Annual Report Summary 2016/17

Annual Report Summary 2016/17

Contents Who we are 3 Our work 3 Our vision, values and strategic objectives 4 Highlights of 2016/17 5-7 Transforming for the future 7 Quality and performance 8-9 Our workforce 10 Strong financial management 11 The Trust Board Back page Welcome Thank you for reading this summary report of our work in 2016/17. It provides an overview of how we served communities in south west London and further afield with high quality, patient-centred mental health services; our performance and challenges. You can find out more in our full Annual Report and Accounts which is available on our website: www.swlstg-tr.nhs.uk

South West London and St George s Mental Health NHS Trust 3 Who we are We are the leading provider of mental health services across south west London, serving more than a million people in the boroughs of Kingston, Merton, Richmond, Sutton and Wandsworth. Our headquarters are in the grounds of Springfield University Hospital in Tooting and we operate from several other locations in London and the south east. We have been providing mental health services to the people of south west London for more than 160 years. Today we are a modern and forward-thinking mental health provider. We gained Trust status in 1994, and are a centre of excellence for several national mental health services. We made 383,000 individual contacts with our patients 46 COMMUNITY SITES We received 28,000 We admitted referrals 1,992 people into our 22 wards Our work We work in partnership with colleagues in primary care, local authorities and the non-statutory sector to: Promote mental health and improve awareness of its importance Support people with mental health problems and their families Provide care and treatment to the highest standards Help schools and employers to challenge stigma We aim to serve the mental health needs of everyone in our diverse communities. Making life better together

4 Annual Report Summary 2016/17 Our vision, values and strategic objectives We are a cost-effective centre of excellence; a place where patients choose to be treated; where clinicians want to train and work; and where our stakeholders want to work with us. We aim to provide the best possible clinical care and support to people who use our services and their carers in the communities we serve. We work in partnership with service users, their relatives, carers and friends, and other stakeholders, to meet our strategic objectives. These are to improve: Quality and value Partnerships Co-production Recovery Innovation Leadership and talent Our values outline how we treat our patients, and work with partners and colleagues. Respectful We are respectful so you feel appreciated and included Open We are open so you feel informed and involved Collaborative We expect teamwork so you feel connected and supported Compassionate We are compassionate and kind so you feel valued and cared for Consistent We are consistent in our quality of care so you feel safe and reassured www.swlstg-tr.nhs.uk

South West London and St George s Mental Health NHS Trust 5 Highlights of 2016/17 Innovation and partnership working continue to play a key role in our efforts to improve the services we deliver and ensure they meet our patients needs. The Care Quality Commission s (CQC) report published in December 2016 rated our overall services as good. In September, its inspectors said they were impressed by the improvements in our supervision, administrative and medicines management processes. In November, we launched an innovative new unit that provides enhanced mental health assessments for patients having mental health crises. The Lotus Assessment Suite, opened by Justine Greening MP, provides a safe and calming environment away from A&E, allowing mental health staff to carry out in-depth assessments of these complex patients. We were the first mental health trust to be awarded the British Deaf Association s British Sign Language Charter. This highlighted the tremendous work of our deaf mental health services, and in particular the deaf recovery tool, which shows how visual communication methods and appropriate language are vital in assessing and providing therapy for deaf service users and staff. A team of artists from Hospital Rooms installed artwork in our wards. The project took place at the Springfield University Hospital site s Phoenix Unit, a secure psychiatric rehabilitation ward for patients diagnosed with schizophrenia. Each of the ten artists renovated a communal area, with residents and clinicians suggesting colours and potential designs. The team then turned their talents to the Recovery College. We won 800,000 from Health Education England jointly with South London and Maudsley Foundation Trust and Oxleas Foundation Trust to recruit mental health nurses. The funding will help to promote: Mental health nurse recruitment and retention across south London Better career development pathways Secured funding from the Burdett Trust to support the development of BME nursing staff. We supported a successful bid by Shaw Trust to deliver Aim4Work in south London. With money from the Building Better Opportunities programme jointly funded by Big Lottery Fund and the European Social Fund - Aim4Work uses the principles of the Individual Placement and Support (IPS) model to help people with mental health problems into education, training or work. Our role is to provide employment specialists to deliver IPS in Kingston, Merton, Richmond and Sutton. IAPT at home in Wandsworth Battersea Healthcare CIC and the GP Federation commissioned us to deliver Improving Access to Psychological Therapies (IAPT) interventions to people with anxiety and depression who are housebound or in domiciliary care. Following a robust commissioner-led procurement process, NHS Wandsworth CCG commissioned us to provide a new service, Talk Wandsworth. This offers a broad range of support for people with mild mental health conditions such as anxiety, low mood and stress. The service has a wide presence across Wandsworth and involves a range of partners including The Awareness Centre, SilverCloud and Ieso. Making life better together

6 Annual Report Summary 2016/17 We commissioned two recovery cafés for people who struggle with mental health and find it difficult to cope. The Tooting recovery café is run by Hestia, and the Sunshine recovery café in Merton is run by CDARs. They are safe and supportive spaces, and help people to find treatment closer to home. Kingston co-ordinated care (KCC) We are working with five other providers (Your Healthcare; Kingston Hospital NHS Foundation Trust; Kingston GPs Chambers and Staywell; and the Royal Borough of Kingston adult social services) to co-design and deliver new ways of working in: Proactive care Enabling and improving independence Maintaining independence and preventative care Crisis intervention Healthy living and wellbeing Richmond mental health outcome-based commissioning We worked through a rigorous assessment process to become part of a new outcome-based commissioning (OBC) contract for delivering mental health services in the London Borough of Richmond from September 2017. The OBC is a partnership-based approach that rewards better outcomes for patients, consisting of eight partner organisations for health, social care and the voluntary sector. South London Mental Health and Community Partnership (with South London and Maudsley NHS Foundation Trust and Oxleas NHS Foundation Trust) Forensics pathway - As part of NHS England s New Models of Care, we are taking responsibility for managing care budgets for secure mental health services from 1 April 2017. The aim is to improve services for adults with mental health problems who need care in a secure setting and/ or specialist forensic mental health service, and ensure that people do not have to move out of the south London area to receive forensics services. Backoffice - As part of the South London Mental Health Partnership we have looked to identify how we can make best use of the resources we currently commit to areas such as legal advice and purchasing pathology, to ensure we are delivering best value for money. We continue to involve and engage all our stakeholders, including patients, carers, partner organisations and other local bodies. The London Assembly health committee investigated the challenges the deaf community faces in accessing mental health services. We submitted a report from our clinicians and service users that provided an insight into the many issues deaf people encounter and that also offered recommendations to encourage greater awareness across London. We will continue to work with the London Assembly and share best practice with other providers such as GPs, local authorities and acute services. To raise awareness of mental health, we have been working with ThriveLDN, a programme that brings together agencies and providers, and voluntary, business and community partners, to do more to improve the mental health and wellbeing of Londoners. Innovation and partnership working continue to play a key role in our efforts to improve the services. We ran and supported more than 50 events for Mental Health Month in October to encourage discussion on mental health and stamp out stigma and discrimination. This also included our popular digital photography competition, #upliftingimage, which invited local primary schools, staff and members of the public to send in images that made them smile and lifted their moods. www.swlstg-tr.nhs.uk

South West London and St George s Mental Health NHS Trust 7 In the last few years we have been leaders in co-production, and have started to change how people think about mental health. Several coproduction initiatives have brought our services and patients closer together. Healing our broken village conference - looking at inequality and black communities in mental health services. Learning disabilities conference - raising awareness of learning disabilities in local communities. Over 100 people attended the conference which continues to build momentum. The conference aims to develop a local network to facilitate seamless care with partners. The community network for family care - Local leaders have been trained in systematic family therapy so they can support their communities with early family support where this is needed. Transforming for the future Service Line management One of the biggest changes the Trust has seen this year is the move to a Service Line Management (SLM) model. Led by clinical directors, supported by heads of service delivery and heads of nursing and quality, this new way of working will allow us to ensure we can deliver a consistent level of quality and share best practice across south west London more effectively. The new model will provide the best outcomes for our patients and service users and will help us to focus even more closely on supporting people with their individual needs. We held several events involving our local partners aimed at keeping our colleagues from external organisations up to date with the changes relating to the new SLM model and provided all colleagues with new Trust contacts to ensure a smooth transition into the new service lines. Whilst SLM is very much about putting the patient at the heart of what we do, it will also empower our clinical staff in a very real and tangible way. Estate modernisation Drawing on an investment of 160m, we have continued to transform our facilities. We will move outpatient services into local communities across the five boroughs we serve, and we will reduce our estate to two main sites delivering acute inpatient mental healthcare the new state-of-the-art hospitals at Springfield and Tolworth. We will also establish a new crisis-response team to support people in the community. It will work alongside the existing crisis and home treatment teams and street triage services. Work has begun on the first phase of development, and we expect to complete 26 new homes at Springfield by October 2017. We started the procurement process to select a master developer and hope to announce a preferred bidder in September 2017. We will then submit our full business case for approval by the Department of Health and the Treasury, which we hope to have by summer 2018. Site disposals: we are currently selling land at Richmond Royal Hospital and Barnes Hospital where inpatient services are no longer provided. All proceeds will go back into the NHS helping to fund our two new state-of-the-art hospitals. Making life better together

8 Annual Report Summary 2016/17 Quality and performance Performance against our targets We continued to perform well in 2016/17 against national and internal targets. Clinical performance monitoring Our key clinical performance indicators 2016/17 where we need to have a continued focus on are: Summary of our performance against 2016/17 key targets Our performance is measured against NHS Improvement metrics covering effectiveness, patient experience, quality and safety. We achieved all key targets. Waiting times performance referral to treatment We continued to manage waiting times and met all monthly targets for the time patients wait to start treatment (the referral to treatment (RTT) incomplete pathway). Access to adult secondary care We improved access to adult secondary care. Our average performance of 83% is above the 80% threshold for seeing non-urgent referrals within 28 days. More young people have accessed CAMHS We are required to see 80% of new referrals within eight weeks. In 2016/17, access to Tier 3 CAMHS was further improved we met the target throughout the year. Factors affecting performance increased demand for inpatient beds Demand for adult acute beds remained high. In November 2016 the Lotus Assessment Suite opened. The suite provides a more comprehensive assessment of clients and helps to prevent admission to an adult acute ward. Monitoring and managing performance We strengthened reporting to the board. Our performance will be further enhanced in 2017/18 by the move to service line reporting. Clinic indicator % CPA patients with a collaborative crisis plan recording % patients with a physical health assessment attempted within 48 hours of admission Adult acute emergency readmissions within 30 days % cluster accuracy and quality Target Our performance 90% 87.8% 98% 94% 8.5% 8.7% 95.0% 84% www.swlstg-tr.nhs.uk

South West London and St George s Mental Health NHS Trust 9 Commissioning for quality and innovation (CQUIN) and the Trust quality priorities These promote good clinical practice and are important drivers for improvements in safety, effectiveness and patient experience. A proportion of our income in 2016/17 was conditional on achieving goals agreed with commissioners for the provision of NHS services. We either met or partially met all the CQUIN targets for local and national services in 2016/17. Last year we identified the following priorities in our quality account: Adult autism fulfilling and rewarding lives - We introduced basic training for all clinical staff and enhanced for learning disability champions and staff in assessment teams. We piloted the use of Skype within an LDMH community team, and configured the electronic care record to promote the recording of learning disabilities/autism. Coordinated inpatient discharge planning (year two of a two-year priority) - The inpatient discharge standards were updated to include the new gatekeeping tool as well as the new national guidance for e-discharges. Priorities for quality improvement 2017/18 Following an engagement programme and discussion with the Trust Board, the areas of quality improvement for 2017/18 are: Improve the consistency and capability of clinical care in community services Patient Experience - Improving the way we collect and make use of feedback Preventing suicide Reducing violence and aggression Improving physical health for service users Improving supervision for staff Improving safety reduce level of serious self harm and suicide - Initiatives included introducing the family liaison service. We also developed desktop reviews and a tool to enable regular reviews of themes and trends. Safety: reducing violence We continue to perform root-cause analysis following serious incidents. This informs any changes to process, policies and training. We co-produced a Making safeguarding personal report and set up the reducing restrictive practice group to ensure we adhere to latest national guidance and best practice. Making life better together

10 Annual Report Summary 2016/17 Our workforce Staff attitude survey results The annual NHS Staff Survey is intended for NHS organisations to review and improve staff experience so they can provide better patient care. Our response rate for the 2016 survey was 52.5% up from 44.2% last year. The average response rate for mental health trusts was 46.1%. In comparison with our 2015 results, we improved in three key findings. The findings where we have improved are: % of staff appraised in last 12 months Fairness and effectiveness for reporting errors, near misses and incidents Effective team working Our staff engagement score, rated between 1 (low) and 5 (high), was 3.68. This is an improvement on 2015 and is in line with the average for mental health trusts. We will be undertaking further work and exploration of the reasons behind staff working extra hours, and whether this has been affected by our work to reduce agency spend across the organisation. Overall, while we have a lot of work to do to improve overall staff engagement, we were the second most improved mental health trust in this year s survey. Workforce performance We monitor key performance measures across our staff monthly. The workforce performance summary 2016/17. Workforce Metric Target 2016/17 Sickness rate 4.6% 4.4% Mandatory Training 95.0% 82.0% Turnover 15.0% 15.0% Vacancy 12.4% 18.3% We have introduced a staff supervision metric for 2016/17 after feedback from the CQC. We have set an 85% threshold of staff to receive supervision every six months. Compliance was achieved in August 2016. However, performance has since dipped a little and an action plan to recover the position is in place. The vacancy rate for the year was higher than the target, though the position improved in the final quarter. Staff turnover decreased during the year. www.swlstg-tr.nhs.uk

South West London and St George s Mental Health NHS Trust 11 Financial Strong financial Review 2016/17 management Making life better together

The Trust Board The Board leads the Trust and provides a framework of governance within which high quality mental health and social care services are delivered to the communities we serve in south west London and nationally. Chief Executive and Chairman Chief Executive David Bradley Chairman Peter Molyneux Executive Directors Non - Executive Directors Medical Director Mark Potter Director of Nursing and Quality Vanessa Ford Director of Finance Philip Murray Non - Executive Director Barbara Greenway Non - Executive Director Dr Ali Hasan Non - Executive Director Jean Daintith Director of Strategy and Commercial Development Suzanne Marsello Interim Director of Clinical Services Eileen Doyle Director of Communications and Stakeholder Engagement Ranjeet Kaile Non - Executive Director Professor Andy Kent Associate Non - Executive Director Sola Afuape Non - Executive Director Jonathan Thompson The following were also members of the Board during the year: Dawn Chamberlain Chief Operating Officer Emma Whicher Medical Director Michael Parr Director of Finance & Performance Director of HR, OD and Workforce Transformation (Job share) Asha Hoque Director of HR, OD and Workforce Transformation (Job share) Alfredo Thompson Trust Secretary Tamara Cowan Non - Executive Director Richard Flatman Mandy Stevens Director of Nursing & Quality Standards Dave Tomlinson Interim Director of Finance & Performance Clive Field Interim Director of Finance & Performance Non-voting members Our values South West London and St George s Mental Health NHS Trust Springfield University Hospital, 61 Glenburnie Road, London SW17 7DJ Telephone: 020 3513 5000 Website: www.swlstg-tr.nhs.uk Copyright 2017 South West London and St George s Mental Health NHS Trust Published and distributed by: Communications Department Connect with us @swlstg