Mental health chief outlines action plan to turn failing service around
PUBLISHED: 17:10 06 February 2015 | UPDATED: 17:16 06 February 2015
It’s been a torrid week for Norfolk and Suffolk’s mental health chief, with regulators branding the trust inadequate and further failings exposed in two deaths. Here he outlines his action plan.
How is the mental health trust planning to turn things around?
Leadership changes being made include:
• Improved communications between board and frontline staff
• Two new non-executive directors, five new governors recruited
• Board to consult staff on the “radical redesign” programme which was introduced in 2012 to make savings of 20pc by 2016
The trust is also introducing:
Programme of Directors’ visits for both
Executive and Non-Executive Directors.
• Resilience training to help managers and staff members take care of themselves or colleagues at times of stress
• A course to help staff better manage their own wellbeing
• A confidential 24-hour counselling service for staff
• Encouraging staff to create their own relaxing breakout areas in their workplace
• An online “wellbeing zone” offering advice and support in making healthy lifestyle choices
• Staff forums giving a place for staff to talk about how they are feeling about work-related issues
• Staff survey completed every quarter with results sent to board
• Chief Executive or director to attend every staff induction
• Email account set up for the chief executive for staff to contact him directly
• Senior management forum held where directors meet with around 100 managers from across the trust
• Chairman Gary Page to send out summary of board meetings to staff
Safety and quality improvements underway include:
• Reduction in number of patients sent out of county (49 to 16 as of Tuesday)
• Urgent mental health crisis assessment ward with 12 beds opening at Hellesdon Hospital in March
• Mental health crisis line introduced in partnership with MIND in January
• Reduction in community caseloads and board agreed investment into community staffing
• Seclusion policies, restraint and medicines management policies urgently reviewed and additional staff training bought in
• Review of learning from incidents, complaints and concerns to ensure emerging trends are dealt with
A recommendation from regulators to put our mental health trust in special measures did not come as a shock to the man tasked with turning around Norfolk and Suffolk Foundation Trust (NSFT).
Michael Scott had been chief executive for four months when Care Quality Commission (CQC) inspectors visited in October last year and said he was well aware of the problems before he took over.
“There were no surprises,” he said of Tuesday’s report, which saw the trust given an overall rating of inadequate.
Mr Scott said an initial action plan to turn around the failing trust was drawn up just after Christmas, when he received a first draft of the damning CQC report.
But he remains steadfast in his belief that under his leadership, and that of chairman Gary Page, the trust can address its significant failings.
He highlighted a governance review taken in August last yea by outside consultants as a sign the trust had recognised and was addressing leadership problems. That review, which cost £60,000, found a blurring of lines between the executive and non-executive members on the trust’s board.
The review “recognised there were problems in the management of the trust,” said Mr Scott.
Changes made since include recruiting new governors and non-executive directors and improving communications between the board and frontline staff over the controversial and unpopular “radical redesign” of mental health services.
“Staff are going to be the starting and central point in any service redesign,” the chief executive said. “In the current redesign of our access and assessment services, for example, we are fully engaging with the teams to get a clear understanding of exactly what hasn’t worked, and how we can put it right, as well as with our service users.”
“Mistakes were made,” Mr Scott admitted, in the “radical redesign” of services. “The new management team are changing our approach. We are going back to staff and seeing how we can improve this.”
“It is vital that as a board of directors we become more visible to our services and teams right across the organisation and that we are seen to be ready to listen and act,” Mr Scott added.
“Many of us have worked on the frontline of services and we have to do all we can to reassure our staff that we understand them and that we need to work closely with them to turn thing around for the better.”
The CQC also gave the trust an “inadequate” rating for the safety of its services. The regulator made 35 recommendations to improve safety by altering the physical layout of wards. Mr Scott said 27 of those changes had already been made.
Another reason behind the low rating for safety was staff shortages. Mr Scott said he had introduced something called “Safer Staffing” to recruit more workers with a £2.6 million investment.
The trust is heavily dependent on expensive bank and agency staff, which the CQC criticised for their lack of training, but 50 new, permanent nurses and 16 new doctors have now been recruited.
The trust currently has 37 vacancies listed on the NHS jobs site and a series of steps are being taken to improve staff morale and wellbeing.
Monitor is expected, over the next two weeks, to agree with the CQC’s recommendation to place the NSFT in special measures.
Trusts are usually put in special measures for 12 months and Mr Scott said he believed the trust could make tangible progress in that time.
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