Sue's post Board blog - October 2018
The Chair of our Board of Directors Professor Sue Proctor writes a blog after every Board meeting. This month, Sue talks about a local health system that is heating up (whilst the temperature outside drops) as well as recruitment and retention of staff, performance, quality, safety and finance. She starts, as always, with reflections on a very heartfelt personal story from Pete, a man who’s accessed services from us and others throughout his entire life.
Hello,
We gathered for our latest Board meeting at the Horizon Centre near Tetley Brewery Wharf in Leeds on 25 October 2018 – agenda and papers can be found here.
We were joined by our new Director of Workforce and Organisational Development, Claire Holmes, as well as a number of members of staff, service users and the public – in fact we had to grab a few more chairs to accommodate them all!
We started as we always do with a personal story – this month from Pete who gave us a fascinating and, at times, very moving account of his life, which included a number of traumas and episodes of mental ill health spanning his entire life.
Some of you may remember Pete bravely telling his story in a video for our Annual Members’ Meeting in 2017, and he again talked about how some of our staff had helped him tremendously.
Pete told us what he felt needed to change. This included:
- Offering more tailored help and support to men – who, as we know, tend to be more reluctant to come forward to discuss health issues
- Getting more mental health help, advice and signposting in GP practices
- Ensuring that NHS staff have the emotional awareness to be able to help and support people like him
He also highlighted issues around carers and families being able to contact our crisis service on behalf of others, and coming up against what he called a “brick wall”. This was also highlighted later on in the meeting and is something our Chief Operating Officer Joanna Forster Adams will be taking away to look at with some urgency.
Chief executive report
Our Chief Exec Dr Sara Munro gave us a very comprehensive run down of key business that’s going on in the Trust right now. She blogged about most of this last week.
I was particularly interested in our new Fire Safety Improvement Collaborative – set up to learn from recent incidents at the Trust, particularly the fire at Ward 5 in the Becklin Centre. This group’s work is very important and needs to ensure that learning from such events is not isolated but is properly shared across other clinical and service areas.
Quality matters
The Chair of our Quality Committee, Non-Executive Director Prof John Baker, presented his Chair’s Report from the committee. This is a highly influential committee and we heard about a few issues that required the Board’s attention.
One being the challenge of maintaining the estate at Mill Lodge, our child and adolescent mental health (CAMHS) unit in York. The property is owned and maintained by NHS Property Services and, whilst they do their best to keep up with the demands of the unit, there can be frequent damage and repairs to perform.
There was also a discussion about reducing restrictive interventions – something that our Positive and Safe Group are looking at. John also highlighted the issues around the consistency of how we apply our smoke free policy and how hard this can be for staff working on the front line.
Performance Report
If there’s a quick way I could sum up the state of the local NHS system at the moment is that it’s heating up. In other words, we’re seeing inpatient bed occupancy at around 100%, delayed transfers of care (when we try and move patients into the community or onto another more appropriate care setting) consistently above target, and out of area placements at a high level. This was all highlighted in the Combined Quality Performance Report presented by our Chief Operating Officer Joanna Forster Adams – item 10 page 54.
There are no easy fixes to any of these problems, and senior clinicians and managers are actively working with partners across Leeds and West Yorkshire on solutions. Of course, we now have winter started to bite, which will increase the pressures in the system further.
One of the issues exacerbating problems for us is a general lack of suitable housing in Leeds, particularly for elderly people with mental ill health. There has been debate at senior level in the Trust and with our partners about how we might use our freedoms as a foundation trust to address some of these issues. This would be a major service and capital development so it needs careful consideration – however we cannot simply sit back and bemoan “the system” so I welcome this creative thinking.
We also heard the good news performance stories, including from our crisis services, community mental health teams, CAMHS and forensics as well as an increase in people completing our friends and family test.
Nurse recruitment, staff wellbeing and new financial support
Claire Holmes’ Board debut was to present the Workforce Performance Report (item 12 page 99), which focused on our student nurse recruitment drive and staff health and wellbeing initiatives.
Colleagues welcomed the work that was taking place but pushed Claire to go further, particularly around targeting the universities in York and recruiting more student nurses there.
Our Workforce colleagues have also been out and about during September and October running staff health and wellbeing roadshows. They offered a variety of things including health checks and advice sessions.
The roadshows have coincided with the launch of our new staff financial support package called Neyber, which offers salary deducted loans at preferential interest rates as well as a range of financial advice and support. We know that financial problems cause stress, and stress is a significant cause of sickness among staff at the Trust. Therefore by putting this benefit in place we hope it will make a big difference to staff who might be struggling.
Finance report
Positive news from finance in that we are currently in a surplus position (item 13 page 107). We have received our Provider Sustainability Funding (PSF) for achieving our financial control total last year as well as benefitting from the sale of some of our estate.
We are looking forward to hearing some positive news for mental health in the autumn budget statement. However there is a lot of noise in the system (some of which has been reported in the health journals) about changes to NHS finances, control totals, ‘CQUIN’ targets etc. Our Chief Financial Officer Dawn Hanwell will be attending a national meeting of finance directors soon where hopefully future requirements will be made clearer. She welcomed the move to five yearly allocations for health commissioners which would hopefully reduce some of the more short term and quick fix solutions we’ve seen in recent years.
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 board. I’d be really grateful if you took two minutes to let me know how I could make it better via this short survey https://www.surveymonkey.co.uk/r/SueBlog