I was made aware of your blog diary entry by NALM who you have mentioned in that entry . Yesterday I sent this e-letter copy to NALM and others about LINks concerns and working members not knowing what budget is alocated for realistic patient and public monitoring which directly interfaces with patients .

“Letter By Email
To Vicki Fitzgerald
Gateway Family Services (HOST)
Copied To Elizabeth Rattlidge et al .

Date : 9th December 2008

Resource Anxieties : An Underlying Information Problem

Dear Vicki et al

At the last meeting of the Mental Health Working Group (MHWG) 5th December 2008 someone who attended from the interim “LINks” Getting Going Group (GGG) raised a point about the various costs in time and manpower of doing a proposed survey of some Mental Health Users . The MHWG is working toward a working action plan which includes creating a focus group type approach and survey-work but which cannot be actioned until it is endorsed by the Core Links Group which as yet does not exist, but is evolving from the (GGG)

I believe I am obliged in this letter to demonstrate some real knowledge of the field so I will continue in that vein and then return to the “resource anxieties” raised .

The MHWG survey of 6 or so questions was proposed by Kate Walker and followed the good practices of PPI that had previously done this kind of exercise in 2004. The survey approach had finally led to independent research well received by the Mental Health Trust. The survey was done Independently by Suresearch (Bham Uni) . The figures of patients involved were 60 + in the first PPI survey and the later Suresearch work involved 63 Users Suresearch also did a secondary analysis of 150 Users . The Interfacing capacity of the initial survey meant the previous PPI met Service Users promoted PPI and “worked at the coalface”. It was good practice and robust monitoring of the patient-perspective and experience . As PPI, and I anticipate LINks, we are supposed to work in an evidenced based way otherwise we are open to accusations of being opinionated, and previous experience suggests to me, that may be used against us . The Health Care Commission-returns from our MH PPI were “evidence based” (not opinion based) and that was the standard set by the HCC and Trust , and Overview Scrutiny Committee (OSC).

(Please see Introductory Page attached of the SureSearch teams report .)

The OSC for instance demanded evidence be shown that Social Care (2007 – 2008), who had entered a NHS contractual agreement with the Trust (Section 31), were not doing satisfactory User-consultations when varying services which legally fell under a Health Service management remit . Evidence was obtained and Social Care were legally obliged to do months of meaningful consultations: other issues were discovered of poorly enfranchised Direct Payment allowances for Users . The Users involved were 200 plus and the knock on effect was some pressure for reform across the services

Returning to the points however that the GGG member raised, which I may term “resource anxieties” :

The anxieties of what resources anyone has on the Working Groups and the GGG, emerges because no-one knows. or can see, what kind of reasoned out cost projections there might be for our combined operations.

I have heard these resource anxieties informally from a number of people but they also emerged on the 5th Dec 2008 in the MHWG (a publicly attended meeting ) and that is why I am now concerned .

(a) I believe there is an appropriate and reasonable “Need To Know” basis by Working Groups from Gateway Family Services to know what kind of cash and resource allocations there are for Working Groups and indeed the operational/financial basis of where we are going with the LINKs.

(b) It is encumbent on the Host to create better clarity surrounding this otherwise resource anxieties arise which in fact though genuinely held are not actually quantifiable or even debatable by the GGG or Working Groups

(c) Furthermore it must be argued : How can a Working Group get an idea of what cash and resource restraints it is working with unless it is properly informed ? How can it shape and constrain its ambitions unless it knows its cash and resource limits ?

(d) How can the eventual Core LINks Group even quantify that a Working Group is within its resource limits unless it knows what resource and cash allocations there are for the work of LINks and its separate parts ?

(e) It is a challenge to produce this projection of cash and resource information for operations, but how can we continue on a guesswork basis with Working Groups trying to plan actions which finally must be resource led. ? It is mystifying and working in the dark .

Therefore I am asking for that information now to be shaped up and shared otherwise Working Groups are open to the accusation that they are being too ambitious or exceeding resource allocations that currently they, like the GGG, are actually unable to debate or quantify .

Paul Brian Tovey.

Ps I have also attached the Durham LINks Constitution Document which I believe anticipates the raising of extra money via them becoming a Charity ,

Pps. See Below For Suresearch Intro Page Re PPI Research No’s Etc ”

[JPG Not Shown Of Research Into ]