Agenda item

 Andy Rogers, Chief Operating Officer and Simon Africanus Rowe, Patient Experience Lead, Camden and Islington Mental Health Foundation Trust were present and outlined the report, during which the following main points were made-

·         The focus has been on patient safety and quality of care and as a result of consultation with all stakeholders, including patients, a list of 9 priorities were identified

·         There have been 3 key areas where significant achievements have been made and with regard to patient safety a comprehensive risk assessment had been introduced. Staff had been upskilled, and staff trained to a level that is more than satisfactory. In addition, poor health outcomes for people with serious mental illnesses has been reduced and the Trust has promoted safe and therapeutic ward environments by preventing violence

·         In addition, physical as well as mental health was assessed, as it is known that psychosis often develops at an early age, and the Trust has introduced a holistic health care package In addition there is now more communication with GP’s

·         Work is also being carried out with those patients that present at A&E and how families and patients can be made comfortable when presenting there. Service users and staff have been engaged in suicide prevention strategies

·         There have also been efforts to engage with other services and staff to develop an information strategy, and the Trust has worked with stakeholder and the NICE guidelines have provided a framework for this. In terms of patient experience progress has been made. However there are sometimes difficulties if there is no next of kin listed

·         With regard to clinical effectiveness the Trust is looking at working holistically with patients, and has developed an integrated practice unit, where signposting, mental health screening etc  can take place. In addition care plans can be reviewed and assessed to get a suitable care plan in place

·         In relation to safeguarding, the Trust has identified approaches that can be used to identify risk and take appropriate measures under the Mental Health Act

·         The overall CQC rating for the Trust is good, and it has taken a great deal of work for the Trust to achieve this rating

·         The Trust has also instituted a Recovery college, and this is doing well and serves service, users, staff and the public. A Women’s Psychiatric Intensive Care Unit has been introduced

·         As previously stated the Trust has identified 9 priorities, which all involved have signed up for and service users and carers are essential to this

·         A Member referred to the improvement of health and wellbeing of NHS staff, and that in quarter 4 this had not been met. The Trust responded that there had been an improvement, however staff, because of the challenging nature of the job that they did, suffer a lot of stress. The Trust recognised that there was still more to do

·         Reference was also made to the prevention of ill health by risky behaviours by tobacco and alcohol targets were not met in quarters 3 and 4 and it was stated that the Trust had decided to integrate physical and mental health. It was recognised that this is an ongoing issue, but the Trust felt confident that this was a reporting issue primarily, and internal monitoring is taking place. However it is recognised that this is an area that the Trust need to focus on. This is particularly important given vulnerable patients

·         Discussion took place as to talking therapies for those patients at medium risk and that there is a disparity in these services being accessed by BME groups

·         It was noted that BME groups tended to present later and at a more acute stage, and tended to suffer from poorer mental health. BME groups are less likely to access IAPT services, however the Trust felt that their services are accessible to all communities and work is taking place between the CCG and GP’s, to identify and refer on patients with mental health issues

·         Members expressed the view that strategies for BME to access services should be looked at further

·         Reference was made to the fact that the management profile of the Trust needed to be more ethnically diverse, and that more work needs to be done on this

·         A Member referred to the number of deaths and the Trust stated that any death is unfortunate, but in their view these were not disproportionate, and in addition Islington has one of the highest rates of mental health problems in England

·         A Member referred to the use of volunteers and peer support workers and that peer support workers did often take up posts at the Trust. The Trust stated that they would provide details of the peer support programme to Members

·         In response to a question it was also stated that there is a BME service user group

·         The Trust recognised that better communication with families is needed with families after serious incidents occur, and this is a priority for the Trust. Where such incidents do occur the Trust need to be honest and discuss this with the family,in order to learn lessons for the future

·         A Member congratulated the Trust on the removal of ligature points

·         Reference was made to the staff survey and that 32% of staff had identified problems of bullying/harassment. The Trust responded that the CQC had identified that the Trust had a high level of agency staff, and the Trust recognised this needed to be addressed.  However there are areas where staff morale can be improved by simple remedial measures, such as repairs to the building and general tidying up. In addition, mandatory training for staff will be taking place

·         The Trust are clear that they will deal with any issues of bullying/harassment, however it is recognised that some staff felt that the Trust did not take this seriously enough. The Trust has put in place the ability for staff to talk to guardians and senior staff in confidence and there is a BME member of staff who can be talked to. Some staff had been trained to be bullying/harassment champions

·         The Trust stated that they felt that the issue of bullying/harassment is mainly a historical one, and a number of BME staff, who had been employed for a long time, had not yet recognised the changes that have taken place

·         In response to a question as to bullying of staff by patients and families, the Trust stated that it would not tolerate this and having a  mental health issue did not excuse this. Staff training has also taken place on how to deal with patients and the public, and the Trust were looking to develop pathways to support staff

·         In response to questions from the Chair, it was stated that in relation to Police powers to remove people with severe mental health problems from the street, The Trust had capital growth to develop facilities on site in a few years time. In addition, mandatory training had been introduced and such training had achieved over target levels. The Trust were also improving recruitment, however the vacancy on acute wards needed to be improved, but it had to be recognised these were difficult places to work for staff

RESOLVED:

That the Trust circulate details of the peer support worker system to Members of the Committee

The Chair thanked Andy Rogers and Simon Africanus Rowe for their presentation