Timely reminder at a late hour

Working late one evening health manager Laurie
Fentimen had a phone call that left a lasting impression.

I never learn. For weeks I’d known I had a
deadline for the board report, but here I was, up against the clock
as usual. The phone went again – I picked it up, and as the woman
on the other end began talking, I realised it wasn’t even for me.
It was about mental health, and I haven’t been responsible for that
since the last reorganisation.

But something made me listen. She was
obviously worried and distressed. Although the caller lived on the
other side of the country, her daughter lives in our area and has
mental health problems.

Because of her illness and distress the
daughter couldn’t quite understand the care plan that had been
drawn up for her. Who was it she was meant to contact when the
suicidal feelings came back? What was the decision about medication
and how it should be monitored? No one was being unhelpful or
inattentive but somehow the communication between the service and
the family didn’t seem to be working as it should.

How was a mother to support her daughter at
such distance, being helpful but not interfering? She decided not
to give me her daughter’s name, not wishing to breach her
confidentiality. I was left with the dilemma of what to do. I
talked to people in the primary care group about the issues she
raised. The policies on medication management and review seemed
fine, care programme approach and clinical governance systems were
in place. The fundamental point seemed to be about communication.
It’s not easy to communicate and be fully understood when the
person you are talking to is distressed or ill. But is that an
acceptable excuse?

In the end, there didn’t seem very much we
could do. Perhaps some good will come from it. Perhaps the story,
although anonymous, can be used in staff training; perhaps the
application of the CPA can be audited; perhaps new guidance on
medication management will be produced. But it was frustrating.

We felt at least we should write back to
acknowledge her concerns. But I didn’t even have her name or
address. Not long after, I received a card in the post from the
mother, thanking me: “My phone bill says I talked for 20 minutes.
Please forgive me, it’s a long time.”

Forgive her, for being concerned about her
daughter? For reminding me why my job exists? I’m writing this
several weeks later. I can’t quite remember what that report was
about, but I don’t think I’ll forget that letter.

Laurie Fentimen is assistant director
of health development at Cambridgeshire Health
Authority.