Grandpa on a skateboard: innovation in a regulated world

We caught up with Tim Farmer last month to find out more about his business and ask his advice for anyone else trying to innovate or do something new in a marketplace steeped in tradition, rules and regulation.

Advancements in medical research and care mean that we are living longer – often with many different and complex conditions. This means that more people are also living with a reduced mental capacity to make decisions in their own best interests. If you are concerned about someone’s decision-making capacity, then you can request a mental capacity assessment. Currently, the average time for an assessment from a GP is four months and the standard of report is often poor.

Tim, a registered mental health nurse with over 20 year’s experience of working with individuals with reduced capacity was appalled by the length of time this sort of assessment can take. When someone requests a mental capacity assessment it is often when they are at crisis point and four months is just too long. Tim set up the, now multi-award winning, TSF Consultants to do something about it.

“The why is simple – I wanted to find a better way of doing it”

In 2011 Tim was working for the NHS and he was troubled by the four-month lead time for mental capacity assessments. He also felt that generally the quality of assessments was poor and did not always put the needs of the vulnerable individual at the centre of the process. He thought he could do better. He started to float his idea with friends and colleagues.

Tim was told it wouldn’t work. Mental Capacity Assessments are traditionally carried out by doctors – not nurses. “I was unconventional because I was “just a nurse” A friend told Tim “With all due respect, as a Consultant Psychiatrist I’m the gold standard. You’re just a nurse and will only ever be, at best, “bronze” Ouch.

“What do I need to do?”

Tim asked his friend Dave Nicholds, a solicitor, for advice on setting up a business to provide quicker and better mental capacity assessments. Dave knew the sector and was also not afraid to challenge Tim. His first question was “Can you do them?” (yes) followed by “Is there a reason why you can’t?” (no).

Tim drafted a letter to solicitors outlining the offer of a more compassionate, better quality and fast mental capacity assessment service. His aim was to reduce the lead time from four months to a week. Dave edited the copy to a more legal language that solicitors were familiar with. They posted the letters. Then they waited.

Three solicitors were interested. Tim met them and proved what he promised in his letter by completing a high-quality mental capacity assessment for them quickly. At the same time, he started to increase his profile by writing articles for leading journals. He used LinkedIn to connect with and meet key people in the field explaining what he could do to help them. Over time this approach gained momentum.

“We set out to provide the assessment in a week. Due to our current workload, we currently average two weeks, it means we have had to revise our target, but it’s still a hell of a lot quicker than the GP’”

Tim and Dave still meet at least once a month to talk through challenges, new ideas and successes. Tim has also added a mentor, Jeremy Nottingham to his list of confidants and finds “both these sounding boards are essential. They constantly challenge me, help me focus on the immediate issues and plan for the longer term. They are also great support for when things go wrong or don’t quite turn out the way I planned!”.

My evidence is as good as theirs.

The Court of Protection is a specialist Court that deals solely with issues relating to mental capacity. Every application to the Court requires a mental capacity assessment.

Tim encountered many barriers to presenting assessments in court, primarily because he was ‘just a nurse’ and he was trying to change a traditional and ingrained belief system – that doctors were the only people who could do mental capacity assessments and be a representative in the Court of Protection.

Healthcare, like many professions, is victim to traditional stereotypes and egos, some jobs are revered more than others and the disparity between the status of nurses and doctors couldn’t be bigger.

Tim had to overcome prejudice and demonstrate that his evidence was as good as a doctor’s evidence. He started with small simple assessments to prove he could do it and then moved to more complex assessments. At the same time, he built networks of high-quality assessors across the UK. He purposefully recruited unconventional healthcare professionals, for example, nurses and speech and language therapists. He is now recognised as one of the leading experts in the field and works alongside government bodies and industry accreditation boards. He is also an award-winning author and expert witness.

“My evidence is good enough to get to court so why not good enough to be considered by the court?”

In October 2015, the guidelines for giving evidence in the Court of Protection were changed from ‘medical practitioner’ to someone with ‘suitable experience’

Now TSF Consultants have over 40 assessors across the UK. 99% of all assessments occur in the individual’s home at a time of their choosing, helping to ensure they feel safe and they can be at their optimum during the assessment.

TSF consultants are continuing to push boundaries. They are now developing a product to challenge the finance sector to make mental capacity assessments at the point of lending to help protect people from taking on unmanageable debt and an academy to teach healthcare professionals to conduct mental capacity assessments to a high standard that puts the person at the centre.

“There will always be naysayer’s whatever industry you are in – that’s why your own belief is important”

Tim has tackled a lot of challenges in setting up TSF Consultants. They constantly change their approach to get around obstacles. Tim’s feels his knowledge of Martial Arts has come in handy. “In martial arts, we often talk about water. I approach any challenge like water approaches an obstacle. When water comes up against something in its path it either seeks out an alternative route, a nook to pass through or a different way around or it simply waits until it’s build up enough momentum to go over the top.”

Everything TSF Consultants do is built from Tim’s original driver of providing a service that puts the needs of the person requiring the mental capacity assessment first and getting the right outcomes for vulnerable people.

Tim’s advice for anyone trying to innovate about anything is…

  • Understand why it’s important to you. Know your values and drivers and stay true to them. Make sure as you develop your products and services you always come back to why you are doing it.
  • Find allies – people who can be a sounding board, have insight into the topic and have also got your back.
  • It’s a roller coaster ride. It’s fantastic when you are up there and very isolating when you are not. You have to be resilient to get through the low times.
  • All good business books say “surround yourself with people who are better than you” but it’s hard when you don’t have money. Identify and prioritise the key areas that you need help with.
  • Ideas and products develop over time, understand what people want and evolve, develop and fine-tune.
  • Don’t be afraid to voice your own opinion.
  • Listen to the people who challenge you and overcome their objections. You can use this response to counter the next person with the same objection. If you can answer one objection you can answer them all.
  • Don’t give up – if the first incarnation doesn’t work then find a different way. There will be a different way and it’s up to you to find it.
  • Just do it – get out there and do it. Better to try and fail than not to give it a try. “Trying and failing results in learning. Failing to try results in a lifetime of regret”.
  • Expect it to go wrong at some point.
  • Don’t be scared. Have faith in yourself. Be brave.

Tim is the founder of TSF Consultants, a registered mental health nurse with 20 year’s experience and author of the bestselling book Grandpa on a skateboard.

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