"Coordination of care and prescribed medications"

To whom it may concern,

In my time with Bentley CTT I have found their systems hard to navigate and believe their is care inadequate. On several occasions when I have spoken with my care-coordinator and expressed that I am starting to feel unwell, their solution is to present to the ED. Never has there been the option of a planned admission to Bentley hospital to avoid crisis emergency admissions to RPH. On one occasion my care-coordinator told my partner that it is too much paperwork for them to admit me to Bentley hospital. I feel that this is an unacceptable response.

While with Bentley CTT I have had contact with three different care-coordinators. When asked what services they can provide, their responses were all similar. One of them responded ‘What services do you want?’ rather than answering my question. In my opinion, the other two either legitimately don’t know what services they offer, how they can help or possibly do not wish to discuss it with my partner and I as they continually seemed to avoid answering the question. I have not found having a care-coordinator remotely helpful. It seems they are merely a middle man between the doctors and clients and little else.

Further to the lack of support and care provided by the care-coordinators, I have also found the psychiatrist registrar that has been allocated to me seems to be reluctant to try anything new, modern or progressive. I feel this doctor is extremely risk averse and in my opinion it certainly comes across that it is more important for them to be risk free and maintain the status quo over the improved health and wellbeing of their patients. I would go as far as saying that this doctor is resistant to progress. I am not an expert however I believe that positive change is required in every field, whether that be medical or otherwise, in order to achieve continual growth. Unfortunately, this registrar does not appear to share this belief.

Further to this, there is often discrepancies between what the registrar and I discuss at appointments and what is passed on to the pharmacy, either in terms of prescriptions or verbal contact. One example of such occurred was on a I communicated to the registrar that I had been having significant trouble sleeping and had exceptionally high anxiety. The registrar responded that I could try taking 2 x 25mg of Quetiapine during the day for anxiety as well as the 25mg of Quetiapine that I take daily for sleep. They said that they would send the prescriptions through to my pharmacy.

When I went to the pharmacy later that day, the pharmacist gave me just 7x25mg of Quetiapine (one week staged supply as per normal). Obviously this is not the amount that we had discussed in session just hours earlier. I followed up with my care-coordinator the next day and then proceeded to visit the pharmacy to collect four extra tablets of Quetiapine. I was told by the pharmacist that these four tablets were not a new prescription rather they had come out of the existing prescription which meant that in a few weeks time the webster pack that they make for me will be missing four Quetiapine. This is obviously going to be a problem as I am unable to sleep without some form of sleeping aid.

At a recent family meeting, I felt that the registrar blamed and shamed me for my mental health struggles. For example they brought up the fact that some months ago, when I was in RPH ED, I was offered to have a stay in their 2K ward. Initially I refused as I didn’t feel like it would be beneficial. I returned home that day and my partner felt that I would benefit from a stay in 2K so they arranged an admission for me and I checked in later that same day. The registrar also frequently states during our appointments that I have refused treatments on multiple occasions. I don’t believe this to be true and when either myself, my partner or my parents have asked for a list of treatments that I have refused neither the registrar nor care-coordinator will provide said information.

I have found that Bentley CTT seems in my experience, to repeatedly take a reactive stance rather than a proactive approach and heavily rely on their clients to put forth ideas regarding treatment plans, whether it be for medication or other relevant therapies. I find this unacceptable.

I believe that what I feel is the lack of support from the care-coordinators paired with a registrar that seems completely unwilling to prescribe any medication that I have not previously been prescribed, nor even look at other treatment options, has led to my detriment and has provided the ideal environment for the continual downfall of my mental health.

I am honestly unsure how having a care-coordinator and psychiatrist registrar in the Bentley system is any better than just having my GP write prescriptions for my medications. This is due to the fact that I have not experienced any positives from having a care-coordinator and I believe the registrar that I have been allocated will only refill prescriptions and not attempt anything new whether it be an alternate medicine or treatment.

It is beyond me as to why I seemingly have to continually advocate for myself when I am at my lowest. Never did I think that I would have to fight so hard to receive what I believe to be adequate treatment.

Please note that this is just a small snapshot of my experience with Bentley CTT over the last 12 months. There is significantly more that I will happily share however I feel that what I have shared thus far provides an adequate impression of the situation I have been facing. I look forward to hearing from you and working on solutions together.

Kind regards,

Depressed&unimpressed