On 27th May 2021, information obtained through a Freedom of Information (FOI) request made to Hampshire Constabulary was publicised. [1] This information adds further weight to the concerns we highlighted pertaining to Serenity Integrated Mentoring’s (SIM) ‘evidence base’, as outlined in our statement released on 22/04/2021 [2] The FOI indicates that concerns were raised by employees of Hampshire Constabulary regarding the accuracy of data associated with SIM as early as March 2018. Around the same time in 2018, SIM was adopted on to the Academic Health Science Networks (AHSN) national portfolio for implementation across NHS England. As a result of this adoption, SIM was implemented across 23 NHS Trusts by March 2020 [3]. In this statement we provide a brief overview of the content of emails released by this FOI, which includes concerns about the omission of data pertaining to negative outcomes which may be associated with SIM.
Concerns about the validity of data used by SIM
A series of anonymised email correspondences outlining significant concerns regarding the validity of HIN/SIM constitute the majority of documents released by Hampshire Constabulary. These notably include an email dated 2nd March 2018, which states:
“The data does not represent the true picture in relation to “Police Incidents” and Hampshire Constabulary therefore cannot support this claim.”’ [4]
It goes on to outline that data contained in SIM’s pilot report [5] has been “grossly distorted”, and this distortion is “highly concerning”. The report on SIM’s pilot intervention includes data from only four individuals, yet acknowledges that six service users consented to participate in the pilot. [6] Significantly, this email appears to provide some concerning details about what happened to the two individuals whose data does not appear in the pilot report:
“six (out of 8) [service users] that agreed to talk to [redacted] — one has been removed from the data after leaving the process and then dying [redacted] and another was removed due to becoming an in-patient.” [7]
We are concerned that the removal of these service users from SIM data indicates that attempts were made to conceal negative outcomes associated with SIM. Concealing through omission negative outcomes which may be associated with a high risk intervention, including the death of a service user and an inpatient admission, is in our opinion negligent and fraudulent. Furthermore, in our statement on Human Rights and Equality [8], we outlined our concerns that SIM operates in breach of Article 2 of the Human Rights Act, Right to Life [9]. Whilst it is not possible to determine causation from the fragments of information provided in the FOI relating to these negative outcomes, in the context of our concerns relating to Human Rights, it is equally not possible to exclude SIM as a potential causative factor.
Email correspondence dated 25th July 2018 expresses further concerns about the continued use of inaccurate data by SIM. The author states that the manner in which data has been used, and continues to be used by SIM is “misrepresentative and not ethical”:
“I am also still seeing the data being used that I have told you is hugely inaccurate. The figures you use for your original data set from the original IOW [Isle of Wight] scheme do not bear any resemblance to the data held by Hampshire Constabulary and the IOW NHS, and the way in which you have then used that erroneous data to produce various charts and graphs is misrepresentative and not ethical.”
“You have left out whole swathes of data that do not support your findings, and even worse you have submitted a “0” response across all categories for one patient who you know actually did make many calls to services in that period.” [10]
“An aggressive sales pitch”
As well as repeating concerns about the validity and accuracy of SIM data, emails from March 2018 highlight significant concerns about the manner in which this data was being used to promote and publicise SIM to NHS Trusts in England: [11]
“I am happy to discuss further, but am conscious that this inaccurate data is cropping up all over their publicity including on NHS websites and material as well as the presentations that [redacted] continues to give all over the country”. [12]
The email correspondence further describes the use of SIM data in this manner as “a method of unfairly bringing pressure on other trusts to join the network in an aggressive sales pitch”. [13] In emails dated 24th July 2018, requests are made for Solent and Isle of Wight to be removed from HIN maps, and mention a need for legal involvement, stating:
“He is still presenting data around the country that we know to be completely inaccurate when compared to both Police and NHS data, as well as being formulated in a way that is just not ethical.” [14]
Evidence that Wessex AHSN (Academic Health Science Network) were made aware of concerns relating to SIM data in 2018
An email dated the 14th of November 2018 indicates that Wessex AHSN were made aware of concerns relating to the accuracy of SIM data during a meeting between a representative(s) from Hampshire Constabulary and Wessex AHSN:
“I have raised significant concerns about the data being used to sell SIM around the country. The raw data is not remotely accurate in a number of ways, and is then being presented in a way that is just not ethical. I have had to make it very clear that Hampshire Constabulary cannot have any connection with SIM in the way it is being presented around the country.
“Wessex AHSN have met with me and I have been very candid about the above. I explained how [redacted] had developed her role outside of SIM and invited them to meet with her. As you have seen, they are very impressed with what she has done, and the difference with SIM. That is why they want to speak to someone from the NHS side to understand the difference.” [15]
The same email finishes by noting the importance of communicating these concerns to the AHSN:
“I think it is really important that the AHSN see the current picture on the IOW [Isle of Wight] as opposed to perceptions of what was happening some years ago. Would it be possible for them to speak to [redacted] please to get that?” [16]
The date of this meeting between a representative(s) from Hampshire Constabulary and Wessex AHSN is not evident. However, given the date of the email was the 14th of November 2018, it would be reasonable to assume that the meeting with Wessex AHSN occurred before this date. In April 2018, SIM was adopted on to the Academic Health Science Networks’ (AHSN) national portfolio for implementation across NHS England. As a result of this adoption, SIM was implemented in 23 NHS Trusts by March 2020 [17]. We are extremely concerned that SIM continued to be rolled out at pace and scale by the AHSN until March 2020, despite the warnings relayed by a representative(s) from Hampshire Constabulary to Wessex AHSN before the 14th of November 2018.
Given the content and nature of the information released during this FOI, on the 14th of June 2021, the Royal College of Psychiatrists released a statement urging NHSE/I:
“to launch a separate investigation into the AHSN response to the warnings from Hampshire Police and if the evidence base originally put forward by HIN was interrogated by the NHS Innovation Accelerator which cleared it for national roll-out by the AHSNs. The findings should be made public to ensure any lessons are learned.” [18]
As outlined in our statement dated the 12th of May 2021, we believe a national, centrally coordinated review into SIM is necessary. Like the Royal College of Psychiatrists, we stated that this review should include organisations involved in its implementation and rollout, including the AHSN and NHS Innovation Accelerator.
In light of the above evidence, we ask:
- Why did AHSNs and NHS England continue to implement SIM after significant concerns were raised about the validity of SIM data, including the omission of data pertaining to negative outcomes?
- Why was this data uploaded to AHSN and NHS websites without being checked and verified?
- How is NHS England and the AHSN planning to investigate the concerns raised in the FOI from Hampshire Constabulary?
In solidarity,
The StopSIM Coalition
Copied to:
Sir Simon Stevens, CEO – NHS England, Lord David Prior, Chair – NHS England, Claire Murdoch, National Mental Health Director – NHS England, Martin Hewitt, Chair – National Police Chiefs’ Council, Sir Tom Winsor, Her Majesty’s Inspectorate of Constabulary and Fire and Rescue Service.
[1] Integrated Recovery Programme 2013-2014. Freedom of Information Request to Hampshire Constabulary. WhatDoTheyKnow [Internet]. 2021. Available from: https://www.whatdotheyknow.com/request/integrated_recovery_programme_20/ [accessed 22 June 2021].
[2] Concerns About the Evidence Base Relating to the High Intensity Network (HIN) and Serenity Integrated Mentoring (SIM). StopSIM [Internet]. 2021. Available from: https://www.stopsim.co.uk/concerns-about-the-evidence-base-relating-to-the-high-intensity-network-hin-and-serenity-integrated-mentoring-sim/
[3] Serenity Integrated Mentoring (SIM). The AHSN Network [Internet]. Available from: https://www.ahsnnetwork.com/about-academic-health-science-networks/national-programmes-priorities/serenity-integrated-mentoring [accessed 22 June 2021]. See also John Pring. Coalition calls for halt to use of ‘unethical and unsafe’ mental distress emergency scheme. Disability News Service [Internet]. 29 April 2021. Available from: https://www.disabilitynewsservice.com/coalition-calls-for-halt-to-use-of-unethical-and-unsafe-mental-distress-emergency-scheme/ [accessed 22 June 2021].
[4] Integrated Recovery Programme 2013-2014. Freedom of Information Request to Hampshire Constabulary. WhatDoTheyKnow [Internet]. 2021. HC 001043 21 Additional Document 6.pdf. 28 February-02 March 2018. Available from: https://www.whatdotheyknow.com/request/integrated_recovery_programme_20/ [accessed 22 June 2021].
[5] Paul Jennings. SIM Project Pilot Report 2013-2015 [Internet]. Available from: https://highintensitynetwork.org/img/resources/SIM_Pilot_Report_2013.doc [archived from website deleted 28 May 2021; last accessed 11 May 2021].
[6] Paul Jennings, Catherine B. Matheson-Monnet. Multi-agency mentoring pilot intervention for high intensity service users of emergency public services: the Isle of Wight Integrated Recovery Programme. J Criminol Res Policy Pract. 2017 Jan 1;3(2):105–18.
[7] Integrated Recovery Programme 2013-2014. Freedom of Information Request to Hampshire Constabulary. WhatDoTheyKnow [Internet]. 2021. HC 001043 21 Additional Document 4.pdf. 02-05 March 2018. Available from: https://www.whatdotheyknow.com/request/integrated_recovery_programme_20/ [accessed 22 June 2021].
[8] Concerns Regarding The Human Rights And Equalities Implications Of The High Intensity Network (HIN) And Serenity Integrated Mentoring (SIM). StopSIM. 2021. Available from: https://www.stopsim.co.uk/concerns-regarding-the-human-rights-and-equalities-implications-of-the-high-intensity-network-hin-and-serenity-integrated-mentoring-sim/
[9] Article 2: Right to life. Equality and Human Rights Commission [Internet]. 2018. Available from: https://www.equalityhumanrights.com/en/human-rights-act/article-2-right-life [accessed 22 June 2021].
[10] Integrated Recovery Programme 2013-2014. Freedom of Information Request to Hampshire Constabulary. WhatDoTheyKnow [Internet]. 2021. HC 001043 21 Additional Document 7.pdf. 24-25 July 2018. Available from: https://www.whatdotheyknow.com/request/integrated_recovery_programme_20/ [accessed 22 June 2021].
[11] Integrated Recovery Programme 2013-2014. Freedom of Information Request to Hampshire Constabulary. WhatDoTheyKnow [Internet]. 2021. HC 001043 21 Additional Document 6.pdf. 28 February-02 March 2018. Available from: https://www.whatdotheyknow.com/request/integrated_recovery_programme_20/ [accessed 22 June 2021]; Integrated Recovery Programme 2013-2014. Freedom of Information Request to Hampshire Constabulary. WhatDoTheyKnow [Internet]. 2021. HC 001043 21 Additional Document 4.pdf. 02-05 March 2018. Available from: https://www.whatdotheyknow.com/request/integrated_recovery_programme_20/ [accessed 22 June 2021]; Integrated Recovery Programme 2013-2014. Freedom of Information Request to Hampshire Constabulary. WhatDoTheyKnow [Internet]. 2021. HC 001043 21 Additional Document 1.pdf. 28 March 2018. Available from: https://www.whatdotheyknow.com/request/integrated_recovery_programme_20/ [accessed 22 June 2021]; Integrated Recovery
Programme 2013-2014. Freedom of Information Request to Hampshire Constabulary. WhatDoTheyKnow [Internet]. 2021. HC 001043 21 Additional Document 2.pdf. 08 March 2018. Available from: https://www.whatdotheyknow.com/request/integrated_recovery_programme_20/ [accessed 22 June 2021].
[12] Integrated Recovery Programme 2013-2014. Freedom of Information Request to Hampshire Constabulary. WhatDoTheyKnow [Internet]. 2021. HC 001043 21 Additional Document 4.pdf. 02-05 March 2018. Available from: https://www.whatdotheyknow.com/request/integrated_recovery_programme_20/ [accessed 22 June 2021].
[13] Integrated Recovery Programme 2013-2014. Freedom of Information Request to Hampshire Constabulary. WhatDoTheyKnow [Internet]. 2021. HC 001043 21 Additional Document 7.pdf. 24-25 July 2018. Available from: https://www.whatdotheyknow.com/request/integrated_recovery_programme_20/ [accessed 22 June 2021].
[14] Integrated Recovery Programme 2013-2014. Freedom of Information Request to Hampshire Constabulary. WhatDoTheyKnow [Internet]. 2021. HC 001043 21 Additional Document 3.pdf. 24 July 2018. Available from: https://www.whatdotheyknow.com/request/integrated_recovery_programme_20/ [accessed 22 June 2021].
[15] Integrated Recovery Programme 2013-2014. Freedom of Information Request to Hampshire Constabulary. WhatDoTheyKnow [Internet]. 2021. HC 001043 21 Additional Document 5.pdf. 14 November 2018. Available from: https://www.whatdotheyknow.com/request/integrated_recovery_programme_20/ [accessed 22 June 2021].
[16] Integrated Recovery Programme 2013-2014. Freedom of Information Request to Hampshire Constabulary. WhatDoTheyKnow [Internet]. 2021. HC 001043 21 Additional Document 5.pdf. 14 November 2018. Available from: https://www.whatdotheyknow.com/request/integrated_recovery_programme_20/ [accessed 22 June 2021].
[17] Serenity Integrated Mentoring. The AHSN Network. Available from: https://www.ahsnnetwork.com/about-academic-health-science-networks/national-programmes-priorities/serenity-integrated-mentoring [accessed 29 June 2021].
[18] RCPsych calls for urgent and transparent investigation into NHS Innovation Accelerator and AHSN following HIN Suspension. RCPsych [Internet]. 14 June 2021. Available from: https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2021/06/14/rcpsych-calls-for-urgent-and-transparent-investigation-into-nhs-innovation-accelerator-and-ahsn-following-hin-suspension [accessed 22 June 2021].
STOPSIM 