Chair's Blog - January 2019
Our Chair Professor Sue Proctor blogs following the meeting of our Trust Board on 31 January.
Hello
This is my first blog of 2019, reporting from the Trust Board’s first meeting of 2019, which took place on 31 January.
A packed agenda as always and we were fortunate to be joined by our new Non-Executive Director Andrew Marran who officially joins us this month. We sadly had to say goodbye to our long standing Non-Executive Director Steven Wrigley-Howe (pictured), who steps down after serving two terms in office.
I’d like to thank Steven for the passion and commitment he’s brought to the Board, particularly for representing the York side of our operation, for championing the voice of service users and carers, and for his able participation in our Quality, and Finance & Performance Committees.
A carer’s five year ordeal
We started as we always do with a story from a member of the public. This one came from carer Lorraine who was representing her daughter. Lorraine described the “five years of hell” she’d been through with her daughter, trying to keep her well and support her through various mental health services and interventions.
However, she described being shut out, side-lined or simply not spoken to about her daughter’s mental health or her care plan. Lorraine clearly understood that, in services like ours, we have to respect the rights of patients which might sometimes mean we don’t reveal everything to family members.
But there has to be a balance between following protocols and procedures, and involving carers and family members in the decision-making and ongoing care of their loved ones. That’s the main thing I took away from Lorraine’s story. We have to get carer involvement right because having a loving family round you is often the key to recovery and rehabilitation.
The NHS can only ever be part of the solution – we can prescribe the pills, offer the therapy or if necessary a stay on an inpatient ward – but we’re no substitute for a loving family member or carer.
Board colleagues could only offer their apologies and commitment to improve. It was encouraging that Lorraine was supported to tell her story by Ansa Ahmed, one of our new Patient Experience & Involvement Coordinators, who is taking a lead on carers’ involvement. I’m also pleased to hear that Lorraine has agreed to support us to improve and agreed to share her story with other senior managers. Our Chief Operating Officer Joanna Forster-Adams offered to keep in touch with Lorraine on our behalf.
“Good and sustained improvements” in performance and access
The Board heard that in the last three months we’d enjoyed some good and sustained improvements in terms of access to our services. This included:
- The 15 day access target for our community mental health teams was met – with the East North East locality team showing considerable improvement
- In memory services, 95% of service users were seen for their assessment within eight weeks of referral – rising from 88% in October.
- Our Autism Diagnostic Service has more than doubled the number of people receiving a diagnosis within the 26 week target.
But some of the familiar problems persist in terms of bed capacity, out of area placements and delayed transfers of care. These were compounded in the last few months by increased staff sickness and the temporary closure of three of our inpatient wards for a few days for infection control reasons. We’re working as a whole system in Leeds and across West Yorkshire to address these issues – and I’m assured that partners are taking this seriously.
Our Combined Quality and Performance Report (CQPR) was presented by Joanna Forster Adams (item 12 page 55). Joanna (pictured) closed the presentation of her report by referencing three upcoming projects she felt would have a huge impact on quality and performance. They were:
- The Community Mental Health Redesign (more about this below)
- Our crisis services out of hospital, and
- The Acute Excellence Project looking at our inpatients and acute care services
One of our non-execs Helen Grantham added a fourth which was our ongoing commitment to partnership working, and I couldn’t agree more.
Safer staffing and working in older people’s services
Our Director of Nursing and Professions Cathy Woffendin (pictured) presented our safer staffing report (item 12 page 93). She informed us of the challenges of staffing our older people’s wards, especially overnight, and that in the last three months on many shifts we’ve been relying too heavily on agency staff.
I’ve challenged colleagues to think of ways in which we could potentially incentivise working in our older people’s services, and come up with an employment package that helps us to recruit into permanent roles.
Community Mental Health Redesign – the final furlong
Our new look community services will go live on 25 March and what a journey it’s been. We received a very comprehensive paper (item 13 page 94) that summarises all the work that’s led us up to this point.
Just to recap, our intention was to develop dedicated services and pathways for older people and working age adults. This is currently an ‘ageless’ service that covers everyone over 18, but it became clear this is not best serving the needs of people as it should.
What struck me was our engagement: nearly 18,000 service users, staff, partners and the public contributed to our plans. And it’s really influenced our final service models. For example, we’ve decided to retain our Care Homes Team as a stand-alone service working across the city seven days a week based on feedback.
Colleagues are now focused on preparing for the new service going live and its subsequent evaluation. We look forward to receiving an update in due course.
Smoke Free policy update
Cathy Woffendin presented an update on the Trust’s work to go smoke free later this year. We had to temporarily roll back our smoke free status in 2017 after it became clear it was challenging to implement.
We’re now working towards this again and our Smoke Free Lead has been very busy training and preparing staff across our wards. We now have a number of smoke free champions in place and our new smoke free policy is due to be published in April.
Workforce race equality – an improving picture
Our Director of Workforce Claire Holmes (pictured) presented her Workforce Performance Report (item 15 page 136) which highlighted some interesting data around the Workforce Race Equality Standard or WRES.
- We’re nearly three per cent above the average for black and minority ethnic (BAME) staff representation
- We’re closer to parity for BAME staff being appointed for jobs from shortlisting
- There’s been an increase in BAME staff believing we provide equal opportunities for career progression or promotion and we’re now eight per cent above the national average, and
- BAME staff reporting abuse, bullying or harassment is 6.5 per cent below the national average.
We’re slightly better than average when it comes to BAME staff entering the formal disciplinary process, although we have spotted a particular prevalence relating to bank staff, many of whom are from our BAME community. We’ve done some work in this area to improve parity with permanent staff, including the publication of a bank staff handbook, and I look forward to hearing how this is working.
Finance update
At month nine (December 2018) we’re on target to meet our control total surplus of £2.4million. In fact, we’re going to exceed it. This is in part to some great cost improvement work by colleagues throughout the Trust which is due to yield over £2million.
However we’ve also benefitted from a few in year activities including our Private Finance Initiative (PFI) refinancing and proceeds from property sales. This makes our financial bottom line look very healthy but, as explained by our Chief Financial Officer Dawn Hanwell, this should be tempered as it is not recurrent income and will not carry through into next year.
Tackling climate change and waste through our Sustainable Development Plan
Climate change is now recognised as one of the most serious threats to the continued health and wellbeing of the global population. The impacts of global warming are being felt worldwide and the scientific community is in agreement that unless immediate action is taken, the negative effects of rising global temperatures will worsen.
The most vulnerable groups within society who are least able to cope will be most affected. It is therefore vital that action is taken – including by NHS trusts like ours. This not only covers obvious things like carbon emissions but also the broader principles of sustainable development by considering the environmental, economic and social impacts of our actions.
All NHS providers like us must have a plan for this, and now we do too [item 17 page 154]. I would encourage staff, governors, partners and service users alike to look through and see where we can make a difference. I’d glad this has executive and non-executive sponsorship and I look forward to hearing progress.
Find out more about Professor Sue Proctor
Polar ice caps picture credit: https://pixnio.com