Jan 152017
 

A specialist women’s mental health service attributed with saving lives is facing threat of closure under proposals currently being agreed by Croydon CCG. The 8-bedded facility providing holistic treatment in a supportive peer environment is highly valued by women who have used its services and their families. However, the CCG claim it is too expensive to run and the money cannot be justified for the number of women admitted each year. Women and their families say this is effectively putting a price on women’s lives.

Bromley and Croydon DPAC is asking for support to challenge the closure.

How you can help:

           Tweet at @NHSCroydonCCG calling on them to #SaveFoxleySaveWomen on Tuesday 17th January from 1pm.

          Sign the petition to stop closure. The consultation period has now ended but the campaign to save Foxley Lane is not done yet: https://you.38degrees.org.uk/petitions/save-foxley-lane-women-s-service

          If you are a Croydon resident please write to your local GP (who are members of the CCG) and to your MP. You can find template letters under this post. 

           If you have used Foxley Lane services in the past and are happy, anonymously or otherwise, to share your story about how this service has helped you and why it is important that it stays open please contact: ellen.clifford@inclusionlondon.org.uk.

          Join DPAC members at the CCG governing body meeting where they are considering the proposal for closure.  The meeting is taking place 1 – 4pm on Tuesday 17th January 2017 Conference Room, Croydon College, College Road, Croydon, CR9 1DX. If you can come along and want more information contact norwichpete@hotmail.co.uk​

 

For more information about the closure you can read these articles in Inside Croydon:

https://insidecroydon.com/2016/11/25/hundreds-sign-up-to-petition-to-save-foxley-lane/

https://insidecroydon.com/2016/11/25/please-dont-close-foxley-lane-it-saves-womens-lives/

To read our consultation response scroll down to below the template letters.

 

Letter to Croydon GP – please insert any relevant personal experiences of Foxley Lane

Dear

I am writing to you as my GP practice to ask for your support in opposing proposals by Croydon CCG to close Foxley Lane women’s mental health service.

Foxley Lane provides a highly effective and specialised service unavailable in neighbouring boroughs and to the benefit of women in Croydon. Just as this service has saved many lives, its closure will undoubtedly cost lives.

At a time when Government has recognised, in the words of Prime Minister Theresa May, the “burning injustice” of how society treats mental ill health, Foxley Lane is a model of provision that should be celebrated and promoted to improve women’s mental health services elsewhere.

There is wide opposition to the closure with a petition having now reached over 850 signatures and rising.

The recent consultation undertaken by Croydon CCG was inadequate and flawed. 54% of respondents to the consultation survey stated that they did not understand the proposals.

Information in the consultation document is misleading. It suggests that numbers of admissions to Foxley Lane have been falling due to declining need for the service. However, the reason for fewer admissions in 2015/2016 was due to longer stays which is indicative of growing rather than decreasing need.

The consultation document claims that home treatment can better meet the mental health needs of women in Croydon, but this is not a view shared by mental health service users, their organisations or staff. For many women the home environment is a dominant factor behind their need to access the Foxley Lane facility and the effectiveness of the support it provides is due to factors that cannot be replicated by home treatment including peer support and group therapy, 24-hour support and consistency of staffing from long-standing and experienced staff members.

A report for Croydon CCG’s January governing body meeting acknowledges that home treatment will not be able to meet the needs of all women impacted by the Foxley Lane closure and announces plans for a new 14-bedded women-only ward on the Bethlem. Acute wards in a hospital setting are not able to provide the same quality of environment as Foxley Lane and are therefore less effective. Moreover, the consultation proposals did not include this information.

The financial value of closing Foxley Lane does not appear to be as clear as the consultation makes out. Beds on acute wards at the Bethlem are more expensive than Foxley Lane and direct admissions to Foxley Lane prevent more expensive detentions under the Mental Health Act. The effectiveness of the support women receive in this service as a step down facility can also prevent readmissions.

Some of the things women who have used Foxley Lane and their families say:

“It is criminal to close such a unique centre. I owe my life and my road to recovery to the amazing staff and all services provided at Foxley Lane. It would be a great shame for other women to lose out on a place at the centre. A human life and mental stability should not have a price-tag.”

“When I was treated at Foxley Lane it was not tenable for me to remain in my home and receive treatment from a community team yet based on previous experiences, staying on a psychiatric ward can be very difficult and distressing for someone in an already vulnerable state. I am very concerned that if (when) I fall ill again in the future, the Foxley Lane service will not be available to me, and my recovery will take longer, at much greater cost to my family and to the NHS.”

“My own circumstances were unique to me but I was so grateful to be able to go to Foxley. I do feel it saved my life too. There is nowhere like this in the UK certainly not in Croydon and the health service should be using this as a model to copy. The other services in Croydon are not adequate and would have been unsuitable for me and many other women.”

“The service offered at Foxley lane is a showcase of best practice in the tortuous process of rehabilitation into the community for sufferers of severe mental illness. My own personal experience on several occasions with my daughter has seen long periods of difficult isolation at home followed by lengthy hospitalisation only for real and rapid recovery occurring at the Foxley lane facility. The peaceful calm environment and the amazing caring and professional staff combine with the result of a step change in speed of recovery.”

I hope that you would agree that Croydon CCG needs to at least rethink its proposal to close such a vital and effective service and look forward to your response.

 

Yours sincerely,

 

 

Letter to Croydon MP – please insert any relevant personal experiences of Foxley Lane

Dear

I am writing to you as my constituency MP to ask for your support in opposing proposals by Croydon CCG to close Foxley Lane women’s mental health service.

Foxley Lane provides a highly effective and specialised service unavailable in neighbouring boroughs and to the benefit of women in Croydon. Just as this service has saved many lives, its closure will undoubtedly cost lives.

At a time when Government has recognised, in the words of Prime Minister Theresa May, the “burning injustice” of how society treats mental ill health, Foxley Lane is a model of provision that should be celebrated and promoted to improve women’s mental health services elsewhere.

There is wide opposition to the closure with a petition having now reached over 850 signatures and rising.

The recent consultation undertaken by Croydon CCG was inadequate and flawed. 54% of respondents to the consultation survey stated that they did not understand the proposals.

Information in the consultation document is misleading. It suggests that numbers of admissions to Foxley Lane have been falling due to declining need for the service. However, the reason for fewer admissions in 2015/2016 was due to longer stays which is indicative of growing rather than decreasing need.

The consultation document claims that home treatment can better meet the mental health needs of women in Croydon, but this is not a view shared by mental health service users, their organisations or staff. For many women the home environment is a dominant factor behind their need to access the Foxley Lane facility and the effectiveness of the support it provides is due to factors that cannot be replicated by home treatment including peer support and group therapy, 24-hour support and consistency of staffing from long-standing and experienced staff members.

A report for Croydon CCG’s January governing body meeting acknowledges that home treatment will not be able to meet the needs of all women impacted by the Foxley Lane closure and announces plans for a new 14-bedded women-only ward on the Bethlem. Acute wards in a hospital setting are not able to provide the same quality of environment as Foxley Lane and are therefore less effective. Moreover, the consultation proposals did not include this information.

The financial value of closing Foxley Lane does not appear to be as clear as the consultation makes out. Beds on acute wards at the Bethlem are more expensive than Foxley Lane and direct admissions to Foxley Lane prevent more expensive detentions under the Mental Health Act. The effectiveness of the support women receive in this service as a step down facility can also prevent readmissions.

Finally, there is also a clear conflict between the closure and with national government policy on mental health. The green paper “Improving Lives: disability, health and work” makes clear the Government’s ambition that health services should fit holistically around individuals, tailored to meet individual need in order to better facilitate all Disabled people into employment with no one left behind. Women who have used Foxley in the past have recovered sufficiently to either return to or take up employment as a result of the high quality individualised support available. In line with government aims to address mental health injustice and to support more people with mental health support needs into work, services such as Foxley Lane should be promoted as best practice.

Some of the things women who have used Foxley Lane and their families say:

“It is criminal to close such a unique centre. I owe my life and my road to recovery to the amazing staff and all services provided at Foxley Lane. It would be a great shame for other women to lose out on a place at the centre. A human life and mental stability should not have a price-tag.”

“When I was treated at Foxley Lane it was not tenable for me to remain in my home and receive treatment from a community team yet based on previous experiences, staying on a psychiatric ward can be very difficult and distressing for someone in an already vulnerable state. I am very concerned that if (when) I fall ill again in the future, the Foxley Lane service will not be available to me, and my recovery will take longer, at much greater cost to my family and to the NHS.”

“My own circumstances were unique to me but I was so grateful to be able to go to Foxley. I do feel it saved my life too. There is nowhere like this in the UK certainly not in Croydon and the health service should be using this as a model to copy. The other services in Croydon are not adequate and would have been unsuitable for me and many other women.”

“The service offered at Foxley lane is a showcase of best practice in the tortuous process of rehabilitation into the community for sufferers of severe mental illness. My own personal experience on several occasions with my daughter has seen long periods of difficult isolation at home followed by lengthy hospitalisation only for real and rapid recovery occurring at the Foxley lane facility. The peaceful calm environment and the amazing caring and professional staff combine with the result of a step change in speed of recovery.”

I hope that you would agree that Croydon CCG needs to at least rethink its proposal to close such a vital and effective service and look forward to your response.

 

Yours sincerely,

 

 

Response to consultation on closure of Foxley Lane women’s mental health service

 

We are deeply concerned by and opposed to proposals by Croydon CCG to close Foxley Lane women’s mental health service. Foxley Lane provides a highly effective and specialised service unavailable in neighbouring boroughs and to the benefit of women in Croydon. At a time when Government has recognised, in the words of Prime Minister Theresa May, the “burning injustice” of how society treats mental ill health, it is a model of provision that should be promoted and built upon to improve women’s mental health services elsewhere. Just as Foxley Lane has saved many lives, its closure will undoubtedly cost lives.

The following response sets out our main points of concern regarding the planned closure.

 

Summary of main points

·         Flawed and inadequate consultation process

·         Disproportionate equalities impact

·         Inappropriateness of home treatment as an alternative

·         Conflict with national government disability policy and negative impact on employment outcomes

·         Questionable value for money

 

Flawed and inadequate consultation process

The engagement document published by Croydon CCG setting out its plans concerning Foxley Lane presented closure as the only option available and feedback from local residents unhappy with the proposals indicates they saw the closure as “a done deal” that they had no power to stop happening.  We believe that this had the effect of limiting the response to the consultation.

Information in the engagement document is misleading. It suggests that falling numbers of admissions to Foxley Lane from a comparison of the 2014/2015 and 2015/2016 figures are evidence that need for a service of this type is decreasing. However, the reason for the lower numbers is that length of stays were longer in 2015/16. This is consistent with the wider picture of growing demands on mental health services and does not prove declining need due to improved community services. The engagement document also fails to explain how the referral procedure for Foxley Lane has changed which has restricted access through direct admissions.

The Croydon CCG “Case for Change” report recommending closure of Foxley Lane includes information about a planned 14 bed women only ward at the Bethlem as a mitigating factor in the impact of the closure of Foxley and as additional alternative provision. There is no mention of plans for this new facility in the engagement document which informed the consultation process. The document makes clear that the primary arguments for closure are cost savings and an emphasis on home treatment. However, replacement of some of the service provided by Foxley Lane with new acute inpatient provision represents both additional cost and a move further away from home and community treatment. Costs per bed for acute wards are higher than the costs per bed at Foxley Lane. None of the additional costs associated with alternative provision on an acute wards are included in the proposals outlined in the engagement document.

The consultation survey was publicised predominantly online and may not have reached or been available in a format appropriate to responses from local mental health service users and survivors. Furthermore, the survey questions were both limited and confusing. Despite good attendance at open meetings and over 700 signatures to a petition opposing the closure, only 57 consultation survey responses were received.  54% of respondents said they did not understand the CCG proposals.

Some of the groups and organisations supporting this submission, whose members include women who have used Foxley Lane and their families, only learned about the planned closure shortly before Christmas. A request for an extension to the deadline was denied.

 

Disproportionate equalities impact

We are concerned that the proposals do not put forward adequate measures to mitigate the disproportionate impact that the closure will have in regards to gender, disability and ethnicity.

In Croydon a similar facility for men, Ashton, was closed and replaced by home treatment as an alternative service. Firstly, we would ask what the measured impact of this closure has been. Secondly we would point to differential factors which need to be taken into account when considering the needs of women for both direct admissions to Foxley Lane and for the step-down facility it provides. These include situations including domestic violence and caring responsibilities which are more likely to affect women.  

 

Inappropriateness of home treatment as an alternative

We question the evidence base on which the claim is made that home treatment can deliver more effective outcomes than a stay at Foxley Lane. For many women the home environment is a dominant factor behind their need to access the Foxley Lane facility and the effectiveness of the support it provides is due to factors that cannot be replicated by home treatment including:

          Refuge away from the home environment

          Peer support and group therapy

          Consistency of staffing from long-standing and experienced staff members

          24 hour staff presence

The proposal document claims that home treatment will be a better option as women who use Foxley Lane predominantly come from north of the borough whereas the service is based in South Croydon. We agree that it is detrimental for women to be sent for inpatient treatment many miles from home but do not consider that the distance between the North and the South of the borough presents the same issue. Foxley Lane is well served by Purley transport links and close to local amenities whilst occupying a peaceful environment conducive to restoring well-being. The suggested alternative of an additional ward on the Bethlem would place women in a location with fewer transport links and in an institutionalised setting away from the local community.

There is also evidence that the home treatment service provided in Croydon is currently unable to satisfactorily meet the needs of its existing service users. For example:

           Lack of consistent staffing. Women accessing the home treatment service have described having to go through the same information again and again to new staff.

          Limited visits at set times rather than support being available as and when required.

 

Conflict with national government disability policy and negative impact on employment outcomes

The green paper “Improving Lives: disability, health and work” makes clear the Government’s ambition that health services should fit holistically around individuals, tailored to meet individual need in order to better facilitate all Disabled people into employment with no one left behind.

By closing the Foxley Lane service, Croydon CCG will be restricting the types of service that are available to meet the different needs of women in the borough. The service provided by Foxley Lane has successfully supported women to return to employment following a mental health crisis. We are concerned that replacement of Foxley Lane with less effective treatment options will negatively impact on the employment outcomes of Disabled women in Croydon.

 

Questionable Value for Money

The consultation document makes clear that the intention behind the closure of Foxley Lane is to save money. Foxley Lane provides a service that is different from anything else on offer and just as it has saved the lives of many women, its closure will cost lives. To deem the service too expensive to continue to run is to in effect put a price on a woman’s life. It also ignores the social returns from enabling a woman to continue in her role within her family and as a member of her community.

As a purely financial exercise the proposal is however also questionable. The cost per bed at Foxley Lane is cheaper than per bed on a ward at the Bethlem. The current context is one where detainment under the Mental Health Act is rapidly increasing as low level and preventative services are cut. The resulting chronic bed shortage is leading to patients being sent many miles away to available places in acute settings. Acute wards provide a very different environment to the one on offer at Foxley Lane where chaos and disturbances can exacerbate and prolong mental distress. There is a likelihood that the closure of Foxley will result in:

·         a rise in more expensive admissions to acute wards

·         increased stays on more expensive acute wards due to a lack of step down facility

·         increased pressure on inpatient beds through readmissions due to the lack of availability of more effective holistic support as provided at Foxley Lane

 

Some of the things women who have used Foxley Lane and their families have told us:

“It is criminal to close such a unique centre. I owe my life and my road to recovery to the amazing staff and all services provided at Foxley Lane. It would be a great shame for other women to lose out on a place at the centre. A human life and mental stability should not have a price-tag.”

“When I was treated at Foxley Lane it was not tenable for me to remain in my home and receive treatment from a community team yet based on previous experiences, staying on a psychiatric ward can be very difficult and distressing for someone in an already vulnerable state. I am very concerned that if (when) I fall ill again in the future, the Foxley Lane service will not be available to me, and my recovery will take longer, at much greater cost to my family and to the NHS.”

“My own circumstances were unique to me but I was so grateful to be able to go to Foxley. I do feel it saved my life too. There is nowhere like this in the UK certainly not in Croydon and the health service should be using this as a model to copy. The other services in Croydon are not adequate and would have been unsuitable for me and many other women.”

“The service offered at Foxley lane is a showcase of best practice in the tortuous process of rehabilitation into the community for sufferers of severe mental illness. My own personal experience on several occasions with my daughter has seen long periods of difficult isolation at home followed by lengthy hospitalisation only for real and rapid recovery occurring at the Foxley lane facility. The peaceful calm environment and the amazing caring and professional staff combine with the result of a step change in speed of recovery.”

 

 

 

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