It is an organisation which has had a troubled few years. New Norfolk and Suffolk mental health boss Antek Lejk speaks to health correspondent Geraldine Scott about turning things around and looking to the future.
The new boss of the region's mental health trust has expressed his disappointment after it was revealed service users and carers gave him low scores during the interview process.
Antek Lejk stepped up as the new chief executive of Norfolk and Suffolk Foundation Trust (NSFT) this week, he was previously the boss at north and south Norfolk clinical commissioning groups.
In a wide-ranging interview Mr Lejk said he 'did not get the message over' with the panel, which was just one part of the appointment process, where he was reportedly given scores of zeros and ones.
He said: 'You go through the process on the day, and you don't always hit it.
'I think I pitched myself slightly wrong with that user and carer group because I think I was trying to get the message over on some of the organisational things I've been involved in. And I probably didn't put enough into my own beliefs and the importance of service users and carers.
'So I could have done better and I regret that I didn't, and now I need to go and make it up to them by proving what I am and what I stand for.'
But Mr Lejk said he was 'passionate about service users and carers and wanting to do a good job'.
He added: 'I took this job on because I want to actually get my sleeves rolled up and get into something which is going to improve things. I obviously didn't sell myself as well as I should have done. So I regret that but I'll have to live with it.'
Plans for the future
NSFT was plunged into special measures for the second time last year, but Mr Lejk said he was keen to overturn the culture as the organisation.
He said: 'It's all about service users, it's all about their experience, and it's all about giving staff that support to be able to do that at a time when the NHS is under pressure. I'm not trivialising any of that, and there's a lot of great stuff going on, so it's kind of rebuilding confidence of the organisation so it's proud of itself.'
But he said there was 'a lack of clinical leadership in terms of the way we make our decisions' which he wanted to address.
Does the trust have enough beds?
In the latest Care Quality Commission (CQC) inspection, it was found NSFT did not have enough beds, and 36 beds were recently closed - some temporarily - due to a lack of staff.
However some new beds would be opened for children and young people.
Mr Lejk admitted sending people out of the area for treatment when there was not a bed available - something which has hamstrung NSFT for years - was 'inappropriate'.
He said: 'We need to eliminate that because it's no good for the individuals, it damages their recovery.
'But what the ultimate number of beds we need in the longer term partly depends on what else we have in place.'
He revealed a review into patient flow was under way - a follow on from a beds review which previously found NSFT could have enough beds if other community services were in place.
'Everything we can do to make people not need a bed, like the crisis hub which is being developed, should stop people reaching crisis and needing beds,' he said.
'And beds are not a great place to be. So our ambition is to have as few people needing acute beds as possible, but anyone who does need one needs to be able to access one and needs to be able to access one locally.'
He added the recent bed closures had not caused a massive impact on out-of-area placements
Asked whether NSFT currently had enough beds he said : 'Clearly not because we've got people out of county, but you can't magic them up. And it's less the beds and more the workforce.'
From purse strings to provider
Mr Lejk came to his new role from previously heading up two commissioning bodies, which decide where money is spent in the local NHS.
The move prompted outcry from critics who said Mr Lejk had been responsible for starving the trust of cash, and NSFT interim chief executive Julie Cave previously told this newspaper she wanted more money for services.
But Mr Lejk said new ways of working meant barriers between commissioners and providers had been broken down.
He said: 'That's the old way of doing things. The new one is partnership and I know it's a bit cheesy but it is about co-design, it's about working together. We've all got a common purpose, we've all got one reason for being in our jobs and that's providing good care, quality care, and supporting our staff to do that.
'I've always seen myself as an NHS person. And actually the CCGs care about mental health services we did increase investment. So that is being matched.
'And I think I recognise the difficulty, but the CCGs aren't the funders of origin, in the end they have to work with the resources they've got as well.'
He said it was key to prove to commissioners why investing in mental health was important - for example where it may stop putting more pressure on physical health services.
But is there enough money?
But he said mental health had previously been the poorer cousin to physical health. He said: 'If we had more money we could do so much more with it. Mental health has, by everyone's acknowledgment received less of the cake than it needs to, so there is not enough money going into mental health services.
'However there's no point beating the commissioners up over that fact because they don't pocket the money that they don't spend, they spend it all.
'So no there is not enough money going into mental health but it's not because anyone is maliciously withholding it, it's the system which needs to change.'
Will Norfolk and Suffolk split?
After Suffolk MPs last month suggested it might be time for NSFT to split into two separate organisations, Mr Lejk dismissed the idea.
He said: 'It's not on the cards in the sense that nobody has a plan to do it. I think what we need to recognise with the creation of sustainability and transformation and emerging integrated care systems there is a real drive to create strong partnerships in localities.
'I've been in the NHS too long to not go through re-organisations, they happen all the time, it's the way of it. So we're custodians of our services not our organisation.
'In the NHS we don't half like to flex our size, it's fashionable to be small, it's fashionable to be large but if you don't pay attention to local differences then you're getting in the way. Our job is not to do that.'
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