Sue's Post Board Blog for November 2018
Our Chair Professor Sue Proctor gives her summary of our monthly Trust Board meetings in a regular blog. This month, Sue touches on how integrated care could have helped a women with very complex needs, preparations for winter, the ups and downs of performance, giving patients a say in the complaints process and the issue of our staff taking time off with mental health related illness.
Hello
Welcome to my post Board blog following the meeting of the Trust Board on 29 November. Each Board meeting starts with a ‘sharing stories’ session, a talk from a service user, carer or member of staff. Sometimes we are humbled, moved, or challenged by what we hear. This month it was all three.
A woman called Debbie spoke to us about her mental health experiences throughout her life. At different times, and sometimes at the same time, she experienced anxiety, depression and an eating disorder that took her weight down to four stone. Debbie presented a list of all the health professionals she’d come into contact with over the years, during courses of treatment and inpatient stays, and it filled a whole sheet of flip chart paper. In short, she’s been through the mill and back again.
Whilst Debbie’s condition remains complex, the one thing that could have made such a difference was if her care had been joined up and centred around her needs. If more of those many health professionals she mentioned had talked with each other rather than dealt with one issue at a time, maybe Debbie’s recovery would have been better or quicker. Her story was powerful and moving – and really brought home the need for us to be person-centred in our services. We are truly grateful to her for sharing her experiences with us so candidly.
Winter is coming but are we more prepared than ever before?
Whilst there is a lot of concern around the NHS’ ability to cope with the effects of winter this year, it does feel like organisations are coming together to plan better for it as a system rather than as standalone bodies. This is set out in our Chief Operating Officer’s report, which includes the Leeds Resilience Plan (item 12 page 95). The plan acknowledges that we’ll only achieve our aspirations in this plan through a collaborative approach and that responsibility lies with us all.
Our local population has a role to play too in keeping themselves healthy, looking out for each other and taking advantage of things like the free flu jab where it’s recommended. We heard that over 67% of our staff have so far received the flu vaccine which is very encouraging.
Performance – ups and downs
October saw a real improvement in some areas for access to our services. For example, Acute Liaison Psychiatry Service (ALPS) and Liaison in-reach team both moved closer to their target levels. In regards to providing access to a mental health assessment in A&E within one hour, our ALPS jumped from seeing 43% to almost 62% for October.
We continue to struggle with the number of people we have to place out of their local area for treatment for acute inpatient treatment. Whilst we recognise this is not ideal, the Board was told that we haven’t had to send anyone a long distance from home. Out of area placements cause a knock on effect of patients experiencing delayed transfers either to other care packages and settings, or discharge back home. I know colleagues are working hard on this and there are no easy solutions. Longer term solutions are being sought using the recent reviews by consultancy firms Niche and Newton Europe.
Read more about our quality and performance in the Combined Quality and Performance Report (item 11, page 56).
Giving patients a say in the complaints process
Our Quality Committee has been looking at our complaints process steps have been taken to strengthen it. However we’ve noted that instead of having a rigid 30 day target for responses, other trusts are agreeing target resolution dates individually with their service users. This seems quite a mature way to handle complaints, considering some can be resolved quickly and others are very complex and involve a range of professionals and services. I’d like to know what service users and their carers feel about this suggestion.
John’s helping staff speak up
Our Freedom to Speak Up Guardian John Verity (pictured) has now been in post just over a year. In his regular report to Board, John described how he’s raised his profile and had around 200 face-to-face contacts with staff. In that time he’s also received 48 concerns raised by staff – the majority of which have been related to behaviours – where working relationships have become strained or have broken down.
John’s view is that one of best ways we could improve this situation is to simplify our policies and procedures to make them more accessible and usable for staff in everyday situations. I hope colleagues will take this on board quickly.
Read more in John’s report (item 14 page 167).
Mental health related staff absence highlighted
Our new Director of Organisational Development and Workforce, Claire Holmes, highlighted a sharp increase in sickness owing to mental health related illness amongst our staff. The number of days lost has risen by nearly 100% from January to October 2018. This is a major area of concern for the welfare of our staff, and also the impact on services. The estimated financial cost to the Trust currently exceeds £500,000 for this financial year alone.
Board colleagues were obviously concerned to hear this. Claire highlighted a number of initiatives that were either already taking place or had been planned, including increasing the uptake of our Employee Assistance Programme, re-establishing peer support networks and recruiting volunteer wellbeing advisors. Claire is looking to increase early intervention and prevention to reduce staff mental health-related sickness and absence, and was fully support by the Board.
Read more in the Workforce and Organisational Development Report (item 18 page 199).
Finances
Whilst we’re reporting a modest surplus at month seven of 2018/19 – our year end predictions are of more concern. We have benefitted from some in year non-recurrent bonuses including our Provider Sustainability Fund (PSF) payment for achieving our control total last year, property sales and good performance from our Commercial Procurement Collaborative. But these are largely one-off payments.
However, we’re also experiencing financial pressures due to out of area placements and agency staff costs and this is set to continue. Therefore we’re relying on staff to continue their great work on driving cost efficiencies in their areas (£1.6 million savings identified to date this year), as well as work with partners to access to additional funding related to things like winter pressures.
Read more about our finances (item 19 page 207).
Strategic plans – how are we doing?
At the end of quarter 2 (September 2018) we’re on track to deliver all of our project milestones by the end of March 2019. Of the 22 schemes we’re monitoring as part of our strategic plans, the majority are on track and a small number rated as amber meaning there’s a bit of slippage for various reasons. The board was informed of the work taking place to address these matters.
Check out the full report for details (item 17 page 187).
Let me know what you think
Thank you for taking the time to read my blog. I hope you find it a useful way to stay up to date on the business of the Trust Board. I’d be really grateful if you took two minutes to let me know how I’m doing and if I could make it any better. https://www.surveymonkey.co.uk/r/SueBlog