Dear NHS Chief Executives,
Re: Total absence of a CQC regulated, clinical, dual-diagnosis/complex psychosis NHS treatment, care and recovery pathway (a pathway is available to UK residents with £20,000 a month to spare).
I invite you towards change, for the long-term benefit of NHS staff and patients. Experience led to the creation of the UK Advocacy and Social Wellbeing Projects, independent developments that serve as a pathway towards purposeful freedom of speech, and which encourage transparent public reporting, as well as potential collective legal action. The Ana Maria Foundation is not in a position to save any individuals, perhaps we find ourselves in the same boat on that front, the one sailing towards The Doom of the NHS.
Shall we ask the artists of our nation to conceptualise a sinking NHS, likening it to the Titanic, only with a very many more souls on board? Propaganda in reverse, shall we utilise it and represent reality only, thus becoming a trusted source of vital and relevant social/public client information? All artwork produced should be protected in original format, with the help of wealthy patrons, and we can display the originals in galleries, while creating collections of posters, pamphlets, and more with the imagery. In such a way, we would be supporting another struggling demographic, the artistic community. Animation, documentary, storytelling, all must come to be employed if we are to protect the staff and patients you are responsible for.
There must come to be only one fight, one war, and it is one we must be on the same side of, should we have any hope of winning it: The War for Public Health and Safety. Manifesto for Change: Dual-Diagnosis and Disparity, is a publication presenting an achievable solution to the crisis that is, ‘No Care Quality Commission (CQC) regulation of NHS dual-diagnosis treatment, care, and recovery pathways’. Without regulation, who is to know what this entire demographic is suffering? I know, I am a witness to it. It is why I write sincerely and with respect for their suffering above all else.
I warmly encourage you to fill in the attached form and return it to: advocacy@anamaria.org. Reporting the dual-diagnosis clinical pathway data (or absence of it) is vital, should we position ourselves towards the successful and swift safeguarding of 80% of acute psychiatric ward admittances, for that is approximately how many patients present with dual-diagnosis (as reported by a local dual-diagnosis NHS clinical nurse). It is known that only one dual-diagnosis hospital in the UK offers comprehensive treatment to patients detained safely for treatment under The Mental Health Act (1983), it is called Sinoue Nightingale Hospital and costs £20k a month. After fighting for years for a referral to this solely available comprehensive treatment pathway for a loved one, I was told over the phone that they do not accept NHS patient referrals. This is experienced gross inequality.
Much must come to light if it is to change. Many patients are unsafe in a medical paradigm that encourages the misdiagnosis of acute, primary psychotic illness in favour of the easier diagnosis of ‘drug-induced psychosis’, which likely happens more than is known. Bed shortages, discharge pressure (does not every admittance begin with the planning of patient discharge?), hospital closures and many other challenges you face will determine a drop in the quality of health and social care provision.
Is it not far wiser and more ethical to notice patterns of injustice and inequality before they cause injury to far too many patients, human beings afforded certain rights under the following Acts of Parliament:
– The Mental Health Act (1983);
– The Capacity Act (2015);
– The National Health Service Act (1946);
– Health and Care Act (2022);
– Health and Social Care Act (2008);
– The Care Act (2014);
– The Equality Act (2010);
– The Human Rights Act (1998);
– The Children Act (1989);
– Children and Social Work Act (2017);
– Safeguarding Vulnerable Groups Act (2006);
– Carers Recognition Act (2008);
– Public Services (Social Value) Act (2012);
– Corporation Tax Act (2010);
– The Parliament Act (1911/1949); and also,
– Care Quality Commission Regulations (2009), NICE Guidelines, and likely additional legislation, regulation and policy I have not yet discovered.
The legislation is in place, we, the people and other responsible service stakeholders, need no longer fight for what is right. Now, my good people, we get to ensure that parliament fund the services in such a way that the common patient experience is first rate treatment and care. We simply need to ensure that the systems reflect best practice by laying them beside modern theory and research, and current legislation. I do believe that most medical professionals and patients hold the same wish for the NHS… for it to be thriving, truly serving those in need, and evolving alongside leaps in modern knowledge (which must swiftly come to be used and applied, and enabled to influence immediately responsive changes to legislation).
We will only see the world change when we force it to, and we are all the more ready to succeed with legislation already in place to secure our victory, that which was fought for and won by our working class ancestors. There can be no doubt of our success, should we employ logic, reason, grit, a moral compass, and patience. What is right is what is right, there can be no negotiations where life is concerned. The old guard, for certain, will always long for their days of unchecked power and ‘glory’, that which has killed millions over the centuries. Let us claim the right to health and safety for our people together and simply let go of what is not working, that which will predictably come to cause more harm and injury than is already being experienced by tax-paying service users.
In a happy turn of events, by exposing legislation we may very well come to restore staff-to-patient ratios, as the welfare of the workers comes into focus too. I am drawn now to a memory of a local parcel delivery worker, he is a kind man, but in visible and constant pain. His job demands that he carries heavy loads by himself, parcels that are surely to be considered a criminal weight when brought out of the shadows and into the light of legislation? He is prevented from working with mild injury, prevented from recovering fully, because online shopping has exploded and nobody is actively protecting his right to health and safety. Should we protect all, do we also protect the NHS? When we step up to improve food regulations, education and more, do we relieve the pressure on our special, rare, free, life-saving healthcare service? When we protect patients, do we protect your staff too, in specific and targeted ways?
Should we support all people, by doing so, do we actively reduce a growing reliance on the systems and improve human health and welfare? Is education encouraging true preventative measures? Are children at risk of harm and injury too because parents cannot access timely, comprehensive mental health treatment pathways? The predictable damages are only going to increase as known-to-be-effective treatment and care paradigms shift and evolve alongside scientific research and breakthrough. When the working and middle classes cannot access best practice with equality, everything needs looking at, because it means the law is being broken, by you, I’m afraid, unless you hold parliament accountable alongside us, with immediacy.
To honour the crux of your profession, that of ethics, one must come to hope that your response to this manifesto is public and encouraging of the service user to speak up via the following data collection and reporting pathways (remember, this is to encourage parliamentary use of the Manifesto for Change and to build a collective action lawsuit against The State for such gross, unchecked inequality):
– Report an unwell person in the community, someone who should be in hospital receiving treatment:
UNSAFE PERSON REPORT (UK ONLY)
– Report a person who has been discharged unsafely from NHS inpatient or outpatient services, someone who has not been treated into a form of recovery pre-discharge and is still declining:
REPORT AN UNSAFE DISCHARGE FROM THE NHS TODAY!
– Report, via the memorial, someone already lost because The NHS and Social Services failed to do what is legislated and to safeguard them and treat them back to health:
Memorial for the dead and hopeful messages for the dying…
– Let the professionals stand beside us, let us fight for a system that upholds current legislation:
Professional Witness Statement Collections
– Service users are able to help us collect evidence via the UK National Data Collection Project, a development that sees transparency injected with immediacy when they copy us into their fight for ethical and lawful outcomes. The aim is to collect enough data in the years ahead, of the damages inflicted by failing services, and to take our evidence to The High Court. The public can copy us into any emails sent regarding the following ‘fights’ for what is owed, by law:
| Area of concern: | The email address: |
|---|---|
| Mental Health | MH.DataCollection@AnaMaria.Org |
| Dual-Diagnosis | DD.DataCollection@AnaMaria.Org |
| Physical Health | PH.DataCollection@AnaMaria.Org |
| Social Care (inc. housing matters) | SC.DataCollection@AnaMaria.Org |
| Carers Rights | CA.DataCollection@AnaMaria.Org |
| Professional Witness Statements | PW.DataCollection@AnaMaria.Org |
| Anything important that we missed | Justice.DataCollection@AnaMaria.Org |
| Mismanagement of taxpayer money | Government.Waste@AnaMaria.Org |
As Chief Executives of government funded NHS Foundations and Trusts, I do pray that you engage with the material delivered to you, namely the publication, Manifesto for Change: Dual-Diagnosis and Disparity (2024).
Now that you have been informed of the unreported crisis and this bundle of relevant, crucial information has been delivered to you, one would expect, as a duty of care owed, immediate remedial responses that hold as much potential for effective safeguarding as that which is presented in the Manifesto for Change.
With thanks for your support, which I hope the incomprehensibly treated demographic of dual-diagnosis patients receives in due course.
Yours Faithfully,
Ana Maria Santuario.
p.s. If you want to be bold, brave and encouraging of ethical transparency, please proclaim yourself an advocate of, ‘letting things change so that lives can be saved’, and consider displaying our posters in your buildings, gift them to your senior colleagues who direct A&E departments or manage doctor’s surgeries, empower your patients instead of defending a life-threatening gap in service provision. Let us snuff out the illusions contained by these ‘surveys’ the NHS send me, documents that make me angry for two reasons:
1 – They waste trees and therefore life-giving air. Is it not a little backwards for a HEALTH supporting institution? I mean, you have sent me reems of paper over the years, and it always goes into the recycling bin because you ask no questions that matter or provoke change via these silly check-box, statistic-creating processes.
2 – These forms waste time! Do your forms save lives? I’d love to know, because anytime I provide feedback, honest feedback, it is met with renditions of, ‘Yes, we understand, but it’s just how it is,’ or, rather devastatingly, ‘Suck it up, get on with it!’
If you want to make whole the NHS, and protect the patients you signed up to safeguard, please allow the public to become aware of the challenges that you face so that they can call for change alongside you. We must accept reality wholly before attempting to change it. In ignorance, we make predictable mistakes, harm will be done, money mismanaged and time, as well as life, will be wasted. Save your forms for later, why not redirect every wasted resource (including human beings full of loving and healing energy) towards this vulnerable demographic and see how much true good can be achieved.
p.p.s. Download the letter here:
When this was letter was emailed directly to the first wave of NHS Chief Executives on 1st May 2024, with parliament copied in, the form below was attached, as was, Manifesto for Change: Dual-Diagnosis and Disparity, along with, Ethical Mental Health Treatment and Care (a clear example of a moral compass point to move towards, collectively speaking). The form in particular encourages transparency, collaboration, and an immediate assessment of whether dual-diagnosis patients have a qualified and experienced professional available to treat them effectively and safely, with relevant knowledge and experience:
© Santuario, Ana Maria (2024). Letters to The World. Faith in Change Publishing, London.
We hope and pray that those with the power to provoke change claim it in any way they can imagine! Let fear not dictate your actions, but ethics, a moral integrity, and heart (if it isn’t too closed already, after suffering immensely as a witness to chronic and complex patient illness).
Do you have a letter that you wish to send to the world?
Submissions are open at Faith in Change Publishing, who are creating anthology, after anthology, of UK-focused human interest stories. By claiming our right to our Freedom of Speech in this professional, unguarded, potentially anonymous manner, does the age old tradition of letter writing lend itself to the call for equality, freedom, safety and change?
Collectively, Ana Maria Ltd., The Ana Maria Foundation and Faith in Change Publishing Ltd., work to gather intelligence by embracing the ancient wisdom and power of storytelling. Such powerful data collection can do nothing but provoke change and force forward motion. It is only in the denial and silencing of reality that suffering persists. The foundations have been laid, let us see what we can grow when we work together, for the good of everyone on our soil.