The Healthy Staffordshire Select Committee Joint Health Scrutiny - - PDF document

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The Healthy Staffordshire Select Committee – Joint Health Scrutiny Accountability Session

5th September 2016

Sir Stanley Matthews

Stoke City F.C. was home to Sir Stanley Matthews, the

• nly footballer to ever be

knighted while playing

Alton Towers

The country’s favourite theme park, water park and hotel complex

The Potteries

The world famous Potteries of Stoke-

• n-Trent helped drive the expansion of

6 towns during the industrial revolution

Oatcakes

One of the most iconic products of the area. Great with bacon and cheese

Musical Talent

Robbie Williams of Turnstall and Slash of Hanley would go on to become two of the worlds best known artists

Interesting facts about North Staffordshire & Stoke-on-Trent

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deprived

Stoke bottom 10% most Area nationally and deteriorating

Life expectancy least v most deprived areas reduced by nearly 7 yrs women & over 5½ yrs men

CHALLENGED

HEALTH

ECONOMY

– legacy Mid Staffs

Some other interesting facts about North Staffordshire & Stoke-on-Trent

Our Trust

41

Sites Work across We are a key partner in the STP providing leadership on

Mental Health Digital System leadership/OD

£84m

annual income

Substance Misuse Learning Disability Children and Young People Neuropsychiatry and Older People Adult Mental Health – Inpatient Adult Mental Health – Community

6

Directorates

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Our Board

Executive Directors Non-executive Directors Additional Members

Our Approach

To be an outstanding organisation delivering safe, personalised, accessible and recovery-focussed services & support, every time.

Our Vision – What we want to achieve

The way we behave

(developed with staff)

Our Values

The way we deliver services

Our Quality Priorities

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Strategy with ambition

1 Our continuing journey of improvement

Quality

2

Service User and Carer Engagement

3

Staff Engagement

4

Strengthening Partnerships

5

Digital by Choice

7

Openness and transparency

8

Strengthening Governance

6

• 1. Strategy with ambition

Third sector

Enhance relationships with voluntary sector Deliver seamless care with voluntary sector services Enhance self care model alongside the voluntary sector

Social care Primary care Secondary care Specialist mental health

Alignment of Council and Trust LD functions Total health economy demand mapping and provision Repatriate services into health economy Develop specialist centres of excellence Expand model to broader collaboration and enhance every service user contact Develop predictive tools and capacity to respond Locality based mental health teams aligned with GP practices (MCP) Integrate care model with primary care, social care and third sector Locality based capitated budgets and needs assessment Develop emergency mental health services to 24/7 Reduce emergency attendance and admission rate per capita In collaboration with secondary care increase out of hospital provision

Quality strategy Digital Workforce planning and development

“The plan sets out a clear vision and milestones for 2016/17 which draws on the Trusts own 5 year strategy, the local transformation priorities identified in the STP and links to national priorities including the 5 Year Forward View”

(NHS Improvement, August 2016)

“The plan sets out a clear vision and milestones for 2016/17 which draws on the Trusts own 5 year strategy, the local transformation priorities identified in the STP and links to national priorities including the 5 Year Forward View”

(NHS Improvement, August 2016)

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• 2. Quality ‘SPAR’

Ligature Risk Reduction Plan

£273k £273k £273k £273k

spent and further work

Safe

£1.5m

recurrent investment in

CYP staffing

following last CQC inspection

(23 additional frontline clinicians in post by end September with improved management and admin capacity)

40%

reduction in dispensing errors achieved

(Aug 15-Jul 16 to Aug 14-Jul 15)

Further development of the learning lessons framework - newsletter recognised as

best practice

by the WM Patient Safety Collaborative

Personalised

Complaints handling

strengthened

85%

Decrease

in people being taken to the Police Custody Suite

Mandatory person centred

care planning training

• 2. Quality ‘SPAR’

Assessment Care Environment Team (PLACE)

PLACE 2016 PLACE 2016 PLACE 2016 PLACE 2016 Cleanliness Cleanliness Cleanliness Cleanliness % % % % Food and Hydration Food and Hydration Food and Hydration Food and Hydration Privacy Privacy Privacy Privacy Dignity Dignity Dignity Dignity and and and and Well Well Well Well Being Being Being Being % % % % Condition, Condition, Condition, Condition, Appearance Appearance Appearance Appearance and and and and Maintenance Maintenance Maintenance Maintenance % % % % Dementia Dementia Dementia Dementia % % % % Disability Disability Disability Disability (new for (new for (new for (new for 2016) 2016) 2016) 2016) Food Organisation Food Ward Food Organisation Organisation Organisation Organisation Average score Average score Average score Average score 99.60 97.20 92.97 99.88 97.54 98.44 96.26 96.48 National National National National Average score Average score Average score Average score 98.06 88.24 87.01 88.96 88.16 93.37 75.28 78.84

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Accessible RAID

Performance

(4 hours – 96%, wider referrals same day – 90%)

Access Service non-urgent waits -

9to1

weeks

Early Intervention in Psychosis target hit for 6 consecutive months June 2016 performance

73%

• 2. Quality ‘SPAR’

Memory Clinic Diagnosis rates – Best performing

Trust in the North Midlands 87.9%

IAPT IAPT IAPT IAPT England Target England Target England Target England Target Our performance Our performance Our performance Our performance 6 weeks 6 weeks 6 weeks 6 weeks 75% 98.5% 18 weeks 18 weeks 18 weeks 18 weeks 95% 100%

Recovery Focused

Shared care service

– Ward 4

60% reduction in Nursing Home admission 20% increase in discharge to home

LD LOS reduced by

75%

in past 18 months

STEP ON

employment scheme 89 jobs secured for service users

• 2. Quality ‘SPAR’

IAPT

Recovery rates improved from

36% April 15 to

61%

June16

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• 3. Service User & Carer Engagement

Service User and Carer Council Young Peoples Council New Parents Council

• 3. Service User & Carer Engagement

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• 4. Staff Engagement

CEO Blog

44 Quality Improvement

Teams under Listening into Action (LIA)

Aston Team Development –

93%

• f teams have commenced

their Aston journey with

75%

showing an improvement from their ART+ 1 baseline score Assertive Recruitment Campaign – reduced clinical vacancy rate from

11% (May) to 5.7% (Aug) with 3.5% (42.7)

awaiting commencement

• 4. Staff Engagement

Staff Survey Highlights

81%

Average or Above (2014 – 48%)

Improved in

majority of areas experiencing experiencing experiencing experiencing

harassment, bullying or abuse from staff and patient The National Workforce Race Equality Scheme

Top performing Top performing Top performing Top performing Mental

Health Trust for BME staff

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• 4. Staff Engagement

LiA Analysis of 20 Picker Key Findings from the 2015 Staff Survey

• 4. Staff Engagement

LiA Staff Survey Results 2104-16

10 20 30 40 50 60 70 80 90 100 Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 Q10 Q11 Q12 Q13 2014 2015 2016

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• 5. Strengthening Partnerships

CYP

“Working directly with Combined has enabled a smooth transition for young people from Tier 2 to tiers 3 and 4 and back down resulting in the most appropriate and timely service – Younger Mind”

Adult Community

“The innovative work of Combined Healthcare with the city council has been extremely effective in improving the lives of the local community – Cooperative Working”

Crisis/Inpatient

“Working in partnership with the Trust has resulted in an 85% reduction in the number of people going to police custody on Section 136 – Staffordshire Police”

Substance Misuse

“The many benefits of the integrated partnership working between ADS and Combined include staff daily knowledge exchange resulting in swifter access and treatment for clients – ADS”

LD

“The excellent partnership working between Stoke Council and Combined is providing ease of access and reduced duplication through integrated person centred services for people with learning disabilities and autism.”

Older People

“The commitment from Combined to work in partnership with primary care to improve the lives

• f the population through new

ways of working is making a real difference - North Staffordshire GP”

• 6. Strengthening Governance

Board to Team

• Execs Q&A’s
• NED/Exec visits
• Team Brief

QSG score – 4 out of 5 External Audit CQINS

Board Assurance

Framework

Management of Management of Management of Management of

risk risk risk risk

Professional

Leadership

for all professions

“The Trust has strong governance arrangements which have been in place for a numbers of years and the revisions currently being made to the Board Assurance Framework should only strengthen those arrangements during 2016/17”

Internal Auditers RSM

“The Trust has strong governance arrangements which have been in place for a numbers of years and the revisions currently being made to the Board Assurance Framework should only strengthen those arrangements during 2016/17”

Internal Auditers RSM

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• 6. Strengthening Governance

– Professional Leadership

All Clinical Directorates have professional leads for: Psychology | AHP | Nursing | Medicine | Social Care Clinical Directorate Professional Leads are all members Nursing Director Medical Director Nursing AHP Social Care Psychology Medicine Pharmacy Quality Committee People and Culture Development Committee Professional Leadership Advisory Group

• 7. Digital by Choice

Ambition to be

national exemplar

£15m investment

in EPR - ROSE

All sites wireless Digital Innovations

Autographer + Flo Deaf Awareness

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The Golden Thread from Board to Ward

2015 2015 2015 2015 2016 2016 2016 2016 2017 2018 2017 2018 2017 2018 2017 2018

Paper based Paper based Paper based Paper based records records records records Integrated Integrated Integrated Integrated Care Record Care Record Care Record Care Record CHIPS CHIPS CHIPS CHIPS Lorenzo Lorenzo Lorenzo Lorenzo

Current records CHIPS Paper case-notes

Trust initial assessment Trust initial assessment Trust initial assessment Trust initial assessment

• Trust Risk Assessment & Management v4.0

Trust Risk Assessment & Management v4.0 Trust Risk Assessment & Management v4.0 Trust Risk Assessment & Management v4.0

• HoNOS

HoNOS HoNOS HoNOS/Clustering /Clustering /Clustering /Clustering

• CPA care planning & review

CPA care planning & review CPA care planning & review CPA care planning & review

• Standard care planning & review

Standard care planning & review Standard care planning & review Standard care planning & review

• Community referrals, contacts & discharge

Community referrals, contacts & discharge Community referrals, contacts & discharge Community referrals, contacts & discharge

• In

In In In-

• patient admission, leave & discharge

patient admission, leave & discharge patient admission, leave & discharge patient admission, leave & discharge

• MDT meeting and day to day notes

MDT meeting and day to day notes MDT meeting and day to day notes MDT meeting and day to day notes

• Intervention plans

Intervention plans Intervention plans Intervention plans

• Observation charts

Observation charts Observation charts Observation charts

• Team/profession specific assessments

Team/profession specific assessments Team/profession specific assessments Team/profession specific assessments

• Correspondence letters sent/received

Correspondence letters sent/received Correspondence letters sent/received Correspondence letters sent/received

• Mental Health Act forms

Mental Health Act forms Mental Health Act forms Mental Health Act forms

• Prescription charts

Prescription charts Prescription charts Prescription charts

• Test results

Test results Test results Test results

• 7. Digital by Choice

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Electronic Patient Records Current systems in use by Directorate

AMH Inpatient CHIPS AMH Community CHIPS Care First Care First Care First Care First Stoke City Council* Care Care Care Care Director Director Director Director Staffs County Council* IAPTUS IAPTUS IAPTUS IAPTUS Healthy Minds Stoke CYP CHIPS LD CHIPS NOAP CHIPS Substance Misuse Nebula Nebula Nebula Nebula One Recovery HALO HALO HALO HALO Inpatients due to go live 29th Sep 2016

*Section 75 services *Section 75 services

• 8. Openness & Transparency

Dear Caroline

Dr Stephanie Cress

Junior Doctor Guardian

Jan Summerfield

Freedom to Speak Up Guardian

Safety Culture

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Capital Developments

Additional £273k to upgrade ligature compliance

£762k

upgrade in clinical environment to improve patient experience at Darwin Centre

(work still in progress)

£500k

upgrading Dragon Square to support CYP Directorate

£2.2m set aside for PICU build

(currently at planning permission stage)

Purchase of A&T Building for

£432k

Replacement of beds across AMH inpatient services and Darwin Centre with reduced ligature version C£60k

Development of business case for A&T upgrade –

C£1.2million

Our awards and nominations

Listening into Action (LiA) shortlisted in the HSJ Awards 2016 – Cultural Change and Improvement

(to be announced 23 November)

Ward 4 shortlisted in the Nursing Times Awards 2016 – Care of Older People

(to be announced 26 October)

LiA shortlisted in the Positive Practice in Mental Health Awards 2016 – MINDset Quality Improvement Awards

(to be announced 13 October)

HR and OD shortlisted in the Healthcare People Management Association (HPMA) Awards 2016 – Aston OD award for team-based working Aaron Parkes, Community Triage Mental Health Nurse shortlisted for the Royal College

• f Nursing’s Care on Camera

photography competition 2016 Julie Richardson, Residential and Resettlement Coordinator WON NHS Development Champion of the Year at the 2015/16 West Midlands Leadership Recognition Awards HR and OD shortlisted in the Healthcare People Management Association (HPMA) Awards 2015 – Aston OD award for team-based working/ Bevan Brittan Award for HR’s contribution to organisational change Community Triage Team shortlisted in the HSJ Awards 2015 – Value and Improvement in Mental Health Trust shortlisted in the NHS Leadership Recognition Awards 2014/15 – NHS Board/Governing Body of the Year

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Our awards and nominations

Chris Malbon, Intermediate Support STR & Julie Richardson, Residential & Resettlement Coordinator Nicky Griffith Access Service Manager Carolyn Wilkes Rehab Service Manager Dan Platt Ward Manager, Ward 6 New Beginnings User Group Substance Misuse Intensive Support Team Learning Disability Services

Recognition

“We are pleased to see that the Trust has been very pro-active since the CQC visit and has worked hard to improve the areas which were treated as requires improvement and we look forward to reviewing the outcome of the CQC’s return visit when they are conducting a further inspection in September 2016.”

Staffordshire Healthwatch

“We are pleased to see that the Trust has been very pro-active since the CQC visit and has worked hard to improve the areas which were treated as requires improvement and we look forward to reviewing the outcome of the CQC’s return visit when they are conducting a further inspection in September 2016.”

Staffordshire Healthwatch

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Thank you and questions

5th September 2016