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Board summary - September 2023

Notes

The meeting started with Mark Yates, Chair and Sarah Dugan, Chief Executive giving thanks to Jamie Morris, Non-Executive Director who leaves the Trust in around 6 weeks. The Board thanked Jamie for his commitment and service to the Trust over the last 7 years, including his work chairing the Mental Health Collaborative Committee and partnership focus which has been crucial in the success of our journey to date.

Positive news and assurance

  • Initial assessment of our estate has not identified the use of reinforced autoclaved aerated concrete ( RAAC) within any of our buildings, however, due to the new guidance a further in-depth survey is being conducted to gain further assurance RAAC is not present across our sites.
  • The Trust and University of Worcester (UOW) has signed a Memorandum of Understanding (MOU) which reflects our new partnership to advance health research in the region. We already have strong existing relationships with the University and this MoU strengthens our commitment to enabling research in particular and nurturing our next generation of health researchers, through training and knowledge exchange
  • Following an independent fidelity review into the Worcestershire IPS (Individual Placement) service, the team have been assessed as ‘Good’.
  • The Trust’s IT Team have retained their Cyber Essentials + certification
  • The Worcestershire ECT service received an award for ‘best patient experience’ from the Royal College of Psychiatrists Electroconvulsive Therapy Accreditation Service (ECTAS) in recognition of best practice.
  • The last remaining dormitory style accommodation has now been removed from our mental health wards in Worcestershire. Both wards, located within the Elgar Unit in Worcester have been redeveloped and now boast modern, private bedrooms for patients, complete with ensuite bathroom facilities. A similar programme of work continues in Herefordshire and is due to complete in Autumn 2024.
  • Work continues in relation to our workforce challenges including key initiatives such as international nurse recruitment, career conversations to improve retention, increased activity and focus in relation to apprenticeships and bespoke recruitment events.
  • Mental health crisis service for children and young people has been extended to a 7 day service, available until 8pm daily.

Matters of concern

  • The nationally funded Herefordshire and Worcestershire Mental Health and Wellbeing Hub, which offered wellbeing support and signposting to staff working in health and social care roles across the two counties closed on 31 August 2023. There is work underway to identify a potential collaboration with regional partners. The Trust continues to offer a comprehensive wellbeing package to staff through our internal Staff Health and Wellbeing Team.
  • Staff sickness levels and appraisal completion rates remain of concern and below-expected targets. Managers are encouraged to undertake wellbeing conversations with their staff during supervision and sign-post to the different support measures available.
  • This year the Trust needs to save £7.4m on its planned spending, this part of the NHS saving target which applies to all NHS organisations and reoccurs each financial year. At month 4, the Trust has delivered a £794k surplus (saving), £169k below plan. The finance team are investigating areas of overspend with budget managers. More information on our savings target is available in the Summer 2023 finance update, shared with staff on 20/7/23.
  • We continue to manage and prepare for industrial action, together with system partners. Although the direct impact so far on the Trust has been minimal, it should be noted that a large amount of elective activity across the system has been displaced.
  • Following the Carenotes outage, we have found large numbers of duplicate patient episodes have been created. At present this is not believed to be causing any direct care issues, but is hampering efforts to restore accurate performance and management data in some services. A task and finish group has been established to tackle this problem.

Updates

  • NHS England has recently issued its Framework for the Fit and Proper Person Test (“FPPT”) for board members. The Framework provides guidance to NHS organisations about the steps they must take to comply with and comes into effect on 30 September. We are reviewing our practice to ensure that we adopt the additional checks and utilise the template for references for Board members. Gill Harrad, Company Secretary is leading this review in conjunction with Mark Yates, Chair.
  • We continue conversations with Trust Directors and our Freedom to Speak up Guardian to agree to strengthen and enhance our arrangements for speaking up. These actions will be integrated into the CQC Improvement plan. As an organisation we are fully committed to having an open culture where all staff feel safe to raise concerns and be confident their concerns will be addressed accordingly.
  • Sarah Dugan, Chief Executive announced plans to retire in April 2024 after 41 years working in the NHS and 12 years as Chief Executive at this Trust. The process to recruit Sarah’s successor is underway.
  • We continue to wait for our full CQC report, in the interim we are focusing on implementing our improvement plan. This activity is being led by Scott Parker, who has joined the Trust on an interim basis as our Improvement Director.
  • The concerns on Hillcrest continue to be mitigated and controlled through the operation of the Hillcrest Improvement Plan. The ward environment and staffing levels have improved, though concerns remain around the constraints of the building, which is not overall well-suited to delivering acute mental health care at scale and lacks resilience. Informal conversations with staff about the future of acute care provision in Worcestershire have commenced. The outputs of those conversations will lead to formal proposals for Board decision, public engagement and staff consultation.
  • A draft version of the Equality Strategy has been shared with the executive team and the final version is due to be shared ahead of Board in November.
  • From April 2024, people needing urgent mental health advice and support in England will be able to contact NHS111 and be put through to their local urgent care helpline. This pathway is being introduced nationally and will launch softly in December 2023, ahead of the formal go-live in April 2024. The existing number for the Herefordshire and Worcestershire 24 hour urgent mental health helpline will also remain active for patients wishing the contact the team this way.

Decisions made

  • We formalised our commitment to eradicating sexual harassment in the workplace by pledging to the NHS Sexual Safety Charter. The Board is committed to developing a zero-tolerance approach to any unwanted, inappropriate and/or harmful sexual behaviours towards our workforce. Where any of the principles are not currently in place, we’re will ensure we’re fully compliant by July 2024.