I recently posted about my fears of meeting my care coordinator, well this meeting wasn’t too bad though funding still remains a big issue, in fact funding is an issue throughout the whole health care system. As my care coordinator referred to my therapy and also his need for progress, he set a definite date for the matter to be discussed and for decisions, he left me with the parting words of how much funding the Clinical Commissioning Group (CCG) has to save. A CCG is a regional health group, set up by the Government to manage the patient services and clinical health needs of an area they receive their funding through the National Health Service.
My care isn’t funded through my local CCG,and local authority, Section 117 aftercare is complex and so despite living a distance from my funders because this particular CCG has a legal duty to fund my aftercare they still pay for the services I receive. They also deem that I have to receive my mental health care from their local area, and not the service providers closer to my home. It means that money is wasted as the care coordinator has to travel over 40 miles each time he visits, I have to travel the same distance to see a psychiatrist despite their being a local one closer to my home. My crisis intervention team is located even further away and so cannot undertake any home visits, instead if they are worried about my safety they would involve the local police, who if they deemed it necessary would have to arrange for me to go to the nearest hospital; who have no knowledge of me at all.
All of this cross-border working is a nightmare and its also hugely expensive, and I doubt I am the only person receiving such provision of care, so there is probably even more wasted miles and costs incurred as a result. Let alone the cost of the police time if I ever needed them, who to be fair should not need to ever be involved, my mental health needs are a matter of healthcare and not a law and order issue. But because the CCG decided in their wisdom to demand that I receive this cross border treatment and services, thus the police are more likely to have to be involved in my case.
The funding the CCG has apparently received is a higher budget amount than previously, but after inflation and increases in other costs now needs to save some £16 million pounds. That isn’t likely to come from cutting the number of managers at the top, or the number of bureaucrats it will come through cuts in patient care. The Local Authority involved has to find even more savings, and so I guess some would say things are not looking good for people like me.
Yet the law says you have to continue to fund Section 117 aftercare if the care needs of the person haven’t changed, I am not sure if the managers at the CCG or Local Authority understand this. I also wonder if they actually calculate the additional costs they would incur if they reduced services to those like myself, its likely we will require additional crisis care, out patients appointments and maybe even hospital stays all of which are vastly more expensive than any savings they might choose to make.
I know we are fortunate in the UK to have a National Health Service but the standard of that service is reducing, the staff who provide the care on the whole work hard and are caring and diligent, yes there are exceptions and some care provision leaves a lot to be desired, sadly I have encountered them along my journey too. But surely the top heavy health care system isn’t helping improve provision to patients, its just providing more job opportunities for those managers at the top.
I will have to face a discussion about funding in mid March, and whilst I am confident that I can work through this as I have some legal protection through the 117 aftercare legislation, and I can access an advocate who will come to my meeting and the family will support me too. That doesn’t mean I won’t worry from now till then, it doesn’t mean I won’t stress and lose sleep especially as that date draws nearer. The more stressed we get the more we switch, and so by the time of my March meeting, I am now worried I will be switching so much I might not even be there, but some other part of me will. That causes issues in itself as one of the professionals present at these meetings wants to stop the meeting if I have switched, so if the part of me that is writing this blog isn’t present and a little alter is, then the meeting maybe delayed. There will certainly be at lot of extra pressure placed upon whatever part of me is there, and if that’s not me it will increase the potential for the system to shut down altogether.
I know that the care coordinator and the other Community Mental Health Team, (CMHT) professionals there want to see progress coming from my therapy, but their idea of progress is that I need less care. I found it hard this week not to erupt at my care coordinator when he asked about therapy, because he was basically asking if we had started trauma work. I think I need to be stabilsed and understand my parts better before we do this, and I think my T agrees with that position. I did divulge the fact I was feeling a couple of the alters, he seemed so disinterested in this yet I feel this is a huge achievement and a great step forward after years of therapy.
Its clear March is going to be interesting and its clear my idea of progress and the CMHT’s differs greatly, I wanted to shout at my meeting this last week “Do you think I want to be like this, to need this help?” but I realised it would be futile and so I am saving my energy for the important things in my life, like my alters and my therapy sessions over the coming weeks.
Yes this last meeting wasn’t as bad as I feared, but March well that’s clearly a different story and another blog post at a later date.
COPYRIGHT: DID Dispatches 2014