Patients and carers' views & experiences of SLaM

Healthwatch Lambeth, Lewisham and Southwark jointly submitted evidence to the Care Quality Commission ahead of its 2015 inspection of South London and Maudsley NHS Foundation Trust (SLaM). The submission drew on feedback received from patients and carers between August 2014 and August 2015 about inpatient, community and outpatient mental health services. Overall, many patients reported positive experiences of clinical care and praised individual members of staff for their compassion, professionalism, honesty and ability to build trusting relationships. In inpatient settings, positive feedback highlighted empathetic staff behaviour, involvement of families and carers, and facilities such as activity rooms that helped relieve pressure and provide meaningful engagement. 

However, a range of concerns were also identified across services. In inpatient wards, some patients reported staff being dismissive or unresponsive, poor communication about treatment and medication, insufficient introductions by staff and concerns about safety due to limited staff presence. Some patients described feeling frightened on wards or experiencing aggression from other patients. Concerns were also raised about ward environments, including cleanliness and limited access to outdoor activity and exercise. 

Feedback about community mental health services highlighted long waiting times for assessments and treatment, delays following referrals and difficulties accessing appropriate support while waiting. Some patients reported referrals being lost, discharge without treatment or being told they were either not unwell enough or unlikely to benefit from services. Concerns were also raised about abrupt discharge processes, uncertainty about ongoing support and difficulties when transitioning from child to adult mental health services. Patients and families frequently described fragmented care, poor communication between services and the need to repeat assessments and personal histories when moving between teams. 

The report recommended improvements in communication, continuity of care, service integration and discharge planning. Patients and carers wanted clearer information about referrals, treatment and support options, greater continuity of relationships with professionals where possible, and better coordination between teams. Additional suggestions included stronger crisis planning, improved support for people waiting for treatment, more appropriate environments within A&E settings for people experiencing mental health crises and greater involvement of families and carers in planning and support arrangements.