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Communications the centre of any therapeutic relationship. An experience with Oxleas this morning 28th April 2018 shows a worrying culture around communication thats seeping into NHS commissioned services.

When a professional is asked what the visiting times for a ward are, they can either tell you, or, say they don't know, let me go check. That's OK, no one can be expected to know every detail of every policy in their work place, and most humans cannot always recall facts. This is what it means to be human.

It becomes a very different matter, when information about ward visiting times, is refused until your name and a patient name are disclosed. What if you are calling on behalf of someone else? Visiting times are public domain information. Its not privileged information.

Patients staff and public should have open access to public domain information regarding hospital visiting times. One expects staff to have no inhibitions about sharing such obviously public information. When staff have hang ups about such simple information its cause for concern.

A fortnight ago I found an elderly man wandering in the street who had no recall of where he was, or, where he lived. It was cold he was wearing pajamas and had no shoes. I took him to A&E in my car, provided the reception with my name and contact details, and the name he gave me on a slip of paper. This was for me to recieve reassurance regarding him getting home safely (either from the hospital or his carer/relative). No one provided such. The current culture seems to avail no one the human capacity for such a humane socially cohesive communication. Communication in NHS funded services should be a tool for humanising, not privileging perceived status.

Public domain information should not be used as a bargaining chip. The interaction this morning with Oxleas raises worrying questions regarding how value is accorded to information and communication in the culture of Oxleas therapeutic relationships.

Dear Paul

Thank you for your comments and we are sorry to hear about your experience.

We are unable to provide any updates relating to a patient's care except to their nearest relatives.

We understand that this may be difficult but we need to adhere to data protection laws and protect patient confidentiality.

We are sorry that no one gave you the information relating to visiting times for our wards. We have raised this issue with Joanne George, Oxleas House Matron, who will raise it with her nursing team and clarify the position.

Thank you very much for taking the time to write to us.

Kind regards

Sophia Ploumaki
Associate Director, Greenwich Mental Health Services

I’ve been waiting for silver cloud for months and still nothing.

They mean well but don’t have the facilities or man power it seems to actually help.

Wish the NHS better funded mental health services like this.

Dear Alice

I am sorry that you have been waiting for input from the Greenwich Time To Talk team for so long.

We have had an increase in our waiting times due to high demand on the service. This wait is currently about 60 days for Silvercloud. So I am sure you will be offered an appointment soon.

Best wishes

Katy Grazebrook
Clinical Lead, Greenwich Time To Talk

My son has been referred to your service, but is getting no response. As a family we are at a loss of how to deal with him. His condition is rapidly declining. Just want my son assessed and to find out how we as a family can help him. I called your response team and was just rebuffed.
Please help.

Dear Mrs M

Thank you for contacting us regarding your son’s experience of using our service.

We are sorry to hear that the experience has not been a positive one. We value our patients and families' feedback as it helps us improve our services.

Jackie Waghorn, Crisis Resolution and Home Treatment team Manager (020 8836 6678 /, will contact you to discuss ways in which we can help.

Kind regards

Sophia Ploumaki
Associate Director, Greenwich Mental Health Services

I would highly recommend Greenwich Time To Talk having felt thoroughly supported throughout my treatment.
I self-referred after seeking advice from my GP and Alanna held my initial consultation over the telephone.
She was incredibly kind and understanding as she guided me through her questions and this helped put me at ease.
It was confirmed I had symptoms of anxiety and depression and was referred to Benjamin for 1:1 CBT.
Ben was consistently very supportive, detailed, professional and compassionate in his approach.
I felt listened to, understood and that my recovery was important. We covered many aspects of my personal history which contributed to my mental welfare issues as well as the immediate circumstances which were the catalyst for me requiring professional help.
This gave me a much clearer understanding of my own personality and behaviours which I found very useful.
We worked through a variety of strategies to enable to me deal with trigger scenarios and the ‘homework’ between each session helped underpin Ben’s advice and allowed me to work on those techniques.
I was also put in touch with Natasha for Employment Support guidance. Once again, the culture of kindness and understanding was very evident as well as Natasha’s advice proving useful on a practical level.

CBT is by no means a magic wand; it does require the willpower and commitment to make a positive change by challenging default thought processes. For me, this will take continued practice now my therapy sessions have concluded but I feel much more positive and confident that I have the ‘tools’ to help me face the future.
I am incredibly lucky to have accessed the Greenwich Time To Talk service and would like to say a very big THANK YOU to Ben, Natasha and Alanna.

Dear Helen

Thank you very much for your very positive comments about the service. I read them at the time and did pass on your thanks. I have been reminded now to thank you.

Best wishes

Katy Grazebrook
Clinical Lead, Greenwich Time To Talk

My father has been admitted to your inpatient facilities several times since August 2013.
His mental health continues to deteriate due to the inaffective 'care' that he receives from Oxleas.

Whilst staying with you, he has not received any formal therapy and is just fed medication to keep him stable and lethargic. He is then discharged earlier than he should be, often into a supposed bed and breakfast which actually turns out to be a dirty, pungent and unsafe halfway house which has an even greater affect on his mental state.

I have attended several appointments and spoken with doctors directly to express my concerns. I'm promised that appropriate action will be taken regarding my father's care, for it to be completely ignored a few weeks' later.

My father was admitted once again 5 weeks ago and through conversations with his doctor I was reassured that they would not discharge him earlier than needed and they would do all that is possible to ensure he is placed in suitable accomodation once he does leave.

Less than two weeks later my father is yet again discharged without anywhere to live, and with just two hours' notice. Whilst I understand that Oxleas have no direct effect over housing; they will definitely have a say on when treatment ends.

My father was subsequently sent to another halfway house that was dirty and unhabitable without any care plan in place. In the days following this, he became highly anxious, severely depressed and unable to eat.

The only way to get readmission is through visiting the A&E department and we have now been sat waiting for 10 hours and counting because of the incompetence of the team at Oxleas House, Greenwich.

When will Oxleas realise that if they treat their patients affectively and efficiently; there will be less readmissions and money will be saved in the long run?

Until then I will keep trying to support my dad the best I can, because Oxleas clearly can't.

Dear Chelsey

Thank you for your message. We are sorry to hear about the issues you have experienced and continue to experience whilst trying to look after your father. Here at Oxleas we actively seek patients and families feedback so we can continually improve our services.

We have asked the Modern Matron, Joanne George, to give you a call today to and discuss your concerns further. Ms George can be reached on 020 8836 6683 - she will make contact with you today to explore ways in which she can assist you and your father further.

Thank you again for taking time to let us know of your recent experience of services.

Kind regards

Sophia Ploumaki
Associate Director, Greenwich Mental Health Services

I have had a stroke and my quad stick is broken and I need urgent access to another one. I am struggling to walk with just my walking stick. Please can someone advise me where I can go to get my quad stick replaced.

Thank you

Dear Delroy

I have called and left you a voicemail message. Please can you call me back so I can direct you to the correct team who can advise you further on how the problem with your quad stick can be resolved. My number is 020 8836 8548.

Many thanks

Lisa Thompson
Associate Director, Greenwich Community Services

I am very interested in undertaking rTMS for treatment resistant depression and I have the funds in place to do so.

Before I proceed, however, I have two questions:

1) If I would like to undertake rTMS as a means to reduce or eliminate the medications I am taking, is it advisable to do this before or after rTMS therapy? I am worried that coming off medication afterwards may 'undo' the effect of rTMS.

2) If I would like to use rTMS to prevent relapse, what maintenance schedule is recommended if, for instance, I would like to take no medication. For instance, would one session per month be an adequate preventative measure? I am keen to maintain the effect of rTMS before I relapse and, therefore, avoid the cost of a repeat course of acute treatment.

I have been reading the anticonvulsants may decrease the effectiveness of rTMS according to Canadian guidance. I take 1800 mg gabapentin as one of my drugs. Is there any truth in this?

To answer your questions, whether you receive rTMS or not, your medication will have to be considered carefully. Most people having rTMS also take medication, unless they have decided to avoid tablets altogether. Many also have psychotherapy. Every component of a carefully considered treatment plan will have a synergistic action. In other words, other interventions may in fact help the chances of recovery with rTMS.

It is true to say that certain medications will be a better choice for a given individual than others, but this would apply in any case, even if you are not having rTMS.

As far as the maintenance is concerned, you are right, we often recommend something like one treatment every month or so, depending on personal circumstances, and this is often enough to keep you well.

Finally, no, I don't think the Gabapentin would be a significant obstacle.

Kind regards

Dr Rafael Euba

This borough’s mental services services are grossly negligent and I’m surprised there hasn’t been deaths as a direct result of the lack of care.

I was severely assaulted 6 years ago and tried to access the services two years later. I tried to commit suicide several times in one year and I have now seen on my notes that I was discharged on the same day I left the hospital. One telephone conversation note that I have read says that I told them I have active plans to kill myself and was going to try again, and the action taking was ‘discharged back to GP, further follow up not required’. I have request multiple times to see someone as my mental health made me unable to function doing simple tasks and I have been refused every time. I have been on 13 different medications in four years as a result of this. I was put on the counselling list in 2014 and I have chased it regularly, and unsurprisingly I am still yet to hear from them and assume I’ve been taken off the list without being told.

After another attempt on my life last year I finally saw a consultant psychiatrist in a private clinic and was diagnosed appropriately and now take anti psychotics.

I now work for the NHS and so I can’t afford to continue going to the private psych because I cannot afford it. The medical reports have been sent to this team and they refuse to acknowledge them and have said this diagnoses are not on the system. Why would they be, you’ve refused to see me? With this diagnoses and with anti psychotics that only a psych can prescribe and change the dose, they still refused to see me. I had a telephone triage and the information I gave has been down shockingly inaccurately to say I drink more than a litre of spirits a day..? How incompetent do you have to be when writing a report where I take prescription sedatives and work full time to not realise that drinking every day and that much doesn’t add up? I have looked at the telephone assessment notes and this isn’t even what the person has written. It seems like facts have been changed to once again take me out of the criteria to see a clinician. The psychiatest has actually told my GP to reduce my dose without meeting me or speaking to me, she told a nurse to tell me, it wasn’t a discussion.

The way I have been treated over several years by this site is disgusting, and seriously negligent. The team does not have any regard for patients and appear to deliberately creating and changing facts to stop very ill patients from getting access. This centre has caused me now to have no access to a specialist, whilst on psychoactive sedatives and anti depressants and beta blockers. Where do I go? The incompetence is terrifying and appalling.

I was referred by my GP for nail surgery on my ingrowing toenail which i had been suffering with for quite sometime. My first appointment was on Weds 4th April at the Fairfield Centre with a lovely lady called Caryn who not only explained everything to me but got me booked in for the surgery on Fri 6th April at the Garland Centre with Christian who performed the surgery for me. All I can say is how lovely they both were I must say they are worth their weight in gold. I can not believe I had suffered with this for so long and now after only not even a week after the surgery my toe feels so much better. I can not thank them both enough and would just like to say if anyone is suffering with ingrowing toenails get yourselves to see Caryn and Christian they really are the best. Thanks to them I'm now pain free.

Dear Janet

Thank you for taking the time to send such a lovely compliment in relation to the nail surgery you had.

We are delighted you are no longer suffering and are pain free as a result of the service.

I will pass your comments onto Caryn and Christian I know who will value your feedback.

Best wishes

Lisa Thompson
Associate Director

My gp faxed an Urgent referral for me to be seen by Orpington Mental Health Services. A few weeks later had a telephone appointment (assessment) with a nurse. After that nothing happend. Then recently, I found out I had been discharged with a referral to Mind who I am already engaged with - and I told the nurse that on the telephone appointment. Frustrated that I can't get to see a psychiatrist with a view to getting therapy for my long standing mental health problems.

Dear Laura

I am sorry to hear you have been disappointed by our service.

I know that Mel Bunyan, a senior clinician in our team, is in touch with you and you are agreeing a way forward. I hope that helps to resolve things for you.

Thanks for bringing this to our attention.

Best wishes

Estelle Frost
Bromley Adult Mental Health Service Director