Roslyn Byfield, Patient Information Manager at South London and Maudsley NHS Foundation Trust (SLaM) has been running a project called Closing the Gap,which has been tackling mental health stigma, lack of information and signposting about mental health services and conditions, and insufficient joined up working between primary and secondary care at a critical junction in the changing health and social care commissioning system.
The Closing the Gap project sought to address the following concerns:
- An information gap between primary and secondary care at a time when the move to GP commissioning within the Health and Social Care Bill makes it imperative to develop joined-up working and closer cooperation between the sectors
- Lack of signposting as to where to obtain reliable patient information for themselves or to support others
- The variability of consistently available and accessible information in primary care, contributing to service users not knowing what they are entitled to, disempowerment and health inequalities.
In terms of the wider context, the project also indirectly addresses standards compliance: the need to share information with patients and carers is a standard to satisfy for NHSLA and CQC compliance.
Regardless of their route into mental health services, the right care at the right time can make a substantial difference to health outcomes. The standards and policies recognise that people need information to help allay anxiety and frustration and to help them make informed choices about their treatment and care. An information deficit can also impact negatively on carers, friends and families.
Therefore they aimed to help service users, carers, clinicians and members of the public across the Trust’s catchment area, by:
- addressing the ‘information gap’ often apparent between primary and secondary care, for example, when people first present to their GP with a mental health issue or are discharged back to their GPs from SLaM services but do not receive any or the right information about their difficulties, treatment and care options and community resources such as support groups. [The existence of this gap, leading to difficulties for people making informed choices about their treatment and care, has been evidenced by local surveys, the Lambeth Information Project and by Warner et al- as described in the project application].
- tackling stigma associated with mental ill-health by employing service users to talk to stall visitors, effectively demonstrating a capacity to live meaningfully despite mental health issues
- reflecting and reaffirming a strategic goal within the Academic Health Science Centre this trust belongs to, currently applicable to dementia, of achieving closer cohesion between primary and secondary care services.
Building on previously successful events marking World Mental Health Day, they organised patient information stalls at three time points during the year 2011-12 in GP surgeries across SLaM’s four boroughs and in local hospitals. This equated to seven or eight stalls each time, ie a GP practice in Croydon, Lambeth, Lewisham and Southwark and at King’s College Hospital, Guy’s Hospital, St Thomas’s Hospital, Croydon University Hospital (last tranche only) and the Maudsley Hospital. To coincide with the busiest times and heaviest ‘footfall’ GP stalls were during the morning and hospital stalls from roughly 10.30 am – 3.30 pm, usually avoiding Fridays. By giving out leaflets about SLaM services, mental health conditions, treatment options including talking therapies and general items on wellbeing/how to look after one’s mental health, ‘freebies’ and interacting with stall visitors they aimed to raise awareness of mental health, tackle stigma and forge closer links between primary and secondary care to give visitors a flavour of having their information needs met.