We see you, we hear you

We can look at reports crammed with facts and figures that indicate increasing levels of pressure on staff and services, but nothing replaces seeing and feeling that pressure first hand.

To hear from frontline staff and service managers about the exhaustion, hurdles, challenges and worry they are facing is stark and sobering. It’s so raw and so real.

The strain that most of our services are currently under is abundantly clear. My service visit to Bury earlier this week, to see teams living and breathing these pressures, really hits home hard. I could have gone to any borough, I know it’s the same for all of you.

We may get a lot of information through our governance routes, but numbers can seem somewhat sanitized and, whilst they inform, they don’t have the same impact as hearing directly from people. They are like a photograph rather than a moving film.

So, I take, fairly and squarely on the chin, any criticism that directors haven’t been as visible as we should have been. We have tried, but it obviously hasn’t been good enough and for that we are sorry. 

Hopefully, with the scaling up of the Board’s service visit programme, we will be able to visit more services and hear directly how it has been for you and what we can do in support. 

Certainly, from the visits I have done over the last few months, I want to say loudly and clearly that I hear you, appreciate where you are and know how tremendously hard it is.

We went into this pandemic with historic chronic underfunding and all the difficulties that come with that. And that’s not just our opinion, as the Niche consultancy work clearly showed how bad it was and the huge pressure our workforce was under.

So, after 18 months of a shockingly brutal pandemic which has not only required us to overhaul the entire way that we work, but has added a thick layer of additional pressure on the system, you are of course utterly exhausted. We’ve got increased service demand, waiting lists and backlogs rocketing. 

This weight is pushing us from creaking to buckling in places and we urgently need to do whatever we can to support.

The national narrative for our colleagues in acute hospital services is one of ‘recovery’ with huge efforts going in to tackle bursting A&Es and long waiting lists for surgery and cancer. But, with 1.6 million people currently waiting to access some form of mental health service across the land, we need the same parity of esteem. That 1.6 million includes people waiting for psychological services; to be allocated a care co-ordinator; for CAMHS services, eating disorders and ADHD; and the list goes on...

The case for equal priority is screaming out loudly.

There is thankfully now recognition that the pandemic has had a significant impact on mental health services, with national leads fighting for funding in the Autumn spending review on a par with the acute sector. We actually got to a good position with our local commissioners before the pandemic, helped by the Niche work, but this is about the entire system – nationally, regionally and locally - weighing in with its joint support.

There’s no easy fix I know, as this isn’t just about money. A big fat cheque can’t magic up clinical staff, for example. It’s going to take innovative thinking and effort in a sustained way on these issues. 

So, we are working with service managers to develop stabilisation plans as a matter of urgency to address our most critical areas, while we also work with partners and the wider system to develop longer term plans. There will no doubt be some tough discussions along the way, but we have to have these.

I was very grateful to everyone I met within Bury, when I spent the day there, for being so honest and sharing their experiences of the last 18 months and how it is feeling right now. 

Of course, I heard some immensely worrying things about just how stretched services are at the moment, but I also heard some great stories of achievement by all the teams and came away feeling more hopeful than hopeless, more inspired than helpless.

I appreciated how tired and under pressure everyone was, and will always feel concerned about that, but the leadership and desire to change things by the teams really struck me.

Donna Edgley, one of the managers I chatted with, was keen to strike a balance between the concerns and the positive things the teams are doing. As she said, “We are up for it and motivated, not crying in a bucket”.

I keep thinking about that quote, because as I chatted to staff and patients, some of the achievements were clear. I saw the upgraded Ramsbottom Ward after the eradication of dormitories, looking fabulous and really dementia friendly. There’s outstanding work between our community mental health services and integrated neighbourhood teams, as older adults and access teams work together; and great collaboration between mental health liaison and A&E. 

I heard about some fantastic research projects in psychological therapies and was also invited to the Moving Forward group at our Hope and Horizon unit, so look forward to hearing more about the positive things they are doing.

What struck me most, was that while the challenges are huge, people do have ideas and ways of tackling them. However, there is a level of frustration that it’s not always easy to take these forward, especially in the recruitment and retention of staff. 

While we are limited in our ability to influence the national funding picture or to address national staffing gaps, if there are improvement ideas that are within our gift as an organisation to implement, then we absolutely need to do this. There is surely a lot we can do on recruitment and retention incentives, as well as making the process easier and quicker.

So, I know you are working your socks off. I felt the intensity and the relentless, gruelling pressure you are under. 

You are possibly going through your toughest time of the pandemic, right now. 

We see you, we hear you, and we will do everything we can to support you.

Best wishes,

Claire

You can follow me on Twitter @ClaireMolloy2