ALL referrals are followed up. Some are getting 'lost'. I urge all patients to check your referral has been received, ensure your GP and the clinical team you have been referred to have the referral. Make sure you have a copy yourself too. Things are difficult and we accept there are waits. Having information on the progress of your referral, and an assurance that is is being clinically prioritised is vital. If patients are fully informed and assured of the progress of their referrals in real-time it could save time and effort in fielding enquiries and prevent them going missing or 'falling into a black hole', which is a reality for some people. It would also prevent clinical priorities being missed. Maybe this is happening, and patients are being kept fully informed in real-time of the progress of their referrals. It would be good to hear examples of best practice.
  8. Community Post
    I believe staff are unsafe if patients are unsafe. The two things go together. The other thing is that when staff see bad practice going unchecked and are victimised for speaking out they leave if they can. Leading to a wide variation across orgnaisations. This is behind many large scale failings in healthcare & part of a worldwide cultural and societal problem.
  9. Community Post
    For me the top 3 are: 1. An individual duty of candour enshrined in law. The current DoC holds institutions not individuals to account. 2. Prescribers held to account for failure to follow the RPS Prescribing Competency Framework. This is a competency framework for ALL prescribers. 3. More education on the implementation of the Mental Capacity Act, and holding to account those who do not follow it. I've chosen these three areas because they are measurable and link directly to high profile failings including: * The alleged cover up of the death of Robbie Powell ( a Police Report suggested 35 criminal charges & the case is with the CPS). * The case of Oliver McGowan where prescribing a medicine he had previously reacted badly too contribuited to his death. * The Gosport Hospital scandal where in June 2018, the Gosport independent panel reported that there was “a disregard for human life and a culture of shortening lives of a large number of patients” at the hospital.
  10. Content Article
    How many of you know the full history of duty of candour in healthcare in the UK? It was Will Powell who, after the tragic death of his son Robbie, brought to light that there was none. Even today we only have an institutional duty of candour in place, leaving clinicians with the right to lie as no specific law exists to prevent this. I have included this poignant video as a matter of public interest. This is an issue which goes beyond party politics. I use Robbie's story in all of my teaching on ethics and clinical governance.
  11. Community Post
    Good question, I don't know. Some suggestions: I tried setting up the Turn Up The Volume! movement and we held two sucessful national workshops. This, I believe, helped bring together the main themes, involve patients (who are often not involved in these type of forums) and link people together who would not have met otherwise. The workshops were attended by senior NHS people, and then shunned by the NHS. http://www.carerightnow.co.uk/turn-up-the-volume-resources-2/ I have been commissioned to conduct a few workshops on whistleblowing (looking at the situation for all angles and encouraging reflection) in NHS trusts, and once in a University. They were well received locally. The NHS Whsitleblowing Support Scheme commissioned a study by Liverpool John Moores University in 2019 'Final evaluation survey - NHS whistleblowers support scheme' I have asked several times when this is to be published but received no reply. This may shed some light on the situation. Realted NHS web page: https://improvement.nhs.uk/resources/whistleblowers-support-scheme/ It's a tough one to crack and very senior people just won't talk about the deep seated problems of victimisation and blacklisting of staff and patients, and have unlimited resources to try and keep a lid on it. As exemplified by the National Guardian's Office, which as you know I believe is a dangerously (some say deliberately) flawed initiative.
  12. Community Post
    Good points Helen and Anton02. Thank you both. I did raise an FOI on the CQC's role, which revealed that they had incorrectly dismissed my 2012 concerns as 'all third hand'. The CQC also said they had lost the report that they asked to be commissioned in response to my concerns. A report I never saw. I think there's a lot more I could 'FOI'. I've chosen not to as it would take up so much time and probably be little help. Most of the blacklisting I experienced is informal and can't be proven. In fact I could be wrong on some of it. The loss of a contract which I was awarded, and which was taken from me the day after the award without a valid reason being given, is a different matter. I chose not to take formal action on this as I didn't want to get involved in legal wrangling. I've never applied for NHS employment since leaving Assertive Outreach in 2006 (except to apply help out short-term as a covid returner, without success). Fortunately I've been lucky as I had other alternatives. I do some teaching, and support 20 Community Pharmacies on Information Governance & do clinical assessment work. It's been tough financially, but I don't regret my decision to leave and to speak out. After all, as I see it, I was just trying to do my job properly.
  13. Community Post
    Thanks Helen. This is such an emotive subject and people (staff and patients) are victimised & blacklisted for speaking out in subtle, and not so subtle, ways all the time. I appreciate your reply. I wasn't expecting any. Maybe someone will comment anomyously. Also, I welcome criticism and questions on my views & experiences, that's how we can all learn.
  14. Community Post
    Way back in March I applied to re-join the NHS to help with COVID-19. I am a mental health nurse prescriber with an unblemished clinical record. I have had an unusual career which includes working in senior management before returning to clinical work in 2002. I have also helped deliver several projects that achieved nation recognition, including one that was highly commented by NICE in 2015, and one that was presented at the NICE Annual Conference in 2018. Several examples of my work can be found on the NICE Shared Learning resource pages. Since applying as an NHS returner. I have been interviewed online 6 times by 3 different organisations, all repeating the same questions. I was told that the area of work I felt best suited to working in - primary care/ community / mental health , specialising in prescribing and multi-morbidity - was in demand. A reference has been taken up and my DBS check eventually came through. I also received several (mostly duplicated) emails. On 29th June I received a call from the acute trust in Cornwall about returning. I explained that I had specified community / primary care as I have no recent acute hospital experience. The caller said they would pass me over to NHS Kernow, an organisation I had mentioned in my application. I have heard nothing since. I can only assume the backlisting I have suffered for speaking out for patients, is still in place. If this is true (and I am always open to being corrected) it is an appalling reflection on the NHS culture in my view. Here is my story: http://www.carerightnow.co.uk/i-dont-want-to-hear-anything-bad-whistleblowing-in-health-social-care/
  15. Content Article Comment
    I'm interested to find out when the results of the evaluation study of the scheme, carried out by Liverpool John Moore's University, will be published? I've asked NHSI. Had no reply so far. If anyone has any update on this is be interested.
  16. Content Article Comment
    I believe this scheme can help some people. It's a step in the right direction in my view. I have reservations about the coaching aspect though. Many whistleblowers are well respected clinicians and able to sucessfully manage their own careers in a non-toxic environment. They were simply trying to do their job properly when they became 'whistleblowers' and, what was a patient safety issue, suddenly became an employment issue. It's the isolation and blacklisting that they can suffer that's the problem. I'm not sure how this can be overcome. Steve

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