A young woman tragically took her own life in Surrey prompting a warning from a coroner over communication barriers between hospitals. Meghan Chrismas, who suffered from anxiety disorder, depression, complex PTSD and ADHD, died by suicide on October 20, 2021 at a Premier Inn in Guildford.

Less than three weeks prior, Meghan had impulsively attempted suicide by overdose and was admitted to Royal Surrey Hospital on the following day. She was offered further psychiatric treatment through the NHS at this time, which she declined in favour of continuing with her private treatments at The Priory Hospital. Information about Meghan Chrismas’ attempted overdose was only sent to her GP and not her private psychiatrist.

Meghan took her own life the same day as her private psychiatrist said she was “progressing well”. Following Meghan’s inquest Coroner Darren Stewart OBE wrote in a Prevention of Future Deaths report to NHS England over the ‘concerning’ communication barriers between private and public healthcare services.

He wrote: “At a time where pressures on the NHS exist, particularly for mental health services, it is of concern that measures which could alleviate this pressure (where someone sources private care) do not exist. There is little or no policy, guidance or other effective arrangements to share important clinical information about patients between private and public healthcare sectors.”

“The passage of information between NHS and private healthcare providers is hindered due to the absence of an adequate structure to share important clinical information about patients in a timely and effective manner. Action should be taken to prevent future deaths .”

Meghan was prescribed antidepressants after a face-to-face appointment with her GP in February 2021. She started seeing a private psychiatrist around July, and received prescriptions both privately and from her GP.

The coroner also raised this as a key concern. They wrote: “This means Mrs. Chrismas had access to double prescriptions. Healthcare professionals treating Mrs. Chrismas placed significant reliance on the perception that she would be open and honest in her communication with them.”

The coroner also raised concerns around police forces communication between each other. It was at, 4.54pm that Meghan contacted Surrey Police to explain that she was fine. At 5.18pm, the call handler in the Hampshire Police control room communicated with Surrey Police only via email.

After receiving no response from Surrey Police, the handler in the Hampshire Police control room communicated with them via telephone Surrey Police then attended the location in Guildford and found Meghan’s room barricaded. Upon gaining access to the room, officers found that Meghan had sadly died.

Officers attempted to resuscitate Meghan and her heartbeat restarted. After resuscitation, Meghan was transported to Royal Surrey County Hospital where she died two days later on October 20, 2021 from a Hypoxic Brain Injury.

The coroner wrote: “The handling of the incident involving Mrs. Chrismas in Hampshire Constabulary’s Force Control Room which resulted in a hour delay in determining that an important communication (being a request for assistance) had not been received by a neighbouring force.” It was not concluded however that this shortcoming contributed to her death.

Hampshire Constabulary have since said they have made significant improvements to their process. These measures included: Revision of training provided and the introduction of additional training for supervisors and control room staff. Implementation of National Policy concerning Missing Persons, including documentation to assist in control room responses to similar circumstances. Revision of the recording of risk assessment measurements on the computer aided dispatch record (CAD) system.

It was further explained to the court that the measures should be seen in the context of wider cultural change management in the supervision and leadership being undertaken by Hampshire Constabulary in the operation of the Control Room.

A spokesperson for Surrey and Borders Partnership NHS Foundation Trust said: “Following Meghan’s death an amendment was made to our Psychiatric Liaison Service policy stating discharge letters will be sent not just to the GP, but also to any other relevant external professional – provided we have the explicit consent of the individual to do this. The measure was welcomed by the Coroner.”

SABP added it has developed new guidelines for both community and in-patient clinicians to ensure it routinely and actively seeks a person’s consent to contact and share information with or from their private practitioner.

The Priory Hospital did not make an additional comment. NHS England has been approached for comment.

Epsom and St Helier Hospital NHS Trust claims it has a ‘strong’ maternity service despite failings in a recent CQC report. Safety in the maternity service was rated ‘inadequate’ in a report published by the  Care Quality Commission (CQC) in February. The service overall was downgraded from ‘good’ to ‘requires improvement’.

Managing Director of the Trust James Blythe said, at an Epsom and Ewell Health Liaison Panel on March 3, he was “disappointed” with the CQC report. He added: “The hospital has a really strong service and what the CQC identified are processes we need to get stronger at.”

However, the CQC’s report highlights practical issues  including qualifications and competence of staff, and an environment ‘not fit for purpose’. 

An update report by the Trust given to the Epsom and Ewell Health Liaison Panel said: “All of our maternity services meet 10 out of the 10 safety actions required nationally.” The 10 safety actions are specific to maternity services and range from submitting maternity data, workforce planning, training and action plans, to delivering best practice. 

However, the  CQC report found the leadership team ‘did not take timely action’ to make change where non-compliance with four safety actions was identified in the 2022/23 inspection.

A report in July 2022 identified a shortfall of midwives, yet this had still not been addressed in January 2023. The service was therefore unable to declare compliance with safety action 5 on midwifery workforce planning.

The CQC report said: “On inspection, there was a lack of clarity from managers and leaders about whether the service was on track to make improvements and declare compliance for 2023/24.”

Epsom and St Helier hospital Trust were asked about the discrepancy between the agenda stating they met all 10 safety actions and the CQC inspection report outlying non-compliance of safety actions. The Trust did not comment on the difference. 

The Trust is planning to invest more than £2m over two years to increase midwifery staffing in the unit by 8% so the Trust can declare full compliance with safety action 5. 

Visiting the hospital in August 2023, the CQC found the service “did not have enough midwifery and nursing staff in the right areas with the right qualifications, skills and training to care for women, birthing [partners] and babies”. 

Staff working in transitional care for babies who require extra support “did not have the qualifications and competence for the role they were undertaking.”

A spokesperson from Epsom and St Helier said: “Our priority is to ensure women and birthing people receive the best possible care, and we have already taken steps to improve and strengthen our maternity services – rated by mums in the CQC’s own survey as the best in London.”

Days before the inspection report was published, the Trust secured a strong result in a CQC patient experience survey of women and birthing partner’s experiences of maternity care in England. 

Maternity services at Epsom and St Helier received the best scores in London, with maternity care at St George’s joint second place.

The environment in some areas was ‘not fit for purpose’, and on the maternity ward this posed an ‘infection prevention and control risk’. Bereavement and recovery facilities did not meet national standards for privacy. 

The Trust is said it is ‘fast-tracking’ estates work with new doors and blinds fitted to improve privacy and dignity. 

The hospital’s environment was “not fit for purpose in all areas” and the facilities and equipment were found to “not always keep people safe”. 

An Epsom and St Helier spokesperson implied that patients deserve better than the current crumbling estate – but the hospital can still deliver and receive safe care.

Founded in 1938, approximately 90% of St Helier Hospital pre-dates the NHS itself. A further 98% of the St Helier estate is said to be either in very poor or bad condition and requires capital investment or replacement.

Millions are said to be invested every year to address the most urgent estate challenges, while also improving the buildings, facilities, equipment and environment for patients and staff.

A spokesperson for Epsom and St Helier University Hospitals NHS Trust said:  “This new rating is partly a reflection of our ageing estate, and – while the care they receive is safe – mums, babies and other patients deserve better, which is why we’re pleased the Government has promised us a new hospital and upgrades to our existing facilities by 2030.”

Epsom-based cancer support charity Look Good Feel Better is partnering with Epsom Café Moka in the Ashley Centre for a pop-up sale of preloved bags on Thursday 29th February 2024 from 11am until 2pm. Funds raised will go towards supporting people facing cancer to build back their self-confidence and improve their overall well-being.

Leigh Beth Stroud, Look Good Feel Better’s Community Fundraising Manager, explains: “Our first ever ‘Bags of Confidence’ pop-up sale is open to everyone and will raise much-needed funds for people undergoing treatment for cancer. Pre-loved, quality handbags will be available to buy, so do come along and have a browse on the day.”

This year, Look Good Feel Better celebrates its 30th anniversary. The charity embarked on its journey in 1994 to support people living with cancer and has helped over 200,000 people to date regain their confidence and self-esteem. Look Good Feel Better knows how challenging it can be to process a cancer diagnosis and manage the physical and emotional side effects of cancer treatment.

The charity runs workshops face-to-face and classes virtually to support women, men, and young adults through this time. Services are free and open to anyone facing cancer, and the workshops are led by trained volunteers in the beauty industry to provide practical advice about changes to skin, eyebrows, eyelashes, hair, and nails during treatment, and body confidence.

Ann M, who was recently diagnosed with cancer, attended a workshop and said: “I signed up to a number of the charity’s workshops, including the hand and nail care; the headwear, wigs, brows and lashes, and the styling for confidence sessions. And I haven’t looked back. The biggest thing was that I felt less alone. Cancer can make you feel very isolated, but here I was surrounded by other people, soaking up the good advice and information. It was just what I needed and I would recommend anyone undergoing treatment for cancer should sign up for a workshop.”

If you are interested in hosting your own ‘Bags of Confidence’ event, the charity will provide you with all the support you need, with a colourful fundraising pack with helpful hints and tips available at www.lookgoodfeelbetter.co.uk

Leigh adds: “You might find your favourite designer bag or pick up another hidden gem. ‘Bags of Confidence’ is a simple and sustainable event where these handbags will go to a new home, while raising funds for the charity. And no bags go to landfill, so it’s a win-win situation.”

Established 30 years ago, Look Good Feel Better delivers cancer support services in local communities across the UK through a series of face-to-face and online group workshops, along with video tutorials. Its services help people face cancer with confidence, regain their sense of normality, make friends, and most of all look good and feel better. Its vision is to be recognised as one of the UK’s leading cancer support charities and the only one dedicated to improving the physical appearance and overall well-being of people living with cancer.

Ahead of Helpline Awareness Day (Friday, 23 February), Surrey and Borders Partnership NHS Foundation Trust and Surrey County Council are highlighting a local 24-hour NHS mental health crisis helpline that supports almost 50,000 people each year.  

The Mental Health Crisis Helpline, run by Surrey and Borders Partnership, is open 24 hours a day, 365 days a year. Since it started in 2010 it has helped around 600,000 people.  

It is staffed by trained professionals who are ready to listen and offer advice, support and signpost to a range of community services. 

A mental health crisis is when you feel at breaking point, and you need urgent help. You might be: 

• Feeling extremely anxious and having panic attacks or flashbacks 
• Feeling suicidal, or self-harming 
• Having an episode of hypomania or mania, (feeling very high) or psychosis (maybe hearing voices, or feeling very paranoid) 
• Other behaviour that feels out of control and is likely to endanger yourself or others

As well as the Mental Health Crisis Helpline, Surrey and Borders Partnership also provides five Safe Havens across Surrey which provide out-of-hours help and support to adults who are experiencing a mental health crisis or emotional distress. 

These Safe Havens are in Aldershot, Epsom, Guildford, Redhill and Woking and are open evenings, weekends and bank holidays. Each one is staffed by a mental health practitioner from Surrey and Borders Partnership and two trained Safe Haven workers.  

Mark Nuti, Surrey County Council’s Cabinet Member for Health said: “We are committed to breaking the silence surrounding mental health and providing a safe, confidential and non-judgmental way for people in Surrey to seek help. 

“We believe that mental health support should be available to everyone. No one should have to suffer in silence – the Mental Health Crisis Helpline is here for anyone who needs it.

“There is help out there, whether it’s through the Mental Health Crisis Helpline or one of the Safe Havens. Let’s break the silence and start the journey towards better mental health together.” 

Emily Hackett, Mental Health Crisis Line Service Manager said: “If you are experiencing a mental health crisis or emotional distress or if you have concerns regarding someone that you care for, please call us. Our dedicated crisis call handlers are on hand to support you 24 hours a day 7 days a week.” 

If you or someone you know is struggling with their mental health, don’t hesitate to call the Mental Health Crisis Helpline on 0800 915 4644.  

_{Image – illustration only – Carl von Essen CC BY-SA 4.0}

Surrey County Council (SCC) has been accused of not taking its responsibilities seriously after an eighteen-year-old tragically died from diabetes.

Jake Baker, an 18-year-old with a learning disability and type 1 diabetes, died at home following Diabetic Ketoacidosis. He required residential care since the age of eight, under the guardianship of the council. An inquest concluded a catalogue of failures by Surrey County Council and other bodies contributed to Jake’s death.

The coroner found Surrey Care Leavers team and Children Services had failed to obtain information about Jake’s cognitive ability and his capability of managing his diabetes independently, a Prevention of Future Deaths report published this month reads.

Coroner Caroline Topping said: “I am not satisfied that Surrey County Council have undertaken a rigorous review of the circumstances of the death, nor that the risk of future deaths has been averted. The issues surrounding the inadequacy of Jake’s pathway plan have not been addressed comprehensively in the last 4 years. Training for personal advisers is not mandatory and is only now being rolled out.”

The court was not provided with copies of the training or any protocol to be assured of the adequacy of the training and its implementation.

The coroner said that Jake’s death was “avoidable” and was “contributed to by neglect”. In September 2018 Jake (then 17) was placed in a full-time residential placement at Ruskin Mill College.

At the time of his death, Jake was staying with family for a few days when he became seriously ill from uncontrolled diabetes. Jake’s mother and stepfather found him unresponsive. His family previously said “there is nothing that can take away the pain” of losing their son.

The days before his death were the first time he had stayed away from his care facilities for more than two nights in a row, since being placed in the care of Surrey County Council when eight years old, his family’s lawyers said.

He was entitled to a personal adviser who had a statutory duty to write a pathway plan for Jake, including consideration of how his health needs were to be met. However, when away from home, no advice was sought from specialist diabetes services to inform the pathway plan and no risk assessment was made for Jake having unsupported contact with his family and managing his diabetes, the coroner’s report concludes.

Meetings discussing Jake staying over at his family’s house without support were unminuted. The emails which refer to meeting decisions made no reference to any of the dangers inherent in Jake’s diabetic condition nor his ability to manage it unsupported. The family were also not given any advice or training on how to keep Jake safe if he became unwell nor any emergency contact numbers.

The coroner added: “The local authority employees held the mistaken belief that if Jake wanted to go home unsupervised once he turned 18 there was nothing they could do to stop him. No capacity assessment was undertaken in relation to Jake’s ability to make a decision to go home unsupported. In my opinion there is a risk that future deaths could occur unless action is taken”

Four years on from Jake’s death, the coroner found the process of obtaining learning disabilities diagnoses remains opaque and difficult as there is no protocol in relation to this. Vulnerable care leavers are at risk of being denied necessary support due to the confusion and delay teams accessing adult social care assessments.

Jake was assessed not to meet the threshold for SCC Transitions Team because a report containing his original disability diagnosis was lost. Children’s Services were unable to obtain an up to date diagnosis. He did not have the support of an adult social work team and this outcome was being challenged when he died.

Overnight from the 28 to the 29 December 2019, Jake developed diabetic ketoacidosis as a result of being hyperglycaemic in the preceding days. He began to vomit and required immediate hospitalisation. On 30 December 2019 the college was notified by his family that he was too ill to travel. The staff who were travelling to collect him were told to return to the college. His family was not told to take him to hospital.

He was last seen alive at 11pm and found dead at 3am on 31 December 2019. If Jake had been admitted to hospital at any time prior to 5pm on the 30 December 2019 he would have been successfully treated.”

The family claim that Jake’s death was avoidable if he had been admitted to hospital any time before 5pm on December 29. In a statement, the family said: “Losing Jake has been incredibly difficult for our family, especially as he died in our home at what should have been a happy time. We trusted Ruskin Mill Trust with Jake’s care, and we have been let down by them in the worst possible way.

“Jake was an enthusiastic and determined young man who always put his mind to things. As a family we did all we could to make sure that Jake was looking after himself and was well taken care of, but those that were put in charge of his care didn’t give us the information necessary to ensure Jake’s safety”

Clare Curran, SCC Cabinet Member for Children, Families and Lifelong Learning, said: “Our deepest sympathies remain with Jake’s family and friends. The services provided to Jake fell short of what he and his family needed to keep him safe, and we are very sorry for our part in that. We have taken a number of actions over the past four years to improve our support for young adults leaving care and we will be responding to the Coroner outlining our action plan to prevent future deaths. While we have already made changes, we know there is still further to go and we will carefully consider the Coroner’s concerns as we take our next steps.”

Published on 14 February 2024, SCC have up to 56 days to formally respond to the coroner’s report and outline the service’s action plan. 

Dementia UK, the specialist dementia nursing charity, in partnership with Leeds Building Society, is launching free face-to-face ‘Closer to Home’ clinics to provide life-changing support to families living with dementia in Epsom. 

The clinics will be held in the Epsom branch of Leeds Building Society, bringing emotional and practical support closer to families with dementia through the charity’s specialist dementia nurses, known as Admiral Nurses. Dementia UK’s Closer to Home clinics will run on 28^th and 29^th of February and the 5^th, 6^th and 7^th of March 2024.  

The face-to-face clinic will offer a safe, comfortable, and private space for families to discuss any aspect of dementia and receive the specialist support of Admiral Nurses. Between June 2021 and December 2023, over 4,000 families have been helped through Dementia UK’s ‘Closer to Home’  clinics, and the charity has partnered with Leeds Building Society to offer in-person support across the United Kingdom since 2022.  

Nationwide research conducted by Dementia UK into the impact of dementia revealed that nearly half (47%) of people in the South East of England have been affected by dementia, and 51% of people in the region are worried about how a diagnosis would affect their relationships with family and friends. Only 16% of people in the South East have heard of Dementia UK’s specialist Admiral Nurses. 

In April 2020, Dementia UK and Leeds Building Society announced a four-year partnership to raise £700,000 to help over 2,500 families with dementia across the UK. As part of this partnership, the innovative ‘Closer to Home’ project was also launched in June 2021, to improve access to dementia care and support. 

The partnership’s initial target of £500,000 has now been exceeded. Thanks to this, Dementia UK has been able to develop and deliver virtual appointments with specialist dementia nurses for an even larger number of families and individuals. 

Hannah Gardner, Admiral Nurse at Dementia UK, said: 

“We’re proud to bring our Closer to Home project to Epsom to offer specialist face-to-face clinics in the area. We know the difficulties that families in Epsom and the surrounding area often experience. We know that dementia doesn’t just affect the person with the diagnosis: families, friends, and carers are also impacted.  

“Dementia is a huge and growing health crisis – someone in the UK develops dementia every three minutes. This means it’s more important than ever for us to reach families and offer one on one support from our dementia specialist Admiral Nurses. From worries about memory problems to understanding a dementia diagnosis and how the condition progresses, we will be providing practical and emotional advice on caring for someone who lives with this progressive condition, along with giving advice on financial and legal issues.” 

Richard Fearon, CEO of Leeds Building Society, said: 

“Dementia UK was voted as our charity partner by our members and colleagues, and we are thrilled to have raised over £700,000 for them, exceeding the £500,000 fundraising target we set ourselves at the start of this partnership.“

Dementia UK’s Closer to Home clinics will take place in Epsom on the 28^th and 29^th of February and the 5^th, 6^th and 7^th of March 2024. 

To book a confidential and in-person appointment with an Admiral Nurse, visit dementiauk.org/closer-to-home 

dementiauk.org

Surrey County Council has announced a significant investment of £3.6 million from the Mental Health Investment Fund (MHIF) into 13 innovative, community-focused projects. This allocation follows a previous grant of £530,000 in 2023 to 9 projects. The overarching goal of these initiatives is to bolster emotional well-being, with a dual focus on preventing poor mental health and providing support for those already grappling with mental health challenges.

The MHIF operates in collaboration with Surrey Heartlands Health and Care Partnership.

The 2019 Surrey Health and Wellbeing Strategy guides the allocation of MHIF funds, emphasizing the reduction of health inequalities and targeting specific groups and neighbourhoods. The MHIF focuses on prevention, dismantling barriers, and empowering individuals to proactively improve their emotional health and well-being.

Mark Nuti, Surrey County Council Cabinet Member for Health, expressed delight in the diverse allocation of the second round of funding. Spread across all 11 districts and boroughs of Surrey, the funds support a range of organizations employing innovative, community-focused approaches to address mental health challenges.

In the table summarizing mental health projects in Surrey, here are the projects targeting Epsom and Ewell and frequently the Court Ward area in Epsom in particular, among other areas in Surrey.

Emerge Advocacy

Supports people aged 10-25 who are in A&E because of self-harm, a suicide attempt or emotional crisis, 7pm – 11pm when many other services are closed, and hospital staff are very busy. The MHIF funding will allow Emerge to expand their post hospital follow up support so that young people and their families do not have to endure long waits for support during their most vulnerable moments. Emerge Advocacy runs Emerge projects in the Royal Surrey, Epsom, Frimley and East Surrey hospitals.

Other projects involving Epsom and Ewell include: 

Barnardo’s Paediatric Parenting Service

• Target District: Court in Epsom
• Description: Barnardo’s will provide support to parents/carers of children under 6 years old, diagnosed with autism and/or ADHD, in key neighbourhoods, including Court.
• Funding: £409,609
• Duration: 2.5 years

PAPYRUS: Prevention of Young Suicide

• Target District:

  • Year 1: Court in Epsom

• Description: PAPYRUS aims to expand its impact in Surrey schools through various initiatives, including direct intervention in specific neighbourhoods.
• Funding: £139,834
• Duration: 2 years

YMCA: Step Forward

• Target District:

  • Epsom and Ewell
  • Hooley, Merstham, Netherne, Tattenham Corner, Preston, Horley Central and South, Redhill West, Wray Common

• Description: Step Forward addresses the gap in service provision for young adults with poor mental health, including those in Epsom and Ewell and surrounding districts.
• Duration: Not specified in the provided information

These projects aim to provide various forms of support, from inclusive wellbeing coaching to parenting services, suicide prevention, and support for young adults, specifically in the mentioned districts of Epsom, Ewell, and Epsom Court.

Epsom & Ewell Borough Council has launched a local campaign to tell residents about community support services that offer them, and their loved ones, a helping hand.

The council offers a range of valuable services for those who are elderly or vulnerable. They are run by staff who provide a personal and caring service, and council subsidies mean that costs are kept to a minimum. Services include:

• The Dementia Hub: respite care for people living with memory loss and dementia.

• Meals at Home: tasty, healthy meals delivered to homes in and around Epsom & Ewell, catering for any dietary requirement. The team can even drop off shopping, too.

• Transport from Home: DBS checked drivers help people in Epsom & Ewell, who are unable to use public transport, with door-to-door travel.

• Community Alarm: easy-to-use devices that raise an alarm in an emergency and can even help find a loved one who has become lost whilst away from home.

• The Community & Wellbeing Centre: support hub for the over 55s; a place to relax, make friends, join activities, and feel at home.

Residents will notice information about the services across the borough on council social media accounts including Facebook, Instagram and X, in the council email newsletter, and in local advertising.

Councillor Clive Woodbridge, Chair of the Community and Wellbeing Committee, said: “As we become older, or for people with additional needs, living independently can feel challenging. We also know that many of our residents are carers for loved ones who would really benefit from our services.

Our trained teams offer care and support for people who need it most, allowing them to stay independent for longer.  We hope this campaign will reach residents who could use a helping hand and encourage them to talk to us to find out how we can help.”

If you or someone you know could use any of these services, please talk to Epsom & Ewell Borough Council today. Call 01372 732000 or visit the website: www.epsom-ewell.gov.uk/communitysupport

The Dementia Hub, meals at home and shopping service are also available for people who live outside of the borough of Epsom & Ewell.

More than a thousand people visited one of St George’s, Epsom and St Helier’s emergency departments (EDs) on Monday, as demand for care soars. 

It was the busiest day this winter, placing extreme pressure on services – which only continue to rise. 

Demand typically rockets when temperatures plummet – often in the days following a cold snap – and this week has been no exception. More than 100 extra people visited one of the EDs compared to a normal Monday.  

There has also been a spike in the number of very poorly people arriving at hospital in recent months, meaning a rise in those requiring specialist and complex care.  

Dr Luci Etheridge, Chief Medical Officer for St George’s, said: “Our hospitals are stretched, and we are under extraordinary pressure. 

“Our priority is to ensure our sickest and most seriously ill patients – of which there are many – receive the care they need. And while we are doing everything we can to provide that care against a backdrop of pressures, the public can also play a significant part in helping us by using NHS 111 online if they need urgent health advice.” 

Dr Beccy Suckling, Chief Medical Officer for Epsom and St Helier, said: “It’s a common misconception that going to an emergency department when it’s not an emergency means you’ll be seen more quickly. You will, in fact, be waiting longer, and could even be redirected for care. 

“When it’s not an emergency, NHS 111 online can signpost you to the best place for care. But prevention is just as important – and one of the best ways you can protect yourself and others is by getting vaccinated this winter. It’s not too late to get your flu and Covid jabs, and if your child hasn’t had their MMR vaccine to protect against measles then I’d strongly urge you to look at that, too.” 

If you need urgent medical help, NHS 111 online should be the first port of call. This is a 24/7 service that can direct people where to go for care. Pharmacies, meanwhile, provide advice on minor illnesses such as colds, coughs, and earache. 

It’s important that people continue to call 999 or go to an emergency department when it is life-threatening. 

Vaccines help stop the spread of winter illnesses, as does washing hands regularly with soap and water. 

Measles cases continue to rise across the country, and parents are being urged to book their children – including teenagers and young adults – in for their missed measles, mumps, and rubella (MMR) vaccine at a GP. Measles is a serious illness, with one in five children who get the disease admitted the hospital for treatment. 

St Georges, St Helier and Epsom NHS Trust.

Image Wellcome Images CC licence Scene of the catastrophe, at the gate, Chelsea Hospital 1852

Epsom and Ewell Borough Council’s approach to dog-fouling in its public parks may seem rather tame compared with the nearby Surrey Borough of Spelthorne.

Spelthorne has adopted powers in the Anti-Social Behaviour and Policing Act whereby its parks are made the subject of “Public Space Protection Orders” [PSPO]. Under these orders fixed penalty fines can be imposed on dog walkers who fail to clean up and indeed for walking unready with a “poo-bag”.

The order, which makes it an offence to take dogs into certain marked areas with fines of up to £1,000 if it leaves its mess behind, has to be renewed every three years. On Wednesday, January 18 Spelthorne Borough Council’s neighbourhood services and enforcement committee did just that.

Despite the notices, dog fouling continues to be an issue with the council receiving around 80 complaints a year. Leader of the council, Councillor Joanne Sexton also pushed for new signage to include scannable QR codes in the hope of making it quicker and easier to report offences – and therefore reduce the amount of dog poo lying on the ground.

Officers told the meeting that catching the antisocial behaviour in the act is extremely difficult given how brief the indiscretions are but said that by reporting it the council could find patterns of behaviour and look to target problem areas – turning up at 5am if that’s what the data showed.

The zones cover the council’s parks and open spaces with dogs excluded from fenced off areas such as tennis courts. Officers told the meeting: “We would like people to report to us. If we know that a dog goes to the park at 3pm on most days we can put in some patrols to give that person some advice – we won’t go in heavy. Our aim is always not to give people fines but to make them compliant with rules and regulations. If people see dogs running around like crazy and frightening their dog they should report it.”

Spelthorne Borough Council provides about 550 bins as well as dog waste disposal bags in 50 of its parks and open spaces.

Since Spelthorne imposed the order in 2012 it has issued a total of 11 warnings under the PSPO – 2 for dog fouling, 1 for means to collect (not having a bag), 1 dog in tennis courts, 1 professional dog walker with too many dogs, and 6 directions given to keep a badly behaved dog on a lead.

The authority also issued 3 Fixed Penalty Notices for dog fouling offences in the same time frame (all paid).

However, Spelthorne acknowledges that dog fouling (and other dog related issues) are notoriously difficult offences to actually enforce, as unless the dog owner is actually known to the person reporting, or officers happen to be in the right place at the right time, there is often very little to no evidence that allows investigation.

This reality may explain Epsom and Ewell Council’s more realistic approach stated on its website:

“What can we all do about dog fouling? Report it and we’ll remove it. If you notice dog fouling, let us know by filling in our online form ‘Street Cleansing’ at the top of this page or calling 01372 732000.”

Nevertheless, without the authority of a PSPO it still may be an offence under the Anti Social Behaviour and Policing Act to allow a dog to persistently foul a public area, leading to the possibility of a prosecution and fine.