"We’ve come a long way and I’m thankful for that" - reflecting on LGBT Pride Month

As you may be aware, every June is the official LGBT Pride Month in celebration of people of lesbian, gay, bisexual, transgender and other gender minorities. 

Celebrations happened around the world and across the UK in commemoration of the Stonewall riots of June 28 1969. This year holds extra significance as the 50^th anniversary of the decriminalisation of homosexuality between men in England and Wales, which forms the foundation of LGBT equality across the UK.

As a gay man myself, I have taken some time to reflect on how far we’ve come as a society and the progress that has been made, from the persecution and prosecution of men before the 1967 act just for being who they are, moving towards a society where men and women are free to marry their chosen partners and be recognised in law, enjoying equal rights; and a UK Parliament that has 45 openly LGBT MPs.

We’ve come a long way and I’m thankful for that and ask that all of us, no matter our gender, gender identity, preferences or views respect all, treating everyone as equals and enjoy the rich diversity of our work colleagues at Pennine Care.

If you would like to get involved we are supporting Manchester Pride this year, as we do every year.  We also have Equality & Diversity and LGBT Network Groups that also meet regularly, which welcome all staff.

Please contact Michelle England, staff side representative or Kirsty Hood, senior HR business partner, for further details. 

Thank you.

Jose Fernandez

Director of Workforce and Organisational Development

An example of integrated care – my visit to ORCAT

We hear a lot about health services changing to become more ‘integrated’. Put simply, this means working closely together so the care patients receive is more joined up.

At Pennine Care, we are working with partner organisations across our footprint to integrate more services and improve patient experience. I recently visited the ORCAT service – a perfect example of this.

ORCAT (or Oldham Rapid Community Assessment Team) was set up by the Oldham Urgent Care Alliance. Pennine Care is a key member of the alliance, which is a partnership of 10 health, care and voluntary sector organisations developed to improve outcomes for local people by enhancing current services.

ORCAT works closely with colleagues at The Royal Oldham Hospital, including those in the A&E department, to react quickly and prevent people from being admitted to hospital if they can be supported at home with the right professional help. Once at home, the team takes a partnership approach to assessment and care planning to understand what level of support the individual may need to live as safely and independently as possible.

It consists of therapists, nurses, health care assistants and mental health practitioners from Pennine Care NHS Foundation Trust, social workers from Oldham Council, and a Promoting Independence in People (PIP) support worker from Age UK Oldham, who have been brought together to work as one multi-agency team.

As well as preventing people from being admitted to hospital by identifying them early, the team works closely with hospital-based nurses, doctors, discharge coordinators and the RAID mental health liaison team to also support patients who have been admitted to the wards who could be discharged early with the support of the service. 

I met with three members of the team - Cathy, Rachel and Claire – as many others were out and about supporting people at the hospital or in their homes.

It was a really good afternoon; we talked through the service model which was brought to life by patient stories that illustrated the support not only for the patient but for families and carers as well.

Everyone talked about how great the ‘team’ feel was and the fact that each member’s contribution was of equal value to the end outcome. The team really valued the input of the Age UK PIP worker, which makes a huge difference to the team’s success.

The team has worked very hard to build relationships with colleagues in the local hospital and over the past few months things have really moved on in terms of embedding the service.  However, they acknowledged there is still some way to go with raising profile for GPs, so that they understand the potential for people to be supported at home by the team. The GPs who they do work with are really impressed with the support the team is able to mobilise at pace and the range of issues that they are equipped to deal with. 

There were, of course, a few frustrations felt by the team – these were mostly around the type of things that can add delay to discharges. Overall, it was lovely to hear that all three staff were enthusiastic, energetic and said they really enjoyed their job and went home knowing that they’d made a real difference to someone’s life.

While I was there, I noticed a compliment that had been sent in by a relative. With the team’s permission, I wanted to include a snippet of it in this blog as I think it really demonstrates how the team can support people:

“Immediate support following discharge from hospital of my 94 year old father… ORCAT is a fantastic service and were a lifeline to our family. All the ORCAT workers who supported my father combined efficiency and knowledge of care for the elderly with kindness, patience and encouragement. They were excellent. The service is well coordinated, ensuring effective care was in place from day 1 after discharge. This is the health service at its best. *Gold Star*”

I went away feeling really upbeat and very impressed with the dedication and values that shone through the staff I spoke with. Thanks to Claire, Cathy and Rachel for meeting with me.

Judith Crosby

Executive Director of Service Development and Sustainability

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)