talkmagazine ouryear Celebrating the achievements and reflecting on the challenges of 2016/17
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1 Trust talkmagazine s p e c i a l e d i t i o n a n n u a L r e p o r t ouryear Celebrating the achievements and reflecting on the challenges of 2016/17
2 Chair & Chief Executive Welcome Our full Annual Report 2016/17 is available to access on our website nhs.uk/the-trust/publications Welcome to our special edition of Trust Talk, celebrating the work of Cumbria Partnership NHS Foundation Trust during 2016/17. As you know we are both new to the Trust, but no strangers to the health care system in Cumbria. Since the end of the 2016/17 period, former Chief Executive Claire Molloy and Chair Mike Taylor have left the Trust. We are pleased to join the trust at such an exciting time and continue the good work that Claire and Mike were instrumental in. It was a busy and challenging year but most importantly a year of opportunities. CPFT has been working more closely with partner organisations across the county s two Sustainability and Transformation Partnership (STP) footprints, and we both are looking forward to strengthening those partnerships further for the benefit of patients in Cumbria. The past year hasn t been without its challenges; increasing financial pressure and difficulty recruiting to some posts have encouraged the Trust to adopt different ways of working. We ve seen improved ratings from the Care Quality Commission and introduced a number of new developments and service improvements, some of which are highlighted in this special edition of Trust Talk. To keep up to date with news from the Trust throughout the year please visit our website or follow us on social media details are on the back page. None of this would be possible without the hard work and dedication of CPFT staff we would like to take this opportunity to say a heartfelt thank you to every single one of you for the work you do every day. There is so much for CPFT to be proud of and we both are incredibly proud to be joining the Trust and taking this good work forward. Robin and Stephen Robin Talbot, Interim Chair Stephen Eames, Interim Chief Executive Happier Healthier Hopeful
3 What we have achieved We have worked closely with our partners as we develop two health and care systems, one covering west, north & east Cumbria, and the second covering Lancashire and south Cumbria. HEALTHCARE FOR THE FUT RE WEST NORTH EAST CUMBRIA In west, north & east Cumbria we were part of the Healthcare for the Future public consultation which ran from September to December A key part of the consultation focused on the future of community hospitals. We have worked closely with our communities, particularly in Alston, Wigton and Maryport, to develop plans to ensure that local people get the right care in the right place in the future. In south Cumbria we have joined with nine partner organisations to form Bay Health and Care Partners and signed a pledge to further integrate services. This means working as one system to simplify local health services. Persistent Physical Symptoms Service We launched a new service to support people with chronic pain or long term conditions such as Fibromyalgia and ME to understand and manage their symptoms. Managing persistent pain can help improve day to day life and wellbeing. The Persistent Physical Symptoms Service is jointly run between CPFT and North Cumbria University Hospitals Trust and is the first of its kind in the country. In collaboration with the Cumbria Police and Crime Commissioner we have launched the Multi Agency Crisis Assessment Service. This Single Point of Access allows police and emergency services to speak directly to a mental health professional if they are presented with someone experiencing a mental health crisis. This means that people in mental health crisis can get better access to services rather than spending hours in a police cell or A&E. I NEED HELP WHERE CAN I GO? Care Plan We became a formal partner in the Waterloo Practice in Millom alongside the GP practice and University of Morecambe Bay Hospitals NHS Foundation Trust. The partnership was created to offer sustainable GP services to Millom. This is an innovative approach to partnership working and involved significant input from the local community.
4 What we have achieved rio, the electronic patient record system, was rolled out in our Children and Families and mental Health Care groups, removing the duplication of former paper and electronic recording systems. it means that all information is recorded in one place so clinicians have a better understanding of the patient s history and patients will receive more consistent and integrated care. the children and families care group has implemented a single point of access to support for children with mental health issues. We are working closely with Barnardo s, who provide emotional health and wellbeing support for children and young people who don t meet the criteria for specialist CamHS services. A full external review was carried out into the diagnosis and management of children with autistic spectrum disorder in Cumbria, resulting in additional clinics and greatly reduced waiting times. We have made significant progress in implementing actions from our november 2015 Care Quality Commission (CQC) inspection, and the two areas re-inspected during 2016/17 have received improved ratings: Children s community services were recognised for providing high quality patient care, improved waiting times and partnership working. Following re-inspection at the beginning of 2017, the services were rated good in every area. in 2016, the CQC conducted an unannounced inspection on edenwood in Carlisle, an inpatient unit for people with learning disabilities and mental health problems. the rating has improved from inadequate to requires improvement with three out of five elements rated as Good. Key factors in this improvement included involving patients in developing their care plans and improving training and safeguarding procedures.
5 What we have achieved There have been a number of developments in suicide prevention including: the introduction of a multi-agency Suicide Prevention Steering Group; a survey looking at staff attitudes; improved access to training and sharing lessons learned. We also secured funding from the Academic Health Science Network to support a pilot project for system wide real time alerts, and a suicide prevention conference which was attended by over 200 people in February We introduced the Falls Risk Assessment and Management Plan across all community and older adult mental health inpatient units to improve assessment, care planning and record keeping relating to falls risk. The Trust has remained a key partner in the North East and Cumbria Pressure Ulcer Collaborative, and held a celebration event in Copeland to share some of the learning. The Care Home involved in the work had not had any pressure ulcers occurring within their home for over 5 months (as of 31st March 2017) and the District Nursing Team have reduced the incidence of pressure ulcers on their caseload by 70%. Waiting times have significantly improved. A number of our consultant led services are required to meet the NHS Constitution s standard of receiving treatment within 18 weeks of referral in those services this standard has been achieved from June 2016 onwards. In our other services, the number of people waiting over 18 weeks for treatment reduced from 128 in April 2016 to 32 in February % of people referred to First Step were seen within 6 weeks of referral (up from 54% the previous year) and 99.4% were seen within 18 weeks.
6 ouramazingpeople Support Services our trust is made up of amazing individuals and teams and throughout the year we celebrate some of the many achievements and highlights in trust talk. We have many staff invited to speak at conferences, winning prestigious awards and being recognised at a national and, in some cases, international level for the work that they do and their dedication to improving healthcare for the people of Cumbria. there are too many to list here; these are just some of the highlights from the year. To find out more, visit our website and search for our amazing people. amanda Hulse won the School nurse of the year award from the Community practitioners and Health Visitors association (CpHVa) Children s Community nurse andrew kelly (pictured here with the rio team) made it to the last 5 from over 400 nominations for the 2016 guardian public Service award for transformation, for his contribution to training staff to use the new electronic patient record system. The acute admission pathway (aap) for mental Health acute inpatient Care was shortlisted for a prestigious national award by the Health Service Journal. The Memory and later life service were recognised for diagnosing Well at the 2017 dementia Quality improvement awards, securing the runner up position. ouramazingpeople Trust Talk, produced by our Communications team, was shortlisted for publication of the year in the UK Public Sector awards in July 2016.
7 In September 2016, Sarah Linnard, Speech and Language Therapist was selected by the late Dr Kate Granger, founder of #hellomynameis, as one of three finalists in the Kate Granger Compassionate Care Awards for her work to improve mealtimes for elderly people living in care homes. ouramazingpeople Mental Health Practitioner Thomas Kearney was credited by the Royal College of Nursing (RCN) in February 2017 as being the first Mental Health Advanced Level Nurse Practitioner in the UK. In October 2016, CPFT were awarded a Certificate of Commitment by the United Nations Children's Fund (UNICEF), thanks to the hard work of Specialist Health Visitors for Breastfeeding Diane Clark and Fiona Sim, who are leading the implementation of the Trust s breastfeeding policy. Two members of staff were recognised in Health Education England s Adult Learner Awards Assistant Practitioner Lisa Holmes won the Career Progression in Health and Care Award while Learning Facilitator Karen Dutton received a highly commended award for Supporting Learners in Practice. In May 2016, five CPFT nurses were awarded the prestigious title of Queen s Nurse: Phil Hunter, District Nurse; Jane Dickinson, Quality and Safety Lead; Helen Boit, Senior Quality and Safety Lead; Linda Graham, Team Lead for Eden Community Nursing and Salli Pilcher, Associate Director of Nursing. Work is much more than a job to us, it s a vocation that drives us to deliver the very best for our patients, to find solutions to the challenges our patients face. ouramazingpeople
8 Our Patient Experience Working with our Patient Experience Involvement Group (PEIG), our Patient Experience Team has captured the views of over 12,700 patients, service users and carers during 2016/17. The findings from surveys, along with complaints, compliments and comments received, help us to know what we are doing well and where we need to improve. 99.4% of people who used the Physiotherapy Service said they were treated with dignity and respect 98.8% of people using the Diabetes Services said that they received clear information about their care and treatment 97% of people using the Specialist and Special Care Dental Services said that their treatment was completed in an efficient, timely and pain free manner 93% of people using the Memory and Later Life Service said that their diagnosis was disclosed in a sensitive and compassionate way 96% of people are extremely likely or likely to recommend the First Step Service to friends and family 100% of people are extremely likely or likely to recommend the Children s Speech and Language Therapy Service to friends and family 97% of people are extremely likely or likely to recommend the Dental Service to friends and family 95% of people are extremely likely or likely to recommend the Minor Injury Unit to friends and family 407 complaints received 3246 compliments received It feels that the Trust is now going somewhere rather than just being. Healthwatch Cumbria, commenting on the 2016/17 Annual Report
9 Developing Our Workforce We have developed a Health and Wellbeing strategy for staff which focuses on Caring for ourselves to care for others. It is our ambition that every employee takes personal responsibility for their own health and wellbeing and that the Trust supports each employee to maintain and improve their health and wellbeing. GreAT #greatteamsgreatcare We have continued to reduce the time it takes to recruit - in late 2016, the Department of Health recognised this by inviting the recruitment team to produce a case study which is now on the national website. Our Great Teams Great Care programme supported 11 teams to build the tools, skills and confidence to bring about change. Over 425 leaders attended leadership and management programmes and senior leaders have also had access to individual or team coaching. We reached round 5 of Listening into Action, a structured approach where staff identify what gets in the way of delivering care and implement improvements. LiA LiA A record 66.4% of front line staff had their flu jab and 63% overall. This is compared 43% of all staff in 2015/16. NHS Staff Survey Top ranking scores 96% of staff who witnessed errors, near misses or incidents in the last month reported them (national average 93%) Staff motivation at work is rated 4 out of 5 (national average 3.94) Effective team working is rated 3.87 out of 5, the same as the national average. Bottom ranking scores 34% of staff experienced harassment, bullying or abuse from patients, relatives or the public in last 12 months (national average 28%) 24% of staff reported good communication between senior management and staff (national average 35%) 53% of staff are satisfied with the opportunities for flexible working (national average 58%)
10 our Financial performance It s no secret that the NHS both nationally and locally is facing tough financial challenges. While we continue to look at ways we can make efficiencies and still have a long way to go - we have made a lot of progress already. We fully achieved our savings targets for the year, as well as financial and operational standards set by the Sustainability and transformation Fund (StF), which is designed to support providers in achieving financial balance whilst improving performance. a proportion of our 2016/17 income relied on achieving quality improvement goals set out through the Commissioning for Quality and innovation (CQuin) framework. We received 85% ( 2.78m) of the total available from the Clinical Commissioning group, and 100% ( 50k) of the total available from nhs england. introducing an internal courier service for transporting paper records has led to a 43% reduction in costs, saving over 50,000. War on Staff rallied behind our War on Waste campaign, making suggestions on how the organisation can make savings. through reducing colour printing and choosing black and white, we saved 11,000 in the first month alone. the trust are now running an Honest about Money campaign to involve staff in making efficiencies and ensuring our money is well spent #honestaboutmoney #saveapoundaday #smallchangebigdifference #waronwaste
11 The Future These are our Trust Objectives for 2017/19 - the things we want to achieve over the next two years. PEOPLE IN OUR COMMUNITIES LIVING HAPPIER, HEALTHIER AND MORE HOPEFUL LIVES Happier Healthier Hopeful Better Care Together STRATEGIC CONTEXT Healthcare for the future (WNE Cumbria) Countywide & wider Sustainability & Transformation Plans (STPs) Q P S e Q P S e KEY OBJECTIVES Quality Successfully address risks and drive improvement to quality, safety and service continuity People Embedding our cultural improvements and implementing sustainable workforce plans services Transformational improvements to services through innovation, collaborative working and co-production efficiency Safely deliver financial recovery and make the most of the Cumbrian pound KEY PRIORITIES Developing and implementing plans to become an 'Accountable Care' based organisation. Implementation of Integrated Care Communities & community hospitals bed consolidation with our communities. Develop our mental health services in line with the development of a mental health strategy. Implementation with partners of a redesigned 0-19 service for children. Delivery of shared support services: IM&T, Estates, Workforce & OD and associated benefits. Achievement of our CQC Action Plans and readiness for reassessment. Clear arrangements to sustain safe, high quality countywide services to secure good patient experience into the future. Achieve sustainable performance for patients and staff through redesigned pathways of care and improved data quality. Continue to embed our values and cultural improvements through effective organisational development at all levels. Delivery of our recovery plan (efficiency, right sizing of services, temporary workforce, reduction of overheads, discretionary spend) and income security through reward/risk sharing with partners.
12 our Governors as a Foundation trust, Cumbria partnership has a governors Council which represents the views of members of the public. on 31 march 2017 the governors Council consisted of 47 governors; most were elected by our members (in both staff and public constituencies) and some are representatives nominated by our key partner organisations. peter Farrell, Staff governor for Carlisle and eden is pictured here with occupational therapist Margaret kaye Jane smith is the Lead governor and Staff governor for allerdale and Copeland throughout the year they have been involved in a number of key pieces of work: governors attended success regime engagement events, public consultation meetings and other local events as well as meeting with the Success regime s lead communications and engagement advisor to discuss Healthcare for the Future in west, north and east Cumbria consultation process and strategy. they wrote to members to ask for their views and incorporated this feedback into the governors Council s response to the consultation. they have also given full support to the alternative proposals made by the trust for Community Hospitals, which have been worked on with local communities. The joint Non-Executive Director and Governor visiting programme gives staff the opportunity to openly discuss service developments and improvements, and to highlight any key issues in their service that might impact on patient experience. governors Special interest groups are a forum for the trust s care groups to engage with governors and members. their purpose is to review the work of the trust within that care group including patient experience, good practice and safeguarding. If you would like to find out more or are interested in becoming a governor, visit our website, askyourgovernor@cumbria.nhs.uk or call Get in touch communications team for trust talk enquiries communications.helpdesk@cumbria.nhs.uk patient experience Team: for any questions, comments or concerns about our services pet@cumbria.nhs.uk your Governors: represent the views of people like you and always want to hear your thoughts on local healthcare askyourgovernor@cumbria.nhs.uk Become a member to have your say: as a Foundation trust we have members and governors local people that input into how we shape our services. anyone who lives in Cumbria, is over the age of 14 and has an interest in their local health services can become a member. It is free to join simply fill in the form on our @cumbriapartnershipnhs youtube/cpftnhs
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