Ambulance service must tackle bullying and harassment

Norman Lamb, MP for North Norfolk, has urged the leadership of the East of England Ambulance Service to act on the findings of an independent review into bullying, harassment and discrimination at the Trust. 

The review was commissioned by UNISON and was conducted by the Andrea Adams Consultancy, which specialises in issues of workplace bullying and harassment. 

Some of the key findings were:

  • There are significant delays in dealing with staff grievances and complaints;
  • Concerns are mainly ignored, dismissed or are dealt with in an unnecessarily protracted way;
  • A ‘Speak Out’ culture is not promoted, and there is a fear of retaliatory action if an individual raises concerns;
  • Investigation processes are not secure and cannot be relied upon to robustly test allegations made;
  • The Trust appears to tolerate a bullying culture and managers adopt, in the main, a bullish approach to people management;
  • There is a strong perception that many issues that should be dealt with are swept under the carpet;
  • The Trust is not perceived to be a listening and learning organisation and this presents high levels of risk to patient and staff safety.

The full report can be read here.

Commenting, Norman Lamb said:

“This independent review found worrying evidence of a bullying culture at the trust, with a lack of robust processes to deal with allegations of bullying and harassment.

“Ambulance staff must have the confidence to speak out against bad practice without fearing for their careers.  It is unacceptable to allow such concerns to be dismissed, swept under the carpet, or met with retribution.

“Failure to eliminate wrongdoing not only has a damaging impact on the wellbeing of staff, but it ultimately puts patients at risk.

“The leadership at the trust must respond positively to the findings of the report and take immediate steps to act on its recommendations.”

Fraer Stevenson, UNISON Branch Secretary for the East of England Ambulance Branch, said:

“It’s vital that staff at every level feel able to speak out freely without fear of retaliation. It’s clear from the report that hundreds of our staff do not feel able to do that.

“We have some very good managers in our Trust and their voices need to be heard and empowered. Some of the poor behaviours we continue to see appears to go unchallenged and this must change.

“It’s important the Trust Board hear the concerns of their staff from across the Trust, support the recommendations in this report and commit to genuine change. This change needs to be modelled through their own behaviours and will require strong leadership.”

Lamb hits out at North Norfolk bed closures

Norman Lamb MP has hit out at plans to cut the number of local patient beds without any consultation, after North Norfolk CCG served notice on the beds it commissions at Benjamin Court in Cromer and Cranmer House in Fakenham.

Mr Lamb believes that the CCG may be in breach of its legal obligations and has asked to meet with CCG leaders urgently.

In November, the Norfolk Health Overview and Scrutiny Committee (NHOSC) was notified that the closure of beds at Cranmer House, to be replaced with a new ‘supported care’ model, was no longer being considered after strong local opposition.  However, the CCG this week announced that beds in Cranmer House and Benjamin Court would be decommissioned without any consultation with the local authority.

Under the Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013, CCGs have a duty to consult the local authority about any proposal they have ‘under consideration’ for a substantial development of or variation in the provision of health services.  As part of the consultation process, the CCG is required to notify the local authority of the date by which a final decision will be taken as to whether to proceed with the proposal.

Commenting, Norman Lamb said:

“It seems extraordinary to serve notice that these beds will be de-commissioned without any prior consultation.  I strongly suspect that the CCG is in breach of its statutory duty to consult on the plans before they were finalised, given that it amounts to a significant change in the provision of local healthcare services.

“The apparent view that there is no requirement to consult because the closures apply to the beds, rather than the units themselves, is hard to justify, especially when the loss of beds could reduce support for frail elderly people for whom care in the home is not appropriate. The CCG itself states that it is introducing a new model of care. This is the sort of change that should involve consultation with the local community.

“The Overview and Scrutiny Committee should have had the opportunity to consider and feedback on these plans before any final decision was taken. Instead, the bed closures are being pushed through without any local scrutiny.

“After the original plans to close beds at Cranmer House seemed to have been shelved just three months ago, this u-turn by the CCG doesn’t inspire confidence.

“I am asking for an urgent meeting with the CCG to explore alternatives to these closures.  As well as a reduction in beds, it seems inevitable that jobs will be lost and I am happy to meet with staff who will be affected by these plans.”

Time to back breathing space for families in debt

Norman Lamb, MP for North Norfolk, has backed calls for a new scheme to help thousands of families regain control of their finances as data from the Bank of England shows unsecured household debt rising at its fastest rate since the financial crisis.

Debt often strikes when people experience sudden changes in circumstances such as job loss or ill health.  Aggressive action from creditors and pressure to repay debts at an unaffordable rate can lead families to cut back on everyday essentials like food, take out other, expensive loans or fall further behind on essential bills. The rise in personal borrowing has led to mounting concern that households who get into debt need safer ways to manage financial difficulties.

In the constituency of North Norfolk, an estimated 2,069 families with 3,604 children are living with problem debt. Analysis from The Children’s Society shows that children in low-income families with multiple debts are more likely to suffer from mental health problems than equivalent families with fewer debts. 

Norman has joined calls in parliament to introduce a ‘Breathing Space’ scheme – supported by The Children’s Society and StepChange Debt Charity - that would offer people seeking debt advice a 12-month legal protection from mounting interest, charges and enforcement action. It would build on protections offered under the Debt Arrangement Scheme in Scotland, which has made sure that families sticking to an affordable repayment plan agreed with their creditors are not harried or hassled for the duration of that plan. 

Commenting, Norman said:

“It can't be right that children's mental health and happiness is suffering as a result of creditors unfairly escalating people’s debt problems.

“Families in problem debt need time and space to get back on their feet. By providing a period free from additional interest, charges and enforcement action, a new Breathing Space scheme would help families recover their financial situation and put in place a plan to affordably repay their debts.

“I’m pleased that the Breathing Space proposal has widespread cross-party support, including from the Work and Pensions Select Committee and the APPG on Debt and Personal Finance. The Government now needs to act by putting a comprehensive Breathing Space scheme in place.”

Norman Lamb pledges support for the 49,000

Norman Lamb, MP for North Norfolk, has committed to support the charity Together for Short Lives’ call to provide better support for children and young people who need palliative care and their families.

The charity, which speaks out for the 49,000 children and young people in the UK who are expected to have short lives, held a special Westminster reception on Tuesday 7th February to highlight the devastating impact that life-limiting and life-threatening conditions can have on children and their families.

MPs heard about the action that the charity would like the Chancellor to take to help these vulnerable families when he delivers his Budget next month, including adequate funding for children’s palliative care services and investment in community nursing teams. The reception also saw the launch of the new All-Party Parliamentary Group for Children Who Need Palliative Care – a forum for MPs and Peers to discuss issues facing seriously ill children and possible action they can take in Parliament to help. 

Children with life-limiting conditions require a wide range of professionals working together across different health and care services to support them. Unfortunately, Together for Short Lives’ commissioning maps show that there is a postcode lottery of support for children and their families. Many cannot access the care they need, because it is not available in their area or there are not enough professionals with the right skills and experience.

NHS England is currently undertaking a review of the Children’s Hospice Grant, and Mr Lamb has written to the Health Secretary and the Chief Executive of NHS England urging them to increase the value of the grant so that every seriously ill child receives the care they need.

Commenting after the event, Mr Lamb said:

“I really appreciated having the opportunity to learn about the wonderful support that children with life-shortening conditions receive from a range of services, including local children’s hospices and palliative care services.

“There is evidently much more to do to help families overcome the serious challenges they face on a day-to-day basis. I support the charity's call to make the mobility component of the Disability Living Allowance available to children under three who are dependent on heavy and bulky life support equipment.  Currently this benefit is only available to children aged three or over.

“I have written on behalf of East Anglia’s Children’s Hospices to the Health Secretary and to Simon Stevens, urging them to respond to the growing demand for services and the increasing complexity of care required by increasing the value of the Children’s Hospice Grant. Every child with a serious, life-shortening illness deserves high-quality compassionate care, and the Government must make sure that local services have the resources they need to deliver this

“I look forward to working with Together for Short Lives in Parliament to support children with life-limiting and life-threatening conditions and their families.”

North Norfolk stroke treatment delays ‘deeply worrying’

Fewer than one in five stroke victims in North Norfolk reach a specialist treatment centre within the ‘golden hour’, putting many of them at serious risk, according to official figures obtained by local MP Norman Lamb.

Under national standards, stroke patients who are potentially eligible for thrombolysis – a treatment to dissolve blood clots and restore the flow of blood to the brain – should arrive at a specialist ‘hyper acute stroke unit’ (HASU) within 60 minutes of an emergency call.

However, this target has been met for just 18% of stroke patients in North Norfolk CCG this year (2016/17) – far below the national standard of 56%.

Figures obtained via a Freedom of Information request show that 27 out of 149 patients who were eligible for thrombolysis arrived at a HASU centre within 60 minutes between April and November 2016.  In November, the latest month for which figures are available, the target was reached for only 13% of patients.

In the East Anglia region, 50% of stroke patients served by the East of England Ambulance Service have reached a specialist unit within an hour this year.  August was the only month where the 56% target was met, while just 44% of patients arrived at the HASU centre within the hour in November – the trust’s worst performance since April. 

Commenting, Norman Lamb MP said:

“These are unacceptable and deeply worrying figures, which show the extent of the disadvantage people in remote rural areas face in receiving emergency treatment.

“Early treatment of stroke is critically important and can prevent long-term disability and death. But in North Norfolk, there will inevitably be people who have suffered life-changing consequences or worse as a result of delays in getting to these specialist units.

“This is not the fault of the paramedics, who are doing brilliant work despite being under immense strain. However, we must review some of the perverse national targets for responding to 999 calls which are not time critical, and other incentives in the system which pull ambulances away from rural areas and into the more heavily populated towns and cities like Norwich.

“People should have an equal right to receive life-saving treatment on time, regardless of where they live.”


Norman Lamb: Norfolk and Waveney health plan lacks funding

Plans to integrate health and care services in Norfolk and Waveney will not be achieved unless additional funding is made available, Norman Lamb has warned.

Responding to the publication of the Sustainability and Transformation Plan (STP) for the region, the North Norfolk MP welcomed proposals to ensure a greater focus on the prevention of ill health, better integration between health and social care, and embedding mental health support more effectively into primary care.

However, in a letter to Dr Wendy Thomson, Managing Director of Norfolk County Council, he said that the plans are “very high level with no detail at all about how these good aspirations can be achieved”

He also suggested that the plan would require “substantial investment in new ways of providing more coordinated and integrated services”, and “does not appear to be grounded in reality in terms of what is achievable” within the current financial constraints in health and care.

Mr Lamb stressed the importance of working towards a single pooled budget and joint commissioning between health and social care in the region. He also outlined the need for a clear plan for digitising the health and care system, linking up primary care, acute and mental health services, social services, the ambulance trust, and patients themselves.

Commenting on the STP, Mr Lamb said:

“Despite the horror stories emerging from STPs in some parts of the country, I am broadly encouraged by direction of travel in the Norfolk and Waveney plan. However, the work is at a very early stage and little detail currently exists.

“The focus on bringing the different parts of the system together more effectively – physical health, mental health and social care – is welcome.

“But these proposals will have very clear cost implications, which I fear will prove fatal to its objectives at a time when the local health and care system is facing an enormous deficit.

“A lack of funding will inevitably result in an emphasis on sustainability over transformation.  If we are to capitalise on the potential of STPs to deliver better and more joined-up patient care, the Government must build a cross-party consensus on a long-term funding settlement for the NHS and social care.”

Norman Lamb holds constructive meeting with the Prime Minister on NHS and Social Care

Norman Lamb, the MP for North Norfolk, today held a "positive and constructive" discussion with the Prime Minister on funding for the NHS and Social Care.

In a meeting with a cross-party delegation of MPs, co-ordinated by Norman Lamb, Theresa May agreed to initiate a dialogue with her newly-appointed Health Adviser on a possible cross-party process to determine how much funding these vital services will require in the future and how this should be paid for. 

The meeting was also attended by Conservative MPs Sarah Wollaston, Dan Poulter and Hugo Swire, along with Meg Hillier and Frank Field from the Labour Party.  They were representing a wider group of MPs who recently called on the government to establish an NHS and Care Convention, which would engage with the public and the healthcare workforce with a view to delivering a sustainable long-term settlement for the health and social care system.

Commenting after the meeting, Norman Lamb MP said:

“I very much welcomed today’s positive and constructive discussion with the Prime Minister. 

“Mrs May seemed willing to engage in a serious dialogue about how best to secure the future of our NHS and social care services. 

“The future of the NHS and Social Care is more important than party politics, which has completely failed to come up with real solutions. The public are crying out for politicians to stop shouting at each other, and instead work together to make difficult decisions to ensure that patients get the right care and treatment when they need it.

“There is a real urgency to this situation, and now is the time to act.  Today’s meeting was an encouraging first step, and I look forward to meeting with her advisers as soon as possible.”

A Statement on Article 50

After spending months campaigning for the Remain side, I was distressed by the decision of the British people to vote to leave the European Union.  Throughout the campaign, I argued strongly that leaving the EU would leave Britain a poorer country and diminish our influence on the world stage.  This remains my view, and I deeply regret the situation we now find ourselves in. However, I accept the outcome of the referendum. 

The British people voted for departure but they did not vote for a destination.  I totally support the demand for a referendum on the terms of the final negotiated deal, to give people the chance to approve or reject the deal and ensure that the final deal has a democratic mandate.

I fully believe that Remain voters and politicians across all parties must play a key role in influencing negotiations, to ensure that we avoid the damage to the economy and the country’s international status that a Hard Brexit would bring.  My personal preference is for the Government to fight for full access to, and preferably membership of, the Single Market, and I will continue, alongside my Liberal Democrat colleagues, to seek to achieve this. I continue to give my full support to Open Britain’s campaign “to keep Britain tolerant, inclusive and open to Europe and the world”.

The Liberal Democrats are united in our opposition to a damaging hard Brexit, united on the Single Market, and united in our determination to make sure the British people have the final say over the final Brexit deal. I fully support our leader Tim Farron and my colleagues inside and outside parliament in campaigning for these outcomes.

However, I have already committed, in public, not to block the triggering of Article 50.  It’s no secret that I have an honest disagreement with the party’s position to vote against the triggering of Article 50 unless the Government guarantees a referendum on the terms of the final Brexit deal. Given the vote of the British people on June 23rd, I am not prepared to vote to block the triggering of Article 50 when the bill is brought before Parliament. 

Irrespective of my views of the outcome of the referendum, there is a democratic principle at stake, and I feel very strongly about this. When we voted to hold the referendum, we did not set out any preconditions for triggering Article 50, in the event of a vote to leave the EU. I do not see how we can introduce them now. I have therefore made the difficult decision to abstain on this vote.

I will continue to fight, alongside my Liberal Democrat colleagues, for a Britain which is open, tolerant and inclusive, standing tall in Europe and the rest of the world.

Norman Lamb

Norman Lamb receives Patchwork Foundation MP of the Year Award

Norman Lamb, the Liberal Democrat MP for North Norfolk, has been awarded the Patchwork Foundation ‘Other Party’ MP of the Year Award for 2016.

The Patchwork Foundation is a not-for-profit organisation dedicated to engaging people from disadvantaged communities in British society through involvement in politics.

A long-standing supporter of the Patchwork Foundation, Norman was selected from a shortlist of MPs outside of the Tory and Labour ranks in recognition of his tireless campaign to end the discrimination faced by people with mental ill health.

Commenting after receiving the award, Norman said:

“It is a great pleasure to receive this award.

“I have enormous admiration for the Patchwork Foundation and the invaluable work they do. It’s massively important that we engage more people from under-represented groups in the political process, to ensure that their voices are heard and to ensure that Parliament works on behalf of those who are disadvantaged in society for one reason for another.

“I have a particular passion for fighting on behalf of those who suffer from mental ill health.  I’ve come across so many people, in my work as minister and in my constituency work, who are disadvantaged by mental ill health and the way in which they are treated. There is a historic injustice we have to overcome – not just in the NHS, but in wider society.

“We are making progress, but there is still a long way to go. So I will continue to fight that incredibly important cause, and I am enormously grateful to the Patchwork Foundation for this award.” 

Norman Lamb leads debate on mental health in schools

Norman Lamb MP has challenged the Prime Minister to respond to the mounting crisis in children’s mental health by improving support for emotional wellbeing in schools.

Leading a debate in Parliament, Norman highlighted the national strategy for improving children and young people’s mental health services – Future in Mind (2015) – which was published when he was Care Minister in the Coalition Government.

Central to the Future in Mind vision is mental health support in schools, which aims to build children’s emotional resilience, prevent mental ill health, and provide early support when problems arise.

However, an independent commission set up by the Education Policy Institute, chaired by Norman Lamb, recently found that this strategy is not being properly implemented in many parts of the country.  Norman secured the debate in Parliament to demand that the Government makes good on its promise to implement this strategy in full, and to ensure that the extra funding secured by the coalition government is used for this purpose. 

In the debate, Norman raised the following key points:

  • One in 10 children are estimated to have a diagnosable mental illness, and 75% of mental health problems in adulthood started before the age of 18, so there is both a moral and an economic case for dealing with mental ill health among children and teenagers.
  • However, three in four children with mental illness are not in touch with appropriate mental health services, and it can sometimes take up to 10 years before the first symptoms are diagnosed and addressed.​  By neglecting children’s mental health problems, society stores up enormous problems for people later in life, at enormous cost to the public purse.
  • School-based counselling is an accessible and highly effective form of early intervention for children experiencing emotional difficulties. However, counselling services are still not a statutory requirement for schools in England.
  • Stigma can exacerbate mental health conditions and prevent people from speaking out and seeking help.  More than one in three young people with mental health difficulties have felt the negative impact of stigma, which is most commonly experienced in schools.
  • Among the recommendations of the Future in Mind strategy was that there should be a specific individual responsible for mental health in every school – to discuss concerns with an individual child, provide a link to support services, and make effective referrals where necessary. It also recommends a named contact point in specialist mental health services for every school.
  • A commission for the Education Policy Institute, chaired by Norman Lamb, looked at what has happened since Future in Mind, and published its final report in November.  It found that although there has been good progress in some parts of the country, very little has changed in others, with the bulk of money for mental health services still going to the acute end of the spectrum rather than being invested in preventive care.
  • Despite securing £1.25bn additional investment for children’s mental health in the coalition government’s last budget, a survey by the charity Young Minds found that 50% of all CCGs are not spending the full allocation on children’s mental health. Instead, it is being diverted to prop up local acute hospitals. This is “scandalous [and] amounts to theft of money solemnly pledged by the Government for children’s mental health”.  
  • In Future in Mind, local areas are only entitled to additional funding if they produce a Local Transformation Plan to show how that money will be spent on changing the system to focus more on prevention.  Echoing a recommendation of the EPI Commission, Norman Lamb challenged the Government to ensure that additional funding is in future tied to a commitment from CCGs that every penny of it is spent on children’s mental health.  
  • Theresa May should launch her own Prime Minister’s Challenge on Children’s Mental Health, as former prime ministers did for dementia to establish "a prime ministerial stamp of importance for the subject".
  • Mental health must be built into the school curriculum so that every teenager learns about their mental health, and about how they can become more robust in coping with the challenges they face.
  • Because there are no maximum waiting time standards, many children experiencing mental ill health are left waiting, sometimes for months, to get any treatment at all. The Government has a duty to ensure that when a child needs specialist evidence-based treatment, they get it on time.

Norman Lamb’s full speech can be read here.

Responding for the Government, the Health Minister Nicola Blackwood paid tribute to Norman Lamb’s “continuing personal commitment to improving mental health services, not only as my predecessor but also through chairing the commission on children and young people’s mental health for the Education Policy Institute”.  She put on record that his work has been “extremely valuable” to the Government.

The Minister reinforced the Prime Minister’s commitment to improving children and young people’s mental wellbeing, and to press ahead with the implementation of Future in Mind.  In order to achieve this, she confirmed the following measures to improve the mental health support available to children and young people:

  • A large-scale school survey on the activities and approaches used in schools to support children and young people’s mental health, conducted by the Department for Education;
  • An in-depth review of children’s mental health services by the Care Quality Commission;
  • A prevalence survey on children and young people’s mental health, which will look at issues such as cyber-bullying and the impact of social media, to report in 2018;
  • Improved collection of data on children and young people’s mental health services to strengthen accountability;
  • A 10-year research strategy will be published, and a new policy research unit for mental health will be established in 2017 to make sure that the research continues to become a reality;
  • The Government will publish a Green Paper on children’s mental health services, with a focus on preventive activity;
  • Funded provision of mental health first aid training for teachers in secondary schools;
  • A pilot programme by NHS England has been trialling a single point of contact in 255 schools across the country. The programme has tested improvements in joint working between school settings and specialist mental health services, aiming to develop effective referral routes and ensure that children have timely access to specialist support where required. The Government is reviewing whether that system is more effective than having an individual counsellor in every school;
  • The Department for Education is looking again at the case for further action on PSHE and sex education provision, with particular regard to improving quality and accessibility;
  • The Department for Education has produced guidance on good school-based counselling as part of a whole-school approach to wellbeing. It has also published advice on behaviour and mental health, which provides teachers with information, and with tools to help them identify pupils who need help and to give effective early support in understanding when a referral to a specialist mental health service may be necessary.

Commenting after the debate, Norman Lamb said:

“I was pleased to lead today’s debate on such a crucial topic.  I welcome the fact that the Government is addressing the issue of children’s mental health, and the focus on schools is right. Failing to ensure access to high-quality services stores up problems in later life, with an enormous cost both in terms of human life and the cost to the public purse.

“However, measures to improve mental health care in schools were already agreed during the coalition, and the current government has failed to ensure the investment needed to implement them has got through.

“Much of the additional £1.4 billion of funding secured for child mental health care is being diverted to prop up other services. When a CCG is under financial stress, it is too easy to shave a bit off children’s mental health to spend it where the public are clamouring for action, because ambulances are stacked up outside the A&E department. This amounts to theft of money intended to improve the lives of vulnerable young people.

“Sadly, mental health is often the first area which loses out when budgets are tight. Unless the government addresses the funding crisis facing the NHS and ensures extra investment gets through to where it’s needed, we will not see the improvements in mental health care that are so badly needed.” 

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