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Annual Report and Accounts 2018/19

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Annual Report and Accounts 2018/19 Annual report and accounts 2018/19 Birmingham and Solihull Mental Health NHS Foundation Trust Annual report and accounts 2018/19 Presented to Parliament pursuant to Schedule 7, paragraph 25(4)(a) of the National Health Service Act 2006 ANNUAL REPORT AND ACCOUNTS 2018/19 | 3 © 2019 Birmingham and Solihull Mental Health NHS Foundation Trust 4| ANNUAL REPORT AND ACCOUNTS 2018/19 Contents Performance report 6 Overview 6 Performance analysis 12 Accountability report 30 Directors’ report 30 Remuneration report 56 Staff report 69 NHS Improvement’s Single Oversight Framework 83 Statement of chief executive’s responsibilities 85 Annual governance statement 87 Quality report 104 Section one: Statement on quality 104 Section two: Priorities for improvement 108 Section three: Review of quality performance 156 Annex one: Supporting statements 175 Annex two: Statement of directors’ responsibilities 185 Annex three: Glossary 187 Annex four: Criteria for indicators 191 Independent auditors’ report on the quality report 193 Independent auditors’ report 197 on the financial statements Consolidated financial statements 2018/19 203 ANNUAL REPORT AND ACCOUNTS 2018/19 | 5 Performance report Overview The purpose of this overview is to give readers of this report a short summary that provides them with sufficient information to understand the organisation, its purpose, the key risks to the achievement of its objectives and how it has performed during the year. Welcome to our Trust We are pleased to introduce you to the annual report for Birmingham and Solihull Mental Health NHS Foundation Trust for the 12 month period from 1 April 2018 to 31 March 2019. The year saw some exciting and innovative developments across the Trust. These ranged from the launch of new services such as the Complex Treatment Service for veterans and a new regional forensic community service for forensic children and adolescents, to digital innovations and further development of new care models to improve patient care. For many years we have been at the forefront of innovation in mental health services, for example in the development of liaison psychiatry and home treatment and 2018/19 was no exception. We completed the second phase of our ‘Digital Ward’ programme, which replaces cumbersome written notes with an app that now allows physical as well as therapeutic observations to be recorded in real time on a hand held device, linked directly to our electronic patient record. This has received national recognition as part of the national Global Digital Exemplar programme, with NHS England recently making a film featuring our ward staff talking about the difference this has made to their experience and to the care they are able to provide. Another unique and innovative piece of work during the year was the piloting of ‘predictive analytics’ within community teams to test an algorithm to see if it accurately predicts service users who are at high risk of experiencing a mental health crisis. This work continues into 2019/20. Partnership working is also something that we have championed over a number of years and our Reach Out and MERIT partnerships, in secure and acute/urgent care respectively, have continued to make a difference in providing care closer to home, with recovery at the heart of their work. We have also continued to play an active role in the development of the Birmingham and Solihull Sustainability and Transformation Partnership strategy. This year we have forged new and innovative partnerships in other areas. One of these involves a different model of primary mental health care, being piloted in East Birmingham. This sees a multi-disciplinary team comprising NHS mental health and community professionals, GPs, local authority and the voluntary sector coming together to ensure a holistic and person- centred approach to tackling the issues affecting an individual’s mental health, whether it be health, social care or other factors such as housing or isolation. We’ve also brought together leaders from the NHS, local authorities, universities, schools, the third sector and local businesses to discuss what actions we can all take together to improve the mental health of our local population, leading to the formation of a unprecedented local mental health partnership that will come together regularly to help tackle some of the key issues around mental health. 6| ANNUAL REPORT AND ACCOUNTS 2018/19 Key to the delivery of these new services, partnerships and ways of working are people – our staff, our service users, their families and carers – and providing them with an excellent experience of the Trust is essential to becoming the outstanding Trust we aspire to be. This year we expanded our popular Recovery College for All to a new site in the north of Birmingham, to add to our existing centres in Moseley and Solihull. Coupled with the launch of our Recovery for All Strategy, this is helping to promote messages of hope, recovery and opportunity to support service users, families and carers to lead fulfilling lives. In the Patient Led Assessments of the Care Environment (PLACE), our scores were once again amongst the best in the country, which is a testament to the excellent working between our estates and facilities and clinical teams, alongside service users and carers. Our Friends and Family Test shows that 90 per cent of service users asked would recommend our services and we also saw improvement in our community mental health survey, particularly in knowing who to contact in a crisis which had been a key area of focus. We accept, however, that there are occasions when we do not provide care that is up to the high standards we set ourselves and we continue to make improvements to how we respond to complaints and learn from incidents. We have around 4,000 fantastic staff across our organisation, who demonstrate unswerving compassion and commitment to providing the best care, in sometimes challenging circumstances, against a backdrop of unprecedented demand for mental health services. We celebrated their achievements during the year, not only through our own Quality and Excellence Awards, but also through a whole range of external awards nominations and successes. And we were extremely proud of Katharine Bird, Advanced Nurse Practitioner at our Ardenleigh site, when she was awarded an MBE in the Queen’s Birthday Honours in June 2018. We marked the 70th birthday of the NHS in July with events and celebrations across the Trust, including our ever-popular AGM, which we live streamed for the first time in 2018 to enable service users and staff in our many sites to participate. This was introduced in response to feedback from service users who are detained in our inpatient wards and wanted the opportunity to participate. While our staff survey showed small improvements in some areas, and our three fantastic staff networks have gone from strength to strength, it is clear that we still have much work to do to ensure that we truly live our Trust values and that all our staff in every area of the Trust feel safe at work and engaged and involved in changes being made. Staff engagement and involvement will be a key focus for us in the coming year as we strive to attract, recruit and retain talented, dedicated and compassionate people from our local communities to work with us. We know that having happy and engaged staff, as well as being important in itself, leads to a better experience for service users and carers. Staff engagement and involvement was one of the areas highlighted in our latest CQC inspection, which took place in November and December 2018. The inspection report, published in April 2019, acknowledges that progress has been made since the last inspection in 2017 and highlights many areas of good practice. To be rated as ‘good’ for being caring and responsive is a reflection of the commitment of our staff to meet the individual needs of our service users and their carers. We recognise that there is still a great deal of work to do to move from our ‘requires improvement’ rating to ‘good’ and achieve the high standards we set ourselves across all areas of the Trust. ANNUAL REPORT AND ACCOUNTS 2018/19 | 7 We welcome the CQC’s recommendations and its support in helping us to achieve them, and look forward to working closely with our staff and local partners to make the changes required to improve the experience of people who work for and are cared for by us. One of the ways we’ll be doing this is through our Trust wide quality improvement programme, which we are delivering in partnership with the world-renowned Institute for Healthcare Improvement (IHI). We started this work with a diagnostic carried out by IHI in autumn 2018, which was followed by them working with the Board and senior leaders in the organisation. We now have more than 60 quality improvement projects under way, led by our staff, as part of a first wave of the programme. Around 80 colleagues have so far been trained in improvement science and tools with more to follow in September. No overview of a year in the NHS would be complete without mentioning finances. We have maintained a strong financial track record over the years and we over-achieved against our annual plan in 2018/19. We were pleased to see the commitment to improving mental health services in the NHS Long Term Plan. It does, however, remain a significant challenge to strike an appropriate balance between the delivery of high quality services and financial sustainability, in the context of increasing demand. Fully engaging our staff and our local partners in quality improvement and looking at different ways of working and delivering services will be one of the key drivers of this in the years ahead.
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