Setting the course for a positive future

In the past, including my interview for this chief exec post, I have used the example of the Ernest Shackleton expedition to the South Pole on the ship, Endurance, as a way describing our collective challenge and how it must sometimes feel working in the NHS. You know, extremely challenging conditions and dubious recognition, but something driving people to be ambitious and to keep going with determination and resilience.

Now, there are still days when this must feel true for you, but recently in a chat with Chris Reynolds, our director of IM&T, he used the analogy of the Dunkirk rescue during the Second World War as a better way of describing our aspiration.

In other words, we don’t consist of a single ship, but a flotilla of boats and ships of all shapes and sizes, united in a joint purpose and a shared sense of direction. I like this analogy a lot as it acknowledges the differences across our organisation in terms of services, size and locations, and what we contribute we make, but recognises that, at heart, we all want the same thing for the people we serve and try to demonstrate a set of shared core values of kindness and compassion, fairness, ingenuity, courage and determination.

We all want to deliver the highest quality care to patients, and through the work we have been doing over the last year on our strategy, we are increasingly making our direction of travel and shared purpose much clearer. 

It feels as if we are on the right course and moving closer, even though we acknowledge we still have a way to go in terms of our journey. So, it's really encouraging the CQC report that will be published on Monday recognises this.

This report feels like it has a distinctly different tone to the last one. I always say that it is accurate to say the glass is both half full and half empty, but this definitely feels like a 'glass half full' assessment. Yes, it acknowledges things we still need to improve, but it very much recognises the progress being made and the hard work and commitment of our staff and services.

Without wanting to repeat the key messages in our email which went out a bit earlier, I'm so pleased the CQC recognises our improvements in both quality and culture. 

And let's not forget that this has been done in a challenging climate. We’re seeing more patients, with limited resources and a whole load of change going on, so it’s a real credit to you all that even through these most challenging times, you have still managed to make improvements.  

We have something you can't put a price on, and that's compassionate and committed staff. It's the most precious commodity we have, and reflected in the CQC report.

I saw that care and felt that commitment earlier this week when I visited Taylor and Saxon wards, Beckett Place and Tatton unit at Tameside Hospital.  I met some really motivated and enthusiastic managers who have a lot of ideas for improvement. What we need to do is find ways of making this easier for them.

It was also great to talk to some front line staff and patients. I sat in on a gambling awareness session being run by our Health and Wellbeing college and its clear this is making a big difference to people’s lives. 

What I appreciate most about these visits is the honesty. I don’t want a ‘royal’ visit where people try to present what they think I want to hear. I am really interested in hearing how things really are. As I have said before, unless we know what doesn’t work we can’t work on fixing it together.

I think the CQC report helps with this because as well as highlighting things that are working, it also helps us stay focused on the areas for improvement. It will also help support honest conversations with commissioners about priorities and resources, as we all want to develop good and outstanding services. 

I think the CQC rating is a fair one, and reflective of where we are on our journey, but our aspiration is to move to good and to use this as a platform to become outstanding and that's where our new strategy comes in, in helping to be clearer about how we do this.

Although the decision about our strategic direction has been tough, it comes from wanting to, and considering where we can, make the most difference. I strongly believe we can make a huge difference as a strong mental health and learning disabilities trust and there will be a lot of opportunities over the next few months for people to be engaged in what this means and to help shape our future. I'll talk more about this and our strategy development in my next blog.

But I leave you with the thought reflecting back to the Dunkirk analogy, that it’s the set of the sails, not the direction of the wind that determines the way we go. We are after all the masters of our own destiny. 

Best wishes
Claire Molloy

Winds are changing and stars are aligning: our Trust is set for a big year

So 2019 is the Chinese year of the pig!

Not exactly the most exotic or cuddly animal. But, forget Miss Piggy and think more Piglet because the Chinese new year pig represents honesty, sincerity, and bravery.

I believe you all have these powerful, positive characteristics in bucket loads, and they will be hugely beneficial throughout this year of transition and change.

I know that when the festive cheer of Christmas has faded, the prospect of a long January can leave even the most positive of us feeling flat. Cold, dreary weather, and too much Christmas food and drink can leave people feeling sluggish and overweight. Plus, I’m aware many people felt really tired at the end of 2018 and, on top of that, there are plenty of winter lurgies going around. I was struck down with norovirus over Christmas which was pretty horrible.

Its therefore more important than ever that we all look after ourselves and each other. Let’s call it a joint new year ‘wellbeing’ resolution, to sit alongside any others we all might have.

I know some of you are already doing RED January and Dry January for the month and hope you’re already feeling the benefits? Incorporating wholesome habits into our daily routine can also provide a pick-me-up, from taking proper breaks to connecting with people.

Like a lot of you, I will be trying my best to be healthier in 2019, and so I’ve agreed with Evelyn, our Chair, that I will be temporarily reducing my hours of work to four days a week in order to spend a bit more time with family. So, I won’t be in on Thursdays, when Henry our medical director will head up things as current deputy chief executive; supported by other  exec director colleagues. Work is hugely important to us all, but we all need to find ways of balancing that with life outside and things that bring us joy and energy and most importantly perspective.

According to Chinese astrology 2019 should also be a year full of joy, friendship and love, as well as a good year to make money and invest, as the pig attracts success in all spheres of life. Which sounds just the ticket! They do say that the only ‘dark side’ to the pig is its stubbornness. Personally, I think that a bit of stubbornness, when its firmly wrapped around ‘doing the right thing’ and sticking to your values, is not necessarily a bad trait.

I’m not really into astrology or horoscopes, but it’s spooky that Mary Poppins is back on the big screen after 25 years and interestingly both actresses Julie Andrews and Emily Blunt were born in the year of the pig. The film is predicted to be a huge box-office success because of its timely message of joy and hope. Its message is set against the backdrop of the film’s only certainty, that whatever happens, the wind will change.

So, here’s to joy and hope, a positive wind of change and your wellbeing in the year of the pig (and the occasional spoonful of sugar….).

Best wishes
Claire Molloy

A big thank you and festive wishes to you all

So many organisations start winding down as Christmas approaches. But not the NHS, and certainly not Pennine Care.

I know things are as busy as ever for us, and I'm conscious how tired people are feeling. So I hope you all manage to find some time relaxing and recuperating over the festive period, or doing something that makes you feel good, if relaxing is not your thing. Not everyone's idea of fun is a film binge day in pyjamas, with sugar overload (although it certainly appeals to me!).

We've now had the last staff engagement sessions for this year, in advance of our final position paper going to our board for approval next Wednesday. We'll then share the paper with you, and keep you fully involved, updated and supported as the transfer and strategy development plans progress in 2019.

My booked slots with individuals and teams, as part of the exec director drop-in day last week, were interesting. I was expecting people to come with understandable queries and concerns, and it was good to discuss how the changes might impact on them. But I also had others arriving with exciting ideas about developing their future services, as well as asking how they could positively help and support the transition.

Thank you to everyone who has fed in views and feedback. It's been constructive in many different ways; from informing our communications plan to resulting in a commissioning decision about our #Thrive children and young people’s emotional well-being service.

Rochdale CCG has just confirmed that they want the #Thrive service to remain with Pennine Care, as part of a new contract aligned to our Healthy Young Minds service. The #Thrive service is currently part of community services, but everyone has recognised the  benefits of this staying with us. 

It was also great to find out that we're getting £4.8m from the government to help build a new 12-bedded male psychiatric intensive care unit. This was the only capital development proposal supported in Greater Manchester and will help us help patients at a desperately critical point in their lives; and ensure that we have dedicated facilities for both males and females.

This is my last blog of the year, as the holiday period begins.

I know it's been a tough year, with changes, challenges and developments. And next year will undoubtedly be another challenging one. But I know we have a fantastic workforce that will rise to that.

We now know our direction of travel and I am hugely hopeful about our future. But, we need to ensure we get there in a positive way, supporting all of you - whether you are transferring or staying - with  openness, clarity, sensitivity, fairness and kindness.

We need to make sure we take care of each other every step of the way as best we can.
Thank you for everything you have achieved this year. I never cease to be amazed and humbled by your skills and dedication. For those of you who are working during the holiday period, a special thank you, it is much appreciated. 

I wish you a really wonderful Christmas - have fun, do what makes you happy, and rest.

Best wishes
Claire Molloy

Listening, sharing and appreciating

I’ve been in listening mode over the last fortnight.

I’ve attended recent sessions about our future strategy position paper with both corporate staff in Trust HQ and community staff from Heywood, Middleton and Rochdale (HMR), where I’ve heard views and concerns. 

I’ve also heard brilliant stories about the results of listening at our Go Engage celebration event. And I’ve been incredibly moved by a powerful and inspirational story at our Board meeting from a teenager on our mental health Horizon Unit in Bury.

While technology has changed the way we work and communicate, nothing beats face-to-face communications in order to really hear someone, understand their issues and respond sensitively and positively.

I heard loud and clear the emotional impact that our future plans have had on community staff in HMR when I met with them this week. They talked about feeling “gutted” and “let down”, because they are so proud of what they have achieved and are anxious not to lose this. 

I acknowledged this and committed to doing everything possible to build in safeguards to not unravel their superb work and positive relationships.  

No-one in the whole system would want that. Their success and the success in all our localities is down to the people working there who have made it happen. And so I am hoping that, regardless of whatever structural changes happen, these staff will still be doing great things in the future whoever they work for.   

At the corporate staff sessions, I saw that people are still digesting the news and wondering what it means for them. I recognise that for these staff they are both impacted by the changes as well as needing to help the organisation enact the changes. 

So the strong commitment and hard work these teams have always shown will be needed now more than ever. I also appreciate, because of the nature of corporate support, that there is less clarity around some things right now. 

They understandably are looking for answers, many of which we don’t have at this early stage. However, we are working through some of the areas you have flagged up where we know we need to give a clear steer such as recruitment to vacant posts and roll out of the electronic patient record. So for now, it’s business as usual but we are expecting to provide clarity in a number of these areas very shortly.  

Like a lot of you, I have personally been impacted by big changes of this sort many times in my NHS career, and have also been responsible for leading and managing such change on numerous occasions. I know how anxiety inducing it can be and although I don’t have all the details and answers yet, it’s important to put myself in your shoes and deliver the sort of open and compassionate leadership you would expect.  

The last couple of weeks have made me think about four things. The power of listening. The power of people. The power of recognition. And the power of hope.

Despite worries about what the changes might mean for people personally, I’ve been really struck by your strong desire to do a good job; and to build on, not lose, the good work you’ve achieved.   Recognising what has been achieved is important. A compliment shows respect, admiration, gratitude, trust, appreciation, and hope. It can lift moods and impact our outlook and it shows that we are valued.

And so it is important over the coming months that we take every opportunity to pay our compliments and to show our thanks and appreciation for what people are doing. There are always plenty of opportunities to do this. 

I was at the launch of our young people’s mental health research unit yesterday where I heard about the great research being undertaken to inform better practice and outcomes for people.I also attended the celebration event for our second cohort of Go Engage staff earlier last week, where I heard about the really innovative engagement work they are doing. Both events were positive ways of recognising and valuing great work and they made me feel inspired and hopeful about the future.

Plus, many congratulations to Rickaia Brown our e-rostering project manager who has just been crowned rising star in the Women in IT Excellence Awards. And also to Dr Sarah Burlinson and Nathan Randles who both won awards last night from the North West division of the Royal College of Psychiatrists. Sarah won 'consultant of the year' and Nathan ‘service user of the year’, which is brilliant.

And talking of hope, my week was really made by a story of hope from a teenager talking about her personal journey and the support she has been receiving from our services. She is just about to leave our Horizon Unit and spoke so eloquently about moving from a dark place where she felt “no-one could fix me’ to her plans to now become a mental health nurse. It was incredibly moving and inspirational. Pain is real, but so too is hope.

Good engagement is needed now more than ever and so too is the sharing of positive stories and praising each other. 

I promise to keep on listening and doing my best to recognise and appreciate your hard work.

Claire

Claire Molloy
Chief Executive

My visit to #Thrive in Rochdale

My week started with a great visit to the #Thrive team in Rochdale. I always hear such positive things about this mental health and wellbeing service for children and young people, but nothing beats visiting a service to really appreciate the benefits it brings to a community.

As well as providing a range of support and activities, such as counselling and online courses, #Thrive helps young people access other types of support, such as sport, drama, music or art, as well as signposting to other mental health services. 

It's a superb example of multi-agency working, with our staff working in partnership with other organisations.

Over the last year, I’ve visited lots of community health services and most of our inpatient mental health wards, but haven’t managed to spend as much time with children’s services. 

This visit was great opportunity to hear more about services for young people and I am intending to try and get out to more of these services over the coming months. In particular, I have heard a lot of great things about the Hope and Horizon units at Fairfield Hospital, Bury, so really want to visit as soon as possible.

I had a long chat with the #Thrive team manager about the potential future strategy, which has given me plenty of food for thought. They are part of community services but, because of the successful integrated model they have for children and young people in Rochdale, they have a strong connectivity with mental health services. 

I knew that staff in this locality had particular concerns about the possible provider split for community and mental health services; many of their staff came to our public board meeting in October when our future strategy position paper was discussed. So, it was good to talk about this on my visit and I am planning on attending a session in Heywood, Middleton and Rochdale to talk to people about their concerns.  

It is clear that the commissioners in Rochdale are very happy with the services we provide and the integrated children’s model is really making a difference. This was reflected in another meeting I had this week with the senior leaders from the clinical commissioning group and local authority in this locality. 

So, we will need to use the next few weeks to explore different scenarios that protect some of the great integration work taking place, not just in Rochdale, but also other localities.

And that’s the genuine purpose behind this engagement period; to hear your views and ideas. As I’ve said before, there does appear to be support from our partners on the overall proposal, so the general main direction of travel is unlikely to change unless we hear a stronger rationale for something different. 

This is the purpose of listening, not just to be sensitive and responsive to your concerns, but to hear specific views about different aspects of the proposal and how it affects different localities, so that these can inform final proposals if possible.

I hope you are all having the chance to feedback, either through the staff engagement sessions which we asked your senior managers to set up, or through other channels such as your line manager or partnership officer.

I know that the proposals are impacting on people in different ways and any big changes of this sort create anxiety and uncertainty, but business as usual must always run strongly alongside any proposed changes. Both are about delivering the best possible care to patients, whether that’s in the here and now or the future. It’s the reason we are all here.

So, once again, thank you for your ongoing engagement and commitment. I do encourage you to take every opportunity to share your views and concerns over the next few weeks and we will ensure we share regular updates through the weekly bulletin that has been established.

Thank you,

Claire

Claire Molloy
Chief executive

Guest blog and announcement on our future (position paper included)

Today our Board had a challenging discussion about our future strategy; one in which we reflected on our previous aspirations and the changing world in which we find ourselves.   

When we took on community services, we had a vision we could make a real difference to people’s lives. By aligning community and mental health services within the same organisation, we felt local people could truly benefit from a 'whole person' service approach; bringing physical and mental health together.

We wanted to showcase the combined impact that these two complementary 'Cinderella' services could make - to support the hospitals buckling under the strain and, mostly importantly, help change lives. We felt that we could provide a local voice and also a safe haven and nurturing environment for our community services.

We have achieved some great things, particularly around children's and older people services, the two ends of life's full spectrum.  Our physical health services benefited from a psychological perspective and vice versa.

But, for a whole host of reasons, we have not been able to fully realise the vision we had for integrated, whole person care.

Now, with the rise of local care organisations (LCOs), we are seeing strong locality ownership for improvement, with a desire for local providers to be very visible and active within borough-based partnerships. 

While people have worked very hard to do this for both mental health and community services, we have struggled to represent all elements of our portfolio with the same strong voice in each LCO.

And that has brought us to today. With a heavy heart, but a huge dose of realism, the recommendations in the position paper on our future strategy were approved by our board this afternoon.  Click here to read our position paper.

As you know, it proposes that we look at community services developing as part of local care organisations and concentrate our efforts on mental health and learning disability services in their widest sense. Allowing both to extend, enhance and fulfil their potential for the benefit of local people in this changing new world.

It was good to see around 30 people in attendance at the board meeting, nearly all of those staff. We opened up the meeting for public questions on our strategy position paper, which included queries about specific services, next steps and possible future providers.

We understand and respect the different emotions that people are feeling, which include disappointment and worries about the future. And we want to always work and behave with complete integrity and compassion. The questions provided an opportunity for us to talk about close partnerships, strong relationships with commissioners and being a strong local alliance member, as the future is about collaboration.  

This is all about people and we talked about our responsibilities as a board to never do anything detrimental to patient care.

While the Board has approved the direction of travel in principle, we need to gather lots of views before our final strategy goes to our board in December.

It's been a journey to get us to this first stage. I hope that the time many services have been with us has been well spent, but accept that this time may be coming to an end.

We should always do the right things for the right reasons, even if it's hard. And that includes acknowledging we might not be the best organisation to continue providing a service.

So, let's keep talking. We want to hear your views and will be putting plans in place to do this. Let's all help shape the future.

Thank you.

Henry

Dr Henry Ticehurst
Medical Director

Guest Blog

It’s 12 months since I joined Pennine Care as Chair, so I thought it was a good time to write a blog.

So much has happened over the last year, with a lot of work on developing our new strategy, culture and the refreshed vision and values to support this. I’ve also had the opportunity to get out and about and visit many different teams, which is without question the best part of my job. I never cease to be impressed, humbled and full of admiration for what you do, day in and day out.

There’s so much more I want to learn about the services you deliver, how your teams work, and the fantastic people that work here.  But I also think it might be helpful to learn some more about me.

So, I’m taking this opportunity to reveal something about myself.

Something personal which has had a huge impact on my life. Something which will hopefully help those who already know me or will meet me soon – and also those who welcome an open and honest message about understanding and respecting everyone as individuals, whatever our challenges.

It’s also important we all feel safe, comfortable and supported if we open up about personal information. Especially when we work for an organisation such as ours.

You see, I’ve been managing a long term health condition whilst holding down a high profile role

Two years ago I had heart failure.

I hate the word 'failure' to describe my living, beating heart, but when I asked another doctor how he'd describe what happened he called it 'heart inadequacy’ which is worse!

Its sometimes easy to forget the psychological impact of a ‘label’, until its ours to wear.

I was visiting Ghana when it happened. I’ve got diabetes and high blood pressure runs in my family, but I started to take a lot of extra medication on this holiday as I was feeling really rotten.

A few days after I returned home, I woke  one morning and was struggling to breathe. It was scary enough for me to visit my GP, and before I knew it I was in an ambulance rushing to the MRI. I was in hospital for 10 days, and the care was amazing. We all know how wonderful the NHS is and how lucky we are to have it.

I now have to take 14 tablets every day, which I find both stressful and tedious. I line them up in pairs, according to their shape – anything to make it feel less of a daily trial.

Only four out of the 14 have side effects, but they are gruelling side-effects and take their toll. That means, especially with sometimes very long days of meetings, that I can struggle.

My mind is fine, it’s just my body that lets me down, but the drugs do mean that I struggle. And it does get me down.

I tell you this in the spirit of openness and caring about the impact it can have on our family, friends and colleagues and so you have more of an understanding about why sometimes I may appear fazed.

I have four children who worry, my son just wants the doctors to ‘fix me’ my eldest daughter practically moved in when I came out of hospital, my middle and youngest daughters worried for some time whenever I went to the GP in case I ended up in A&E again and my adorable grandchildren (6 & 7) worry about me dying.

We also laugh about it though, as there are plenty of funny moments. My relationship with lifts and stairs, and my reaction to being advised to get a ‘blue badge’ are just a couple they tease me about.

Laughing is a good medicine, but one of the best things is that when needed I can indulge in my ‘guilty pleasure’ TV court shows - Judge Judy, People’s Court, Paternity Court and judge Rinder – without feeling I should be ‘up and about’ busying myself all the time.

So, I’ve opened up my ‘weak’ heart to you all. It’s still bursting with pride to be part of our fantastic organisation.   I just want you to know that my passion for and commitment to the Trust is strong and I will work to ensure that I carry out my role effectively.

Thank you for reading.

Evelyn Asante-Mensah MBE
Chair