Bereaved families bring case against government over prisoner suicides

Relatives of prisoners at HMP Woodhill who have taken their own lives are to bring a legal challenge against the institution’s governor and the justice secretary for allegedly failing to introduce basic safety measures. Eighteen prisoners have killed themselves at the jail in Milton Keynes since early 2013 despite repeated recommendations and guidance from coroners’ reports and official bodies that investigate deaths in custody.

The most recent death at Woodhill was before Christmas, shortly after the high court granted permission for the case to be heard. Deaths in custody reached a record high in England and Wales last year. In 2016, there were 119 self-inflicted deaths; the previous year there were 89.

The action has been brought by Pearl Scarfe and Julie Barber, the mother and sister of Ian Brown, who took his life in his cell in Woodhill on 19 July 2015, and Jamie Blyde, the brother of Daniel Dunkley, who died on 2 August 2016, four days after he was found hanging in his cell.

The families are seeking to persuade the court to order that the governor of Woodhill prison and the justice secretary, Liz Truss, take urgent action to reduce the risk of self-inflicted deaths in the future. Woodhill had the highest suicide rate of any prison in 2016; seven prisoners killed themselves there last year.

Barber said: “Ian was much loved. Our loss has been unimaginable. We all miss him every day. I believe if he’d had the help and support he needed he’d still be here. Every time I hear about another death in the prison, I think: ‘Why?’

“If lessons had been learned when my brother died, all those families would not have had to go through what we have had to go through. It’s hard for us to hear about more deaths. It makes me angry that suicides have happened that could have been prevented if changes had been put in place, as they should have been.”

The judicial review, to be heard at the Royal Courts of Justice in central London, is being supported by Inquest, the organisation that helps relatives at coroners’ courts. Inquest says it is concerned about the lack of a national oversight mechanism to monitor, audit and follow up actions taken in response to recommendations by the Prisons and Probation Ombudsman and coroners.

Deborah Coles, the director of Inquest, said: “The number of self-inflicted deaths occurring in prisons in England and Wales is currently at record levels. It is therefore more vital than ever that preventative actions are identified, changes implemented, and sustained improvements enforced to prevent future deaths.

“The current system for learning lessons and implementing changes arising from deaths in custody is not fit for purpose; it does not adequately prevent future deaths, meet the hopes and needs of bereaved families, or satisfy the wider public interest.

“The deplorable situation at HMP Woodhill is just one stark example of a much wider national problem. Deaths occur time and again as a result of repeated failings. Families are told that lessons will be learned, but nothing changes. The reality is that the Ministry of Justice has wholly failed to address the unacceptable rise in self-inflicted deaths.”

Jo Eggleton, a solicitor at the law firm Deighton Pierce Glynn, who represents the families of Brown and Dunkley, said: “[They] have shown great strength in bringing this claim. Despite the awful ordeal they have been through, they have put themselves on the line to try and protect others and prevent future deaths.

“They and the other families of men who have died at Woodhill that I represent share this common goal and have worked together to try and make it possible. They should be recognised and applauded for that. It’s just a shame that this claim has had to be brought at all.”

In a letter to Truss last week, the Labour MP Harriet Harman, the chair of parliament’s joint committee on human rights, called for a national oversight mechanism “with a duty to collate, analyse and monitor learning outcomes and their implementation arising out of deaths in prisons”.

In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.

Bereaved families bring case against government over prisoner suicides

Drive to bring health and social care together is a well-intentioned mess

As figures leaked to the BBC reveal the worst A&E performance figures in 13 years, a dissection by the National Audit Office of the stalled progress towards health and social integration lays bare government hubris and fictional promises of progress from within the NHS.

Integration takes many forms, including multidisciplinary teams making coordinated assessments of a patient’s care needs, services for a particular condition being brought together, and organisations pooling budgets and jointly commissioning services.

Governments and the NHS have been firing off integration policies since the 1970s. Recent ones include the 2010 announcement that £2.7bn would be transferred from the NHS to local government to promote joined-up working; the 2013 spending review announcement of the Better Care Fund, which resulted in health and local government pooling £5.3bn to integrate services and reduce pressures on hospitals; the launch that year of the Integrated Care and Support Pioneers Programme to make joined-up and coordinated health and care the norm by 2018; and the Five Year Forward View in 2014.

Every time ministers indulge in this sort of nonsense it undermines the credibility of subsequent attempts at reform

The NAO skewers the government on its failure to provide any evidence that integration delivers sustainable cuts in costs or hospital activity. An international study by the University of York in 2014 of 38 integration schemes in eight countries failed to find any robust evidence supporting claims of sustained cuts in admissions, yet ministers persist in creating the impression that integrating services will lead to costs falling out of the system.

The Better Care Fund epitomises the endless cycle of central money being tied to unachievable targets, which encourages local NHS bodies to make promises they have virtually no chance of keeping.

The fund aimed to save £511m in its first year, by cutting demand for hospital services. Everybody in the NHS knows that stabilising emergency admissions would be a huge achievement, let alone cutting them, yet local Better Care Fund plans played along with the fantasy that they could deliver a rapid reversal by promising total reductions of 106,000 admissions between 2014-15 and 2015-16, saving £171m. Admissions went up by 87,000, costing £311m more than planned. Furthermore, delayed transfers were supposed to be cut by 293,000 days; they went up by 185,000.

Every time ministers and NHS leaders indulge in this sort of nonsense it undermines the credibility of every subsequent attempt at reform. Cynicism takes hold, rotting belief that improvements can be made.

There were better outcomes for reducing admissions to care homes, and increasing the proportion of older people still at home 91 days after discharge, but these in no way compensated for the reversals elsewhere.

Damningly, the NAO points out that the three main barriers to integration – misaligned financial incentives, workforce problems and poor information sharing – have been flagged since at least 2003.

The failure to break down these barriers leads to the crazy situation where health and care staff can only succeed in working more closely together if they fight the very system that employs them. In any rational world, processes and structures would be set up to promote the goals you are trying to achieve, not obstruct them.

System bodging should be a compulsory training module for NHS and social care managers, as it is now a core requirement of the job. From STP governance arrangements to competition law to sharing patient records, astonishing amounts of time and money are squandered trying to find ways around the rules.

Overall, the drive to bring health and social care together is a well-intentioned mess. Countless integration cottage industries across the country are working largely in isolation from each other and semi-detached from wider work such as the STPs. Their work is based on poor evidence, effort is duplicated, and time and money is wasted fighting the system.

If integration is to have any chance of happening, government and the NHS central bodies need to focus relentlessly on removing the barriers to change, joining up disparate policy initiatives and gathering and disseminating credible evidence as to what everyone should be doing.

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Drive to bring health and social care together is a well-intentioned mess

How to Bring the Joy of Gardening Indoors

So, you’re not an outdoor person. The thought of bugs and sunburn have you running for the safety of your home. Just because you prefer the indoors doesn’t mean you can’t reap the benefits of gardening and plant life.

Many believe plants can make people happier by giving you more meaning in your life. Watering a plant occasionally does not seem profound, but it really can have a positive impact.

Caring for greenery has other added benefits. Plants filter the air. They absorb gasses around them and emit cleaner oxygen. Learning the needs of different plants expands the mind. Some like lots of sunlight and water. Others prefer shade and infrequent watering. It is fun to learn what your potted beauty prefers.

If you decide to plant herbs and veggies, your loving kindness produces fresh herbs and vegetables for the table. Eating the fruits of your labors is a joy like no other.

Herb Garden

Growing herbs in your home is a great way to add some green on a small scale. Grow your favorite herbs in just a couple of small containers. Unless you have a large window, you may need to invest in some grow lights as well. Many people are able to have a flourishing garden on the windowsill. Popular choices include basil, bay, chervil, chives, oregano, parsley, rosemary, sage, tarragon, and thyme.

Pick plants that you think you will use in the kitchen to start with. This gives you a little extra motivation to tend to your window garden. These herbs will leave your home smelling fresh and your dishes tasting even fresher. Your herbs will need at least four hours of natural light a day. South and southwest facing windows are the best.

Tea Garden

Tea gardens are just another form of herb garden but with a different benefit. Tea herbs are great for hot and cold beverages as well as medicinal purposes. Chamomile, lemon balm, and mint are great to get started with.

Chamomile is a relaxing tea that helps calm nerves, settle stomach aches and indigestion, and help you sleep. It can even be used for a soothing foot bath. It is an easy plant to grow from seed. It has an attractive and fragrant white flower that adds a little brightness to an indoor space. Pick the flowers as they start to bloom and dry in the shade for the best tea.

Lemon balm has a light lemony taste and fragrance. It is known as the ‘happy herb’ because it acts as a natural anti-depressant. This is probably due to its soothing effect on the nervous system. This herb thrives in the sun or in the shade. Leaves should be dried in the shade.

Mint can easily share a pot with your lemon balm plants. Peppermint tea is great for soothing stomach aches. Mints are easy to grow and come in many varieties. Make sure to select a container with a wide surface. Harvest the leaves before budding and hang to dry.

Your well-being is increased by any form of gardening. Herb gardens are an easy and enjoyable way to bring the joy of gardening indoors. Plants bring fresh air, life, and beauty to any space.

How to Bring the Joy of Gardening Indoors

For change in social care to bring value, it must be messy

Last year was characterised by sudden, unpredicted change. Some certainties unravelled overnight, as polls turned out not to reflect votes, others had been building for some time.

The crisis in health and care services is being dangerously accelerated by cuts, but you can trace its roots back to decades-old failure to take seriously the ever-growing gap between what services can deliver and the growing demands on them. It is easy to believe that all the future holds is the loss of services. But the future will be whatever we choose to make it.

There is a time for tweaking and refining the existing model, but perhaps the middle of the widespread collapse of health and care services is not that time. We need significant central government investment to avoid crisis becoming catastrophe, but then what?

Sustainability and transformation plans (STPs), which were the big headline of NHS change in 2016, are for the most part prime examples of how we lack a model for radical change in public services. They are the system responding to crisis by doing what we always do – just faster, at bigger scale and with more anxiety. The more urgent and important the work, the less leaders feel able – or obliged – to involve a wide group of organisations, let alone people who use services and their families.

Most STPs express what leaders were already intending to do, with little of the involvement of new people that would have led to new aims, approaches and behaviour. Lack of collaboration has bred suspicion, but they are not the secret cuts plans they have been dubbed: they are more likely to avoid talking about cuts that have been inevitable for years.

Where they say the right things about community-based care or prevention, many are essentially works of fiction with no model for the culture, power and economic changes needed.

There is much talk of scale in public service delivery, but nearly always this is the industrial age’s need to operate in large units. Our large organisations, silted up with the governance requirements that must accompany any big budget, are not the place where change will happen.

The real challenge is to scale those bureaucracies down to be human and family-sized again. The lesson of successful models – such as personal budgets, Shared Lives, community enterprise, Buurtzorg, local area coordination and Homeshare – is that we avoid the prototype-then-replicate approach and instead create enough infrastructure for people to form similar but entirely individual relationships everywhere. This is the scaling model of the internet age.

The only kind of change you can make happen suddenly, on a large scale, is destruction, whereas creation of anything real and valuable starts small, but ambitious. For real change to take hold, you need to involve people who don’t always agree with each other and you need a tolerance for messiness: the neater the plan, the more fictional it is.

There many kinds of people who care about each other and who already change the world around them: hundreds of Homeshare households, thousands of community entrepreneurs, 10,000 Shared Lives carers, tens of thousands of timebankers and millions of unpaid family carers. Can those overlooked groups join together, gradually and messily, to become a national movement that chooses to build a better, more human future? Do we still have time?

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For change in social care to bring value, it must be messy

NHS plans could bring benefits but we"re barred from telling the public

I work in programme management in the NHS for a commissioning support unit: we support GPs’ clinical commissioning groups and other organisations on matters such as finance, IT, service transformation and change management. Recently I’ve been supporting our local system to develop a sustainability and transformation plan (STP) – bringing NHS bodies together with councils and community providers, and producing a five-year plan to improve care and find the very ambitious savings required of us.

The benefits of STPs could be huge. The whole system is short of money, and we have a growing and ageing population with increasingly complex needs. To have any chance of sorting this out, we must bring health and social care services together – and STPs have sparked some real collaboration. People who have been plugging away at different aspects of the same problem for years are now working together, and there’s huge enthusiasm.

We had a difficult start, though, because NHS England made up the policy on the hoof. Late last year, work had started across England on initial plans: by April, we were to submit plans to transform and connect the IT of NHS and social care bodies within our “footprint” areas. Then at Christmas, we were suddenly asked to produce an STP by June.

There was no clarity about how STPs were to line up with the initial plans, and in some areas their footprints aren’t coterminous – which is daft. NHS England’s guidance was fragmented, emerging in bursts while we worked, often leaving us little time to respond to new requests. Still, we hit the deadline, expecting a written response in July; but as of late August, we haven’t heard back. NHS England are constantly telling us to work “at pace and at scale”. It would be helpful if they worked at the pace that they expect of us.

A second big challenge with STPs is their lack of a formal structure or leadership. Volunteer chief executives lead STPs alongside their day jobs, and the organisations involved report to their own boards – which have a legal responsibility to protect their own bottom lines. Plans that are good for the whole system can lead to individual organisations losing income, which may put boards in conflict with STP ambitions. The government should create formal structures that will enable STPs to appoint full-time leaders, make the necessary strategic decisions and, crucially, move money around the system to where it’s needed.

System-wide reforms may also involve controversial changes such as closing A&E departments. It’s an NHS England requirement that there’s strong public and patient engagement before these decisions are finalised: when we don’t get people’s buy-in, the result is protests, judicial reviews – and delays that we can’t afford.

We need to start consulting on our plans, having an open conversation with the public. But NHS England tells us that we can’t publish our STPs – presumably because it’s worried about negative headlines. I think we have a duty to tell the public about the plans, and NHS England says we must move “at pace”; yet we’re barred from explaining our plans. That’s a problem.

STPs are helpful in driving collaboration; in integrating health and social care; in creating a climate for change. But they need the right management structure to make system-wide decisions, along with the freedom to publish and consult as they see fit. I’d like to hear much stronger signals from NHS England that they’re committed to this model; that it won’t be swept away in yet another round of top-down reforms. Then people will recognise that this is for real, and commit themselves to the agenda – and we’ll be able to use reforms to make the savings asked of us, even as we improve services for patients.

If you would like to write a blogpost for Views from the NHS frontline, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

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NHS plans could bring benefits but we"re barred from telling the public

Diabetes "threatens to bring down the NHS"

Diabetes “threatens to deliver down the NHS”, a leading Uk charity has warned following the number of people with the illness rose to a lot more than three million.

Situations in England and Wales have risen by 59.8% in the past decade – as an added 1.2 million adults are now residing with the issue in contrast to ten many years ago.

The figures, extracted from NHS data and analysed by the charity, present that three,333,069 individuals have been diagnosed with the ailment.

Diabetes Uk warned that there is an urgent need for successful care for sufferers, even though a lot more should be carried out to highlight the value of prevention.

The charity said that 6 in 10 individuals in England and Wales obtain the eight care processes advised by the National Institute for Well being and Care Excellence (Great), and additional that poorly managed diabetes can lead to “devastating and costly health complications” including amputation and stroke.

“This is why it is crucial that the Government requires urgent action to ensure that everybody with diabetes receives the eight care processes, reducing their chance of even more well being issues and the fees these incur for the currently strained NHS budget,” the charity stated.

Barbara Younger, chief executive of Diabetes United kingdom, explained: “More than the previous decade, the quantity of men and women residing with diabetes in the United kingdom has enhanced by over one particular million people, which is the equivalent of the population of a little nation this kind of as Cyprus. With a record quantity of people now living with diabetes in the United kingdom, there is no time to waste – the Government need to act now.

“We need to see more folks with diabetes getting the eight care processes suggested by Good. It is unacceptable that a third of people residing with the condition do not at present get these, placing them at improved risk of creating issues, this kind of as amputations, heart attack or stroke.”

She added: “Diabetes presently costs the NHS nearly £10 billion a yr, and 80% of this is invested on managing avoidable issues. So there is enormous likely to conserve income and minimize pressure on NHS hospitals and services through delivering greater care to avoid men and women with diabetes from developing devastating and pricey issues.

“The NHS need to prioritise offering much better care, along with enhanced and more flexible education choices, for men and women with diabetes now, and give them the best possible chance of living long and wholesome lives. Right up until then, avoidable human struggling will carry on and the fees of treating diabetes will continue to spiral out of handle and threaten to bankrupt the NHS. Now is the time for action.”

The charity predicts that if present trends carry on, 5 million men and women will have diabetes by 2025.

Diabetes "threatens to bring down the NHS"

How a tiny faith can bring a lot of really like

Married churchgoers with active social lives are most likely to be the happiest in love, according to a review.

Researchers also noted that individuals aged 31 to 59 tended to be slightly happier with their love lives than people who have been 60 and above.

And although education was found not to have an effect on a person’s happiness in really like, religion was. The staff, from the University of Porto in Portugal, noticed that folks who routinely check out church tended to be far more positive about their enjoy lives. The discovering backs up prior investigation that suggests religious involvement leads to greater psychological overall health and better sexual relationships.

The examine was published in the journal Utilized Analysis in High quality of Daily life.

How a tiny faith can bring a lot of really like

We chose to bring up our severely disabled little one in France

Before I knew it I was unstrapping Ailsa from her buggy and (carefully) laying her on the tarmac in front of the attendant. “Look at her,” I said. “It’s perfectly obvious that she’s disabled.”

While part of me dimly grasped that my behaviour was deranged, I didn’t doubt that I’d be allowed to park. But no – the woman stuck to her guns and watched as, hardly able to see through my tears, I struggled to load Ailsa and her chair back into the car. Something in me had snapped. I couldn’t stop crying for three and a half hours.

Parenting a profoundly handicapped child is a trial anywhere, but my partner, Scott, and I chose to do it in a foreign country. We had no warning Ailsa would be handicapped. My expectations of parenthood involved yummy-mummy-style fantasies of a rural French idyll where our child would grow up bilingual and inoculated against junk food.

Twelve hours after she was born, in London, Ailsa had a massive fit. Doctors advised us to mark her notes “do not resuscitate”, saying she’d probably need ventilation and tube-feeding.

Scott and I had no idea if we’d be able to love our own child. In our first shock, we thought about institutions. We were told by British social workers that babies are better off in families.

If we weren’t able to cope, we’d have to put her up for adoption. That was unthinkable. With seemingly nothing to lose, we went ahead with our move.

The stress that Ailsa’s condition put on us would have been bad anywhere. Night after night, we watched our child go blue as she suffered massive fits. We rowed about everything – but mainly about whose turn it was to sleep. We begged French social services for help, only to be told that our paperwork had not come through. It took 18 months.

By then we were beyond desperate. But struggling with the language, the bureaucracy, the rural environment and caring for a child who’ll never be able to do anything for herself, we found that we had fallen in love – with our child, with the beautiful part of France we live in, and with one another all over again.

Scott and I knew we’d reached a turning-point when we found ourselves at a tribunal passionately arguing that Ailsa – who needs to be watched over 24 hours a day – should not be put into an institution (as seems to be more common for profoundly disabled children in France). The panel listened and granted us 12 hours of outside care a day, paid for by the state.

We’ve been lucky to find a couple in the nearest village who now help us look after her in our home. It means that Scott and I are able to sleep on some nights, and we’ve also been able to start working again. This in turn makes it possible for Ailsa to live with us at home and means that the time we spend with her is quality time, not a sleep-deprived blur.

Scott and I love each other more than ever because we’ve seen each other at our very worst and very best. And we love Ailsa perhaps more than a normal child because we’ve had to do so much for her. That, we’ve come to realise, is the secret of how love grows.

“The Mouseproof Kitchen”, by Saira Shah, is available from Telegraph Books

We chose to bring up our severely disabled little one in France

We chose to bring up our severely disabled child in France

Before I knew it I was unstrapping Ailsa from her buggy and (very carefully) laying her on the tarmac in front of the attendant. “Look at her,” I mentioned. “It’s completely evident that she’s disabled.”

While part of me dimly grasped that my behaviour was deranged, I did not doubt that I’d be permitted to park. But no – the lady stuck to her guns and watched as, hardly capable to see by way of my tears, I struggled to load Ailsa and her chair back into the auto. Anything in me had snapped. I couldn’t quit crying for three and a half hrs.

Parenting a profoundly handicapped child is a trial anywhere, but my partner, Scott, and I chose to do it in a foreign country. We had no warning Ailsa would be handicapped. My expectations of parenthood concerned yummy-mummy-type fantasies of a rural French idyll exactly where our youngster would expand up bilingual and inoculated against junk meals.

Twelve hours after she was born, in London, Ailsa had a huge match. Doctors advised us to mark her notes “do not resuscitate”, saying she’d almost certainly want ventilation and tube-feeding.

Scott and I had no notion if we’d be in a position to enjoy our personal little one. In our first shock, we thought about institutions. We have been advised by British social employees that babies are better off in families.

If we weren’t capable to cope, we’d have to place her up for adoption. That was unthinkable. With seemingly nothing at all to lose, we went ahead with our move.

The anxiety that Ailsa’s condition place on us would have been negative anyplace. Night soon after evening, we watched our kid go blue as she suffered substantial fits. We rowed about everything – but primarily about whose flip it was to sleep. We begged French social solutions for assist, only to be told that our paperwork had not come via. It took 18 months.

By then we were past desperate. But struggling with the language, the bureaucracy, the rural environment and caring for a little one who’ll never be in a position to do something for herself, we discovered that we had fallen in really like – with our child, with the stunning part of France we dwell in, and with 1 an additional all more than once again.

Scott and I knew we’d reached a turning-level when we found ourselves at a tribunal passionately arguing that Ailsa – who wants to be watched in excess of 24 hours a day – need to not be place into an institution (as appears to be a lot more typical for profoundly disabled young children in France). The panel listened and granted us twelve hours of outdoors care a day, paid for by the state.

We’ve been fortunate to uncover a couple in the nearest village who now help us seem soon after her in our house. It indicates that Scott and I are able to rest on some nights, and we’ve also been in a position to start off operating again. This in turn can make it achievable for Ailsa to dwell with us at residence and means that the time we spend with her is quality time, not a sleep-deprived blur.

Scott and I adore each and every other much more than ever because we’ve seen each other at our extremely worst and really best. And we love Ailsa possibly a lot more than a normal child due to the fact we’ve had to do so much for her. That, we’ve come to realise, is the secret of how enjoy grows.

“The Mouseproof Kitchen”, by Saira Shah, is available from Telegraph Books

We chose to bring up our severely disabled child in France