Dr Peter J Gordon: Care of Older People in Hospital Standards – Reblog

Hole Ousia

The Chair of Healthcare Improvement Scotland, Dr Denise Coia, has confirmed that the Care of Older People in Hospital Standards are scheduled to be published at the end of March 2015.

I submitted my considerations on the Draft Standards last November and I wrote to Dr Coia to seek an update on further progress made. Dr Coia’s reply was very helpful and I wanted to acknowledge this:

Care-Standards1

My interest in the Care Standards goes back many years. Although Healthcare Improvement Scotland have not always considered me to be an “interested clinician” I have in fact been an NHS Consultant in NHS Scotland for 14 years:

Care-Standards2

I remain hopeful that Healthcare Improvement Scotland might give some written response to my considerations and questions regarding Delirium screening in Scotland which I wrote almost a year ago. It would have been preferable to have had the thoughts of those involved with delirium improvement…

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exchanging Emails with Derek Feeley IHI (formerly NHS Scotland head), a Fifer born and bred

On Sunday I had forwarded the Email I sent to my MSP, Roderick Campbell, to Derek Feeley, Institute of Healthcare Improvement (IHI), Cambridge, Massachusetts, USA (formerly Chief Executive of NHS Scotland until 2013) and to his colleagues at IHI:

On Mr Feeley’s IHI bio it says he has “executive-level responsibility for driving IHI’s strategy across five core focus areas: Improvement Capability; Person- and Family-Centered Care; Patient Safety; Quality, Cost, and Value; and Triple Aim for Populations. His role is international in scope, guiding work to deliver on IHI’s mission to improve health and health care around the world.

No pressure there then.  I just want to see psychiatric services improve in Fife where I live and where Mr Feeley was born and bred, and lived before going off to the US of A.

Here is the Email sent to my MSP:

Yesterday I received a response from Mr Feeley:

“Dear Chrys,

Thank you for copying your email to me and to some of my colleagues here. I just wanted to offer three pieces of clarification to you:

  1. I have never worked in NHS Fife. I was born and brought up in Fife and I lived there before I left for the USA.
  2. IHI does have a contract to work with the NHS in Scotland. This was awarded after an open competition. I was not involved in the decision to award the contract.
  3. I did not receive any payment when I left my role with the Scottish Government and NHSScotland.

I hope that this is helpful.

Regards

Derek”

To which I responded, with passion and, I have to admit it, great irritation and annoyance on hearing that Derek Feeley is a Fifer and has lived in Fife yet did not manage to shift the abusive culture in Stratheden Hospital, despite heading up NHS Scotland and having the ear of the First Minister (2002-4) and others in government.

I’m from Perth and not a Fifer, yet I’ve lived in Fife since 1990.  The fact I’ve had to take a stand against the abuse, and that my family have had to suffer for it, really gets my goat. Plus the bucketloads of money that seems to be changing hands across the ocean while I am having to manage on £61/week as an unpaid carer (Grrr… gritting my teeth):

Strapline: Stratheden Hospital, Fife – locked seclusion room, no toilet, water, light switch outside – human rights abuse 2012 – Mad in America blogger – Tidal Model of recovery

“Dear Mr Feeley

Thank you for responding.

I am interested to hear that you were born and brought up in Fife, and lived here before going to the US.  I do wonder why then, having such an understanding of Fife, working as Chief Executive of NHS Scotland until 2013, how you could be so unaware and ignorant of the culture in Stratheden psychiatric Hospital, Cupar, Fife, where they have been using a locked seclusion room with no toilet or drinking water, light switch outside, for over 30 years and more?  I know of one man from Glenrothes who in 1981, aged 16, was locked in this same seclusion room for over 12 hours at a time, physically assaulted and then sexually groomed by a male nurse.

A Fifer and living in Fife, with a lifetime’s working experience of NHS, and yet you didn’t know what was happening behind the locked doors of the main psychiatric hospital in Fife.  I am astonished and astounded.  I have lived in Fife since 1990 and my experience of Stratheden’s Lomond Ward from 1995 onwards alerted me to the issues in the hospital, having been an inpatient myself in 2002 briefly.  Not least the fact of nurses being sacked for assaulting patients and there being the most “Left Behind” patients, according to the Mental Welfare Commission report of that name, in 2011.

My youngest son became an inpatient of the Stratheden IPCU for the first time on 1 February 2012 and it only took me a few days to realise that something was very seriously wrong with the nursing practice and with the treatment of patients in the ward.  Locking my son up for hours at a time in the seclusion room, broken hand untreated, no toilet or water to drink, whereby he had to defecate on the floor.  Because no-one came to rescue him my son staged a dirty protest and for this he was held face down in his own urine and faeces, resulting in a glandular inflection and a number of veruccas on his feet, requiring months of podiatry treatment after discharge.

I took my complaint against NHS Fife to the Ombudsman and my complaint was upheld in September 2014, “unreasonable treatment”, which was in fact human rights abuse, worse treatment than what prisoners get in Scotland.  Who at least get a toilet in their cell.

In case you were unaware, here is my blog on Stratheden Hospital which details parts of my campaign:
http://strathedenhospital.blogspot.co.uk/

I also have other blogs, some of which are below on my signature, and write for Mad in America as a “foreign correspondent”:
http://www.madinamerica.com/author/cmuirhead/

The Mad in America website is run by Robert Whitaker, author of his book of the same name and Anatomy of an Epidemic, published in 2010.  I believe Bob Whitaker lives in Cambridge, Massachusetts, where IHI is based so you may know him already.  He was an investigative reporter with the Boston Globe in his earlier days and is an author of other books also.  I invited Bob to Cupar, Fife, in November 2011, to give a lecture on his Anatomy book, he stayed in St Andrews, Fife, for two nights.  Here is the film of his talk, for your interest, as I don’t think you were there:
https://vimeo.com/40373667

Prof Phil Barker and his wife Poppy Buchanan-Barker, Fifers like yourself, introduced the lecture and gave a closing speech.  Phil and Poppy are architects of the Tidal Model of Recovery, a nursing practice model.  I believe that NHS Fife nurses have been trained in Tidal but don’t practise it.

I hope that you find this information helpful.

I will return to the second and third points in your Email, if I may, at a later date,

Yours sincerely,

Chrys Muirhead (Mrs)”

To be continued ….

 

why I was shocked but not surprised at the scandal about NHS Scotland, IHI and HIS in Scottish Sunday Express 22 February 2015

sunday_scottish_express_logoAlthough I have been campaigning and speaking out critically about Healthcare Improvement Scotland for some time, including my exclusion from patient safety events and the bullying I have been subjected to by Scottish Government uncivil servants because of it, I was shocked but not surprised to read the Scottish Sunday Express news article yesterday about the millions of pounds changing hands, involving IHI, HIS and NHS Scotland, with links to government ministers:

NHS Scotland in takeover by US health giant‘ Ben Borland, Sunday Express, 22 February 2015

It took my breath away, the scale of the scandal, and the fact that I had sat through a Derek Feeley “masterclass” in the Chrystal Macmillan building of Edinburgh University, on 5 November 2014, organised by the Health & Social Care (former Long Term Conditions) Alliance, for their new H&SC Academy, opened by Alex Neil MSP on 19 May 2014, at which I was a spectator. 

Mr Feeley, who was born and brought up in Fife, had lived here when he was the Chief Executive of NHS Scotland, at the 5 November Alliance event brushed off my question about the “unreasonable treatment” of my son in Stratheden Hospital, Fife, saying that things were worse in other parts of the world.

As if human rights abuses going on in Fife psychiatric wards are OK. Well I don’t think so, not when it’s my son who’s being abused. That is unacceptable in my opinion, and insulting.

It is very galling to read that the organisation Mr Feeley now works for, the Institute for Healthcare Improvement in Cambridge, Massachusetts, was involved in setting up Scotland’s patient safety programme, linking with Healthcare Improvement Scotland, which has been excluding me from national and international events because I have a critical voice and a negative story to tell, of psychiatric abuse in Fife.

Then I read that Mr Feeley has “a gold-plated Scottish Government pension worth £1.1million” from Scottish Government and is still earning a fair whack, no doubt, while I am picking up the pieces after traumatic psychiatric treatment on a Carers Allowance. I have attended 3 Carers Parliaments, from their inauguration in 2012 to the last one on 8 October 2014.

alexsalmondFM

Carers Parliament 2013, Alex Salmond speaking (photo by me)

Alex Neil MSP and at that time Cabinet Secretary for Health attended the Carers Parliament on 8 October 2014, along with Michael Matheson MSP. I notice in the Express article that Alex Neil MSP, gave Mr Feeley a “glowing reference” along with the million pound pension handshake on his resignation as head of NHS Scotland in 2013. Off he sailed to Boston and the IHI gravy train.

Scottish Sunday Express page 4

Meanwhile HIS managers are swanning off to Florida with their sunscreen to have a “Team Scotland huddle”, including Dr Brian Robson and Jason Leitch. Here is a tweet that I sent to Dr Robson when he was at the Orlando conference on 10 December 2014:

Richard Norris is Director of the Scottish Health Council and I spoke to him at the Stronger Voice event on 9 October 2014 in the Dundee Discovery Point, where I was filmed by a social reporter speaking about the importance of critical voices and listening to people’s pain:

[Although I mention in the video that the Alliance were supportive I am now not so sure of this and think they are more about political involvement, keeping government happy, rather than standing with unpaid carers and people who use services, on the breadline. Sad to say.  And so I have withdrawn my membership of the Alliance.]

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Here is another strand to what I and others see as the undue influence and power of HIS linked to IHI and NHS Scotland:

Dr Brian Robson (@brobson3), HIS Executive Clinical Director, IHI Fellow and GP, was responsible for hounding my friend, Dr Peter Gordon, an experienced >consultant psychiatrist for older adults, out of NHS Forth Valley in the summer of 2014, because Dr Gordon has a questioning voice.

Blog post by Dr Gordon on his Hole Ousia website from 23 July 2014:

Correspondence with Healthcare Improvement Scotland (HIS)

Which contains a letter from Dr Brian Robson, dated 22 May 2014, to Dr Gordon’s employers NHS Forth Valley, accusing Dr Gordon of “unprofessional” behaviour:

robson letter may14

extract from Dr Robson letter 22 May 2014

this individual” “Dr Gordon has persisted” “unprofessional” “misinformation” “behaviours” and so on, language that was both undermining and bullying by intention, I contend.

This attack on Dr Gordon’s character caused him to resign from the permanent post he had been in for 13 years with NHS Forth Valley and led to him looking for temporary work in another health board area.

And then on 5 December 2014 I witnessed another personal attack, on social media, by HIS National Clinical Lead Karen Goudie who used #unprofessional in a tweet to describe Dr Peter Gordon.

I immediately warned Ms Goudie that I was watching and thought her tweets were bullying in nature, then raised a complaint with the HIS Chief Executive Angiolina Foster. On 30 January 2015 I received a letter from Robbie Pearson, Deputy Chief Executive, Director of Scrutiny & Assurance, Healthcare Improvement Scotland (HIS), to say that my complaint had been upheld and an apology given, to both Dr Peter Gordon and myself.

Dr Gordon’s blog post on Hole Ousia, 31 January 2015:

Apology from Healthcare Improvement Scotland

Here is a link to the blog post about my complaints process with HIS: 

My Complaint to Healthcare Improvement Scotland about the Targeting of a Doctor by their National Clinical Lead‘ 

Dr Peter Gordon’s blog post 7 February 2015: ‘Why I have decided to leave Social Media

Extracts from blog post: 

There are several reasons why I have decided to leave social media behind however the primary one is that as an NHS employee in Scotland I do not feel safe in using social media.

The personal consequences for me in raising ethical considerations on twitter to try and help improve care for our most elderly have been most significant. The organisation that appears to have struggled most with my ethical questioning has been Healthcare Improvement Scotland. There are individuals who have not shared my views who have associations with Healthcare Improvement Scotland and may have contributed to this response.”

Here is just one aspect of Dr Peter Gordon’s ethical endeavours, his continuing campaign for transparency in drug prescribing through his Sunshine Act for Scotland petition:

Open and transparent from omphalos

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After reading the Scottish Sunday Express news article yesterday morning, at 11.35, I wrote to my MSP Roderick Campbell, shocked and upset by the content:

And then later in the day yesterday, at 15.27, I sent another Email to my MSP copied in to other government ministers, including a blog post I’d written with the tweets from the Derek Feeley “masterclass” on 5 Nov14 organised by the Alliance. I was still in a state of shock about the whole affair:

I forwarded on this Email to Derek Feeley and a number of his colleagues at the Institute for Healthcare Improvement, Mass, USA. Then today I received a response from Mr Feeley to which I replied. I will put these Emails in a following blog post, together with any other responses I may receive from Scottish Government ministers.

I am still very unhappy at the way I’ve been treated by Scottish Government civil servants and health board staff, for speaking out about psychiatric abuse and unreasonable treatment in Stratheden Hospital, Fife. I have been targeted by uncivil servants and excluded from key patient safety events for no good reason, had my reputation and character slandered by people who are paid by government.

For over 3 years I have been fighting for justice and to be heard while also supporting my son singlehandedly after his traumatic experience as an NHS Fife psychiatric inpatient in February 2012, through the flashbacks and coming off the psychiatric drugs. In addition I support another son who has a disability. On £61/week as an unpaid carer and at 62 years of age, a grandmother.

It’s a scandal right enough.

 

‘NHS Scotland in takeover by US health giant’ Sunday Express & my tweets #DerekFeeley masterclass 5Nov14 @alliancescot

NHS Scotland in takeover by US health giant‘ Ben Borland, Sunday Express, 22 February 2015:

“THE astonishing and largely hidden influence of an American private healthcare giant at the heart of Scotland’s NHS can be exposed today.

Boston-based multinational Institute for Healthcare Improvement (IHI) has been paid millions of pounds in public money to introduce sweeping reforms across Scottish hospitals.

The extraordinary relationship was cemented two years ago when the former chief executive of Scotland’s NHS stepped down in the wake of a scandal to become Executive Vice President of IHI.

Derek Feeley and his colleagues in Massachussetts now work closely with Scottish Government and play a key role in steering policy in the NHS, as well as social services, early years care and education.

This is despite the SNP insisting that the private sector is only involved in the “margins” of the health service in Scotland.

Last week, Health Secretary Shona Robison praised a fall in hospital death rates and announced a funding boost for the “world-leading” Scottish Patient Safety Programme.

However, the programme was in fact developed by IHI and the firm has been instrumental in rolling it out across the country ever since the SNP first came to power.

Carol Hararden, another IHI Vice President, “currently leads IHI’s work with Health Improvement Scotland aimed at transforming the safety of every Scottish hospital over five years”.

The Scottish Government has paid IHI at least £5.6million in Scottish public money for its various contracts.

IHI – founded by Professor Don Berwick, who led the controversial ‘Obamacare’ health reforms in the USA – is a not-for-profit company.

However, accounts show it generated some £26million in operating revenues last year and had £62million in cash and investments. It also receives funding from a number of US health insurers, such as Kaiser Permanente and Blue Cross Blue Shield.

Mr Feeley resigned to join IHI in April 2013, with a glowing reference from then Health Secretary Alex Neil, just weeks after it emerged he had put pressure on Audit Scotland to water down a report on problems with hospital waiting times.

A career civil servant, who also served as Principal Private Secretary to First Minister Jack McConnell, he retains a gold-plated Scottish Government pension worth £1.1million. His new salary has not been disclosed, although IHI paid out £17million in wages and other benefits to its 140 staff last year.

Derek-Feeley-256690

Derek Feeley (Express photo)

Mr Feeley had to be granted special permission from then First Minister Alex Salmond and Permanent Secretary Sir Peter Housden, head of the civil service in Scotland, in order to take up his new role in August 2013.

A letter from Sir Peter, released by the UK’s Advisory Committee on Business Appointments, shows that Mr Feeley was forbidden from “lobbying” the Scottish Government for two years from that date.

However, he was back in Scotland earlier this month to attend a “strategic meeting” between IHI and the Scottish Government.

He also spoke at the firm’s National Forum in Orlando, Florida, last December, which saw a number of senior NHS and Scottish Government officials jet across the Atlantic at taxpayers’ expense.

They included Jason Leitch, the National Clinical Director Healthcare Quality and Dr Brian Robson, the Executive Clinical Director of Healthcare Improvement Scotland.

Indeed, so many Scots were present at the sun-soaked conference that photos have emerged showing Dr Robson leading a “Team Scotland huddle”.

It was held at the Orlando World Center Marriott Resort & Convention Center, a luxury resort with its own swimming pool “oasis”, giant waterslides, 18 hole golf course, award-winning restaurants and spa.

In December 2011, Mr Feeley – then still in charge of the Scottish NHS – was a keynote speaker at the Florida conference, alongside the Hollywood actor Michael J Fox.

Two years later, in 2013, he posted on Twitter: “Just arrived in Orlando for my 1st Forum as an IHI staff member. Can’t wait to get underway. Weather lovely – bring sun screen.”

Back in Scotland, the most recent contract has appointed IHI to act as NHS Scotland’s “Quality Improvement Partner”. Awarded in June 2013, it has so far been worth more than £860,000.

A “core team” of seven employees runs the “Scotland Programme”, making crucial decisions about the day-to-day operation of the NHS and advising on everything “from healthcare to road safety”.

Other programmes include Safety in Maternal Care, based on a project with disadvantaged mothers in Louisiana, and the Primary Care Safety Collaborative, which learns from IHI’s work with Native Americans.

IHI has contracts with with private healthcare providers across the USA, and also operates in England, Saudi Arabia, Qatar, Singapore, India, Denmark, Sweden, New Zealand, South Africa, Brazil, Chile and Colombia.

It was founded by Professor Berwick, who went on to become Barack Obama’s head of the Medicare programme and later carried out a review of patient safety in English hospitals.

Although his appointment was opposed by Republicans, his work with IHI – including his mantra that much health spending is “waste” – had previously won praise from ultra-right wing American politicans such as Newt Gingrich.

Last night, the Scottish Conservative health spokesman Jackson Carlaw said: “This exposes the SNP’s referendum rhetoric on the independent healthcare sector as a fraud.

“It’s incredible that the Scottish Government should be so damning of private health on one hand, yet so dependent on it on the other.

“These revelations have left the First Minister with some very tricky questions to answer indeed.”

A Scottish Government spokeswoman said: “The Institute for Healthcare Improvement is a not-for-profit organisation, and has been instrumental in helping to deliver the world-leading patient safety programme that has had such a positive impact on the safety of patients across Scotland.

“The programme has become internationally recognised for the improvements in care and safety that it has delivered, since 2008, as we have seen a reduction of 25.5 per cent in surgical mortality, an 80 per cent fall in C.Diff rates in the over 65s and an 89 per cent decrease in the number of MRSA cases in Scotland.

Derek Feeley has had no involvement in contractual decisions, has not lobbied Ministers or officials, and has operated within the Business Appointment rules.

“A small number of officials travelled to the Institute for Healthcare Improvement International Forum in order to ensure Scotland continues to learn from and share the very best practice on patient safety and quality improvement.””

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Here are a series of my tweets from a masterclass with Derek Feeley on 5 November 2014, organised by the Health & Social Care Alliance through their #handsascademy (health and social care academy) initiative, which I attended and walked out of during Mr Feeley’s talk. (Alex Neil, MSP and CabSec Health at the time, launched the H&SC Academy 19 May 2014 at the Edinburgh City Chambers, another event I was present at)

I was annoyed at Mr Feeley’s response to my question about the “unreasonable treatment” and human rights abuse going on at Stratheden Hospital, Fife, where he used to work. I find it insulting that IHI, where he now holds a high position after receiving a large pension from Scottish Government, should be main players in the Scottish Patient Safety Programme.

I am also concerned about the links between IHI and HIS who have banned me from attending Scottish patient safety events and have blocked me from their twitter accounts. For speaking out about psychiatric abuse and the bullying of healthcare staff.

 

 

 

 

 

 

 

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Link to Healthcare Improvement Scotland page on my blog

 

“Toxic certainty” – Alzheimer’s Society; Reblog

Hole Ousia

In a recent post I asked ten questions of Alzheimer Scotland. I was worried that they were in a bit of a muddle. So far Alzheimer Scotland has not answered my questions. The elders of Scotland may not have such choice.

In this post I will ask questions of a sister “campaign”, that of the Alzheimer’s Society.   AS 01

The Alzheimer’s Society has huge influence and like our Prime Minister, in his “Dementia Challenge”, they adopt “fighting talk”

Fighting talk from omphalos on Vimeo.

Like Alzheimer Scotland, the Alzheimer’s Society have an  “early diagnosis campaign”

AS04

I am a specialist in dementia. The Alzheimer’s Society talk of the “right” to have “certainty” as part of their “early diagnosis campaign”.

A colleague of mine, an old age psychiatrist, has recently retired. This colleague was also Chief Executive Officer of the Mental Welfare Commission. He said, a year or…

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Letter to Director of Training for Psychology Services at NHS Education for Scotland – “I wanted to strike while the iron was hot”

Here is a letter I sent by Email this morning to Judy Thomson, Director of Training for Psychology Services at NHS Education for Scotland (NES), copied in to the Professors, academics and administration workers whom I know at the DClinPsy courses, Glasgow and Edinburgh universities:

Strapline: Formal Response Letter – NES “independent review of EBE involvement in DClinPsy training in Scotland” – initial suggestions

“Dear Judy

I am writing to you as the Director of Training for Psychology Services at NES (please correct me if I have your title wrong), in respect of this statement in the formal response letter sent to me yesterday:

“NHS Education for Scotland will commission an independent review of EBE (experts by experience) involvement in DClinPsy training in Scotland. We will be considering the scope, remit and methods over the next couples of months in consultation with partners.”

I wanted to strike while the iron was hot, before the review started, to give you some of my thoughts, both as an experienced, qualified community and project development manager/leader, and as an EBE who has been trying to be meaningfully involved in the DClinPsy programmes at both universities since 2009. I think this gives me the right to comment and to be heard.

Firstly I have to say that the government should be putting money or resource into the EBE programme. I know that there was a £444million underspend by Scottish Government at the end of 2014 report:

http://www.heraldscotland.com/politics/scottish-politics/scottish-government-in-record-444m-underspend.115737258

And I know that the HEAT target of reducing waiting times for access to psychological therapies, to within 18 weeks, is struggling to be met in many health board areas. Therefore it makes sense to set aside a decent sum of money to garner the experience of people who use, or have used services, and their carers, in the design and delivery of the clinical psychology training in Scotland.

I would recommend creating specific development/co-ordinator posts to assist with the task, maybe split FT posts, half of the hours going to a user/carer/EBE consultant, the other to a seconded DClinPsy staff member or CP from a health board area who lectures on the course. Pay them both the same rates per hour which will mean a decent salary for the user/carer/EBE person. You could ask, work with, the user/carer groups, CUSP and APEX, at both universities to design a job spec and task sheet etc.

I recommend asking the group members to work on this in their own time also so that it doesn’t take a year to hire someone. The key thing, in my experience, is to set timescales and stick to them. Move quickly so as to keep the momentum going. There is no reason why you couldn’t have two people in post within 6 months and with an action plan set up, for the first year. You may describe the EBE post as user/carer or “lived experience” but it might not mean that the person employed still uses services or is a carer but that they have past experience of it. People do recover from mental illness.

To clarify, I don’t want a paid job out of this and I don’t intend to be coming back to either DClinPsy EBE group. I’ve been there, done that, and I’m busy with other stuff these days. However I do want to see EBE meaningfully involved in Scotland’s clinical psychology training and level playing fields for everyone participating. A place at the table for a range of voices. It’s why I first got involved.

I hope this is helpful. I’ll be putting it in a blog post as usual,

Yours sincerely,

Chrys”

 

Reblog, Dr Peter J Gordon: Sponsored medical education: another Scottish NHS Board

Hole Ousia

Those who have followed my posts on Hole Ousia will know that I have petitioned the Scottish Parliament for a Sunshine Act. As an NHS doctor working in Scotland I was recently invited to this educational meeting. I thought it might be useful to use this as an example of the current situation for continuing medical education as I have encountered it in Scotland.

Passmore, 26-2-2015, NHS Lothian

Although this flyer does not make clear, this educational meeting is sponsored by the Pharmaceutical industry. Professor Peter Passmore has been described as a “key opinion leader” in medical education both in the UK and internationally.

This list of declarations for Professor Peter Passmore is from 2008 as given to the Journal of the Royal College of Physicians in Edinburgh.

Geriatric-Medical-Symposium2

I do my best to avoid sponsored medical education but I do try to attend meetings organised by the Royal College of Psychiatrists. For the Autumn…

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