Disability access in A&E Mental Health Suites

The request was refused by NHS Camden Clinical Commissioning Group.

Dear NHS Camden Clinical Commissioning Group,

As you are fully aware non of the 3 A&E's in the MH Trust area ( Camden and Islington NHS Foundation Trust) have disability accessible rooms in the MH suites. This includes 2 that are commissioned by Camden CCG - in Royal Free Hospital and UCLH.

The CCG has a legal duty to ensure that those with a protected characteristic of physical and/or sensory disability are provided for under the Equality Act. At present those who present informally or who are detained under the Mental Health Act have NO access to accessible rooms.

This includes not having provision to lie down as there are only chair/2 seater low sofas despite the fact that people can be lawfully kept there for 24 hrs and have often been forcibly kept in these rooms & units for over 24 hrs. There are no signing interpreters on call, there are no braille signs .

There is no agreement between Acute Trusts and the MH Trust on providing nursing staff so there is no disability support for even the most basic of care needs - including whereby an individual has a full care plan when at home. Security guards are allocated in place of nurses ( as you have admitted you are fully aware)

In your response please do NOT conflate chronic illness with disability.

Please therefore provide the following details:

(1) Are the Chief Operating Officer and Chair personally aware of the above and that it has been raised as a serious issues for many years?

(2) Given that the CCG is responsible for funding these areas please provide a copy of the Equality Impact Statement you as commissioners are required to have produced when decisions to finance the redesign and reconfiguration of the Mental Health area of ED areas have been made. This is required at commissioning level so do not signpost me to the Acute Trusts concerned.

(3) Please provide the details of how much money has been spent specifically on making these areas accessible to the groups identified above ( ie with physical and/or sensory disability). Please provide this for the period April 2015 and to include projected spending April 2020.

(4) Please provide details of who in Camden CCG is responsible for ensuring that the Equality Act is implemented in mental health areas of the ED. Please provide the name of the officer /s.

(5) Please provide a copy of ALL guidance given to Acute Trusts on this matter . Please include where specific reference has been made to the Equality Act and HRA. Please explain what work the CCG has done to ensure that those with significant care needs have these needs met when detained /restricted to these areas

(6) Please advise what work has been done whereby these very longstanding issues have been addressed. Please confirm which physical and sensory need disability groups have been specifically consulted when redesign of the mental health areas was undertaken/proposed. Please explain why the CCG does not insisit on the ED having provision for MH pts to lie down .

(7) If NO work at all has been done to address the inequalities faced , including consultation beyond mental health service user groups supported by the MH Trust, explain why not and where that decision was taken to ignore the needs of those with these protected characterististics

(8) The CCG is required by law to adopt an integrated approach. You have explained in other FOI's that you have NO knowledge of how many patients under the care of the MH Trust have physical and/or sensory disability. Please explain therefore - beyond the 'assurances ' given by the MH and Acute Trusts- what action you are currently taking to address this serious knowledge gap.

Yours faithfully,

Alea

Dear NHS Camden Clinical Commissioning Group,

You have failed to acknowledge receipt of this request and failed to respond.

You have one day left until statutory time limit is exceeded

If after this date you have still not complied in full a referral will be made to the ICO

Yours faithfully,

Alea

Foi (NHS NEL CSU), NHS Camden Clinical Commissioning Group

Dear Alea

We apologise for our delay in responding to your email and any
inconvenience this may have caused you.

However, in order to meet the requirements of a valid FOI request, we
require a full name from you.

This can be given in any of the formats given below;

·         Joe Bloggs

·         J Bloggs

·         Mr J Bloggs

·         Mr Bloggs

Until we receive this, we will be unable to process your request any
further.

Kind regards,

Freedom of Information Team
NEL
[1][NHS Camden CCG request email] 

 

Lower Marsh, 3^rd Floor
Waterloo, London, SE1 7NT

  

[2]www.nelcsu.nhs.uk 

[3]@NELCSU 

[4]LinkedIn 

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Dear Foi (NHS NEL CSU),

You know full well that my legal name as changed by deed poll is Alea Iacta Est.

You know this because I have requested other information from you before ( directly) and in email dialogue you apologised and accepted that you know.

You also know because your team has been active in blocking SAR under the same name resulting in Camden CCG being served with legal action.

You also know because the ICO had to serve you with notice before.

So in my opinion this is deliberate obstructive decision making after discussion with other agencies whereby you continue to try and block rights to information.

Yours sincerely,

Alea Iacta Est

Foi (NHS NEL CSU), NHS Camden Clinical Commissioning Group

Dear Alea Iacta Est

Thank you for your email. Section 8(1)(b) of the Freedom of Information
Act 2000 requires that a request for information must include the name of
the requester. The Information Commissioners states:

‘Authorities do not have to take into account the possibility that there
may be staff elsewhere within the organisation who have dealt with the
requester before and might be capable of working out their identity from
the contents of their request alone.’

The Commissioner further goes on to considers:

‘Even if this were the case, the authority could still refuse the request,
as the absence of a real name would make it technically invalid under
Section 8(1)(b). Any variation of the requester’s title or first name
combined with their surname (e.g. Mr Smith or John Smith) will be
sufficient to meet this requirement. However, a first name or surname
provided in isolation, or a set of initials, will not.’

We have not disputed your name, only that you did not supply a sufficient
amount to meet the requirements under Section 8 of the Act.

Kind Regards

Kevin

Kevin Winter
Head of FOI and IG Compliance

NEL

Lower Marsh, 3^rd Floor
Waterloo, London, SE1 7NT

[1]www.nelcsu.nhs.uk 

[2]@NELCSU 

[3]LinkedIn 

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Dear Foi (NHS NEL CSU),

Seriously?

Noted that you chose not to raise this before as an alleged issue.

You responded to me on this site in March as well as the very same FOI team being involved re an SAR . This is considered obstructive as I said before.

I will presume that despite legally being required to hold the information the CCG will next try and claim an exemption to mask the fact it doesn't.

If I have to refer to the ICO I will annotate accordingly. It seems an unlikely coincidence that your partner agency in this matter also ignored and as such has just been served with a notice by the ICO. Presumably you wouldnt decide jointly to try and obstruct lawful requests....

You are now past the legal deadline.

Yours sincerely,

Alea

Foi (NHS NEL CSU), NHS Camden Clinical Commissioning Group

Dear Alea Iacta Est

RE: Freedom of Information Request

I am writing to formally acknowledge your request for information
regarding disability accessible mental health suites which will be
processed under the Freedom of Information Act 2000. I can confirm your
request was received on 20 September 2018 by NEL on behalf of the Clinical
Commissioning Groups (CCGs) listed below. The references for your requests
are shown alongside.

NHS Camden CCG                            FOI.18.CAM149

An initial investigation is currently taking place into whether the
information you have requested is held by the CCGs and if so, whether it
can be released in accordance with the legislation.

Any fees applicable to this request will be detailed in writing as soon as
they can be determined. Your request will then be placed on hold and you
will have the choice of whether to proceed with your request. Should any
clarification of your request be required we will advise you accordingly.

If you require any assistance, or would like to discuss your request,
please do not hesitate to contact us quoting the reference number above.

Yours sincerely,

Freedom of Information Team
NEL
[1][NHS Camden CCG request email] 

 

Lower Marsh, 3^rd Floor
Waterloo, London, SE1 7NT

  

[2]www.nelcsu.nhs.uk 

[3]@NELCSU 

[4]LinkedIn 

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Dear Foi (NHS NEL CSU),

It was received 22 nd August as you already had confirmation of my full name.

Let's see if you actually respond or obstruct in some other way

It's a very very simple request for information that the CCG is lawfully required to hold. Any further delay will be shared with the ombudsman for reasons you are fully conversant with

Yours sincerely,

Alea

Foi (NHS NEL CSU), NHS Camden Clinical Commissioning Group

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    Response FOI.18.CAM149.pdf

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    Annex A Guidance 7 Equality Analysis Q A CCCG.PDF.pdf

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    Annex C Equality Analysis Template.pdf

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Dear Dear Alea Iacta Est

Please find attached response to FOI.18. CAM149 on behalf of NHS Camden
Clinical Commissioning Group (CCG).

Freedom of Information Team
NEL
[1][NHS Camden CCG request email] 

 

Lower Marsh, 3^rd Floor
Waterloo, London, SE1 7NT

  

[2]www.nelcsu.nhs.uk 

[3]@NELCSU 

[4]LinkedIn 

Dear NHS Camden Clinical Commissioning Group,

You have failed to acknowledge receipt of this request and failed to
respond.

You have one day left until statutory time limit is exceeded

If after this date you have still not complied in full a referral will be
made to the ICO

Yours faithfully,

Alea

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Dear Foi (NHS NEL CSU),

Share this with Paul Lelliott at CQC, with Marcel Levi the CE at UCLH and with Angela McNab the CE of the MH Trust. Plus of course with the chair Neel Gupta who must have authorised this response. ALL of whom I presume have been consulted regarding this response given that this is an ongoing Ombudsman case and that you have been so willing to quote the CQC as endorsing the status quo repeatedly throughout the 'response'

Written with Advocacy Support:

No disabled access in UCH and Royal Free A&E's for those with a mental health condition means that people needing crisis care to prevent suicide or harm to themselves or others are never able to access the emergency care they require. As you well know.

It means that if you cannot get the help when needed and when the mental health Trust ( Camden and Islington NHS Foundation Trust) tell ALL those in distress to attend A&E you are telling physically disabled vulnerable people that their lives are worth less than if they were not physically disabled. Your responses have actually condoned this. You havent even bothered to reply with the detail requested - so low a priority are those with physical and sensory disability on your radar.

I am sure Paul Lelliott who heads up the CQC will be reassured to learn that you quote the CQC inspection as if to endorse no access when suicidal or with voices telling someone to jump in front of a train. For the record the CQC claim that they do NOT inspect for compliance with the Equality Act. Maybe you would like to fact check before implying that they do on a public site.

It's not as if the MH Trust has any crisis services that go out to people in distress is it?.You failed to provide ANY Equality Impact Statement. Presumably because disabled persons with a severe enduring mental health condition weren't worth the paper exercise. Neither the MH Trust nor either of the Acute Trusts bothered to undertake this either - as you must know? Please confirm that you bothered to check with them before diverting me to them - when in fact I have already asked them this and they state Camden CCG did this ( that is YOU by the way). You are the commissioners and have the legal duty - assurances aren't enough. Please go back to your lawyers and check this response. If NO Equality Impact Assessment has ever been done then state this- it is what those you commission have stated so why the discrepancy?

This response says all anyone ever needed to know about how the most vulnerable in society were treated by Camden CCG. What you rate as 'good' escalates risk exponentially. What do you think happens when someone cant access an A&E when in severe MH crisis? What do your MH commissioners think happens? Why hasn't the Camden CCG Equality and Diversity lead even bothered to check this situation - despite knowing the complaints . Has he/she been to these sites and inspected?

Not surprising that many disabled people feel utterly worthless and less than sub human when the CCG states that this is all OK. You do not seem to have a single clue on what your legal responsibilities are when it comes to funding mental health services- you cant provide a single eg of checks and balances beyond 'assurances'. You have failed to list what disability organisations were consulted re access in the way described. The data you have linked to does NOT provide ANY information on how many people in the borough have physical an'or sensory disability AND a mental health condition.

When there is no access to mental health crisis support people die. The suicide rate in Camden for those known to services is always in the top few places in the country for men and women. For those KNOWN to services - NOT the out of area people you like to refer to

Yours sincerely,

Alea

Foi (NHS NEL CSU), NHS Camden Clinical Commissioning Group

Dear Alea Iacta Est,

We apologise for the delay in responding your below email, but we are
writing to acknowledge your request for an internal review of
FOI.18.CAM149. This request and the respective FOI response have been
passed to a senior manager for investigation and review.

We will be in touch with the outcome of the review once it has been
completed.

Kind regards,

Freedom of Information Team
NEL
[1][NHS Camden CCG request email] 

 

Lower Marsh, 3^rd Floor
Waterloo, London, SE1 7NT

  

[2]www.nelcsu.nhs.uk 

[3]@NELCSU 

[4]LinkedIn 

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WINTER, Kevin (NHS NEL CSU), NHS Camden Clinical Commissioning Group

Dear Alea Iacta Est

I am the senior manager undertaking the review of your request FOI.18. CAM149. In order for me to determine the scope of the review, please can you provide specific details on the areas of the response you are unhappy with? This will need to be specific to the response you received and not any wider concerns you are exploring with the CCG. Any new Freedom of Information requests can be sent [NHS Camden CCG request email]

Kind Regards

Kevin

Kevin Winter
Head of FOI and IG Compliance
NEL
[email address]
07944116668
Lower Marsh, 3rd Floor
Waterloo, London, SE1 7NT

www.nelcsu.nhs.uk
@NELCSU
LinkedIn

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