Chair's blog April 2018
This month our Chair, Professor Sue Proctor, talks about Trust priorities, reducing out of area placements, hitting financial control targets and getting down with digital.
Scything through the thicket of priorities
It was our first board meeting of the new financial year on Thursday 26 April and, since the early glow of spring had faded away into a cold and dismal week, we were enlightened by hearing about the Trust’s priorities for the year ahead.
Prioritising in the NHS always makes me think of Professor Michael West’s “thicket of priorities” analogy in so much as, you can’t have 1,001 priorities, that’s simply a long list! He came to speak to us about this as part of his compassionate leadership session in January and you can find it all on our You Tube channel.
We received and discussed a really helpful paper from Chief Exec Sara Munro which boiled these down to four. They are, in short:
- Defined change projects – such as our community redesign, our new electronic patient record service etc.
- Cross cutting enablers which translates as people and things that are common across all projects that will help make it all happen i.e. staff engagement, quality improvement, finance, estates etc.
- Business as usual – in other words, making sure we don’t lose sight and momentum on the really important issues happening right now i.e. reducing out of area placements, delayed transfers of care, delivering our winter plan
- Our Mental Health Collaborative and the wider work across the West Yorkshire and Harrogate Health and Care Partnership (formerly known as the STP). This includes a model for learning disability services, psychiatric intensive care, forensics etc.
Business as usual also includes delivering our CQC action plan following the publication of our report and ratings on Friday 27 April. Colleagues will be working on the action plan during May.
There’s more detail in Sara’s paper (item 7.1) including a set of principles which will guide delivery, and a table outlining where all this sits in the organisation.
Reducing out of area placements
There continues to be good news on our work to reduce the number of people and the amount of time they spend receiving treatment out of area, which can be read in the Combined Quality and Performance Report (item 8). At 17 April, there was only one service user out of area and, during March, only six new out of area placements were made. This compares with a full year average of nearly 17 per month. The table below shows the progress we’ve made in the first three months of 2018, which is remarkable – well done to all involved.
| Service area | January 2018 | February | March |
| Adult acute | |||
| Number of new placements | 16 | 7 | 4 |
| Total bed days out of area* | 464 | 300 | 154 |
| Psychiatric intensive care unit (PICU) | |||
| Number of new placements | 13 | 5 | 2 |
| Total bed days out of area | 158 | 114 | 58 |
| Older adult | |||
| Number of new placements | 0 | 0 | 0 |
| Total bed days out of area | 31 | 1 | 0 |
*Total bed days includes new placements and those continuing from previous months
My hope is we can sustain this performance and eradicate out of area placements altogether.
Bittersweet financials
Great news for those who follow the ups and downs of NHS provider trust control total surpluses. In short, we’ve met ours for the year 2017/18 (subject to audit confirmation) and delivered our control total with a bit to spare.
My Board colleagues and I wanted to recognise the hard work of all budget holders and the finance team in delivering the control total. This is also good as it means we get a ‘bonus’ payment from the NHS of around £1 million.
However, and there is always a however with finance, our position has only been achieved due to one offs and non-recurrent income which doesn’t carry through into this year. This includes a number of unfilled vacancies.
We also managed to save £2.8 million as part of our cost improvement plans (CIPs) which is a great effort – and budget holders across the Trust should be proud of the work they’ve done to contribute to this. Unfortunately we were £3.2 million short on the target we set ourselves. Whilst we were able to underwrite this shortfall via other non-recurrent means (such as unfilled vacancies) there’s more work to do here going forward into 2018/19.
Let’s get Digital
The Board received an updated Strategic Health Informatics Plan (item 12) prepared by our Chief Information Officer, Bill Fawcett.
Bill’s plan presents an exciting vision for us to become a leader in digital mental health in the NHS, and to provide “the best systems and services at the best cost, to meet local and national objectives”.
Good systems and IT are, quite simply, essential in managing the demands of a modern day NHS. Indeed, one of the biggest complaints we often hear from staff is about our patient records system, and accessing and sharing information in a timely way. So its great news that we’re getting a new one and a full announcement will be coming out soon about this.
The plan has a set of guiding principles which include “always looking for clinically-led solutions that improve the service user experience”. This is spot on as we shouldn’t invest in technology unless it improves health and lives. The other principle which was of great comfort to me was “always trying to make our systems simple and easy to use.”
Indeed, these are exciting times to be involved in digital health in Leeds. As an NHS mental health trust we’re aiming to become one of NHS England’s “Global Digital Examplars” with the help of a dedicated digital exemplar post working alongside our health technology innovators mHabitat. More to follow soon about this too.
Find out more about Professor Sue Proctor.