19 Nov
2019

Bid to Sam Allen, CEO of SPFT, for a license for SECTCo to provide socially prescribed mindfulness classes at Essence Hove                                   27.10.19

CREATING A SOCIAL PRESCRIBING LICENCING SYSTEM  TO REDUCE HEALTH INEQUALITIES AND IMPROVE MENTAL HEALTH

By John Kapp, 22, Saxon Rd Hove BN3 4LE, 01273 417997, johnkapp@btinternet.com Papers referenced thus (9.91) are to www.reginaldkapp.org. Other sources are given on my PRESCRIBE FITNESS CAmpaign for Social Prescribing Of Talking Therapies CASPOTT www.caspott.org.uk

1 Summary conclusions

  • Medication as street drugs have been used to mask human suffering for millenia, but it is only palliative, and does more harm than good with side effects, including addiction, which makes it irreversible. The incidence of depression used to be rare (less than 1 in 1,000) called ‘nervous breakdown’ from which most patients recovered without treatment after a few years. Since 1960, the drug companies developed ‘brain drugs’, which act like gin or vodka, and have conned the governments of the world to finance them as licenced treatment at taxpayers expense. This has reduced GPs to pill pushers in a toxic, polypharmacy, adverse drug reaction ridden NHS, increasingly prescribing antidepressants against NICE guidelines to now 1 in 7 (7 million) in England, to which 1 in 10 (4 million) are now addicted. This has created the crisis in primary care and the epidemic of ‘depression’, which the World Health Organisation predicts will become the worlds’ greatest disease burden by 2030, having overtaken heart disease.
  • GPs prescribe more treatment for depression (antidepressants, against NICE guidelines) than psychiatrists, and all other secondary mental health practitioners combined, but should not, as they have not got the specialist knowledge to help patients withdraw. They know that they are doing immense harm, which is why they retire early (average age 55) and nobody wants to replace them, but they are too ashamed to admit this betrayal of their trust in governments and drug companies.
  • Can the drug companies’ monopoly be broken by social prescribing?   Perhaps, as under the NHS long term plan, 1,300 new Primary Care Networks (PCNs) have been created in England, with link workers already in post to signpost vulnerable patients to suitable social interventions run by the Community and Voluntary Sector (CVS) of which I am a part. However funding to pay the  social intervention providers does not yet follow the patient, but could if Health and Wellbeing Boards and Clinical Commissioning Groups (CCGs) work together to divert some of the drug prescribing budget (now £20bnpa) to social prescribing, as CASPOTT campaign for.
  • Is SMC an open community or a closed shop? The motivation for this paper originates from my experience at the 7th Sussex Mindfulness Centre’s conference on 25.10.19, ‘New frontiers in mindfulness based approaches’. I was apprehended by Robert Marx for distributing leaflets about my free Mindfulness Based Cognitive Therapy courses in Hove because you are not recognised by Sussex Partnership Foundation Trust (SPFT).
  • While I fully understand that recognition cannot be a free-for-all, my previous applications for recognition were turned down unreasonably, leading me to believe that SMC is a ‘closed shop.’ This attitude contrasts strongly with the welcome Brenda Roberts gave to me when I first joined her Mindfulness Interest Group in 2005, which was based on the principle of the ‘sangga’ – everybody’s welcome – from which SMC originated. Open-hearted inclusivity is also implied in the SPFT strategy shown on the screen: ‘PEOPLE, PREVENTION & PARTNERSHIP. Our strategy is about working with others to improve the mental health and wellbeing of local communities.’
  • I have long wanted to become recognised by SMC and SPFT as one of their facilitators of Mindfulness Based Cognitive Therapy (MBCT) but do not comply with the British Association Mindfulness Based Approaches (BAMBA) guidelines, clause B4, as I do not hold a ‘clinical qualification.’ I have written a paper calling for this to be relaxed, as mindfulness is a teaching, not a therapy. It is called: ‘Ending the Prozac nation by allowing teachers to teach MBCT courses on  GP referral’. 30.4.15 (9.90)  and am reapplying through my supervisor, Phoebe Roman.
  • Application process I therefore wish to go through the process of becoming recognised by SMC, SPFT, PCN as a qualified and licenced provider of SECTCo’s NICE recommended Mindfulness Based Cognitive Therapy (MBCT) 10 week courses as a clinically appropriate social intervention and talking therapy for NHS patients and staff and public sector staff, to improve their mental health and wellbeing, reduce health inequalities, and for it to be advertised so on the SPFT and BHCC intranets.
  • Application This paper is therefore an application from an applicant, (John Kapp, of SECTCO and Essence Hove) to a qualifying body (Sussex Partnership Foundation Trust (SPFT) and Brighton and Hove City Council (BHCC) and their Clinical Commissioning Group (CCG) to recognise me (the applicant) as a licenced provider for social prescribing by PCNs.
  • Is there a licencing process to which I can apply? I do not know whether a social provider assessment licencing process exists, but it is badly needed to heal and cure the current epidemic of depression and the crisis in primary care. This paper proposes a new method by which applications (such an mine) from counsellors, psychotherapists, complementary therapist, including yoga teachers and personal trainers, could be assessed for recognition to qualify them for a licence to provide social interventions and talking therapies under the new Primary Care Networks social prescribing proposed under the NHS Long Term Plan, published Jan 2019.
  • Recommendations to qualifying and commissioning bodies, including SPFT, BHCC (HWB, CCG) Community Works, etc
  • Set up a cross organisational committee, called the ‘social prescribing licencing committee’ hereafter called ‘the committee’ to create a new licencing process to vet would-be providers of therapeutic social interventions and NICE recommended talking therapies to NHS patients and public sector staff. The application form for a licence should include the following questions in the table in paragraph 3 below, and my application (John Kapp, of SECTCo, operating out of Essence premises) to become a licenced provider should be considered as a test case, and shows how I compare with antidepressants.
  • The outcome of this vetting process will be a ‘checkatrade’ type approved list of licenced individuals/organisations who are deemed qualified to treat NHS patients and public sector staff with their social intervention or talking therapy, and who are called ‘social prescribing providers’ hereafter abbreviated to ‘the licencees’.
  • The committee should also create a social prescribing budget (like the drug prescribing budget) from which the licencees will be paid direct for providing their services on receipt of the used and signed social prescription forms, (as pharmacists are paid for drugs) (9.116, 9.117)
  • The committee should gradually transfer money from the drug prescribing budget (now about £20bnpa nationally and 100m locally) to fund social prescribing (presently £100mpa for the next 5 years nationally, £0.5mpa locally).
  • The committee’s objective should be to cure the crisis in primary care and reduce public sector staff sickness by empowering GPs to do their original duty of teaching patients how to live healthily (the word ‘doctor’ comes from latin ‘doctare’ to ‘teach’) They can do this by adopting a policy of ‘medication to meditation’ by increasing the social prescribing budget at the expense of the drug prescribing budget. They should aim to do this by a factor of 100 by 2025, to at least £10bnpa nationally, and £50mpa locally, when it will equal half the present drug prescribing budget at £10bnpa nationally and £50mpa locally
  • Questions that should be asked to assess the suitability of the applicants for a social prescription license.

No

Question

Present applicant

Antidepressants

1

Is the applicant’s social intervention evidence-based to heal and cure mental disturbance?

Yes, MBCT is NICE recommended

No, they just suppress symptoms.

2

Is the applicant’s organisation sustainable?

Yes SECTCo is

yes

3

Is the applicant qualified with a qualifying body?

No, as BAMBA requires clinical qualifications

Yes, they are presently licenced, but don’t deserve to be as they are no better than placebo

4

Is the applicant qualified by experience?

Yes, for 9 years

yes

5

Is the applicant providing suitable premises for the intervention?

Yes, Essence is suitable

Not applicable

6

Are the interests of patients, doctors and taxpayers protected?

Yes, patients have to sign off satisfaction on used prescription form

No, these interests are betrayed because they do not cure, and have side effects and addiction.

  • Details about the present applicant
  • The present applicant is John Kapp, who is asking for recognition as a qualified facilitator of NICE- recommended Mindfulness-Based Cognitive Therapy (MBCT) 10-week courses, to teach NHS patients and public sector staff on GP referral, while acting as the clinical lead practitioner in the following organisation:-
  • The Social Enterprise Complementary Therapy Company  (SECTCo) www.sectco.org.uk as a not-for-profit body corporate, registered number 7319842, and is willing and able to provide social interventions and talking therapies to West Hove Primary Care Network, (PCN) on GP social prescription referral, to which the link workers can signpost patients and staff to access treatment at the following premises acting as a licenced Community Care Centre:-
  • Essence, 86,  Church Rd Hove, BN3 2EB (opposite Hove town hall) www.essencehove.com.

5 Context of this bid.

  • Under the Health and Social Care Act 2012, about two thirds of the health budget (currently about £80bnpa) is delegated to Local Authority Councils, of which Brighton and Hove gets about £450mpa, to be spent by our Clinical Commissioning Group (CCG) which is accountable to, and overseen by the 5 councillors democratically elected on our Health and Wellbeing Board (HWB). However, these 2 bodies have not yet worked together in the integrated way intended by Parliament, seeing themselves (wrongly) as 2 separate, autonomous bodies. They should work together as Parliament intended to ‘fill the democratic deficit in health’ by the CCG officers acting as the executive arm of the HWB, like every other department of the council has been for 70 years.
  • Under the Better Care Fund (BCF) legislation 2013, (currently about £40 mpa in Brighton and Hove) is supposed to be delegated to fund ‘better care’ (social interventions) for vulnerable patients, personified as Rachel, (65, depressed, in sheltered accommodation), and Dave, (40 alcoholic and homeless) Parliament intended ‘better care’ to mean that they are treated with the latest evidence based social interventions and talking therapies (such as MBIs) in Community Care Centres near GP surgeries. However, in spite of my protestations, (9.79) no CCC has yet been provided in the city, and no Rachel or Dave has yet been treated. (source: answer to a HWB public question by me in 2017)
  • 1,300 Primary Care Networks (PCNs) have been set up in England under the NHS Long Term Plan to reduce health inequalities and improve mental health through empowering GPs to socially prescribe social interventions (such as gym and yoga classes). Clusters of about 6 GP surgeries work together to serve populations of about 50,000 inhabitants, and employ a director, and link workers to signpost patients to Community and Voluntary Sector (CVS) services who presently provide these social interventions.
  • West Hove PCN consists of Mile Oak, Benfield Valley, Portslade Community Centre, Links Rd, Wish Park, and Hove Medical Centre. The PCN director is Dr Rowan Brown (a GP at Portslade Community Centre) and their Link Worker is Clair Rowe of Togetherco (formerly Impetus) The above applicant wishes to be awarded a licence to provide social interventions and talking therapies (such as MBCT courses) to NHS patients and public sector staff, for which GPs could give them social prescriptions under this new PCN which could be provided at Essence, which is conveniently placed to serve those patients. A proposed business plan is shown in 9.117.    

6 John Kapp’s curriculum vitae (CV)

Born 17.11.1935 in Croydon, to Reginald Kapp (consulting electrical engineer) and Dorothy nee Wilkins, (psychiatrist)

1957 Graduated as electrical engineer, 1958-60 graduate apprentice with WHAllen, Bedford, 1960-62 National service, commissioned in army.

1963 married Janet nee Weir, and had 3 children. Worked as consulting electrical engineer for McLellan and Partners, West Byfleet 1962-66, WSAtkins, Epsom 1968-70, and Preece Cardew and Rider, Brighton 1970-80.

1970 Active trade unionist with UK Association of Professional Engineers. Elected to Council of Institution of Electrical Engineers, and Council of Engineering Institutions.

1979 Created Marabu Sailing Club, and sailing school, and ran them as commodore until 2000. Active politically

1991 aged 55, health broke down with osteoporosis, put on ibuprofen and vioxx, but withdrew and had weekly reflexology instead, which cured it by 1994.

Elected to Hove Borough Council 1995, and Brighton and Hove Council 1996-9, representing Stanford ward (now Hove Park)

2000, wife Janet died. 2001, bought 86, Church Rd Hove BN3 2EB. 2002, married Phoebe Wyss and created Planet Janet.

2004 Right hip collapsed, had hip replacement surgery with Bupa. 2005, right knee collapsed with osteo arthritis, wheelchair bound for 3 months. Had much complementary therapy, including cranio-sacral therapy,  reiki.

2005 Joined Brenda Roberts’ Mindfulness Interest Group (MIN) at Hove Polyclinic. 2008-11 elected secretary of MIN.

2006 Left knee collapsed, wheelchair bound for 2 months. Had much shiatsu, chiropractic manipulation

2008 Did MBCT 8 week course with Rory Singer’s New Rd company at Brighton Buddhist centre.

2004-8 Completed a 4 year training in Family Constellation Group Therapy in India and Spain with Svagito Liebermeister.

2009 Did MBCT facilitator training with Prof Mark Williams Oxford Mindfulness Centre.

2003-8 Visited a meditation centre in India for a total of 4 months, and did many meditations and trainings.

2010 Created SECTCo, and taught MBCT 10 week courses, and facilitator training. To date SECTCo has run 41 courses for donations for over 300 starters and over 200 finishers.

2012-15 Ran a Community Care Centre at 3, Boundary Rd Hove providing 2 MBCT courses every week and daily supporting meditations for donations, attended by a total of thousands.

2013 Did the Mindfulness in schools .b course in Oxford. 2016 did the Foundation course with Taravajra in Hove. Supervision with Taravajra. Maintained Continuous Professional Development by attending Sussex Mindfulness Centre training events.

April 2019 Completed  9 days training in Brainspotting (www.bspuk.org.uk) My arthritis is now completely cured thanks to mindfulness practice, which I want to share.

Oct 2019 Supervision with Phoebe Roman. I have been supporting SECTCo financially to a total to date with over £70k out of my own pocket. I am now running the following free events at Essence, for which I seek recognition by the NHS and Council:

Tuesdays 930-1230 MBCT course (Course book 9.91)

Sundays 10-11 CASPOTT, 11-1230 Brainspotting, 2-5pm Family Constellations.

7 Lessons learned from my experiences of physical and mental disturbance.

I have found that my mental disturbances and my physical ailments (arthritis) were healed and cured by learning mindfulness meditation (an altered state of consciousness, ASC) by which we become aware by watching our breath non judgementally as much as possible, which gets easier with practice. In an ASC we can then get revelations (aha moments) about the root emotional cause of our problems, which hypnotise us to behave in habitual ways. These are often traumas inherited from our ancestors’ of which we are unconscious. Mine were from my father who fought in the first world war, and my grandparents, giving me new understandings and attitude. When we are under the influence of drugs (street and prescription) it is more difficult (maybe impossible) to get into an ASC, hence healing, so these should be avoided. To effect a permanent cure, we have to  remember this new understanding and resulting behaviour for 40 days (a quarantine) which is the time needed for new neural pathways to grow, after which the new behaviour becomes hard wired.

The SECTCo MBCT course teaches these techniques, and the family constellation groups enable participants to get these healing revalations, hence heal and cure our problems. They are clinically appropriate for anyone.

8 SECTCo

2010 John created SECTCo with other complementary therapists. Registered number 7319842 See www.sectco.org.uk for constitution, minutes, etc.

Mission: to provide patients with their statutory rights under the NHS Constitution to NICE recommended complementary treatment to promote wellness, prevent illness and remove health inequalities in the city of Brighton and Hove.

Vision: Medication to meditation. Give a man a pill and you mask his symptoms for a day. Teach him mindfulness meditation and he can heal his life.  Logo: The wounded healer, Chiron.

SECTCo bid unsuccessfully for public sector contracts, such as the Healthwatch contract, 2014, the Wellness Service contract 2017-20, and campaigned for more MBCT courses to be commissioned.

2019 I created PRESCRIBE FITNESS CAmpaign for Social Prescribing Of Talking Therapies CASPOTT www.caspott.org.uk.

9 Essence Hove, at 86, Church Rd Hove BN3 2EB (opposite Hove town hall)

2001 I bought the building, and converted it to a complementary therapy centre, with the help of my new wife Phoebe Wyss.

2002 We opened it as ‘Planet Janet’ in memory of my late wife.

2003 We let it on a 20 year lease 2003-23 to Richard and Clare Brown, who rebranded it ‘Revitalise’.

2016 Richard and Clare resigned, and we assigned the remainder of the lease to Robert Brayley-Hodgetts, who rebranded it ‘Essence’. See www.essencehove.com.

9 Who should be on this committee?

I propose that the following people (or their delegated staff) should be consulted about representation on this committee.

No

Name

Organisation

Position

1

Sam Allen

Sussex Partnership Foundation trust (SPFT)

Chief executive

2

Rick Fraser

Clinical director

3

Rachel Kenney

Participation lead

4

Alex Garner

See correspondence appendix 1

5

Robert Marx

  Sussex Mindfulness Centre

Head of mindfulness training

6

David Supple

Brighton and Hove CCG

Former chairman

7

Hugo Luck

Sussex Alliance Sustainability and Transformation Partnership

Primary care lead

8

Harrington

CCG

Commissioner mental health

9

Anna McDevitt

MIND charity

10

Sally Polanski

Community Works

Director

11

Jo Martindale

Community worker, Hangleton and Knoll project

Community lead worker

12

Martyn Yeats

Links Rd Patient Participation Group, and Network

Chairman

13

Fran

Health watch

Chairman

14

Nancy Platts

Brighton and Hove City Council

Leader

15

Clare Moonan

“ Health and Wellbeing Board

Chair

16

Carmen Appich

   

Deputy chair

17

Sue Shanks

   

18

Sarah Nield

   

19

Samer Bagaeen

   

Opposition spokesman

20

Greg Barnes

Wish Park surgery

Practice manager

21

Rowan Brown

West Hove Primary Care Network

Director

22

Clair Rowe

Link worker

23

NHS England

England.voluntary partnerships@nhs.net

24

Pennie Ford

NHS England

Representative on HWB (never attends)

25

10 Conclusion. Vision for a recognised and licenced  SECTCo working at Essence as a Community Care Centre as a pilot to reduce health inequalities

The outcomes of this paper that I hope for are:-

  • SPFT and BHCC will advertise on their intranets my MBCT courses every Tuesday 930-1230 and my brainspotting and family constellation groups every Sunday.
  • SECTCo will be accepted as a licenced provider of MBCT 10 week courses and supporting meditations.
  • Essence will be accepted as a Community Care Centre for West Hove Primary Care Network.
  • I will get say 50 clients who will benefit from them over the next 6 months, expanding to 300 patients annually, according to my business plan, see paper 9.117 of www.reginaldkapp.org. dated 4.5.17, when funding (estimated at about £300,000pa) is available. See also www.caspott.org.uk.

Appendix 1 Correspondence with Alex Garner, People Participation lead, SPFT,   24.10.19, following my attendance at an EBE event.

Hi John. Thanks for getting in touch following last week’s Expert By Experience Supervision Meeting.  I’m sorry if it feels as though there is glass curtain between the Trust and our third sector and community partners.  In answer to your questions, we have a position in the Trust and don’t recommend particular mindfulness courses or teachers for two reasons.  One is that we can’t be sure of the quality of everything we recommend; the other side of that is that we don’t want to leave ourselves open to accusations of bias by recommending only the ones we know are good and omitting others that may be good but which we don’t know.  This applies to how we signpost to other therapies as well.  If people ask us for recommendations for mindfulness locally, we point them to the national list of mindfulness teachers who meet the Good Practice Guidance: https://app.ukmindfulnessnetwork.co.uk/uk-listing/ .  Whilst this is a voluntary register it does provide the public with some assurance that providers meet these minimum standards of training and experience.

With regards to the Working Together Groups; you are very welcome to join this forum – the plan for these sessions now is to have one per month rather than bi-monthly. One month will be led by me and focused on a particular topic that our Experts by Experience (EBE) have requested more information on or that the Trust would like to consult EbE’s on. The next month will be an open forum led by and for EBEs (and any other interested parties) to come together and talk in a safe place about things relating to Sussex Partnership services that matter to them. I think this second session in particular would perhaps be a good place for you to talk about the groups and sessions you have shared with us.

And lastly, having now been to an EBE Reflective Practice Group Supervision session I hope you will understand if I now suggest that perhaps these sessions are not the right place for you currently. The sessions are designed for people who are currently in EBE roles across Sussex Partnership services who want to come together with other people in similar positions to discuss how this work is going, how it is impacting them personally and to work together to create solutions to any problems identified. Should you go on to do some work with us as an EBE then you would of course be welcome to attend these sessions in the future.

Thanks and best wishes, Alex Garner . People Participation Lead,  Deputy Lead Governor, Organisational Development Practitioner
Sussex Partnership NHS Foundation Trust ,Aldrington House, New Church Road, Hove, BN3 4AG , Tel: 07738757493
Email: alex.garner@sussexpartnership.nhs.uk   People Participation Team: 0300 304 1434.

My response to this is:

By having a policy of not recommending any mindfulness teachers you (SPFT) are  denying patients and staff the opportunity to learn mindfulness, and hence heal and cure their mental distress. You are also denying facilitators in the private, and community and voluntary sector (CVS) to opportunity to teach patients and public sector staff. This divides society into the public sector (which is massively funded by taxation of everybody) providing drug treatments which do more harm than good, and the Alternative Health Service of complementary therapy, which is making a poor living on the disposable income of those rich enough to pay for it.

What is needed is the best of complementary therapy to be integrated into the NHS commissioning system, as Prince Charles called for in his speech to the health ministers of the world in May 2006. I joined his Foundation for integrated Health, and have campaigned to this for decades. We presently have a mad situation in which we pay our taxes for GPs to poison us, while the NHS refuses to pay complementary therapists to treat patients and public sector staff. This is why health inequalities exist, and why the system perpetuates them and makes mental health worse. The only beneficiaries are the drug companies, but their propaganda has been so effective, that it is not politically correct to say so.                                                                  7 pages, 3,915 words

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