Annual Report and Accounts

ANNUAL REPORT AND ACCOUNTS 2019/20 Berkshire Healthcare NHS Foundation Trust Annual Report and Accounts 2019/20 Presented to Parliament pursuant to Schedule 7, paragraph 25 (4) (a) of the National Health Service Act 2006 ©2020 Berkshire Healthcare NHS Foundation Trust Annual Report & Accounts 2019/20 CONTENTS Page Foreword by Martin Earwicker, Trust Chair 1 SECTION 1 – PERFORMANCE REPORT Overview of the Trust 3 Monitoring Performance 6 Social, Community, Anti-Bribery and Human Rights Issues 12 Sustainability and Climate Change 14 Emergency Preparedness, Resilience and Response 17 Diversity and Inclusion 18 Stakeholder Relations 27 SECTION 2 – OPERATING REVIEW AND SERVICE DEVELOPMENTS Operational Goals and Priorities 28 Service Review and Developments 28 Patient Experience 46 SECTION 3 – ACCOUNTABILITY REPORT Directors’ Report 50 Board Assessment and Review 51 Focus on Quality 52 NHS Foundation Trust Code of Governance Compliance 54 Modern Day Slavery Statement 54 Governance Framework 56 Board Committees 58 Attendance at Board Meetings and Committees 2019-20 60 Board Members 61 Remuneration Report 68 Staff Report 78 Council of Governors Report 88 Membership Report 92 Public Interest Disclosures 95 SECTION 4 Annual Accounts 2019-20 96 6 CHAIR’S REPORT Introduction This has been an eventful year. The advent of the COVID-19 outbreak has brought out the best in all those working for the Trust. Staff, led excellently by the Executive, have responded with the highest professionalism. The Trust quickly and calmly implemented their leadership reorganisation for such events without fuss, albeit with considerable work by all. Staff at the front line continued to focus fully on the care of their patients, whilst dealing with a rapidly changing circumstance, and at times, regulatory uncertainty. Many staff have moved from areas where demand was temporarily reduced to take on quite different roles to help in higher priority clinical areas. Morale of staff has remained high. Digital working Although it has become very difficult to meet face to face, either as colleagues or with patients, the Trust’s digital expertise has proved to be a game changer. Nearly half the Trust’s staff are working from home using digital communications; the Executive holds weekly briefings to staff with the majority of staff joining via video-conference keeping them informed and able to ask questions in real time; the Board meets virtually; patient consultations are held virtually too. All this has been made possible by the investment the Trust has made in digital, as recognised by our award as a Global Digital Exemplar. Although it will need time to reflect on these changes, the experience of working digitally confers considerable advantages. We are keen to understand and embed these advantages of digital working for the future. Care Quality Commission Inspection The other major event for the year, somewhat overshadowed by COVID-19, was our Care Quality Commission Inspection. The Trust at its previous inspection in 2018] was rated Good with two services rated Outstanding along with the Trust’s leadership. One of the important features of the Trust has been the adoption of a Quality Management approach to continuous improvement giving front line staff the tools and freedom to analyse and develop improvement solutions within their own areas, guided by clear corporate priorities. It was a great pleasure that the Trust, at its latest Care Quality Commission Inspection in December 2019, was rated as Outstanding overall with four core services also rated outstanding in addition to our leadership. This is a particularly commendable in view of the complexities of leading combined mental health and community services over a large geographical area. Our financial performance remains excellent with the Trust remaining in NHS Improvement’s highest category. Staff There are of course many factors that give rise to such an excellent performance, but key among them is our staff. The commitment of our staff and the way the Trust respects and support staff is the principal factor in excellence. Our staff engagement score in the national NHS Staff Survey 2019 places 1 us as joint second place for combined mental health and community health trusts in the country which reflects the Trust’s commitment to supporting staff. But we are not complacent. We know that our Black, Asian and Minority Ethnic (BAME) staff whilst positive still have concerns. The reinvigoration of our staff networks for BAME, LGBT and disabled staff have proved very positive. Nevertheless, in spite of progress we are still not seeing enough BAME staff in senior positions and this is an issue that we are determined to resolve. System Working The Trust continues to play an active part in two Integrated Care Systems: Frimley Health and Care, and Berkshire West, Oxfordshire and Buckinghamshire. Although the exigencies of responding to COVID-19 have paused some aspects of their development, the rapid joint response of NHS Trusts, Clinical Commissioning Groups, Primary care and local authorities to COVID-19 have demonstrated what can be achieved between partners without undue overhead. Governance The Board said farewell to Bev Searle, Director of Strategy and Corporate Affairs. Ms Searle had made a significant contribution to the work of the Trust, particularly in relation to Equalities and Diversity and strategic planning. The Board also said farewell to Ruth Lysons who has been a very diligent Non- Executive Director and Chair of the Quality Assurance Committee for many years. We welcomed Kathryn MacDermott, Acting Executive Director of Strategy. We also welcomed, as a new Non-Executive Director, Aileen Feeney who joined the Board in December 2019. The Board now works remotely and experience of doing so is, so far, proving positive. Our Governors had, prior to COVID-19, been working well. We welcomed several new members and the support and constructive challenge of the governors has proved a real asset. We are still in the process of deciding how best to continue to discharge the Governors role in an era where face-to-face meetings are impractical. Summary Although COVID-19 has proved a substantial challenge, it has been much easier to manage as a result of confident leadership, the excellent commitment of our staff and the availability of digital services to enable work to continue with minimum disruption. I, and my Non-Executive colleagues, are full of admiration for the way the Trust has responded and look forward to being able to learn the positive lessons from events and to celebrate with staff the Care Quality Commission Outstanding rating. Martin Earwicker Trust Chair 2 PERFORMANCE REPORT Overview The purpose of this section is to provide an understanding of the Trust, as well as setting out our performance in 2019/20. Brief History and Summary Information Berkshire Healthcare NHS Trust was established in 2001. The Trust successfully gained NHS Foundation Trust status in May 2007. The Trust was issued with its provider licence in April 2013. In line with the Trust’s provider licence, the principal purpose of the Trust is the provision of goods and services for the purposes of the health service in England. The Trust is the main provider of mental health and community health services to a population of 900,000 people across Berkshire. We operate from over 100 sites across the county, including 323 inpatient beds across 16 wards over 8 locations. The majority of our healthcare and therapy services are provided to people within their own homes. The Trust employs approximately 4,500 staff which includes medics, registered nurses, therapists, psychologists, and both clinical and non-clinical support staff. We work with our health and social care partners as across two Integrated Care Systems; Berkshire West, Oxfordshire and Buckinghamshire Integrated Care System and Frimley Health and Care Integrated Care System. The Trust is commissioned to provide services and works closely with its two main Clinical Commissioning Groups (CCGs); Berkshire West, covering Reading, West Berkshire and Wokingham and Berkshire East covering Bracknell, Slough, Windsor and Maidenhead. In addition, there are a smaller number of services that are commissioned by NHS England and NHS Specialist Commissioning. In addition to our NHS partners, the Trust works with our six local unitary authorities, West Berkshire, Reading, Wokingham, Windsor and Maidenhead, Slough and Bracknell Forest. We are structured to reflect the localities in which our services are delivered, with Community Health and Community Mental Health services in both the East and West of the county. In addition to these services, we operate a Mental Health Inpatient service at Prospect Park Hospital in Reading, and our Children and Young People Service which spans our geography. All these services are supported by our central corporate teams. Our Information Management and Technology programme is a key enabler for the delivery of all our strategic goals and we achieved “Global Digital Exemplar – Mental Health” development status in 2017 (accreditation due in 2020). This status along with the supporting investment has enabled us to become one of the most digitally mature NHS providers. 3 Our Trust Vision and Values We are committed to our vision: “To be recognised as the leading community and mental health service provider, by our patients, staff and partners” We have three core values which guide us in the way we behave and what we prioritise. During the year we have reviewed and updated our Strategic Plan, informed by both the NHS Long Term Plan published in June 2019 and the Integrated Care System’s five-year plan submissions in November 2019. We will be publishing this in 2020/21. Statement on Performance This year we have seen strong performance from across the organisation. We have improvement in both the safety and quality of our services as well as continued to deliver on our financial commitments. We have continued our commitment to providing high quality services that meet the requirements of our Care Quality Commission (CQC) registration and in compliance with the conditions of our provider licence.

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