Sue's Post Board Blog - May 2019
Our Chair Professor Sue Proctor blogs after our full Trust Board meetings. This month she reflects on the Leeds Autism Diagnostic Service’s improvement journey, quality measures for our recently-launched community mental health service, looking after our junior doctors and major investment to support our workforce.
Welcome to my blog following the meeting of the Trust Board on 23 May 2019. All the papers from the meeting can be found on our website here.
We started with a story of service improvement from Dr Alison Stansfield, Clinical Lead and Consultant Psychiatrist for the Leeds Autism Diagnostic Service (or LADs).
Autism is a different way of thinking and feeling. It affects how you experience the world around you. Being autistic doesn’t mean you have an illness or disease but that your brain works in a different way from other people. Autism is not a medical condition with treatments or a “cure” – but some people need support to help them with certain things.
Getting a diagnosis is an important step towards getting that support – and this is where Alison’s team comes in. However, since they first started in 2011, they have experienced a massive rise in referrals, particularly in the last couple of years. Therefore they consulted our Continuous Improvement team to help them work smarter.
Over the course of a year they’ve looked at everything they do and now they’ve come out the other end a changed team. Lots of small improvements now mean that they’re seeing the right people, within the right amount of time (at a time that suits them) and offering them a high quality experience.
There’s so much to learn from the team’s experience – you can read more about it in Alison’s excellent presentation here.
The May Board is a heavy one as it is year-end annual report season! We considered annual reports from the:
- Quality Committee
- Mental Health Legislation Committee
- Audit Committee, and the
- Finance and Performance Committee
We also reviewed the Annual Accounts, Annual Report, Annual Governance Statement and Annual Quality Report.
Quality and measuring the impact of our new community services
There was a lot to talk about in this month’s Combined Quality and Performance Report. There were many positives including meeting our access standards for:
- assessments by the in-reach liaison psychiatry team within 24 hours
- Community learning disability team referrals seen within 4 weeks, and
- referrals seen within 15 days by the community mental health teams.
Data for our new community mental health services is starting to come through following the launch of the new services in March. This is important as it will help show how the changes we’ve made are making a positive difference to service users and their families.
For the crisis and intensive support teams, the new model is about providing a flexible resource, with a focus on face-to-face assessment and providing more home-based treatment.
For example, the new Crisis Resolution and Intensive Support Service (CRISS) has been set up to deliver the nationally-recognised Crisis Team Optimisation and Relapse Prevention (CORE) standards. CORE recommends that 90% of appropriate crisis referrals should be offered a face-to-face assessment within four hours of referral.
It will take a while for these new services to get up to speed and for the data to start coming through consistently. But we’ve got high hopes of some real demonstrable benefits so we (and our commissioning colleagues) will be keeping a close eye on this.
Looking after our junior doctors
You may recall the protests in 2016 when junior doctors were transitioned onto new contracts, with a lot of focus on their working conditions.
That same year we appointed a ‘guardian of safe working’ who is responsible for the safe working conditions and well-being of our 130 or so junior doctors.
I mention this as we now have a Junior Doctors’ Forum at the Trust, which met four times during the last year to help give a voice to this highly-valued but often seldom-heard professional group. This has been reported in the Guardian of Safe Working’s report and they’ve been addressing issues like:
- Lone working
- The use of pagers, and
- The use of smartphone apps, like What’s App, to discuss confidential patient-related information
I’m pleased to see this work in progress. Our junior doctors provide such a valuable contribution to patient care, and we need to support them.
Workforce matters – it really does
Improving levels of health and well-being amongst all our staff continues to be a major priority for us.
So I was pleased to see we are recruiting a Health and Well-being Manager to improve our offer and to ensure support is rolled out effectively. They’ll also oversee the roll out of NHS Improvement’s Supportive Leadership Programme. Aimed at mid to senior leaders, this develops supportive leadership behaviours with a focus on resilience and well-being.
We’ll also be investing in two other key workforce roles. One looks at our employee value proposition. In other words, what our benefits package is for staff that makes us an attractive employer and helps us recruit good people. The other will look at retention and how we can be smarter at holding on to our staff – for example offering flexible working options or advice on career progression.
I’m also pleased to see us engaging more with our bank staff. We employ around 450 bank staff who are able to work flexibly on ad-hoc placements or on longer assignments.
Bank staff are an important part of our workforce and, although we have other engagement mechanisms in place, we don’t routinely get good quality feedback from them. So it’s great to hear we’ll be including them in this year’s national staff survey for the first time and I’ll be interested to see what the findings are.
We agreed to set up a new Workforce Committee which will report directly to the Board and ensure we keep a clear focus on the work across the Trust to attract, recruit and retain staff, and also to plan for the workforce of the future.
Delivering on our objectives
The May Board is always a very heavy agenda because of the need to receive and review all the various annual reports. This is an important part of the governance and leadership of the organisation. It ensures we are delivering on the standards set by ourselves, our regulators and commissioners.
This year we recognised that despite the many challenges faced by the service in 2018/19, we have largely delivered on our objectives. This includes our financial objectives. We received a positive letter from our external auditors, who review all our financial management over the year.
I would like to pay particular thanks to the finance team for their hard work, and also to everyone across the Trust who has a responsibility for managing a budget. Being clear and careful about how we spend tax-payers’ money to deliver services is an important part of the role of the Board. We were pleased to see this was managed well and efficiently.