March 2013 Issue 15
OURVOICE
Doctor who?
AWP’s medical director Dr Arden Tomison compares
notes and ideas with his successor, Dr Hayley Richards.
PLUS: Race to Recovery * Dealing with addictions *
Early interventions count * Stepping out * and more!
feature
welcome
It’s bigger on
the inside...
Come on in, gang. Don’t worry, you haven’t picked up
the wrong magazine.
Military intelligence
Attending an army health awareness event made
SDAS Involvement Worker Gareth Sharman look
back on his own experiences…
“
Recently I went with a colleague to an
Army Health Fair in Wiltshire. For me
as a veteran, attending these health
fairs every couple of months or so
is an exciting and sometimes rather
poignant experience. I was stationed in Wiltshire when,
unfortunately, my mental health
problems got the better of me many
moons ago, and every time I drive past
my old barracks a chill runs down my
spine. That was where I had my first
ever alcohol withdrawal seizure which
was a pretty scary and unpleasant
event for everyone concerned. Especially as I had a loaded rifle in my
hands at the time...
Anyway, going to these army events
is a great chance to talk to serving
soldiers and officers about their
local mental health service (very
few have heard about AWP before
they talk to us), to explain about the
South West Veterans service and our
journey towards Foundation Trust
status. But for me, the real benefit
is the opportunity to talk to the
young men and women who pass our
stand (approx 500 this time) about
any concerns or issues they might
have about their mental health. Often, of course, any chats are about
“friends” but that’s absolutely fine
of course. Being ex-military means
that I understand their jargon and can
ingratiate myself a little more easily
than would otherwise be the case. The combination of working with the
army’s drug and alcohol awareness
team for about four years before
I joined AWP, along with my own
experiences, gives me quite a unique
insight into the drinking and coping
culture and it’s very gratifying to be
able use that experience.
“
The fact is that so many of them are
so young and the nature of their job
means that discussing any aspect of
mental health can be perceived as a
“weakness” when they’re with their
mates. Being aware of this can be very
important. They talk about all sorts
of things from alcohol and drugs to
depression and Post Traumatic Stress
Disorder and if we can help a few or
point a few in the right direction then
that can be very satisfying.
If you are aware of someone who could benefit from the support offered by
the South West Veterans’ mental health service, please encourage them
to visit www.swveterans.org.uk
2 Enabling people to reach their potential.
Our cover – and one of the big features – has the feel
of a certain Timelord about it and it’s all thanks to a
comment made by Dr Arden Tomison. He said to his
team that handing over the title of medical director to
Dr Hayley Richards put him in mind of regeneration;
the title may stay the same but there’s a new face, new
ideas, a different way of doing things. So, never ones to
be put off from tampering with time and space, we put
the two of them together to see what would happen.
Read all about it – from behind the sofa if you wish – on
the next page.
Bet you could do with a rest after that thrilling start,
eh? Well you’re out of luck! There’s hardly a moment to
sit down as we take you back in recent history to join
the Race for Life, the frankly brilliant story of a service
user who has overcome the odds to set her sights on
completing a marathon.
We also have two features that share a common theme
of addictions and how we attempt to deal with them.
They may cause you to take a long look at your lifestyle;
they certainly did for me.
Meanwhile, jetting around the AWP universe as ever
is our own Lucy Robinson and this time she’s reporting
back on her travels to some amazing places. For
instance, she’ll be telling you about the importance of
early interventions in Wiltshire, and taking two giant
“steps” for services that look at less well known areas
of mental health services. Try and keep up at the back!
Everyone aboard? Good, then let’s set the coordinates
for the next page. Hold tight!
Simon
Simon Gerard, Editor
contents
4 The Two Doctors
It’s all change for our
medical directors.
6
7
Accentuate the Positve!
We take a Positive Step to
North Somerset...
I want a spindle fluted
hemlock and I want one now!
Great ways for NHS staff to sniff out
a bargain or two.
8
The ‘I’s have it
A tale of innovation, inspiration,
intuition...and ginger cake.
10 Race to Recovery
A service user’s ambition realised.
11 Ashes to ashes
Time to kick the smoking habit!
12 Stepping out
The STEPS team invite you around
their great new home.
13 30 Second interview
Marian Liebmann
14 A Bitter Pill
The hidden - and often ignored dangers of addiction.
Empowering people to live fulfilling lives. 3
feature
feature
When the opportunity arose again,
I felt things were changing [within
AWP] and there was a sense of a new
dynamism. That’s when I became
convinced... actually, desperate to take
the role. I did a lot of preparation and
got quite intense about it! So, to hear
I’d got it was a huge reward.
AT: Did you have people rooting for
you? Family, friends...?
HR: My children were very excited
even if they weren’t sure what it
meant. My 12-year old daughter
advised me on interview technique:
“Why don’t you tell them you’re
going to be very, very good at the
job, Mummy!”
AT: That’s very good advice!
HR: How do you feel though,
now that the process is over?
Are you relieved?
...the NHS has trained me, brought me up,
given me a great career, and there’s hardly
been a moment when I haven’t enjoyed the
work. I owe the NHS quite a lot.
The NHS has helped,
supported and guided me
and I feel quite a debt
of gratitude.
The Two Doctors
With our medical director
about to ‘regenerate’,
we wondered what would
happen if we could bring
the “old” and the “new”
together to meet. We simply
reversed the polarity of
the neutron flow, promised
them donuts, and here
they are…
Dr Arden Tomison (current medical
director): Now, we should be honest
and admit that this isn’t the first time
we’ve met...
Dr Hayley Richards (new medical
director): Not at all! You were my
clinical tutor when I was doing my
post-grad training.
AT: That’s right...
HR: It would have been 1990.
AT: So that’s when destiny started
bringing the two of us to this point?
HR: [laughs] Yes, but I don’t think
anyone starts their career thinking
they’re going to become medical
director. When I was a House Officer I
was just keen that I got through the
next job. Or the next night!
4 Enabling people to reach their potential.
AT: Although you reminded me the
other day that the training scheme
you were on and that I tutored has
spawned four medical directors.
Quite amazing actually.
But listen, I have to say I’ve never seen
anybody more excited about taking on
a job than you were when you knew
you’d got this role. You were
absolutely ecstatic. I wondered what it
was that was so exciting for you?
HR: Well, I do naturally respond to
things with great enthusiasm and
excitement; it’s my default position.
The interesting thing is that I hadn’t
thought about applying to be medical
director when it was first advertised
in the summer.
AT: Yes, I am to be honest. It’s been
a really long finish. A fifteen month
process which is probably too long
for anyone and too long for the
organisation. But the positive side is
that it’s been a slow glide to,
hopefully, a soft landing.
HR: It must be odd for you though,
Arden? After a long and illustrious
career, these are the final days of your
NHS employment.
AT: It’s... [he pauses for an age] ...lifechanging. I’ve lived and breathed it
for a long time – 32 years – although
it won’t be the end of clinical practice
for me. I still enjoy the connection
with patients and the challenge of
working with people in distress. Trying
to work through and understand their
needs is an enduring interest.
The thing is that the NHS has trained
me, brought me up, given me a great
career, and there’s hardly been a
moment when I haven’t enjoyed the
work. I owe the NHS quite a lot. But it
is definitely time for me to step away
and let the new blood in. It suddenly
feels very real now though!
HR: It’s funny that you said you owe
the NHS a lot because that’s part of
the conclusion I came to as to why I
wanted this job. The NHS has helped,
supported and guided me and I feel
quite a debt of gratitude. Same with
AWP...
AT: That’s right. Everyone knows the
NHS is changing fundamentally but
the core values and principles carry on,
don’t they?
HR: And in a way I think we’re
returning to and re-establishing those
values.
AT: Yes, and it’s those values that will
carry the services, irrespective of how
they’re configured or what the current
thinking is, above and beyond any
organisational changes. The landscape
of delivery is changing for mental
health services and that gives a lot of
new opportunities for how we provide
services. It’s much more than just
either community based services or
inpatient services.
HR: Can you explain that a bit more?
AT: I think it’s going to be about what
the public wants; a demand-led
service, where the population needs it.
That’s not only physical places but
smart phones, online-
“Why don’t you tell them
you’re going to be very,
very good at the job,
Mummy! ”
HR: -yes, I think technology is an
exciting frontier but mental health
support is fundamentally about
relationships isn’t it. Technology can
help us but it can’t ever replace that
human contact. On the subject of
advancement, how do you think
mental health services look now
compared to 32 years ago?
AT: When I started it was still “asylum”
based. People were in psychiatric
hospitals so the caseload was fixed.
The big changes are the range of skills
and techniques we now have. Skills
development across the workforce has
been huge. There’s other big steps
such as anti-dementia drugs, evidencebased approaches, better therapeutic
options...
HR: I think we’re defining what we do
and what we can do rather better too.
Drug and alcohol services, for instance.
We can state the reasons we do it and
the benefits. We never used to be able
to reference specialist services in the
way we do now.
AT: And let’s not forget that nurses
now routinely manage very complex
and challenging presentations of acute
mental illness in a way that was
inconceivable 20 or 30 years ago.
That’s often unsung.
HR: But I do think we have the
opportunity now to work with partner
organisations to raise the profile of
mental health nursing, and provide a
wider understanding of the issues and
the prevention side of it. Because
that’s what councils, CCGs, other
health bodies will expect of us too.
Good mental health is a joint
responsibility.
AT: True but it is still hard to talk
about mental health on a personal
level for many people, and to have a
national dialogue on it that doesn’t
get distorted through the lens of
media portrayal, fear or whatever it
might be. We haven’t had a concerted
public health campaign on these issues
for a long time. Although I think that
may be changing over the last year or
two with Time to Change for instance.
HR: Something that may well make a
big difference is the mandate to acute
hospitals to take care of the mental
health needs of their physically ill
patients. But stigma exists and I think
seeing people as a whole rather than
just as a set of mental or physical
diagnoses is how we might tackle that.
Ourvoice: Time is nearly up
unfortunately but we have one final
question. In the way that a new
government sweeps away all that its
predecessor put into placeHR: [laughs} NO! If you’re saying am I
coming in with an agenda and
ignoring what Arden has achieved, it
doesn’t work that way.
We have similar views about staff
development, quality, local standards.
What is going on around us –
foundation trust status, quality
governance, structures - dictates part
of the big agenda but you have to be
ready to spot the opportunities and
the needs as they arise while still
maintaining a strategic approach.
AT: Couldn’t have put it better myself...
HR: See? We’re the same but different.
Empowering people to live fulfilling lives. 5
feature
feature
From left to right: Adrian
Dugmore,
Heather Dugmore, Alex Ste
phens and Sarah Branton.
Accentuate the Positive
Sarah Branton attributes the success of
her service to a great team and supportive,
positive commissioners and partners.
The rise of Positive Step – North
Somerset’s improving access to
psychological therapies (IAPT) service
– since 2009 is due to all of the above
combined with the simple fact that
the service meets a need of the local
population in an accessible and
straightforward way.
Their courses, guided self help and
brief interventions are increasingly
popular. So when commissioners at
North Somerset PCT and the
incoming Clinical Commissioning
Group were faced with a series of
conundrums, Positive Step worked
with them to develop three new
services and pilots.
First of these is a service for people
with co-existing long term physical
conditions and mental health issues,
for example angina and anxiety, the
symptoms of which mirror and
exacerbate one another leading to
high use of health services. Focusing
on angina, type 2 diabetes and
chronic obstructive pulmonary
disease, the new service considers the
whole person.
Sarah says, “I feel very strongly about
integrating physical and mental
wellbeing and getting mental health
onto the physical health radar – the
two can’t be separated.”
Health psychologist Alex Stephens,
one of several recent recruits to
Positive Step, says, “Using similar
tools to the core service, we will help
people adjust psychologically to long
term conditions and managing their
day to day activities accordingly.
Additionally, we will be training the
core team to consider the impact of
long term physical conditions on
clients and we’re supporting physical
health practitioners to ask their
patients about mood and emotions.”
“I feel very strongly
about integrating physical
Hands up who
likes a bargain?
Melanie Vincent
goes in search
of savings.
and mental wellbeing and
getting mental health onto
the physical health radar –
the two can’t be separated.”
Sarah and Alex have joined forces
with cardiac and diabetes specialist
nurses, who will also deliver elements
of the courses, to provide a stronger
emphasis on the importance of
mental health matters.
The most recent addition to the
portfolio is weight management.
Working with the PCT’s obesity lead
and dietitians at Weston General
Hospital, Sarah and Alex are
developing a ‘readiness to change’
pilot. Over a year, five six-week
courses will prepare people – using
motivational techniques and the
change cycle – to make the changes
necessary for weight loss.
Hot on the heels of this came the
opportunity to develop a
psychological therapies pathway
specifically for carers. Heather
Dugmore, senior high intensity
therapist, says, “We’re working with
Crossroads, the local carer’s
organisation, to focus on the
emotional needs of carers, helping
them to maintain their caring role.”
Sarah says, “We’re excited about
getting these new services right
alongside continually improving our
core service and making it even more
accessible.” Adrian Dugmore, clinical
lead, concludes, “Throughout
Positive Step, the earlier we can
see people, the bigger the impact
we can have on wellbeing in
North Somerset.”
6 Enabling people to reach their potential.
I want
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We all like a saving, especially when
it comes to making big purchases like
a new TV, fridge-freezer, or when
splashing out on a holiday abroad.
But what about the smaller purchases
– what if you could always make a
saving on almost anything you buy,
from the essentials like food and
toiletries to the more obscure like an
oven door shield, an aerated block or
a spindle fluted hemlock?
One of the benefits of working for
the NHS is that employees can access
a whole range of discounts that can
save you hundreds of pounds a year.
For instance, did you know you could
reduce your shopping bill at
Sainsbury’s by 4%, or save 5% at
Argos or a whopping 7% at Wickes
(which is, by the way, where you can
buy that hemlock thing)?
There are over 200 popular retailers
offering these sorts of discounts to
staff, which means that in almost
every aspect of your life you could be
making a saving. Some of the better
know brands include Asda, B&Q,
Boots, Debenhams, Morrisons,
Mothercare, Pizza Hut, Thomas Cook,
Weight Watchers, WHSmith, and the
list goes on.
Reduce your shopping
bill at Sainsbury’s by 4%,
or save 5% at Argos or a
whopping 7% at Wickes
An easy way to find out what
discounts are available and where, is
to register with one of the
organisations that collate all this
information. A quick Google search
will reveal quite a few, but one of the
better known is National Health
Discounts* (formerly known as NHS
Discounts). By registering with them
at www.healthservicediscounts.com
you’ll have full access to their website
through which you can buy the
‘discount gift cards’ that can save you
up to 15% at some of the bigger high
street names, and you’ll also receive
email notifications of the latest offers.
And it’s not just shopping and leisure
activities where you can make
savings. There are deals to be had on
insurance, utilities, telephone and
broadband.
AWP’s very own Wellbeing scheme
also provides staff with a number of
benefits including reduced gym
membership and discounts on buying
new bicycles, as well as operating a
Staff Counselling Service which can
provide help and support if you are
having financial worries.
So next time you’re about part with
your cash, why not see if you can
make a saving? Many retailers are
happy to give a discount when
presented with an NHS ID badge. All
you have to do is ask – be bold and
brave and bag yourself a bargain!
*National Health Discounts and similar
organisations are independent of the NHS.
Before signing up or making payments over the
internet, make sure you’ve read and understood
all the relevant terms and conditions.
**Staff Counselling Service operates 24/7 –
telephone 0845 954 1511.
Empowering people to live fulfilling lives. 7
feature
feature
Inclusion is a big theme. The whole
team is included in working with all
the service users under their care.
Christine Dunnery, specialist nurse
practitioner and dual diagnosis link
worker, said, “We never feel as though
we are carrying risks alone – it is a
team risk with team support and team
problem solving.”
From the outset they include new
service users in group activities. They
include parents. And they include
brothers and sisters, who have role to
play in understanding and supporting
their siblings and, crucially, in their
future social inclusion.
The team realised early on that an
inclusive, activity-focused approach
Wiltshire early intervention in psychosis team
The ‘I’s have it
The Wiltshire early intervention
in psychosis team gave me cake.
A great slab of gorgeous iced
ginger cake baked – and this is
important – by their very own
Sara Simms. But more of that
(I wish) later…
This is a story about intuition, inclusion
and innovation. Once upon a time, not
so very long ago, an intrepid team set
off into a rural landscape to seek out
and help young people developing
psychosis. Their quest would prove
challenging yet rewarding.
Fast forward seven years. On a snowy
January morning I am sitting in the
Wilts early intervention team meeting
listening to Simon Hall, lead clinician,
suggest a novel collective solution to
the housing dilemmas of several
service users. Turning to include me,
he explains their intuitive approach.
“We work in a way that seems right
and effective for our population. We
listen to what our service users and
their families want and need, and
that shapes the service.”
8 Enabling people to reach their potential.
great way to gauge levels of function;
for example, seeing who has the
confidence to go to the counter to
place their order.” This starts the
journey for them to return to college,
university or back to work.
As I add this new ‘I’ to my list, Simon
explains that all the early intervention
teams in AWP take a similar
open-minded approach, sharing
ideas and best practice at quarterly
network meetings.
The inclusive, innovative approach
was embodied perfectly by a ‘fete-like’
activity day in December for service
users, families and friends. Organised
with siblings, more than 40 people
took part in arts and crafts, baking,
Innovation breeds innovation.
Involving siblings has led not only
to the activities day, which will be
repeated in the summer, but also to
one brother making a series of short
films. Topics to date include: siblings’
experiences of psychosis; medication;
staying well; and the benefits of early
intervention. Some of the brothers
and sisters are planning a siblings’
group. And following a 10-session
group for service users exploring
‘how to explain the unexplainable’,
“We work in a way that seems right and effective for our
population. We listen to what our service users and their
families want and need, and that shapes the service.”
would be much more effective than
individual appointments alone.
Regular groups include baking,
football, badminton, walking and
therapy focused groups.
“Doing a normal activity is a great way
of breaking down barriers,“ says Paul
Graves, occupational therapist and
vocational lead. He continues, “Doing
it in a group gives immediate peer
support and helps young people
realise that they are not alone – there
are many others going through similar
experiences.” Some strong, supportive
friendships have developed between
service users, too.
Sara Simms, specialist nurse practitioner
and carer and family work lead,
explains, “Observing ‘normal’ activities
such as meeting at a coffee shop is a
a walk, a raffle and information
sessions on dual diagnosis, cannabis
use, vocations and motivation. It was
also an opportunity to listen to
everyone’s views about how the
service should develop.
I ask how they funded the event.
There’s a brief pause before Simon
reintroduces the magnificent cake to
the story. As team baker extraordinaire,
Sara got busy in the kitchen, paying for
ingredients out of her own pocket. The
rest of the team then paid handsomely
to eat the results. They are a dedicated
bunch. It also helped that Simon pulled
strings to secure the venue, Warminster
Rugby Club, gratis.
specialist days are in the
pipeline on subjects including
‘how my brain works’ and ‘how to
tell loved ones how I’m really feeling’.
An hour has passed. The immediate
needs of their clients have been
discussed, actions agreed, cake
demolished. One brief snowball fight
later, the team sets off into the wintery
morning to make things happen.
Lucy Robinson
Sara sums up the team’s ethos,
saying, “It would be easy to
say ‘oh, we can’t do that
because there’s no
money’. Instead we
need to be inventive”.
Empowering people to live fulfilling lives. 9
feature
feature
len, Hayley
From left to right: He
line.
and Casey at the finish
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Here,
I have always had a passion to do a
marathon but never voiced it as I
thought I would be laughed at. I have
suffered with mental health problems
for about 15 years alongside many
physical conditions, not least of which
stem from a badly broken ankle
sustained in a car crash 24 years ago.
Wow! I felt so great
at the end. I felt like
I could do anything
– the world is now
my oyster!
Over the years my psychologist, Bill
Jerrom, and my family have kept me
alive and made me stronger to deal
with my mental health challenges.
But I have had too many operations
to count on my foot and I had just
about given up the idea of walking
unaided ever again. Then, one day,
I was struggling in a wheelchair at a
meeting at Callington Road. Helen
Abbott, head of physiotherapy,
saw me and offered to help.
Since then I have received so much
support, guidance and practical help.
I am losing a lot of weight with advice
from dietitian Natalie Clarke, I am
exercising and getting back to
swimming, which I love. I’m feeling
so much more positive about myself
and I’m walking, which I never
thought I’d do.
10 Enabling people to reach their potential.
Then, last summer, I achieved
something I hadn’t dared to believe
possible. With the support of Casey,
my daughter, and Helen Abbott,
my physiotherapist, I completed the
five km Race for Life on the Downs
in Bristol, finishing in one hour.
Wow! I felt so great at the end. I felt
like I could do anything - the world
is now my oyster! The Race for Life is
an achievement that has changed
everything. I have hope. I know there
will still be ups and downs but I hold
onto how I felt when I finished, with
my family cheering me on and my
husband standing there waiting for
me to finish with the biggest smile
and tears in his eyes. He was very
proud of me.
I have already registered to do the
ten km Race for Life this year and
hope that in 2014 I will be able to
complete a full marathon.
I finally feel I’m on the road to
recovery – but it’s also a long and
painful journey of discovery. Discovery
that I am stronger than I thought I was
and that my strength is growing day
by day. Of course I still have setbacks
and bad days, but I hold onto the
strength I have and I’m keeping my
eye on my goal.
With the help of my family and the
right psychological and physiotherapy
support, anything is possible. My
message to others battling with health
issues is to hold onto hope. And now
I hope to help others on their own
roads to recovery as I continue
along mine.
Ashes to ashes
Is smoking leaving a nasty taste in your
mouth? It might be time to give AWP’s
smoking cessation service a try.
Smokers eh? Why don’t they just give
up the filthy habit? Think of the money
they’ll save! And they could live longer
if they quit.
If you are, or ever have been a smoker,
you’ll have heard comments like that
a hundred times, but what those nonsmokers don’t realise is just how hard it
actually is to quit. Something that may
make it easier is AWP’s secret weapon:
the smoking cessation service.
Community Psychiatric Nurse, Chantelle
O’Shea had been smoking for about
ten years – not that she looks old
enough to have racked up that time
– and although she wasn’t aware of
health problems, she was encouraged
to stub out the habit. “I was smoking
perhaps 10 to 15 cigarettes a day, more
at the weekend if I was going out,”
she says.
“The weird thing was that I didn’t have
a big moment of thinking ‘I must quit!’.
I’d taken a break from it before then,
thought about giving up… Louisa was
around a lot and so we’d be talking
about helping other people to quit
smoking and I thought ‘why not?’.”
The Louisa that Chantelle mentioned
just then is Louisa Foxwell, AWP’s
lead active life trainer and specialist
smoking cessation advisor for mental
health. She had set up the smoking
cessation service to help staff and
service users to break away from the
difficult relationship smokers find
themselves in with the object of their
addiction.
The aim is to give
people the maximum
chance of success.
Louisa says, “The aim is to give people
the maximum chance of success. So,
for example, we chase any missed
appointments and are available
for those who need extra support
by telephone. We can meet service
users at home or another convenient
location and we meet staff in the
workplace, so hopefully it makes it as
easy as possible.
of giving up is that you need constant
praise! I don’t know why but that
motivation and praise helps you
carry on.”
Part of the process is to have weekly
CO2 readings to monitor how well your
body is responding to quitting and to
make sure you’re not having a sneaky
smoke. Louisa was able to prescribe
nicotine replacement therapy or NRT
for Chantelle. Fairly soon, Chantelle
found she needed the support less and
less, although she does stress that she
always carries the NRT around with
her just in case.
Currently the service is only available to
BaNES service users and BaNES based
staff although for colleagues outside
of that area there is an online elearning
course available on the MLE.
This article deliberately doesn’t raise
all the facts and fears around smoking.
If you smoke, you’ll know what they
are and the chances are you’ve put
them out of your mind for a long time.
So we’ll simply leave you to decide
what you want to do. But, just in case
you want to know more, you can email
Louisa on [email protected]
Chantelle admits that she was a
“committed smoker”, the type to go
out in all weathers in order to have
a drag, so how easy did she find the
process of quitting? “It helped that
I was in the same office as Louisa so
we could talk about it often. The thing
about being a smoker in the process
Empowering people to live fulfilling lives. 11
feature
regulars
Stepping
out
3
THE
STEPS colleagues, Ch
erry McStea and Tom
Snook chat in their ne
w surroundings.
SECOND INTERVIEW
Who has time to talk these days? Art therapist
Marian Liebmann – recently awarded an OBE
for her work – does but only for 30 seconds...
Q: You’re an art therapist but do you doodle while talking
on the phone?
Yes, of course – but I don’t spend ages trying to interpret them!
The STEPs eating disorders service
– headed up by Angie Jakubowska
– has come a long way since its
inception in 1999. Since moving into
Clifton Building at Southmead at
the end of 2012, the pace has really
picked up and they are stepping out
in some interesting new directions.
Ourvoice paid them a call to hear
more and find out how the new
facilities are working out.
between the different elements of
the service. Previously we had six
beds on an adult acute ward. Now
we have a ten-bed specialist unit and
also, for the first time, a dedicated
inpatient team working seamlessly
with the community team. It makes
life easier for clinicians and enables
us to work together more flexibly
and responsively. It is also much
better for service users and carers.”
“We’ve developed a real team
spirit since we moved in, “ says
Elaine Bartley, STEPs administrator.
Elaine and ward manager Adam
Deuchars are showing me around
Clifton Building and they are clearly
delighted with their new base. She
continues, “When the inpatient
beds and community service were in
different buildings, many of us knew
names but not faces – now we see
one another every day.”
Elaine adds, “It really helps that most
people who come in as inpatients
are already familiar, as outpatients,
Adam guides me around the
thoughtful layout: the dining room,
therapies room, group room and
inpatient area all open off the
spacious foyer. He says, “Co-locating
has enabled great cross-working
The new facilities are clearly a
success, but there are also some
pretty exciting-sounding service
developments. Following a successful
pilot with Bristol University’s Student
Health, STEPs has been commissioned
to provide a new primary care eating
disorders service and has recruited
three additional clinicians, based
in GP practices. They primarily use
cognitive behavioural therapy to help
people address eating disorders, thus
opening up this specialist service to
many more people.
nd two years,
Service users are typically with us for arou
,
often including more than one inpatient stay
a benefit.
so a familiar, comfortable environment is such
with the staff and building. It’s much
less daunting and they settle in more
quickly. Service users are typically
with us for around two years, often
including more than one inpatient
stay, so a familiar, comfortable
environment is such a benefit.”
12 Enabling people to reach their potential.
Next, STEPs’ increasing involvement
in research. A current six-month
study, led by the nursing team,
focuses on STEPs’ popular therapeutic
writing group for inpatients.
They are reviewing the themes of the
writing, how the activity is viewed
by participants, and outcomes.
What makes this study particularly
noteworthy is that, in the field
of eating disorders, research into
inpatient interventions is still rare.
Finally – for now at least – the
team has embraced experience
based design (EBD) with the aim of
streamlining their admission process.
Adam explains, “At first
we were sceptical but we’ve become
quite excited about EBD. People’s
experiences of admissions are being
recorded and analysed to allow
us – with service users, carers, GPs
and commissioners – to identify
improvements.”
It seems more exciting times lie
ahead and as Ourvoice went to press,
an open day was being planned to
celebrate their various developments.
The knowledge and expertise of the
clinical team aside, the dedication
and interest of the admin team is
particularly striking at STEPs – and
this is surely a sign of a great service.
Q: Has anyone made you laugh today?
Yes, I laughed when I saw kids in the snow enjoying themselves. Q: What job did you dream of doing when you were 16?
I dreamt of being a famous scientist (my parents were both
physicists) like Einstein, and travelling the world.
Q: Have you already chosen your attire for when you collect the OBE?
I won’t be wearing a hat, that’s for sure! I might wear my favourite
smart conference jacket, and buy a new shirt to go with it.
Q: If you receive bad service in a restaurant would you
complain or say nothing?
It depends. Mostly I would complain (in an assertive way, of
course!), as things can’t get put right if you don’t say anything!
If it’s something really small, I might not bother, life’s too short
to take up every issue.
Q: The tiger in the lifeboat is about to eat your entire CD collection.
Which album will you save?
Joan Baez – that probably shows my era! She has a beautiful voice
and sings about important issues that I feel strongly about, such as
peace and social justice. She also leads a life that’s congruent with
that, which many celebrities don’t. Q: Will you use ‘OBE’ at the end of your email signature block? Mostly not – but I have a friend who has been unjustly treated, and
I hope to write a letter on his behalf, signed OBE in large letters! Time’s up!
Empowering people to live fulfilling lives. 13
feature
feature
“Alcohol is a major problem around
here,” she says. “But it isn’t just street
drinkers or young people binge
drinking on the weekends. The
problems are hidden with middle
class or middle age drinkers, as it is
sociably acceptable to do so every
evening. 70% of people within this
cohort drink at home. Because we’re
doing it in our homes we don’t think
there’s any issue.
A Bitter Pill
Spend some time with the
Specialist Drug and Alcohol
team in B&NES and you’ll soon
realise there is no “them and
us” with addiction; just “us”…
14 Enabling people to reach their potential.
While some people do fit a stereotype
the reality is they are no different
from you and I, and addiction can
strike anyone at any time, any place.
People appear to be going about
their daily business and showing no
outward signs of problems. I dress
well and have a decent life so how
can I have a problem?
“Bath has addiction problems that
are not very different from those in
Bristol, Trowbridge or Midsomer
Norton,” according to Paris James,
Service Manager in Bath and North
East Somerset (B&NES) and Wiltshire
for the Specialist Drug and Alcohol
Service. “However Ketamine (an
animal tranquilliser) use is rife within
B&NES, which has led to a Ketamine
steering group being formed.
“Unfortunately, there’s a view that
you can have a detox and that’s the
end of your problems. It isn’t. People
need to take more responsibility for
their lifestyles and be aware of the
amount they drink. Daily continual
use of alcohol can lead to problems
such as liver disease later on in life,
it is therefore recommended that
people have at least two drink free
days together a week.
Obviously there are other addiction
problems which aren’t quite as
common place as booze and
cigarettes – “two of the most
dangerous drugs on the market”
is the view of the team – but which
still cause an enormous amount of
damage. Amphetamines, so-called
“legal highs” (usually synthetic
compounds which mimic the effects
of illegal narcotics) alongside
Ketamine are regular issues for
SDAS to try and tackle.
“You can go into shops around this
area and find legal highs openly on
sale,” says senior administrator
Fiona McCraw, clearly irritated by
the situation.
“There’s no regulation on these
things and nobody knows what is in
them. But because they’re “legal”
people think they’re safe. It’s the
same as “cutting” pure drugs with
other products – baby powder, Ajax,
cement dust – in order to make more
money for the dealers. You might
think you’re getting cocaine or
whatever, but you don’t know how
many other things you’re putting
into your body.”
Recently, SDAS were informed that
they were the successful provider of
the substance misuse complex service,
which includes social care,
prescribing, GP support services and
more. With the service showing
response rates amongst the best in
the country, this is seen as excellent
news for staff and service users.
“In each of our sites we work closely
with the recovery services to ensure
that our clients get the best level of
care,” says Paris.
Pictured, Non medical prescriber
Steve Barnes; senior administrator
Fiona McCraw; (front) Paris James.
One of the innovative approaches
being taken by the SDAS team is
the mysterious sounding Project 90.
Created by the team, Project 90 is
a support group that helps people
detox from opiates over two weeks
with psychosocial support for a total
period of 90 days, whereas normally
it would take a lot longer. Already
the signs are good and the project
could be extended to other parts
of the Trust.
“What is very special about B& NES is the
ers,
relationships we now have with commission
g
service users and our partners – all workin
offer
together for a common aim and that is to
very.”
service users the best possible chance of reco
“We are really creating something
unique for the service users in
B&NES,” says Paris.
“What is very special about B&NES is
the relationships we now have with
commissioners, service users and our
partners - all working together for
a common aim and that is to offer
service users the best possible chance
of recovery.”
Empowering people to live fulfilling lives. 15
The achievers
Congratulations to the following colleagues.
Business and Administration NVQ
level 4 qualifications:
Elayne Richards (Medical Secretary, Recovery
and Intensive Team, Bath NHS House) completed
in November 2012
Business and Administration NVQ
level 3 qualifications:
Carrie Bryant (Secretary to Dr. Dietrich,
Intensive Support Team, Long Fox Unit) completed
in November 2012
Nadia Simons (Administrator, Positive Step,
Coast Resource Centre) completed in November 2012
Ruth Langenberg (SPE Referral Co-ordinator, BBH,
Bristol) completed in January 2013
Health and Social Care NVQ level 3
Sharon McKeown (HCA on Laurel Ward, Callington
Road Hospital) completed in January 2013
Certificate in Working in Community Mental
Health Care level 3 – all completed in January 2013
Wendy Appleford
(Recovery support worker, Wiltshire)
Linda Doel (Assistant Psychologist,
Green Lane Hospital, Devizes)
Victoria Bolton (Mental health worker,
NWilts CIT, Green Lane Hospital, Devizes)
Mary Groake (Mental health worker, CIT, Bristol)
Elisabeth Hardwidge (Nursing Assistant, S & SS
Rehab, Larch, Callington Road)
Sandra Jennings (Nursing Assistant, S & SS Rehab,
Elham Way, Weston Super Mare)
Debbie Kingsbury (Recovery support worker, Adult
Community Wiltshire, Intensive North)
Muriel (Joyce) Jones (Recovery support worker,
Adult Community Wiltshire, Intensive North)
Gary Evans (Recovery support worker, Adult
Community Wiltshire, Intensive North)
Adam Parker (Drug & Alcohol worker, SDAS BANES)
Christine Salter (Nursing Assistant, SGlos Therapies)
Carol Pattinson (Drug & Alcohol worker, SDAS KNW)
If you are a Band 1-4, you may be interested
in the following courses:
The level 3 Certificate in Working in Community
Mental Health Care (Community staff only, not
specifically working with people with dementia)
The level 3 Diploma in Mental Health Care (Staff
not specifically working with people with dementia)
Or for people working with people
with dementia:
The level 3 certificate in Dementia Care
The level 3 diploma in Health and Social Care
For further information, please contact
[email protected]
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If you prefer to read them online you can now find them
on our website. Search ‘Ourvoice’ and you can catch up
on all your favourite features. Don’t miss it!
Published: March 2013
Editor & cover design: Simon Gerard
AWP communications team
Email: [email protected]
Trust Headquarters
Jenner House, Langley Park Estate,
Chippenham, Wiltshire SN15 1GG
Switchboard: 01225 325 680
www.awp.nhs.uk
Printed on FSC approved paper using vegetable inks
Story for the next issue?
Email: [email protected]
using subject header ‘story’.
Graphic Design: Ice House Design – Bath