A meeting of minds


Jim SymingtonGuest blog written by Jim Symington Consultant to the Mental Health Crisis Concordat and National Advisor to the National Collaborating Centre for Mental Health (Royal College of Psychiatrists)

A thought provoking, reflective and unusual event happened in Surrey during this year’s Mental Health Awareness week which has the theme of relationships.

The Centre of Excellence for Information Sharing facilitated a meeting of minds between over 30 experienced professionals working in mental health teams, social care, the police and voluntary sector together with representatives from NHS England, the Home Office and the Department of Health.

The day focused upon the management, benefits and constraints of information sharing between organisations. It explored all the day to day practical issues experienced by those with a part to play in supporting people experiencing a mental health crisis – who have said that they expect “Every effort is made to understand and communicate with me. Staff check any relevant information that services have about me and, as far as possible, they follow my wishes and any plan that I have voluntarily agreed to.”[1]

Messages to central Government were agreed, alongside the sharing of positive practice by services and Concordat partnerships from across England.

After a powerful user perspective from the Surrey Safe Haven the tone was set for an explorative workshop involving a diverse network of colleagues, meeting together for the first time.

Much of their respective language and associated jargon is miles apart. However, I was struck by the speed at which common ground was found by people working under the guidance of the Caldicott framework and those guided in pursuit of policing purposes of protecting life.

The common threads throughout the day were trust and relationships – between people in distress and services, as consent and jointly produced crisis plans are key.  Trust between staff as partners with different roles and responsibilities is also critical – as well illustrated by those already working together in street triage services, for example.

People making difficult professional judgements said that they want – and need – to share accurate, timely information in order to make their best possible decisions. They deal with very significant clinical risks, as well as the possibilities of loss of liberty or of loss of life. Everyone was alert to the sensitive and proportionate nature of any sharing between roles and different agencies. These are issues which are well suited to any friends and family test, and often hard to get just right in urgent or emergency circumstances.

There are some widespread frustrations – mainly, IT systems which cannot or will not speak to each other, even when all involved want them to.

We also heard some really positive developments – digital dictation, electronic directories of services and the gradually increasing use of ‘Summary Care Records’ and ‘Smartcards’ within NHS mental health care.

The day concluded in an open discussion with central Government representatives. They heard very clear messages including:

  • the need for greater promotion and understanding of the Caldicott principles (all of them, but especially the most recent principle 7!);
  • more explicit awareness and support for frontline services when they undertake their duty to share;
  • a challenge for joined up government to promote and co-ordinate common national approaches, including training, which build upon the best of existing practices in the  safeguarding of  vulnerable people.

[1] www.crisiscareconcordat.org.uk/about

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