Can Do Health & Care - NHS Uncomfortable Truths Report

Part 1: WHY as system leaders we need to address culture to improve outcomes | 25 Uncomfortable Truth 10: We don’t know anywhere near enough about the people who die in our care and why. Grant Thornton, The Learning Social Worker Zoe: For my own organisation the uncomfortable truth which has been rightly exposed is that we don’t learn enough from incidents and from deaths in mental health. It is shocking that we don’t know basic information on why people are dying early in our communities, and in particular those people who had been in contact with mental health services in the last six months, and the circumstances. Even more appalling is not even being clear on the numbers of people who have died early. It has been a moment of great reflection for our organisation and our system. “We have lost sight of the fact, in large organisations, that we are dealing with people. These are human beings, this ‘data’… these numbers of mortality, as we have described it, are our brothers and sisters, our daughters and sons, and our nephews and nieces.” We have dealt with mortality as a statistical administrative process rather than a humanitarian understanding of a person’s life, how they came to live that life and how they came to die in the circumstances in which they did. Let’s stop hiding behind numbers and data analysis and start looking at individuals as human beings to change the life chances of people and narrow the shameful inequality of life expectancy for those experiencing mental illness. Richard: I think one uncomfortable truth is that we do know quite a lot about why people are dying in our communities earlier than they should be. There is a huge gap in life expectancy and our communities are shouting out to us about the things we need to do to change that. “Are we truly listening to those difficult truths that we need to hear? A lot of what we need to do will be hard to do, but if we are going to make a difference, we are going to have to do something different.” We need to do more to truly listen to people with lived experience. We have signed up to co-production, and we use that word a lot, but are we demonstrating that every day in what we do? For myself I can say, probably not. We are still very reactive to crises and the latest ask from NHS England, like the CORE20PLUS5, and whilst this is important there are wider things we should also be doing. Some of this will take a long time to do but we must start now.

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