Title: Report to: Executive Director of Patient Services Report Trust Board Date: 1 June 2015 Security Classification: Public Board Meeting Purpose of Report: This is a regular report to update the Board on Trust operational matters. The report is to inform and update the Board on the progress of key operational issues across the Service Lines. Recommendations: The Trust Board is asked to note progress made over the period November and December 2015. Report Sponsor: Andy Graham, Executive Director of Patient Services Report Author: Name: Andy Graham Title: Executive Director of Patient Services Tel Number: 020 8702 4196 E-mail: andy.graham@beh-mht.nhs.uk Report History: Budgetary, Financial / Resource Implications: Equality and Diversity Implications: Links to the Trust s Objectives, Board Assurance Framework and / or Corporate Risk Register Regular Report None. Equality and Diversity features in how the Trust will plan and deliver services. Links to the Board Assurance Framework summary (Trust Board agenda item) are indicated where relevant in the report. List of Appendices: None.
Report 1. Introduction 1.1 I am very pleased to present this report, the first in the new borough structure following the establishment of our new management structure teams. I would like to extend a warm welcome to those teams and to thank them for their excellent work through implementation and in setting their priorities for 2015/16. In support of our new arrangements, the Information Team has been working to develop the new format Integrated Quality and Performance report included as Agenda Item 2.2 in the Board Papers. This reflects a broader range of indicators than previously presented and at Borough and Specialist team level forms the cornerstone of our new Performance Management System. This will be in place in June and is built on joining up our conversation on quality, operational targets, workforce and fiancé to support our new management teams. The remainder of this report reflects some inpatient local issues. 2. Barnet Borough Services 2.1 Recruitment Recruitment to the Barnet management team is complete. This includes the substantive appointment of Dr Peter Dutton as Clinical Director. 2.2 Barnet Mental Health Liaison Service The Barnet Mental Health Liaison Service has been successful with an application to extend the 24/7 running of the service until the end of June 2015. Commissioners and the Acute Trust acknowledge the benefits of this service and better patient experience. The Trust will be working with commissioners to negotiate a longer term arrangements relating to this service. 2.3 Barnet Memory Service The Barnet Memory Service had some excellent news from commissioners who confirmed that the team had been key in enabling early detection of dementia in primary care over the previous 12 months exceeding the desired rate of 67%, which has enabled earlier mobilisation of care and treatment. 2.4 The Recovery and Enablement (RET) Enablement The RET approach has now launched in the Community Support and Recovery Teams in Barnet. Teams are building up their caseloads and delivering this highly personalised and outcomes focused approach for people in Barnet. 3. Enfield Borough Services 3.1 Adult Mental Health The Trust is recruiting to posts as a priority and has recently made appointments to team leader posts. Service manager posts are also in the process of being recruited. 3.2 Launch of the Barnet Borough Structure To launch the new Barnet Borough team, a half day event is being held at Forty Hall on 9 June for team leaders and senior clinicians. The programme will include table top poster
presentations by teams, the team s approach to Enablement, to inform one another of the team s broad range of community and mental health services and provide networking opportunities. In particular, connections are being encouraged across areas previously divided by Service Line boundaries to facilitate shared learning and improved clinical pathways. There will also be a short programme of presentations by senior leaders in the Trust to provide direction, foster leadership and inform on recent developments in activity and governance which will better enable our teams to perform at optimum. 3.3 Electroconvulsive Therapy (ECT) Service Accredited with Excellence The Trust s ECT department was recently audited by the Royal College of Psychiatrist s (RCoP) peer review accreditation scheme and achieved Accreditation with Excellence for the fourth time. Accreditation will run until March 2018. The RCoP described the team as well-staffed, with good team working, good communication and that the team takes pride in delivering a high quality service. The clinic facilities were also described as very good. 3.4 Care Home Assessment Team (CHAT) Shortlisted for Patient Safety Award CHAT is a multi-disciplinary team who work with 31 care homes in Enfield, providing expert assessment and treatment. The team have been shortlisted for the Patient Safety in Care of Older People Award as part of the Patient Safety Congress event, sponsored by the HSJ and Nursing Times. The team presented their innovative work to a panel of judges on 22 May and will attend the awards ceremony on 6 July in Birmingham. 3.5 Cornwall Villa Dementia Friendly Garden The Cornwall Villa Dementia Friendly Garden was officially opened on 22 May. This scheme was funded via the Dragon s Den initiative. The team are preparing a submission for the Building Better Healthcare Awards under the Dementia Design category. 3.6 Sexual Health Tender The Trust has arrangements in place, including a project team, to prepare the Trust s submission for the provision of Sexual Health. 3.7 Musculoskeletal (MSK) Programme Tender The Pre Qualification Questionnaire (PQQ) and Memorandum of Information has been released. A partnership group with the North Middlesex University Hospital, Royal Free Hospital, Royal National Orthopaedic Hospital has been established to provide a joint submission for this tender. The next stage of the procurement process is to submit the PQQ by 8 June 2015. The Invitation to Tender deadline for submissions is mid September with service commencement expected from 1 August 2016. 3.8 Enfield Child and Adolescent Mental Health Services (CAMHS ) The Trust is undertaking weekly liaison with the Enfield Clinical Commissioning Group (CCG) and Enfield Council with regards to the release of their Commissioning Strategy. The Trust has been informed that the Commissioning Strategy will take into consideration the work streams for the Governments Future in Mind strategy. This is new national guidance concerning the future direction for CAMHS. Additional funding has been signalled; the Trust has been advised that it is likely to be requested to submit bids at short notice. Additionally, there is potentially a small amount of additional funding for children s services via the Better Care Fund.
3.9 Universal Children s Service The Trust continues to make progress with the Government funded Health Visitor recruitment and training project. The Trust is required to recruit a further 28 Health Visitors before 1 September 2015. Plans are established and the Trust is pushing forward with this final recruitment drive. The CCG s will be handing all commissioning responsibility for Health Visitors and School Nurses over to the Enfield Council from 1 October 2015. 3.10 Cedar House The Trust is undertaking improvements to the environment for children using services at Cedar House in St Michael s Hospital. 4. Haringey Borough Services 4.1 In-Patient Services The first internal Quality Visit was completed on Finsbury ward. Managers are currently working through the outcomes of this, which will be feedback to improve standards of care for service users. The Manager of the Telephone Helpline (HUB) has been appointed. Anna Mbachu will be starting her new role shortly. 4.2 Haringey CAMHS A new Manager has been appointed to the Haringey CAMHS team. The Trust is working actively with Haringey CCG in their review of CAMHS. 4.3 Older Peoples Service Funding has been agreed via the Haringey Better Care Fund for two Community Mental Health Nurses for the Haringey Locality Team project in which the Trust is actively involved. The funding has been agreed for the period of a year and will be reviewed. Recruitment to the two posts is about to start. The CCG visited the Memory Services in all 3 boroughs. The Trust received very positive feedback about the services and recognition about the increasing demand. 4.4 Early Intervention Service The Trust is in the process of recruiting to the Early Intervention Service Manager post and two employment specialists within the Twinings project,one of which will be based in the Early Intervention Service. Their outcomes will help people with mental health problems into employment as well as making sure that people who are already in employment, remain employed. 4.5 Community Support and Recovery Teams The work on the operational pathway for the Recovery and Enablement Team (RET) has started.
5. Specialist Service Line 5.1 Eating Disorder Service (EDS) The EDS is working on a business plan looking at the EDS footprint in order to accommodate the growing outpatient clinical work. This also includes restructuring the service towards having 20 beds on Phoenix Ward which will help integrate inpatient, day programme and outpatient care pathway. 5.2 Police Liaison and Court Diversion The Trust is completing a service review of the local Wave 1 services to map services against the operating model and look to advance services ready for the move to Wave 2. In the Trust s joint project, with Central and North West London NHS Foundation Trust and 2gether NHS Foundation Trust, the Wave 2 service provision has started to extend services to young people and those with a learning disability across extended working hours. 5.3 London Pathways Partnership (LPP) The Trust continues its partnership in the LPP and has recently developed a website for professionals and service users, which holds information on services provided, helpful links to NHS Personality Disorder (PD) guidance, advice on managing difficult behaviours and an area for service user support. This can be accessed at www.lpp-pd.co.uk In addition to the community probation project, Mentalisation-based treatment groups and challenge treatments the Trust has recently been given additional funding for a community forensic psychology post, in order to make PD services in the Trust s quadrant comparable to the other LPP areas. Trust staff have contributed to the second version of the Department of Health s publication entitled Working with Offenders with Personality Disorder, a practitioner guide. This is due for publication in the coming months. 5.4 HMYOI Aylesbury Pathways Service The HMYOI Aylesbury Pathways Service has entered its second financial year funded through the OPD commissioners. The service is for high risk young offenders aged 18-21, with signs of an emerging personality disorder. The service offers a range of activities to help the young men progress through their sentence, addressing their needs in an individual way through outreach and longer term interventions. The Pathways service is also supporting the prison to establish Enabling Environments within two prison wings through the provision of a range of supportive activities, including structured and creative groups. 5.5 Prison Services Across HMP Brixton, HMP Aylesbury and HMYOI Feltham the services are looking specifically at how the Trust can learn lessons from incidents both in the service and nationally through published ombudsman reports. The Trust is actively working on action plans to mitigate against repetition of concerns. HMP Pentonville is integrating the increased in funding received in this year of the contract, new staff are joining the team and there is already an increase in therapeutic activities available as a result. HMYOI Feltham is working hard to achieve their accreditation with the national autism society.
Following the Trust s success in receiving funding from the NHS Innovation Fund last autumn, The Trust will be working with User Voice and Verve Communications to produce an Inside Guide. The guide is designed to be used in cells and has four sections related to coping in prison, keeping busy and finding meaningful occupations, self-management of mental and physical health concerns, and a section to assist in preparing for leaving prison. The guide has been written and is currently with copywriters, with a view to being published in the coming quarter. 5.6 The Beacon Centre A supportive learning event for staff was facilitated at the Beacon Centre in April following the Coroners Court Inquest held on 24/25 March. This was an opportunity for all staff to consider the issues raised and how lessons can be embedded in practice. A further embedding action day is planned for June and colleagues from the CAMHS pathway, Trust, NHS England, and other relevant agencies have been invited. 5.7 Medium Secure Inpatient Services A written report has recently been received for the North London Forensic Service (NLFS) Peer Review which took place on 24 and 25 February 2015. Areas commended included the range of therapeutic activity and psychology services, positive management culture, service user engagement at many levels and good staff / service user relationships. Areas for development were noted as upgrading works required to seclusion rooms on Devon Ward and Regent House, greater user involvement in Care Programme Approach, personalisation of bedrooms and continuing maintenance of the physical environment. Self-catering is identified as a key area of development for the NLFS for 2015/16. Recent contractual negotiations have established options for recharge in relation to meals not required by wards and the delivery of raw ingredients only. Blue Nile House is set to become entirely self-catering from July 2015, and it is envisaged that this will be extended to other Low Secure Unit environments later in the year. Self-catering will also be developed further within the Medium Secure Unit wards. 5.8 Smoking Cessation Working in liaison with the Forensic Services of West London Mental Health Trust and East London NHS Foundation Trust, the NLFS is continuing towards smoke-free status by 18 January 2016. A Working Group has been established along with a timeline setting out the actions required in the lead up to the start date. On 27 March 2015 an event to launch the Countdown to Smoke Free was successfully held with colleagues from South London and Maudsley NHS Foundation Trust Forensic Services. 6. Budgetary / Financial Implications Implications 6.1 There are no budgetary / financial implications as a direct result of this report. 7. Risk Management 7.1 There are no risk management implications as a direct result of this report. 8. Equality and Diversity Implications 8.1 None.