Sara's leadership blog - October 2024

Our Chief Exec Dr Sara Munro has published her leadership blog for October 2024.

Hello,

Welcome to my leadership blog for October 2024. I’m writing this following a long day with Trust Board colleagues on Thursday 26 September. There was a lot to discuss – I’ll start with finance.

Money, Money, Money (or a lack thereof!)

In April 2024 the Trust forecast a year end deficit of £18million. This is the first deficit forecast we’ve made in my time here as chief exec.

Colleagues have since been working hard to manage expenditures and drive efficiency and productivity across every area of our business.

And that work is starting to pay off. At month five (August 2024), we’ve recovered around £400,000 on our year-to-date position. But we’re still reporting a £1million deficit at month five – so we need to carry on with existing measures and go further with new ones.

We will be launching an ‘Ideas Exchange’ in the coming weeks. This is a way for staff to submit ideas of doing things smarter, leaner or just better! We know staff see opportunities to do this every day, and we want to hear about them. Watch out for this launching soon.

Another thing to watch out for is an efficiency audit taking place in the Trust. This will be led by Price Waterhouse Coopers (PWC) and has been organised by the West Yorkshire ICB to review all providers in our region which will hopefully give us some more ideas on where we can work smarter and leaner.

New NHS 111 Mental Health Crisis Service goes live

Millions of patients experiencing a mental health crisis can access support through the new NHS 111 service’s mental health option. This is a national change and was soft launched across West Yorkshire in May 2024 so we could test out the new approach. The aim is make accessing mental health support simpler and easier with a single front door that connects people to the right service for them. The range of mental health services available across Leeds alone can often be overwhelming for people.

The launch of the NHS 111 mental health option in West Yorkshire coincided with a change in use of our Single Point of Access (SPA) phone number. This number is now specifically for primary care colleagues and other professionals. This means our highly trained crisis staff can spend more time in contact with people who really need their help.

The Trust will be running a campaign in the coming weeks to promote the new NHS 111 mental health service and remind people about the change to the SPA.

Early feedback suggests accessing 111 has been a generally positive experience and that referrals to LYPFT are being made. We are also collating feedback on where further improvements should be made.

Demand and pressure on services

Our Chief Operating Officer Joanna Forster Adams reports regularly on pressures within our services. Our main concerns reported to Trust Board in September were:

• Access and waiting times in Adult ADHD, Leeds Autism Diagnostic Service (LADS), and Gender Services mainly due to capacity to meet ever growing demand,
• Enteral feeding for people with Learning Disabilities,
• Access to our Leeds based inpatient Children and Young Peoples Mental Health service due to staffing levels,
• Meeting our 4-hour response target in our Crisis Service, and
• Demand for adult acute admission beds including sending people out of area where a local bed cannot be found.

There is some good news on the last point, where we’ve been making progress on our Out of Area Placements (OAPs) through our inpatient flow work (see below).

Reducing our out of area placements

Work to reduce our out of area placements (OAPS) continues to go well. We had a slight blip in August which you can see illustrated in the chart below – but we never expected it to be a straight line of improvement as the issues affecting patient flow are often complex.

The blue line shows our plan, the purple line shows how we are doing against the plan. The chart also shows the actions we’re taking to improve how patients ‘flow’ through the system so they can be discharged out of acute beds and either back home or as close to home as possible.

At Trust Board we heard that, at the end of September, we were down to 18 people placed out of area – down from 44 in April. Great work from our Improving Patient Flow group.

How’s Community Mental Health Transformation going?

I’m excited that we’ll soon be able to share an evaluation of our three community mental health early implementor areas which went live in March 2024.

Transforming how we work with partners across the city will have a huge range of benefits, including how patients access the help they need, from the right people, closer to home, and without as many barriers to care as they may have experienced before.

Keep an eye on our transformation website for more details, or to find out more about what transformation means.

Consulting on an upgraded inpatient facility

People have shared their feedback on our plans to develop a new modern and fit-for-purpose mental health facility. Throughout September the Trust sought the views of residents, businesses and other local representatives ahead of submitting a planning application to redevelop its Parkside Lodge facility in Armley, Leeds.

Our vision is to provide high quality rehabilitation services at Parkside Lodge to improve the mental health, psychological wellbeing, social inclusion and quality of life for people with complex mental health needs.

Men from the West Yorkshire area with complex psychosis and serious mental illnesses, some of whom are currently receiving care in hospitals far from home, will be supported to live independently again. They will be cared for by our expert and compassionate staff team who will be delivering therapeutic approaches that meet the diverse needs of these people.

Find out more on our website.

TWO Ministerial visits!

Over the last month we’ve had not one but two ministerial visits to services within our Trust.

Firstly, we welcomed Karin Smyth MP, Minister of State at the Department of Health and Social Care (DHSC) to our Red Kite View young people’s inpatient service on 2 September. Karin was interested in our workforce recruitment, how we managed the build of the new unit, and how we were managing out of area placements.

The DHSC posted a short video about the visit on X (formerly Twitter).

Minister for Health @KarinSmyth visited Red Kite View, a mental health facility @LeedsandYorkPFT recruiting locally to train mental health nurses.

This government is committed to reform and growth, especially in areas where the NHS most needs additional trainees and staff. pic.twitter.com/azC3CLIBKC

— Department of Health and Social Care (@DHSCgovuk) September 5, 2024

I’d like to thank all the staff who rallied round quickly to provide such a great experience for Karin.

Then, we welcomed Andrew Gwynne, Parliamentary Under-Secretary of State for Public Health and Prevention on 30 September. Andrew (pictured below) visited the NHS Northern Gambling Service’s head office in Leeds – meeting with clinical lead Dr Matthew Gaskell and members of his team. He was keen to hear how services are delivered and what specific challenges gambling addicts face compared with other forms of harm.

What’s going on nationally (is the NHS broken?)

I recently attended a leadership event with the new Secretary of State for Health and Social Care, Wes Streeting. He set out candidly the need for change in the NHS. Mr Streeting has adopted the controversial phrase “the NHS is broken”. This should not be seen as a criticism of NHS staff who work hard every day in difficult circumstances, but a reflection of experiences of many patients who simply cannot access the care they need.

He went on to say it is not beyond repair – but was open about the challenging context of constrained resources that will mean difficult decisions and trade-offs in the short term, and that this should not be seen as a sign of the longer-term commitment to the NHS.

The development of a 10-year strategy for health will be key to setting out how the government intends to progress the three key aims of:

1. Hospital to community,
2. Treatment to prevention, and
3. Analogue to digital.

The forthcoming strategy intends to set out expectations of the NHS, and what is possible within its scope. Consultation with the public and stakeholders will get underway in the coming weeks and the aim is to have the strategy ready by Spring 2025. It will be informed by findings from the recently-published review by Lord Darzi.

This sets out some key issues in the way the NHS is run and governed which has made it difficult to make sufficient progress in improving services for patients and the working experience for NHS staff.

In the meantime, the message is clear – we need to deliver on the operational priorities for this year within the resources we already have.

Reasons to be proud

Prize for Dad’s Group Founder Errol

Huge congratulations to Errol Murray, our Perinatal Peer Support Worker and founder of the Leeds Dads support group who recently picked up Outstanding Community Organisation of the Year at the National BAME (Black, Asian and Minority Ethnic) Health and Care Awards.

The judges said Errol had: “created and scaled an essential community resource that fills a gap in care provision, particularly for fathers who are often overlooked in traditional programmes. [His] work has addressed key inequalities, as evidenced by the growing membership and engagement. This initiative demonstrates the importance of inclusive, focused support in creating lasting change.”

We are proud of Errol’s contributions to supporting fathers across the city and I’m sure colleagues in our perinatal service also feel equally proud.

We should also celebrate colleagues who were shortlisted for the BAME awards, which included Consultant Psychiatrist Dr Nazish Hashmi for Clinician of the Year, and Balvinder Dosanjh, Sharon Prince and Maxine Brook who were all nominated for Inspiring Diversity and Inclusion.

Errol was also a finalist at the National Diversity Awards along with our Gender Outreach Service which took place on 4 October.

Olympic games came to The Mount

The spirit of the Olympics came to The Mount this summer with a friendly competition between our four older people’s wards which included service users, family and carers. Activities included balloon volleyball, a paper plate discuss and an Olympic bake off.

The closing ceremony and medal celebration took place on 17 September. This is a fantastic example of involvement and I’d like to congratulate the staff who lead on this series of events on top of their day jobs.

CREST recruitment experience gets ‘shortlisted’

I’m delighted that the Trust’s Community Rehabilitation Enhanced Support Team (CREST – pictured below) has been shortlisted in the Nursing Times Workforce Awards 2024 for ‘Best Recruitment Experience’. Well done Team CREST and we’ll all have our fingers crossed for the ceremony on 28 November.