CONTINUING THE PHILOSOPHY OF REGINALD O. KAPP

9.84 Business plan for SECTCo –Medication to meditation to cure the toxic NHS
          14.1.15


Written by John Kapp, 22, Saxon Rd Hove BN3 4LE, 01273 417997, johnkapp@btinternet.com. www.sectco.org.uk, and Section 9 of www.reginaldkapp.org

Contents
1 Abstract – model Community Care Centre to cure over-medicalistion of primary care
2 COMMUNITY CARE CENTRE (CCC) PROJECT (as called for 14.12.14 in NHS England’s Better
      Care Fund allocation of an extra £1.9 bnpa on top of the £3.8bnpa already allocated)
3 Summary – end the Prozac city by implementing IAPT with MBCT courses
4 Our modular (chemist shop) approach to planning the provision of MBCT courses and supporting meditations.
5 Our proposal would meet the recommendations in the following reports
6 SECTCo annual report for 2014
7 Finance report for 2014
8 Projection of budgeted finances for 2015
9 Brief history of SECTCo’s campaign for more MBCT courses to be provided for depressed patients
10 What are we planning in 2015?
11 Should we expand further by acquiring 2BR?
12 Which GP surgeries would we serve?
13 We plan to ‘do it anyway’, but what if we get a contract?
14 City wide plan proposed
15 The revenue cash flow stream for 3BR as a typical meditation centre open 5 days per week
16 Fixed annual cost expenses of a small meditation centre £ pa (independent of numbers treated)
17 Variable cost expenses £ per course (dependent on the numbers treated)
18 How many satisfied patients do we need per course to cover costs?
19 What is the minimum number to start running a course?
20 Staffing levels for 25 courses pa
21 What staffing level would this require?
22 What other costs would be incurred?
23 How many staff would be required for the city?
24 How would staff be trained?
25 Action plan for supporters of our vision – please lobby your GP and councillors and ask them to
      support mindfulness meditation courses instead of antidepressant medication.
26 Who are our present directors?
27 Conclusion – SECTCo’s vision of a new profession of mindbody meditation facilitators
Appendix 1 List of MBCT courses run by SECTCo
Appendix 2 Digest from the House of Lords report on Wellbeing
APPENDIX 3 MAP OF THE LOCALITY OF 3, BOUNDARY RD HOVE
Appendix 4 Memorandum and Articles of SECTCo
Appendix 5 Plan view of 2 and 3 Boundary Rd

Abstract – model Community Care Centre to cure over-medicalistion of primary care
Our shop at 3, Boundary Rd, Hove is a trial meditation centre associated with nearby GP surgeries, to which GPs can prescribe NICE recommended Mindfulness Based Cognitive Therapy (MBCT) 10 week courses as easily as Prozac, and where their patients can access a free course within a few weeks. We estimate that 2 out of 3 of the 137 people who have completed our MBCT courses since 2010 have experienced improved mental health, and a reduction in their need for public services. We estimate that if what we provide was commissioned, it would save £7 for every £1 invested. If replicated throughout the city and country it could prevent GPs burning out and cascade failure of primary care

Summary – end the Prozac city by implementing IAPT with MBCT courses
This paper sets out SECTCo’s achievements to date, and our vision and business plan for 2015-20. Over the last 5 years we have set up and tested a new system of providing meditation courses, in the form of talking therapy based on mindfulness. Our ‘enhanced sandwich mindfulness course’ gives patients one day per week for 10 weeks (90 hours total tuition) in how to look after themselves better, and reduce their needs for public services. The core of this is the NICE recommended Mindfulness Based Cognitive Therapy (MBCT) 10 week course, supported by other meditations.

In our experience this intervention is 100 times more cost effective than one to one Cognitive Behaviour Therapy (CBT) as adopted by the Improving Access to Psychological Therapies (IAPT) programme since 2006, because one facilitator can train 15-20 patients who get peer support from one another. Furthermore, in the altered state of consciousness called meditation, the patient can download the new programming required to rewire their brain to heal and cure their condition. Meditation with CBT makes MBCT 7 times more effective than CBT alone, being effective in about 2 out of 3 patients, whereas CBT is only effective in about 1 in 10 patients. We propose a quick new procurement system for outcome-based contracts, based on a licencing scheme to qualify providers (such as yoga centres) who meet minimum standards of clinical governance for these courses, (see paper 9.81 ‘Proposal for a licencing scheme to procure NICErecommended MBCT courses for depressed patients on GP referral by voucher prescription.’) We have campaigned for this scheme to be commissioned and provided free on the NHS, so that GPs could prescribe our courses as easily as Prozac, and patients could freely cash them at meditation centres near every surgery within a waiting time of a few weeks. This would create a mental health service worthy of the name ‘service’, and include crisis management. Many other reports call for the same approach, as shown in paragraph 3 below.

It would also solve the crisis of over-medicalisation in primary care which is overwhelming general practice and A&E, and causing doctors to leave in droves due to burn out. As reported on 11.12.14 from the Health Survey for England, nearly half the adult population is now on prescription drugs, which don’t cure the condition, but keep patients coming back with side effects.

Since 2006 when the IAPT programme was introduced to ‘end the Prozac nation’ anti-depressant prescribing has doubled from 30 to 60 million monthly prescriptions, so 5 million patients are on them, despite them not even claiming to cure depression, but only suppress symptoms until the patient changes their lifestyle to reduce stress.

Since 2010 SECTCo has run 21 of these MBCT courses for donations for about 217 starters and 137 completers, as shown in appendix 1. We have also run other meditations for these and other people. From feedback received from them, we believe that over 100 of them have been enabled to heal and cure their mental sickness, and reduce their dependence on drugs and public services, saving £1 million in taxpayers money. Over the last 2 years we have been providing these courses in our dedicated Community Care Centre at 3, Boundary Rd, Hove, serving the community in South Portslade and West Hove.

We have support in principle from local GPs Dr Susie Rockwell, of Portslade Health Centre, and Dr Duncan Wells of Wish Park surgery, who say that they would refer their patients to us if and when the CCG give them written approval. To date the CCG has declined, saying publicly (25.11.14) that they have no plans to increase provision of talking therapies, as they believe that they already meet the new access standards applying from 1.4.15.

We contend that this belief is based on false data, which ignores the needs of 26,000 depressed patients in the city, all of whom have the statutory right under the NHS Constitution to be offered a MBCT course if their doctor says it is clinically appropriate. To meet this statutory obligation, we are calling for a further 1,000 MBCT courses to be commissioned each year. As the CCG is not listening to us, we have appealed to the councillors on the Health and Wellbeing Board (HWB) (see paper 9.82 ‘Cure the crisis in primary care by ending the Prozac city’)

We believe that the CCG needs to heed us because the crisis in primary care is worsening, as reported on the news on 18.12.14 (‘Record A&E admitted of 111,000 last week’) We also believe that the toxicity of primary care with over-medicalisation is the root cause of the closure of Eaton Place surgery in East Brighton, and the threatened closure of more than 100 practices in London. As GPs burn out there could be cascade failure throughout the whole primary care system.

We believe that sooner or later the crisis will force the HWB and CCG to adopt our proposed solution, and invite organisations (including SECTCo) to apply for a licence to provide meditation courses throughout the city. We cannot predict when that will be, but we are ready to hit the ground running whenever we are called, (in 2015, 2016 or after) but we are confident that we will then be awarded a public sector contract in accordance with this business plan.

It could be just for the needs of the surgeries in West Hove and Portslade, or for the West locality, or even throughout the whole city. In the meantime we are continuing to trial our proposal by ‘being the change that we want to see in the world’, and walking our talk.

We are expanding to run our courses beyond 3, Boundary Rd Hove, to Kemptown and off London Rd. We are also developing our course material with the help of our supervisor (Taravajra) We have already trained over 40 facilitators, and are continuing to run facilitator training courses every Thursday.

We believe that every GP surgery needs a dedicated meditation centre near it, just as each needs a dedicated pharmacy near it. This means that 45 more meditation centres are needed to serve the other 45 GP surgeries in the city of Brighton and Hove. These could all be separately run, or linked (perhaps franchised) and run by one or more organisations on a regional basis (say West, Central and East locality)

We are therefore developing and testing how SECTCo could run several satellite meditation centres, in order to be ready to contract to provide such, as and when requested. We are building up our board of directors, and we invite those interested to attend our monthly directors meetings, details available on request.


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