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The call for A Parliamentary Commission into Perinatal Mental Health Care in the UK Presented by Chris Bingley

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Title: The call for A Parliamentary Commission into Perinatal Mental Health Care in the UK Presented by Chris Bingley


1
The call for A Parliamentary Commission into
Perinatal Mental Health Care in the UKPresented
by Chris Bingley
Charity Registration Number 1141638
2
JBMF Founders Statement
     Joanne, or Joe as she preferred to be
called, was a nurse with over 20 years
experience. She was dedicated, caring and
diligent as are most health care professionals I
have met. But Joanne was let down by the very
NHS organisation that she gave everything to and
just 10 short weeks after giving birth to her
much longed for daughter Emily, whilst being
treated at home for severe postnatal depression
she took her own life.         
The Joanne Bingley Memorial Foundation is a
charity that exists to ensure future generations
such as my daughter have access to the
appropriate care and support, that services
adhere to care quality standards and to inspire
sustainable change in the perception and
provision of maternal mental health services in
the UK
3
Parliamentary CommissionInto Perinatal Mental
Health
Where we are at The requirement for such a
commission has been voiced between various MPs
and 3rd sector organisations over the last 2
years but taking proposals forward had to wait
until the NHS accepted the legal claims regarding
the treatment and death of Joanne (Joe) Bingley.
Scope Proposals Agreed with the Head of
Health at Policy Connect Timeline and
Plans Outline agreed with Policy Connect, who
will run the Parliamentary Commission Current
Support Various cross-party MPs have agreed their
support - including Barry Sheerman, MP for
Huddersfield and Char of Policy Connect A
selection of 3rd sector organisations have
reviewed plans and agreed their support - using
Dads as the link to focus on the impacts felt
upon the whole family Funding 100,000
required, (grants and funding bids in
progress) Next Steps Confirm Funding Identify
Steering Group Members Launch of Parliamentary
Commission in 2015
4
Parliamentary CommissionInto Perinatal Mental
Health
  • Proposed Scope and Terms of Reference The
    inquiry will provide an independent review and
    detailed investigation to understand and
    highlight the issues and policy areas
  • Why? has there been a failure to implement
    Specialist Perinatal Mental Health Care Services
    across the UK despite Parliamentary and
    Department of Health promises after the death of
    Daksha Emson.
  •  
  • Why? has there been a failure to implement
    lessons learned from Independent Investigations
    and Confidential Enquiries and a failure to
    implement and follow Care Standards.
  •  
  • Why? Dads are not being recognised as Carers by
    NICE even though Home Care is the primary
    treatment offered by Mental Health Crisis Teams
    (Note use of the term . Significant Others)
  •  
  • What? are the implications and costs to society
    and the economy
  • Mums - unnecessary Suffering in Silence and
    Avoidable Deaths
  • Dads Caring for Partners and suffering from
    PND
  • Early Years Child Development issues in the
    1001 Critical Days
  • The breakdown of Family Finances, Family
    Relationships and Resulting Deprivation
  • Businesses Productivity and Employer Costs
  • The Consequences of Failure on the wider
    community and general public
  • What? are the required actions to enforce the
    implementation of Care Standards and Lessons
    Learned, and to ensure promises made are
    delivered.
  • What? are the recommendations to reduce the
    unnecessary suffering and avoidable deaths

5
Why .?
  • Joanne (Joe) Bingley
  • Joe was a dedicated and caring nursing
    professional
  • Trained initially through Huddersfield Royal
    Infirmary to qualify as a Registered Nurse, then
    completed an Honours Degree at Huddersfield
    University
  • She spent 20 years working at Huddersfield Royal
    Infirmary where she was Sister on day surgery.
  • 10 weeks post-partum, whilst being treated at
    home suffering for severe PND, Joe committed
    suicide
  • Her funeral attended by over 400 people included
    ex-patients and many of her colleagues from HRI
  • I felt all their eyes on me asking the same
    question that I kept asking myself
  • Why ?

6
Daksha Emson Public Enquiry
  • In 2003 following the release of the public
    enquiry into the suicide of the psychiatrist Dr
    Daksha Emson and infanticide of her child, the
    government made promises that the NHS would
    deliver Specialists In Perinatal Mental Health
    to care for women in crisis who suffer from
    postnatal depression. 
  • The Royal College of Psychiatry created the
    faculty of Perinatal Mental Health as a
    specialism.
  •  
  • Yet more than 10 years after the Public Enquiry
  • More than 35,000 mums are left suffering in
    silence every year
  • Mums are too scared to come forward for treatment
    for fear of having their child taken away
  • Dads are left supporting Mums who are too scared
    to seek help or turn to health care professionals
  • Health Care Professionals are still asking for
    Specialists In Perinatal Mental Health and
    access to services so that they can support mums,
    dads and families suffering the mental trauma and
    crisis
  •  

7
Confidential Enquiries
  • The Confidential Enquiries into Maternal Death
    are recognised as the
  • gold standard in in investigating the cause of
    mums death and
  • they detail how Postnatal Depression is not a new
    problem
  • 2002 Confidential Enquiry into Maternal Deaths
    highlights suicide as a result of postnatal
    depression a leading cause of maternal death.
  • A plethora of policies, guidelines and
    legislations follow
  • Carers Acts 1990, 1995, 2000, 2005
  • Specialised Mental Health Services (2004)
  • National Service Framework Maternity Standard 11
    (2004)
  • Perinatal Healthcare in Prison A Scoping Review
    of Policy and Provision (2006)
  • NICE Guidelines CG90 Depression in Adults (2007)
    revised (2009)
  • NICE Guidelines CG45 Antenatal and Postnatal
    Mental Health (2007)
  • NHS Acts, Human Rights Act, The NHS Constitution
    (Health Act 2009)
  • 2011 Confidential Enquiry into Maternal Deaths -
    suicide is still the leading cause of maternal
    death.

8
Coroners Inquest Oct 2011
  • The criminal standard of proof beyond reasonable
    doubt, represents the evidential hurdle or
    threshold that the coroner had to consider for
    suicide or unlawful killing. He resolved to
    return a narrative verdict, and his 21 statements
    of fact include
  • A personal and family history of mental health
    problems as well as significant adverse life
    events befalling her in the last 5 years of her
    life. (Including prior treatment for PND)
  • By the 22nd April her condition was such that she
    was referred to the Mental Health Services who
    responded promptly. At and around this time she
    was expressing suicidal ideation, low mood,
    anxiety and a poor sleep pattern.
  • At a meeting it was determined she could be
    treated at home. I have found as fact that no
    discussion of other therapeutic options took
    placeinformed consent has not been obtained.
  • Independent medical care advice commissioned from
    Dr Oates and Mr Ketteringham. I have accepted
    their view that the possibility of admission
    should have been part of the initial treatment
    care plan and discussed with the patient and her
    husband as a treatment option if she either
    became worse or did not improve.
  • I find as fact that her health fluctuated and did
    not improve.
  • It is also their evidence that on the 27 April,
    if not before, there was clinical indication to
    be admitted to a Mother and Baby Unit. (i.e. 3
    days before she died)
  • It would follow from this opinion that if
    admission had taken place Joanne Bingley in all
    probability would not have died on the date or in
    the manner that she did.

9
Mums continue to die asLessons Learned not
Implemented
  • The Independent Investigation into Joanne (Joe)
    Bingleys death resulted in 21 recommendations
    for improvement i.e. lessons learned, which the
    NHS trusts agreed in an action plan with her
    husband Chris to implement in full the by
    September 2011.
  • After being told by NHS staff actions had not
    been implemented as the NHS trust had told him,
    Chris requested the Care Quality Commission to
    investigate.
  • In April 2012 the Care Quality Commission,
    following complaints raised by the husband of a
    patient who had deceased, reported on the NHS
    Trust that treated Joe
  • their investigation found the NHS Trust had
    failed to implement many of the Lessons
    Learned and many failed to meet acceptable care
    standards
  • Mums suffering severe PND Women in this
    specific user group at risk
  • 3 Deaths in 4 years of mums referred as patients
    to the same NHS Mental Health Trust
  • Following the CQC report, at least 2 further mums
    died whilst suffering from severe postnatal
    depression / psychosis receiving treatment at
    home by the same NHS Trust.
  • Jan 2013 Clair Tuprin, Sheffield
  • Treated at home for severe PND, jumps from John
    Lewis building in Sheffield
  • Dec 2013 Roaseanne Hinchlife,

10
The NHS Constitution (Health Act 2009)
  • On 19 January 2010 The Health Act 2009 came into
    force placing a statutory duty on NHS bodies,
    primary care services, independent and third
    sector organisations in England. The Constitution
    clarifies patient rights such as
  •  
  • Informed Consent
  • To be able to give valid consent to treatment is
    a fundamental right and absolutely central in all
    forms of health care.
  • You have the right to be involved in discussions
    and decisions about your healthcare, and to be
    given information to enable you to do this.
  • So a patient can make informed decisions they
    need access to impartial, evidence based,
    accurate, readable, information.
  • This is especially important when a person has
    severe depression.
  • Treatment Options
  • Patients have the right to be treated with a
    professional standard of care, by appropriately
    qualified and experienced staff.
  • You have the right to drugs and treatments that
    have been recommended by NICE for use in the NHS,
    if your doctor says they are clinically
    appropriate for you.
  • You have the right to be given information about
    your proposed treatment in advance.
  • Learning by Experience
  • You have the right to expect NHS organisations
    to monitor, and make efforts to improve, the
    quality of healthcare they commission or provide.
  • In the case of an NHS body or private
    organisation, it must take reasonable care to
    ensure a safe system of healthcare using
    appropriately qualified and experienced staff.

11
Negligence Claims and NHS Legal Costs (Joe
Bingley)
  • In December 2013, nearly 4 years after her death,
    the Director of Nursing from the NHS trust that
    treated Joanne (Joe) Bingley finally admitted
    negligent liability for her death.
  • 2 years after the Coroner issued his Statement
    of Facts, In a statement issued into court the
    NHS accepted that
  • In all probability had specialist perinatal
    psychiatric treatment been offered, including the
    admittance to hospital in a specialist mother and
    baby unit, it would have been accepted.
  • Had specialist treatment been provided the
    patient, Joanne Bingley, would have been expected
    to make a full recovery.
  • Their (NHS Trusts) breach in duty of care was the
    probable cause of death
  • 1/5th the NHS budget currently goes to cover
    negligence claims with 1.8bn spent annually in
    legal costs defending negligence claims .
  • Whilst stating their desire to settle the claim,
    4 years after her death NHS lawyers have yet to
    agree heads of agreement prior to discussing
    the value of any claim
  • Joes husband had the family home repossessed and
    faces bankruptcy with his own legal costs
    currently in excess of 400,000, with estimates
    of total legal costs gt 1m.

12
A National Scandal
  • The death of Joanne (Joe) Bingley highlights a
    national scandal
  •  
  • The Patients Association Survey in 2011 found
    more than 50 of Mental Health Services acting in
    breach of care standards
  • failing to follow care quality standards,,
  • failing to employ the required specialist
    perinatal psychiatrists,
  • failing to provide information to patients
  • NICE guidelines specify that those who suffer
    severe postnatal depression should be referred to
    a specialist perinatal psychiatrist
  • less than 37 of PCTs commissioned specialist
    services.
  • NICE Guidelines state the preferred treatment for
    severe PND or Puerperal Psychosis is
    hospitalisation in Mother and Baby Units (MBUs)
  • less than 91 beds exist with places for a
    maximum of 593 mums
  • 10 Dads suffer Postnatal Depression, Dads are
    not recognised by NICE
  • no specialist services are available for Dads
    either as Sufferers or Carers
  • Despite Ministerial promises, NHS Service
    Frameworks, NICE Care Standards and various
    Guidelines. the NHS has failed to commission
    Perinatal Mental Health Services across most of
    the UK.

13
Why things remain unchanged
  • According to The Confidential Enquiries into
    Maternal Death the highest cause of maternal
    death is suicide as a result of suffering
    depression.
  • 86 of deaths are avoidable deaths based upon
    findings that it was possible to have identified
    the illness and provided treatment for the Mums
    to have made a full recovery.
  • The sad facts are
  • The stigma associated with suffering mental
    illness has not gone away
  • Mental illness does not get parity of care with
    physical illness
  • NHS Primary Care Trusts failed to commission
    perinatal mental health services across more than
    50 of the country (1)
  • Huge gaps and discrepancies in provision of
    services across the UK (3)
  • Currently 97 of Health and Well Being Boards in
    England have failed to include any strategy on
    Perinatal (Maternal) Mental Health.
  • This is WHY outcomes for most patients have
    remained unchanged for 10 yrs
  •  

14
Parliamentary CommissionInto Perinatal Mental
Health
  • Proposed Scope and Terms of Reference The
    inquiry will provide an independent review and
    detailed investigation to understand and
    highlight the issues and policy areas
  • Why? has there been a failure to implement
    Specialist Perinatal Mental Health Care Services
    across the UK despite Parliamentary and Dept
    Health promises after death of Daksha Emson.
  •  
  • Why? has there been a failure to implement
    lessons learned from Independent Investigations
    and Confidential Enquiries and a failure to
    implement and follow Care Standards.
  •  
  • Why? Dads and Significant Others are not being
    recognised as Carers by NICE even though Home
    Care is the primary treatment offered by Mental
    Health Crisis Teams
  •  
  • What? are the implications and costs to society
    and the economy
  • Mums - unnecessary Suffering in Silence and
    Avoidable Deaths
  • Dads Caring for Partners and suffering from
    PND
  • Early Years Child Development issues in the
    1001 Critical Days
  • The breakdown of Family Finances, Family
    Relationships and Resulting Deprivation
  • Businesses Productivity and Employer Costs
  • The Consequences of Failure on the wider
    community and general public
  • What? are the required actions to enforce the
    implementation of Care Standards and Lessons
    Learned, and to ensure promises made are
    delivered.
  • What? are the recommendations to reduce the
    unnecessary suffering and avoidable deaths

15
The Joanne (Joe) Bingley Memorial Foundation
  • Founders Statement
  • How we help
  • Why I am here

16
JBMF Founders Statement
     Joanne, or Joe as she preferred to be
called, was a nurse with over 20 years
experience. She was dedicated, caring and
diligent as are most health care professionals I
have met. But Joanne was let down by the very
NHS organisation that she gave everything to and
just 10 short weeks after giving birth to her
much longed for daughter Emily, whilst being
treated at home for severe postnatal depression
she took her own life.         
The Joanne Bingley Memorial Foundation is a
charity that exists to ensure future generations
such as my daughter have access to the
appropriate care and support, that services
adhere to care quality standards and to inspire
sustainable change in the perception and
provision of maternal mental health services in
the UK
17
JBMF How we help
  • How the foundation delivers its aims
  • Website and information leaflets - we provide
    information on what you need to know so dads,
    grandparents and friends can help.
  • We publish stories in national media, Twitter,
    Facebook and our website to encourage open
    discussion and raise awareness
  • Knowledge of Best practice legislation, care
    quality protocols, befriender and peer support
    groups, self help, supervision, etc presenting
    at seminars and workshops to inform
    commissioners, dept health, parliament, etc. on
    patient and service issues.
  • We provide training education workshops for
    professional health care workers and volunteers
  • We have supported research including
  • The Patients Association survey of Primary Care
    Trusts
  • Kings College User Group
  • Through links with MPs and other organisations
    we inform NHS policy makers and parliament of
    service user issues and expectations
  • Supporting the Maternal Mental Health Alliance we
    work with other organisations to deliver
    improvements in PNMH services.

18
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