SOMERSET PARTNERSHIP NHS FOUNDATION TRUST CHIEF EXECUTIVE REPORT 1. MEETINGS 1.1 The Chief Operating Officer and Director of Finance and Business Development attended a meeting of the Somerset Health and Social Care Leadership Group at the Holiday Inn, Taunton, on 21 October 2015, on behalf of the Chief Executive. Discussion included updates on Outcomes Based Commissioning, winter pressures and planning, the role of the System Transformation Group and the relationship with the Leadership Group and other current issues. 1.2 The Chief Executive and members of the Executive Team met with Paul Mears, Chief Executive of Yeovil District Hospital NHS Foundation Trust and members of his Executive Team, on 2 November 2015 at South Petherton Community Hospital. Areas discussed at the meeting included winter pressures, interface issues, potential for further joint working, IT and data sharing, Vanguard project, use of community hospital facilities, integration, Outcomes Based Commissioning and recruitment and retention. 1.3 The Chief Executive and other members of the Executive Team attended a meeting of the Senior Medical Staff Advisory Group at Long Sutton Golf Club on 4 November 2015. Issues covered at the meeting included an update on the Care Quality Commission inspection and next steps, financial position, NHS Benchmarking 2015 project, recruitment and retention and IT issues in Wells. 1.4 The Chief Executive, Director of Finance and Performance, Director of Nursing and Patient Safety and Associate Director Strategic Planning and Performance, participated in a Quarter 2 Conference Call with Monitor on 10 November 2015 at South Petherton Community Hospital. Items covered in the call included CQC warning notices, operational performance and financial issues. 1.5 The Chief Executive, Director of Finance and Business Development, Chief Operating Officer and Associate Director of Commercial and Business Development met with James Scott, Chief Executive of Royal United Hospitals Bath NHS Foundation Trust and other members of his Executive Team to discuss the proposed move to Outcomes Based Commissioning in Somerset, on 12 November 2015 at Shepton Mallet Community Hospital. November 2015 Public Board - 1 -
1.6 The Chief Executive and Executive Directors attended the Service and Team Managers Away Day at Canalside, Bridgwater, on 17 November 2015. The agenda for the Away Day included updates on finance and strategic planning, divisional discussion groups, highlights from divisions, questions for the Directors, examples of good practice from divisions and next steps. 2. VISITS 2.1 The Chief Executive, accompanied by Shaun Carthew, Matron, visited Shepton Mallet Community Hospital on 12 November 2015. 2.2 The Chief Executive, accompanied by Tracey Deacon, Ward Manager, Colin Reynolds, Ward Manager and Phil Wainwright, Deputy Ward Manager, visited Ash Ward, Willow Ward and Wessex House on the Broadway Health Park site on 13 November 2015. 2.3 The Chief Executive, accompanied by Mandy Shiel, Integrated Team Operational Service Manager, visited Glanville House, Bridgwater on 13 November 2015. 3. OUTCOMES BASED COMMISSIONING 3.1 The Somerset Health and Care Leadership Group meeting on 21 October 2015 provided significant insight into what the likely outcome of the geographical lot structure will be, with an expectation that this is likely to be a multi-lot solution. 3.2 Aligned to the Trust s desire to be a key integrator across the county, an action plan has been developed which aims to bring together all key organisations and stakeholders to commence discussions now as to how a joint venture approach can be taken, irrespective of the number of lots which are created. Letters have been written by Stephen Ladyman, Chairman to Chairs of all key organisations including primary care and the third sector and from Edward Colgan, Chief Executive to fellow Chief Executives across the county. 3.3 Meetings have been held with Yeovil District Hospital NHS Foundation Trust and The Royal United Hospitals Bath NHS Foundation Trust, as well as the discussion at the leadership meeting which have been useful in enabling a clearer understanding between the respective executive teams as their thoughts regarding more collaborative working. 3.4 The outcome of the meetings suggests that the most likely decision is that a multi- lot model will be developed in which the Trust will play a leading role along with the other acute, primary care and social care organisations. Further discussions are ongoing as to how to create a November 2015 Public Board - 2 -
county-wide forum to maintain equity of access and drive best practice alongside discussions with the likely joint venture partners who will be aligned to the potential geographical lots. These lots will be decided at the Clinical Commissioning Group s Governing Body on 17 November 2015 and Somerset County Council Cabinet Meeting on 6 December 2015. 4. CARE QUALITY COMMISSION (CQC) COMPREHENSIVE INSPECTION 4.1 On 7 September 2015 an inspection team from the Care Quality Commission (CQC) arrived at the Trust to undertake a planned comprehensive inspection of its services. 4.2 The inspection covered core mental health, community health, learning disability and dental services across the Trust. 4.3 The Chairman, Chief Executive, Chief Operating Officer, Medical Director and Head of General Nursing and Clinical Governance made a formal presentation to the CQC inspectorate team at the Holiday Inn, Taunton, on 7 September 2015, accompanied by Board members, senior managers and service leaders. 4.4 During the course of the week the inspectors made more than 150 visits to services across the Trust, held 40 focus groups and conducted numerous interviews with Board members, senior managers, service and team managers and clinicians from almost every service. 4.5 In their high level feedback after the inspection week, the CQC inspection leads advised that, across all services, the inspectors found very caring, passionate and committed and motivated staff and they found examples of excellent care across many of the services. There were areas where the Trust can improve its services and we will receive details of these once the inspection has been completed and the final report issued. The inspectors identified particular concerns about learning disability services provided by the Trust and we have developed an improvement plan in response to the concerns raised, working with CQC, Somerset Clinical Commissioning Group and Somerset County Council. 4.6 The Trust expects to receive the draft report in November 2015 and a Quality Summit will be held with the CQC inspection team and key stakeholder organisations on 11 December 2015 to discuss the findings and recommendations before the report is published later in December 2015. November 2015 Public Board - 3 -
5. NHS BENCHMARKING 2015 PROJECT 5.1 The Chief Executive, as Chair of the NHS Benchmarking Network Mental Health Reference Group, chaired the Network Annual Benchmarking and Good Practice Conference at Dexter Court, The Old Royal Mint, London, on 6 November, at which the national 2015 NHS Benchmarking Mental Health Project was launched. Speakers at the conference included Paul Farmer, Chief Executive of MIND and Chair of the Mental Health Task Force, Professor Louis Appleby, Director of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness and Dr Geraldine Strathdee, National Clinical Director for Mental Health. There were also presentations on the outcomes of the Mental Health Benchmarking Project 2015, results from other mental health work undertaken by the Mental Health Reference Group including ward staffing, perinatal mental health services, use of restraint, EIT (Early Interventional Treatment), use of acute beds and the CCG commissioner programme. The conference received presentations from Humber NHS Foundation Trust on optimising community based care and Street Triage initiatives in Thames Valley and West Midlands and on the development of international benchmarking of mental health services. A press release is attached which sets out some of the national findings from this year s benchmarking project. The Trust has received its individual benchmarking report for 2015. The Chief Executive will be arranging for Lee Cornell, Associate Director Strategic Planning and Performance, to provide a presentation on the 2015 Mental Health Benchmarking Project to the Board. 6. 2015 NHS SOUTH WEST RECOGNITION AWARDS 6.1 The NHS South West Leadership Academy Recognition Awards were held at Brunel s Old Station, Bristol, on 13 November 2015 and were hosted by the Chief Executive as Chair of the Board of the NHS South West Leadership Academy and Christina Quinn, Director of the NHS South West Leadership Academy. The guest speaker was the Rt Hon Alan Johnson MP. Seven nominations for the 2015 awards were made by the Trust and colleagues from the Trust were shortlisted in three categories:- Sue Balcombe, Director of Nursing and Patient Safety for NHS Inspirational Leader of the Year; November 2015 Public Board - 4 -
Ethna Bashford, Head of Division Children, Young People and Families for NHS Patient Champion of the Year; See Something, Say Something Team for NHS Innovator of the Year. Ethna Bashford, Head of Division Children, Young People and Families, was successful in winning the NHS Patient Champion of the Year award. 7. OTHER ACTIVITIES 7.1 The Chief Executive, as NHS Employers Co-Chair of the NHS Pension Scheme Advisory Board, participated in a teleconference with Gerry O Dwyer, Staff Side Co-Chair of the Scheme Advisory Board and Rachel Court, Chair of the NHS Pensions Board, on 5 November 2015. 7.2 The Chief Executive, as Chair of the NHS Benchmarking Network Mental Health Reference Group, participated in a meeting with colleagues from the NHS Benchmarking Reference Group and GGZ Nederland, to discuss the development of an international mental health benchmarking project, at Central and North West London Foundation Trust Headquarters, on 5 November 2015. 8. USE OF THE CORPORATE SEAL 8.1 As outlined in the Standing Orders, the Somerset Partnership NHS Foundation Trust is required to produce a quarterly report of all sealings made by the Partnership Trust. The Board is asked to note that there were not entries in the Seal Register over the period 1 July 2015 to 30 September 2015. 9. HOSPITAL ACQUIRED INFECTIONS 9.1 There were no out breaks of MRSA, Ecoli bacteraemia, C. Diff and MSSA Bacteraemia in October 2015. 10. POLICIES 10.1 The following policies were ratified by the Senior Managers Operational Group Meeting, or Executive Team, in support of the Partnership Trust s Risk Management Standards Assessment, during October 2015: Version 3.1 Long Service Awards Policy; Version 1.5 Agile Working Policy; November 2015 Public Board - 5 -
Version 1.6 Policy for the use of Acupuncture as Physiotherapy Modality; Version 1.8 Performance Management Strategy and Version 2.2 Performance Management Framework; Version 5.1 Controlled Drugs Policy. November 2015 Public Board - 6 -
www.nhsbenchmarking.nhs.uk PRESS RELEASE 5 th NOVEMBER 2015, Embargoed until 00.01 6 th November 2015 LARGEST EVER NATIONAL REVIEW OF MENTAL HEALTH SERVICES REPORTS ON FINDINGS INCREASES IN EFFICIENCY EVIDENT IN HIGHLY UTILISED SERVICES The NHS Benchmarking Network has published findings from a comprehensive review of NHS mental health services across England, Wales and Scotland. All NHS mental health providers in England and Wales contributed with 57 mental health Trusts from the NHS in England, all Local Health Boards from the NHS in Wales, Greater Glasgow and Clyde Health Board from Scotland, and a number of large independent sector providers. The review is the largest analysis of mental health provision ever undertaken in the NHS and provides insight about the range of service provision across the NHS. Included within the review are inpatient services, community mental health services, finance, the mental health workforce, and a series of quality measures so that a rounded view on organisational performance can be taken. The findings will be presented at a national conference in London on 6th November 2015 where speakers include, National Clinical Director for Mental Health in England Dr Geraldine Strathdee, National Clinical Director for the Justice System Professor Louis Appleby, Chief Executive of MIND and Chair of the NHS England s Mental Health Taskforce Paul Farmer, and a range of clinical experts from across the NHS. The report shows interesting variation across the NHS in both service demand and provision arrangements. Services are utilised at different rates potentially reflecting local commissioning priorities, levels of investment, service development decisions, history and practice. The main findings from the review for adult and older adult mental health services are: A reduction in adult mental health inpatient bed provision in the last year, around 5% fewer adult acute beds were available compared to the previous year. A total reduction of 17% in the number of adult acute mental health beds has taken place in the last 3 years. The reduction in the number of beds for older adults mental health is 6% in the last year. There has been a 24% reduction in bed numbers in the last 3 years. Admission rates to mental health beds however appear to be consistent for the last 3 years although the acuity of these patients has increased in the last year as has the number of patients sectioned under the Mental Health Act. The number of patients in mental health beds who have been sectioned under the Mental Health Act has increased by 10% in the last year.
www.nhsbenchmarking.nhs.uk This steady state level of admissions to inpatient beds with a reduced bed base demonstrates increases in efficiency although bed occupancy has increased for the 4 th consecutive year with 94% of available bed days occupied for adult acute services. Patients in adult acute mental health wards stayed for an average of 32 days in 2014/15. Older adults stayed on average 72 days. Hospital readmission rates for adults in mental health services are around 9% of patients being re-admitted within 30 days of discharge Increased pressures within the health and care system are though evident with delayed transfer of care for adult inpatient services increasing to 4.7% of all bed days. This relates to patients who were medically fit to be discharged but could not be discharged due to a number of reasons which could include the lack of a community care place or access to appropriate housing. Waiting times for community based mental health services are improving in some areas. Improvements are evident in waiting times for services to patients experiencing a first episode psychosis which now average 2 weeks, however, variation is evident with patients waiting up to 9 weeks in some areas. The average maximum wait for a community mental health team appointment is currently 30 weeks. The NHS has made substantial progress in maximising the amount of mental health care that is delivered in the community rather than in inpatient units. Comparisons of where patients received care in 2014/15 confirmed that well over 90% of patients on mental health caseloads were treated in the community and did not require access to inpatient care. Community mental health team caseloads have been increasing in recent years as more care shifts into the community setting. The national patient s survey for 2015 for community mental health services shows service user satisfaction with community mental health services at a 69% level. The national NHS staff satisfaction asked staff about their satisfaction with the quality of work and patient care they are able to offer which is now at a level of 76%. A large number of indicators relating to service quality were collected. These include data on medication incidents, ligature incidents, violence and seclusion. All of these indicators improved in the last year. The inclusion of service quality measures for the second time in 2014/15 allows the progress on measures associated with safety and quality to be assessed. Trusts and Health Boards generally reported fewer incidents in the last year than in 2013/14. Feedback from participants suggests that quality systems are now well established with a commitment to transparency of reporting evident. Stephen Watkins, Project Director from the NHS Benchmarking Network said the review has produced a significant amount of new evidence to aid the understanding of how mental health care is delivered in the NHS. It is pleasing to see the improvements in productivity that have been made by mental health services over the last year, along with
www.nhsbenchmarking.nhs.uk parallel improvements in service quality. We will be repeating the project in 2016 with an aim of measuring the progress made by mental health services on an on-going basis. Edward Colgan, Chief Executive of Somerset Partnership NHS Foundation Trust and Chair of the NHS Benchmarking Network s Mental Health reference group said This most recent benchmarking exercise provides a wealth of data and information for providers of mental health services in determining how well their services are performing across a range of measures. It is critical that with the increased focus on patient safety and quality of services on the part of both commissioners and regulators, Boards need to fully understand the implications of the benchmarking data and areas where there is need to improve performance. The benchmarking project has been developed from the rich data that providers hold. We are actively encouraging providers to share their learning and performance with their commissioners to enable a more effective and evidence based planning of mental health services to take place. The work this year on quality and patient safety is particularly important in the light of the Francis report and we will look to build on this in future years. For interviews and queries please contact: EDWARD COLGAN, Chief Executive, Somerset Partnership NHS Foundation Trust & Chair of the NHS Benchmarking Mental Health Reference Group Edward.colgan@sompar.nhs.uk Tel 01278 432094 Stephen Watkins, Project Director for Mental Health Benchmarking, NHS Benchmarking Network s.watkins@nhs.net Tel: 07721 622951. Website: www.nhsbenchmarking.nhs.uk Notes to Editors 1. The NHS Benchmarking Network is the in-house benchmarking service of the NHS. The Network is a member based subscription body which is currently hosted by East London NHS Foundation Trust. The Network has 350 member organisations including 57 specialist mental health Trusts in the English NHS. All Welsh Local Health Boards are also members of the Network. The NHS Benchmarking Network is one of the world s largest healthcare comparison services.