My visit to the children's community nurses in Heywood, Middleton and Rochdale

I recently went to visit the Heywood, Middleton and Rochdale (HMR) children’s community nurses based at Callaghan House in Heywood.

For background, the nurses are part of our HMR Children’s Acute and Ongoing Needs Service, which was launched in September last year to bring together a range of community services for children and young people and make them accessible through a single point of access (SPOA).

During my visit, I was keen to see how the team was finding the new service arrangement. I was pleased to hear that the bringing together of the children’s specialisms in the borough is working well and seems to have improved access to support through the one telephone number.

I also wanted to find out about the team’s experience of mobile working. The children’s community nurses were one of our pilot teams for adopting mobile working and PARIS – our electronic patient record – and it’s proved very successful. Lisa Hufton, the service lead for the Children’s Acute and Ongoing Needs Service, is a real advocate of the system and of the new mobile devices the team are using to allow them to update electronic records while they are out on visits.

We have to acknowledge that the implementation of PARIS across the Trust so far has not been without its challenges so it’s positive to hear from a team who have adopted it successfully and are seeing real results. We’re at a stage where around 25% of the Trust is using PARIS and further support is needed to continue the roll out to the remaining 75%. 

We’ve invited Lisa to attend an upcoming session with the Board to demonstrate how PARIS and mobile working has worked for her team, share some of the obstacles they faced, and join the discussions about the investment needed to complete the roll out.

Another highlight of the visit was learning of the partnership work the nurses are doing with Greater Manchester Fire and Rescue Service (GMFRS). It involves the staff referring families to GMFRS if they may benefit from health and wellbeing checks which include fire safety advice and accident prevention. The partnership works both ways, with GMFRS contacting Pennine Care if they come across any families who may benefit from health support. I know this is happening in other service areas but I’m keen to see if happening consistently across the Trust so have put Lisa in touch with our Fire Safety Manager to share this best practice.

I just want to thank Lisa and her team for giving up their time to meet with me and for sharing their experiences.  

The exec team will be conducting more visits around the trust on a regular basis and will share updates with staff via the blog.

Thank you
Martin

Martin Roe, Chief Executive (Acting)

"I wasn't prepared for just how profound it would be" - my experience of a Schwartz round

I attended a Schwartz round last week as part of Mental Health Awareness Week.  I had some idea of what to expect but I wasn't prepared for just how profound an experience it would be. 

I was asked to join the panel, along with three other colleagues, to share our stories about when we have experienced a difficulty or pressure and how we came out the other side, linked to the theme of 'survive or thrive'.  

I can’t disclose the names of the people on the panel or their stories because Schwartz rounds are completely confidential sessions.  What I can say is that each person’s story was completely different but there was still something to relate to from each experience.  

This included feelings of parental guilt when balancing work and life, being overwhelmed by workload or expectations, dealing with a major incident and experiencing a crisis at home.  All of the stories were incredibly moving; I was taken aback by how every single one of us could relate to the notion of surviving or thriving, no matter what role or position, and this was felt by everyone in the room (around 40 staff members).  

It really was a powerful session and made me think more about my own mental wellbeing, as well as how we support staff across the Trust who are experiencing a difficult time at home or in work.  After all, we are all human and could do with reminding ourselves that work is just one part of who we are.

If you haven’t ever been to a Schwartz round before I really would recommend it.  You don’t have to be on the panel or participate in the discussion if you didn’t want to, you can still go and listen and hopefully learn something.  Teams and departments can also request a Schwartz round to address a particular theme or issue, just get in touch via: pcn-tr.schwartzround@nhs.net 

Staff wellbeing service 

The need for staff wellbeing services has been clearly identified across the Trust, with stress and mental health related staff sickness accounting for at least half of all occupational health referrals.  Last year, 115,882 working days were lost due to staff sickness! 

The staff wellbeing service was launched in September 2014 after the Trust decided to use our in-house expertise to deliver psychological therapies to staff, rather than outsourcing to an external provider. The aim was to deliver a completely confidential free service to all employees, offering a wide range of interventions to help support staff through mild to moderate psychological difficulties that were impacting on their functioning at work.

The service has proven to be a great success - 507 staff were seen during the first year, with 19% supported back in to work and 72% helped to remain in work.  The service now receives around 40 referrals on average each month. 

The Executive Directors have recently reviewed a business case to support the staff wellbeing service and based on the results, we were delighted to approve permanent funding to ensure it continues to provide vital mental health support to the workforce. 

If you want to know more about the staff wellbeing service, there is lots of information on the Trust intranet - you have to be on the network to access this link. 

Keith Walker

Executive Director of Operations

New Chief Executive appointed

As staff will be aware, Pennine Care has been undertaking a recruitment process to select a new Chief Executive over the last few months.  I am now pleased to announce that Claire Molloy has been appointed to the position.  

Claire has been the Chief Executive of Cumbria Partnership NHS Foundation Trust for the last four years.  The trust provides mental health and community services across the county of Cumbria, employing 3,500 staff.  Prior to that she held the position of managing director at Heart of England NHS Foundation Trust and has worked within primary, community and acute settings. 

It is anticipated that Claire will start in post from September.  In the meantime the trust’s existing interim leadership arrangements will continue.  

Claire was selected due to her proven track record as a Chief Executive, particularly at a trust providing mental health and community care across a broad footprint.  During the process, she demonstrated extensive experience of building strong relationships with partners in order to improve patient care and is passionate about staff engagement to build a strong and motivated workforce.  

All of these attributes are very much in line with Pennine Care’s strategy and values and I am confident that she, along with the executive team, will provide the trust with strong leadership into the future.

The selection process was thorough, involving staff, stakeholder and patient panels, as well as a final interview.  The appointment was ratified by the trust’s Appointment and Remuneration Committee, before being approved finally by the Council of Governors.

Commenting on her appointment, Claire said: “I am very much looking forward to working with everyone at Pennine Care and building on the fantastic work that is already taking place across the trust.  I believe this will be best achieved by working collaboratively with staff, patients and partners within each town.  I understand there are many challenges facing the trust and wider health and social care system across Greater Manchester, so look forward to overcoming them together.”

Staff and stakeholders will continue to be provided with updates regarding Claire’s appointment, as well as progress towards recruiting a new Chair in preparation for my term coming to an end in October.  

Thank you for your continued hard work and commitment. 

John Schofield

Chairman

My visit to the Bury Community Mental Health Team

I went to visit the Community Mental Health Team in Bury based at Humphrey House this week, it was a chance to learn more about what they do and understand the challenges they are facing.  

For those who don’t know, Community Mental Health Teams (often called CMHTs) support people living in the community who have complex or serious mental health problems.  This includes people with severe depression, anxiety, psychological difficulties and psychotic symptoms.  CMHTs are multi-disciplinary teams made up of mental health nurses, social workers, occupational therapists, support workers and consultant psychiatrists who work with the team.  

It was clear that the Bury team are incredibly committed to providing the best care they can to patients, but they are feeling the pressure of increasing caseloads and finding that patients have got more complex needs.  The team talked a little about how more service users are now using the illegal drug Spice, which seems to be a growing problem across Greater Manchester and has been widely reported in the Manchester Evening News recently.

Given that the clinical challenges are demanding enough, I formed the view that there is more that we can do to improve the working environment particularly in relation to medical records, IT and car parking.  I will be raising the issues at the next Executive Director team meeting with a view to prioritising better infrastructure support.

I just want to thank the team manager Dawn Parker and her team for giving up their time to meet with me and for their honesty in the challenges they are facing.   Their commitment to patients was clear to see and they have to make some really difficult decisions on a daily basis in order to keep people safe and manage the service effectively. 

The exec team will be conducting more visits around the trust on a regular basis and will share updates with staff via the blog. 

Thank you

Martin 

Martin Roe, Chief Executive (Acting)

Mental Health Awareness Week (MHAW) 2017 runs from Monday 8 to Sunday 14 May.

It is a national campaign by the Mental Health Foundation. This year's theme is ‘surviving or thriving’, which aims to shift the focus away from mental ill-health to explore how you can thrive in life with good mental health.

Visit the Pennine Care website for lots more information on mental health. 

Update from the Acting Chief Executive

The blog has proven to be popular with staff and so the Executive Director team have taken it over and will be posting regular updates.  Here is an update on some of the most important things happening within the Trust a the moment:

Strategic plan

The Trust’s five year Strategic Plan has now been approved by the Board. Overall, the strategy is working towards the delivery of whole person, place-based care. This broadly means we want all of our patients, carers and families to receive care that meets all of their mental, physical and social needs, but that this is arranged according to the needs of each town we serve. 

Where it makes sense, plans will be drawn up on a Trust-wide level and applied universally across all divisions but much of the work and innovation will be carried out locally in each town and may differ from place to place. The strategy also identifies what priority work needs to happen in order to support the delivery of the offer to the people and the place. Again these will apply both Trust-wide and locally as appropriate.

Whilst this is a five year strategy, the strategic objectives will be reviewed each year to ensure we are making progress and our approach still makes sense in the context of the everchanging environment in which we operate. The objectives for 2017/18 are currently being worked up and will be published when ready.

Ultimately the Strategic Plan describes how Pennine Care will ensure the services we deliver are safe and high in quality, whilst thinking about the whole person and the place in which they live.

A summary version of the strategic plan can be viewed on the Trust website.

Second CQC inspection announced 

Following the inspection outcome in December in which we were rated as 'requires improvement' overall, the Trust has now developed a detailed improvement action plan and revised Quality Strategy so we can move forward with the recommendations set out by the CQC.  

A joint Improvement and Transformation Board has been established to oversee progress. Many of the recommendations set out by the CQC require additional investment or a change in working practices that would need support from commissioners and other parties. Therefore, the Board includes representatives from the Trust and Clinical Commissioning Groups (CCGs), who have joint responsibility for the action plan.

The Trust has now also received notification that the CQC will be conducting a further round of announced and unannounced inspections, ahead of a well-led review of the Trust, which is planned for the week commencing 3 July 2017.  This is part of the new inspection regime for all trusts and Pennine Care is being included in the first phase.

It is anticipated that inspections could take place at any time up until that date, so we ask all services to be vigilant.  So much preparation took place last year for the full inspection, we are confident that most services will still be inspection-ready.  But if you have any concerns or queries, please do email pcn-tr.cqc@nhs.net 

Financial position 

The financial plight of the NHS is nothing new; the NHS nationally is predicted to have a deficit of £30 billion by 2020 and at a Greater Manchester level it is expected to reach a £2 billion deficit. All health and social care organisations are therefore required to find savings to close this £30 billion gap.

Staff will be aware by now that we find our required savings through cost improvement
plans (CIPs). In 2016/17 the Trust’s CIP target was £9 million, which we were able to achieve.  I know that it is incredibly difficult to find these savings within services, so thank you to the hard work and dedication of teams who have been through a CIP this year.

NHS Improvement also asked all NHS trusts to deliver a ‘control total’, which is a financial stretch target to try and reduce the national deficit. To achieve the control total for 2016/17, Pennine Care had to deliver additional savings of £0.9 million, which we have been able to do as a one-off without impacting on frontline budgets. For this, NHS Improvement provided the Trust with a financial incentive of £1.3 million to bring the control total to £2.3 million.

The financial plan we submit to NHS Improvement every year takes into account the amount of income we have, compared to our running costs (eg. pay, medicines and estates) which increase every year due to inflation. Because of this, we have to reduce our overall running costs to achieve financial balance, which we do through CIPs. However, Pennine Care already has some of the lowest running costs in the country, which means our services are already very lean and efficient.

Therefore, for the first time ever, the Trust has submitted a deficit plan for 2017/18 – we expect to only achieve £6.1 million of the required £8.5 million CIP and we are not planning to achieve a surplus control total of £2.3 million. The Board took the view that further savings could not be achieved in 2017/18 without compromising service quality and safety. It is important that we continue to work as efficiently as possible and where it is safe to make a CIP we will still do it.

The Trust is in discussions with commissioners, the Greater Manchester Health and Social Care Partnership and NHS Improvement about the financial position moving forward. We are in a better place than most trusts, the majority are already in considerable financial deficit and we are confident that we will be able to find a solution to prevent further financial problems in the future.

Thank you for taking the time to read the blog, if you want to hear about anything in particular, please email suggestions to ceo-penninecare@nhs.net 

Martin Roe
Chief Executive (Acting)  

Farewell from me...

So here it is my final blog as Chief Executive of Pennine Care!

I imagined I would only write that line at the point of retirement, but after 16 years in Pennine Care (and previously Stockport’s mental health services) I am moving on. Today is my last day and tomorrow I start my new role, as interim Chief Executive to lead the team to build a new Local Care Organisation (LCO) in the city of Manchester. There is a procurement process to go through before we can fully mobilise the new organisation, but its scale and ambition led me to agree to move to the new role.

On Friday night I went for dinner with the executive team and a few of my longest and closest colleagues, who have become friends over the many years we have worked together. Then last night I had a leaving presentation and was joined by many colleagues and friends, past and present. Martin Roe, our Director of Finance and Deputy Chief Executive, gave a speech which was both very funny and moving. Lots of jokes at my expense! The Chairman said some very kind words and I said a few words too. I must record my deepest gratitude for a number of very generous leaving presents, thank you everyone.

I would like to thank everyone for their support and hard work over the last 16 years. It was emotional to look around the room and see so many familiar faces. It reminded me what a great organisation Pennine Care is, we don’t enjoy the resources, profile or the support at times you see some trusts receive. What we do though, is deliver the best possible care we can manage with what we have. The hallmark of this organisation is the dedication of staff to provide high quality care and the collective values we all share to achieve the best we can. As a group of people we have always kept patients and carers central to our goals and ambitions. 

I am proud to have been apart of the many achievements we have had together. In my first blog over three years ago I said how proud I was to be given the opportunity to be the Trust's Chief Executive. I have carried that pride with me every day and feel lucky to have worked with such able, talented and caring people. It has been an absolute privilege and I hope we can stay in touch. I won’t be far away and I will follow the Trust's onward journey with great interest and support.

I would like to thank the Chairman, the Board and the Council of Governors for their support and sponsorship in my time at Pennine Care. Please keep pushing forward for ever better services for people who need our help, especially mental health to make sure it receives the attention and investment it needs and deserves. 

Whilst writing this final blog I have people calling in to say goodbye and also cards with lovely warm and emotional words wishing me well and saying goodbye. Today is a terribly sad wrench for me now that it comes to finally moving on and saying goodbye, it is a measure of the importance of the work we do, for it to attract such emotion and meaning between us all.

Pennine Care is a fantastic organisation and there will be a lot of interest in the Chief Executive post when it is advertised. I wish everyone all the best for the future, take care and good luck. It has been an honour to work with you all.

Thank you,
Michael 

Merry Christmas and best wishes for 2017

Staff will be aware that I am leaving Pennine Care in the New Year. I have been overwhelmed by the amount of people wishing me good luck and saying they are pleased for me. I have also heard the odd rumour or question as to whether my departure has anything to do with the CQC rating, or had I been positioning myself with the work I have done at a Greater Manchester level. Neither of these are true or accurate and so, having been at Pennine Care and previously Stockport mental health services for 16 years, I wanted to write a blog explaining why I am moving on.

The main feedback I have had following news of my departure is shock that after 16 years I was moving on, given I am seen to be synonymous with Pennine Care. There is also concern as to what this will mean for Pennine Care NHS Foundation Trust. This will be a brief blog in which I hope to address and answer three questions: is my move in anyway related to the Trust’s recent CQC rating? Have I been seeking other opportunities as part of my work at a GM level? What does this mean for the Trust going forward?

Taking each question in turn.

My move is not in any shape or form related to the recent CQC rating of Requires Improvement. I can understand why people might ask the question but there aren’t any links and it worries me that staff, patients or the public might think the recent rating by the CQC was significantly negative, because that just isn’t the case.

The CQC described our rating as a ‘Green’ Requires Improvement. If you read the report and look at the ratings there are many green and good ratings, we can be proud of what we have achieved. I am not trying to downplay the Requires Improvement rating, we must take the concerns raised seriously, I am just trying to provide some balance. Our CAMHS in-patient services were rated outstanding, which is a fantastic achievement, and no services were rated inadequate. Where we do Require Improvement, these are services we are actively supporting. An example of this would be the additional investment into our wards which we secured last year and have done again for 17/18.

Pennine Care’s CCGs have offered to set up a supportive Improvement Board, where we can collectively progress the action plan already in place. This support is very welcome and the CQC felt we should be able to secure an overall Good rating within a relatively short space of time. So there’s much more good news than bad, a lot to be proud of and not a reason to be moving on or be moved on!

Turning to why I am moving on. Staff work tirelessly for this Trust and for me as Chief Executive, so I thought it important to offer a personal explanation as to why I have accepted a new position. To give some context to my decision, over the nine years I was a Director of Operations and the three years I have been Chief Executive, I have been approached on a number of occasions encouraging me to apply for other positions and opportunities. I have always said no as I could never envisage a better opportunity than the one I have here at the Trust. I have loved my work at Pennine Care and am immensely proud to have led the Trust and served the six towns we provide services for. I believe in our strategy and feel we have really achieved a lot together. The Trust has a strong reputation and is viewed positively by the vast majority of stakeholders and those who use our services. We don’t get everything right but we can justifiably stand tall at the dedication of the Trust’s staff to deliver high quality and safe services.

In the last year or two, my profile as Chief Executive has been raised within Greater Manchester but I haven’t pursued this to position myself, as that just isn’t my style. All I want to do each day, and have done since I was a student nurse, is do the best job I can and try to make sure patients get the best care possible. As part of my personal objectives, I have had two in particular that I suspect have led to the opportunity I am going to. Firstly, I was tasked with influencing the Greater Manchester strategic case for health and social care to ensure out of hospital care and mental health featured in the GM strategy. I am pleased to say we definitely influenced themes 1 and 2 of the GM strategy developing (prevention and community services respectively) and we helped ensure mental health has secured its own strategic space. Secondly, during the bid for Manchester’s mental health services (which we didn’t win!) we learned the Trust’s profile and reputation wasn’t high enough. Again I was tasked with making sure the Trust was better positioned in the bid process we were pursuing. We definitely had the Trust’s qualities, values and capability showcased during the bid and received some overwhelmingly positive feedback. That said, we couldn’t compete financially, which I think ultimately left us unable to win the bid.

All of that work shone a light on Pennine Care and the great work we do. It also highlighted in the GM system the style and approach I take as a Chief Executive. Without a long winded explanation, the opportunity in Manchester and my leadership offer seemed the right fit. Once I saw the detail and the potential I have to concede I was unable to resist the challenge.

Third question: what next for Pennine Care NHS Foundation Trust? A change of leader can be unsettling and create some uncertainty. However, a leader is just one person and the Trust succeeds upon the efforts of many. Pennine Care is a valued member of a leadership community across six towns, helping lead the development of Local Care Organisations (LCOs) and as a leader for developing and implementing a mental health strategy. The Trust is valued based on all our collective efforts and this won’t be diminished by my moving on. My personal view is that the Trust has a strong future and the challenge ahead will attract a high quality leader as the next Chief Executive.

I would like to wish everyone a Merry Christmas and for those who don’t celebrate the festive season, a peaceful break and for everyone all the best for 2017.

Finally, a big thank you to all our staff who will be working during the seasonal period. I want to personally acknowledge the work you provide to keep services open 24/7, 365 days a year and the vital support this provides to people with health and social care needs.

Best wishes to everyone and I will blog in the New Year to reflect on the many achievements we have had together over many years, to celebrate the great work of the Trust as I move on to a new challenge.

Thank you,
Michael