As the health and social care system moves towards greater integration, the people best placed to tell us whether it is working are those it serves.
Fatima Elguenuni, Grenfell community consultant, Central and North West London Mental Health Trust, talks about the importance of language and listening in the context of delivering health services to the Grenfell community.
My name is Fatima Elguenuni, I'm working for Central and North West London Mental Health Trust as a Grenfell community consultant.
Initially I was approached to help in the immediate response to the Grenfell disaster and my role since July 2017 has been trying to help the Trust to think about how it delivers a health service to a very traumatised community.
I'd worked in in this community for many, many years as an ex-NHS employee and I think one of my first thoughts was they needed, the local authority, the NHS, needed to sit with community members and to listen to them and to think about - to think with them - and collaborate with them and respond according to their needs.
So initially we had a population of bereaved and survivors that really felt that they needed to go back to the tower and it was for various reasons. For some it was to retrieve their belongings, for others it was to go back and say goodbye to their loved ones, because a lot of the bereaved families didn't actually live in the area so it was their only opportunity to go back to the site where they lost their loved ones. And there seemed to be quite a call from among the bereaved and survivors to say that we want to go back.
I think that caused quite a lot of difficulties and quite a lot of concerns for the key stakeholders which was essentially the police, the NHS, the local authority but I think people did come together and they did sit down together and actually consider and try and work through some of the huge obstacles in order to make that happen.
By doing that, it was the most effective way of engaging the bereaved and surviving population because up until then they weren't responding to the 'screen and treat', they weren't responding to anything, but in that sort of action people felt held and people felt valued, because in order for them to go up you had to have six or seven different individuals go up with you: so you had a paramedic, you had a doctor, you had a health and safety person and you had a clinician, a psychologist, the therapist, you had the police, and the feedback for me from those who did go up the tower was that as they were walking up the stairs and they looked down, they felt incredibly valued because they had all of these services just there supporting them, and that went a long way to create that relationship, that trusting relationship, so yeah they walked up with me and they were there for me and it was nothing to do with you know therapy or CBT or PTSD, they just felt that as human beings we were able to just be there together.
The feedback from everybody was that it was very, very helpful and there was a lot more referral into the trauma service because people have by now built a trusting relationship but it also indicated to me that if people work hard enough, you can remove obstacles, systems can actually come together and all it needed was to work through some of those barriers. It taught us that when you rely on systems and keep relying on systems, there is a danger the minute you remove that element of 'let's think about the individual rather than a system' – you know that there's potentially danger of miscommunication.
Also what I've understood is that you've got local authority and the NHS but everybody is speaking in their system language. I've sat in meetings where you have commissioners and service providers and they're both talking a different language. By the time that gets out to the service user it's even more complicated so it's something about removing those system languages, and actually learning a different language, and in order to do that people need to actually understand the language of the population that they are intending to serve. For me that's the biggest lesson: unless we understand the individual we will not be able to deliver anything effective and Grenfell has taught me that because individuals were saying things many, many years ago but they weren't listened to and then we ended up with 72 people losing their lives because people weren't listened to. And for me I will continue to translate and continue to bridge for as long as people listen.