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annual report 2005-06
helping people get better 27512_BSMHT 18/9/06 6:13 pm Page 2
CONTENTS
Mission Statement 2 Substance misuse services: Taking action 16-17 Chair’s Foreword 3 New facilities: Better environments 17 Chief Executive’s Foreword 4 Complex care: Closer to home 18 Our Vision 4-5 Small steps: Big impact 18 HELPING PEOPLE GET BETTER: Beyond barriers 19 Alongside our communities 6 Maximising our resources 20 At accepting and understanding 6 In our practice 21 Meeting diverse needs 7 By being included 21 Through having their say 8 By raising high standards 22-23 With wider health issues 8 Staff say... 24-25 Patient experience 9 Learning right from wrong 25 Through person centred work 9 Going for gold – Foundation Trust Application 26 Right place: Right time 10 Operating and Financial Review 2005/06 27-30 Intensive support and treatment 10-11 Financial Summary 31 2 In their later years 12-13 Trust Board and Management 38 Through wider horizons 13 Service Directorates and Main Trust Sites 39 Earlier treatment: Better outcomes 14-15
MISSION STATEMENT
Our mission is straightforward: to help people get better and create a service that we are all happy to recommend to others.
We aim to make sure that people with mental health surroundings and the way people behave towards them – problems receive swift and appropriate treatment in the so we will also do our best to improve our service users’ best possible setting to suit their needs and wishes. This lives through our work with other organisations. means providing high quality, safe services that knit This means working with people’s carers, their families and together with each other so that the right level of support the wider community to help them to lead purposeful lives is available to people with mental health difficulties – at among people who accept them – breaking down the whatever stage of their illness. barriers of stigma which often accompany mental health Everyone’s general well being is influenced by their problems and lead to social isolation.
Our vision therefore requires that:
People with common mental health Strategic partnerships, sometimes through problems are managed effectively within sub-contracting, where appropriate, are the primary care system. established with non-statutory sector 1 3 organisations, community and user-led groups to create a continuum of: a. Appropriate employment, educational, social and leisure opportunities b. Appropriate housing (independent and supported)
People with complex mental health Focused and co-ordinated activities are problems are swiftly referred to and developed to help improve tolerance and managed as appropriate by specialist understanding within neighbourhoods and 2 mental health services in our Trust. 4 communities, and to enhance access to excluded groups. 27512_BSMHT 18/9/06 6:13 pm Page 3
Birmingham and Solihull Mental Health NHS Trust Annual Report 2005-06
CHAIR’S FOREWORD
I have come to enjoy writing the foreword to the Birmingham and Solihull Mental Health NHS Trust Annual Report, a time to reflect on the Trust year that ended in March 2006, and to look forward to the year ahead.
2005/06 marked the year that the exciting us. As the Annual Report Trust grew up. It was the third year goes to press, we are in the middle of that it functioned as a pan- our public consultation process, and Birmingham and Solihull organisation, we are determined to make this covering a population of close on 1.25 process as broad and as meaningful as million people, and offering possible. Without prejudging the specialised services to all those process, it seems to me that the Trust suffering from severe and enduring will be much better placed to meet mental health problems. With 4,000 the kinds of challenges I have listed So I hope that everyone who works in staff working from around 100 above if it achieves its Foundation and around the Trust will face the year different premises, it is one of the status: a strong organisation, lying at ahead with the same anticipation (and largest mental health Trusts in the the heart of the NHS, but with the a little trepidation too) as me; the 3 country, and we are working to use autonomy and authority to determine transition to Foundation Trust status is our ‘critical mass’ to drive excellence the ways in which it functions. not an easy one to make, and we will and innovation in all that we do. all need to reframe the way we work In 2005/06 we made good progress and even the way we think about our on delivering the objectives agreed users, our organisation, and the with all our service commissioners, At the strategic services we deliver. running our services more efficiently than ever before, and doing so in a level, it is the way that has been recognised externally by the Healthcare possibility of Commission’s Standards for Better Jonathan Shapiro, Chair Health, our Improving Working Lives becoming a Practice Plus award, the Clinical Foundation Trust that Negligence Scheme for Trusts, as well as by our local Primary Care Trust should be exercising (PCT) commissioners and the Strategic Health Authority, among others. and exciting us The year’s progress has given us an excellent grounding for the challenges and opportunities that lie ahead. At This new-found autonomy will be the day to day level, the financial partly due to the influence that our pressures that beset the whole health users and staff will have on the style service will have their impact on the and nature of the care that we deliver, ways that we work; we will need to and partly due to the fact that, for the continue focusing intensely on our first time, we will effectively be tasked efficiency, developing our ability to with running ‘our’ organisation, with deliver more and better services in the power and responsibility to make ways that are more effective, more it sink or swim. This will do much to easily accessible, and make the best focus all our thinking, helping us to use of our most valuable resource, become more confident and those who actually deliver the care. motivated in all that we do as a Trust, At the strategic level, it is the but with the knowledge that we have possibility of becoming a Foundation to exert these new attributes Trust that should be exercising and conscientiously and with care. 27512_BSMHT 18/9/06 6:13 pm Page 4
CHIEF EXECUTIVE’S FOREWORD
We have moved mountains these past twelve months thanks to the efforts of our staff, service users and carers and our wider partners. When most of the NHS has been undergoing change, and financial reductions, we have dug deep and still managed to achieve huge improvements.
At a time when almost every corner of on an ongoing basis the way they do the NHS has been undergoing change things, and look for how simple and re-organisation, we have improvements in process or care managed to dig deep and produce pathways can be made. We should all significant improvements to many of be proud of what we have so far our services. There are lots of achieved. Thank you and well done to examples within our Trust where staff all our staff because it is all down to have begun to systematically review those small but steady steps that a real momentum for improvement has Looking for constant improvements, been created. no matter how good a particular 4 Set out below are our Trust’s 10 service is already, is the key to strategic goals which will guide our becoming one of, if not THE BEST. We We are very much work and decision making over the all need to keep looking and next few years. They all involve reviewing how and what we do on track to seeking improvements and doing our because our service users deserve best – whichever department we work nothing less. With these efforts become one of, in or role we undertake. I know that continued, I believe we are very much the vast majority of staff try and do on track to become one of, if not THE if not THE BEST this already, which is how we have BEST mental health service in the managed to achieve so very much in country – and when all is said and mental health service such a short space of time. Many done, that is why we all do the work in the country examples of our determination to do we do – so let’s keep going! our best are illustrated in this year’s annual report, but there are at least as many others which we did not have room to include this year. Sue Turner, Chief Executive OUR VISION
The implementation of and progress towards our vision can be translated into 10 key strategic goals, as below, where we will:
1. Be the valued and preferred provider of mental 2. Significantly extend our engagement with local health services for complex conditions for our communities and businesses in order to: local, regional and, where appropriate, national • Eliminate stigma; populations; • Remove barriers and create opportunities for new Competition will grow over the next few years and a development and employment; range of healthcare providers will emerge. It will no longer be the case that local Trusts can provide what they • Optimise charitable income generation. have always done. We aim to be the best choice for our Local communities and businesses are potential partners service users, their families, and those commissioning in our work and can ‘make or break’ the successful services, in the treatment of complex mental health recovery of individuals suffering mental health problems. problems, so that as full a range of services as possible By working more closely as a local ‘business’, and can be provided by our Trust, and real improvement, can neighbour and employer (as well as a healthcare provider) be felt by all. we believe we can open up new opportunities for the benefit of all. 27512_BSMHT 18/9/06 6:13 pm Page 5
Birmingham and Solihull Mental Health NHS Trust Annual Report 2005-06
3. Ensure our place as the employer of choice 7. Shape and grow specific specialty interests where through recruiting, developing and retaining the we aim to be service leaders; best workforce via teaching, research, reputation, Some of our specialties cover populations much wider and ongoing development programmes; than Birmingham and Solihull and, due to the scarcity of Our staff can expect the very best opportunities for such services, attract experts from their field. Where we personal development, career development and wider can, and it makes sense to do so, we will expand these learning. As a member of BSMHT, our staff will have services and use any ‘excess income’ to help improve ongoing support and development to reach the very best services across the Trust more generally. standards of practice and excel at what they do best. 8. Review and realign our estates’ asset base to our 4. Ensure ongoing excellence and competitiveness clinical service facilities thereby ensuring value through making the best use of national and for money; international benchmarking for cost, price, Although we have improved and developed a lot of our management, outcome and organisational estate base, we do still have in excess of 100 different capacity; sites, not all of a good standard. We will therefore review, To be one of the best requires not just high quality and locality by locality, where improvements can be made effective outcomes, but also value for money. We will through newer, shared facilities and where ‘fixed costs’ make sure we stay abreast of wider benchmarking associated with buildings might be able to be reduced information and understand how we compare to others whilst improving the overall quality of environment. on all of these indicators so that local improvements can 5 be targeted and focused. 9. Enhance service provision by developing added value trading arms offering specific products 5. Sustain and further develop our role and allowing re-investment in our core services; reputation as an innovative educator and trainer Some of our core skills can be used in alternative settings of current and future health professionals; which will attract additional income. Examples already in We have a good track record at teaching and training place include counselling and support services to West doctors, nurses, occupational therapists, psychologists Midlands Police Force for staff dealing with road traffic and other professionals, including managers. This is an accidents, hostage situations, etc. Although these will important aspect of our work and will become more always remain a modest part of the work we do, there explicit over the next few years. We intend to bolster this are other examples we could pursue. Income earned aspect of our work and remain ahead of the field in these through such ventures could then be reinvested into our respects. This will be key both to our recruitment and core local services. retention strategies and ensuring our services are provided in the best way by the best people. 10. Increase our sub-contracting arrangements with complementary organisations involved in the 6. Strengthen and develop those services which same care pathways as BSMHT to optimise assist our local health economies, optimise the services for our users. quality of services, ensure value for money and Parts of the care pathway for service users we support minimise financial risk; specifically through involve activities which could be provided by other review of: organisations. Some day services, supported housing, • General hospital costs and capacity; employment services, and daily rehabilitation activities are good examples. We will work hard with such local • Out of City placements; organisations to ensure that they develop their own • Mixed sector economies. strengths and that arrangements are in place between us to ensure seamless support to service users and their There are many examples where developing or enhancing families. In this way, we believe we will be able to local mental health services can help our Primary Care enhance the range of services available, and ensure good Trusts (PCTs) save money from elsewhere. As partners in a value for money overall. wider health economy, we will ensure that we play a full role in developing such plans. For example: a person with complex diabetes and depression is four times more likely to be admitted to hospital through A&E than someone with complex diabetes but without depression. Focused strategies for this cohort of people would be much cheaper (and have better outcomes) if a relatively small amount was invested in mental health care than admissions to acute hospitals. Traditionally we have not been involved in developing such strategies. 27512_BSMHT 18/9/06 6:13 pm Page 6
Helping People Get Better
Helping people get better Alongside our communities
One of the areas our Trust has really determination to overcome fierce local service users, families and carers, has focused on is engaging with our opposition to the development of the received a national recognition for one diverse communities through a variety new mental health unit at Showell of its projects. of ways. This has been acknowledged Green Lane. The Himmat Nammo (meaning at a national level through the Partnership working has helped ‘strength in talking’) project provides National Institute for Mental Health in develop positive relationships with direct support to carers from England (NIMHE) award for local people, which has resulted in a marginalised groups, including young community development work and a more progressive atmosphere and a people who live with parents or Positive Practice Award for work with major reduction in open siblings with mental health difficulties. prison services, as well as locally by demonstrations and negative press. 6 our Strategic Health Authority (SHA) Presented by Jimmy Carr at a banquet in the BEST awards. The judges added: “BSMHT has in London, the Community Care 2005 overcome the barriers to service Award for Carers went to a project It’s official – we’re one of development in a deprived area where based in Springfield and Acocks the BEST! mental illness carried real stigma. Green. The £5,000 prize will be used by Himmat Nammo to develop the The hard work and commitment “The way patient, public and carer service across the city. devoted to enhancing community engagement has been integrated into relations in Sparkhill/Sparkbrook paid the mainstream business of the Trust “The success of the winning service is off when we won a prestigious award was particularly impressive.” in its simplicity,” explained organiser at the 2005 ‘Celebrating the BEST’ Jane Thakoordin. “By supporting both ‘Celebrating the BEST’ awards aim to awards. carers and loved ones at the same identify, celebrate and reward local time, both parties are able to Appointing a Community excellence and spread good practice. Development Worker to work participate and increase their self alongside the New Hospitals Project Our community achievements at esteem and confidence.” Showell Green Lane were also highly was voted the winning initiative in the Carers participate in personal commended at the third NIMHE Promoting Race Equality category, development groups, are offered Positive Practice Awards in London. with the judges calling it “brave, out advice and support in relation to all of the box thinking”. Strength of support aspects of the caring role and receive Beating off stiff opposition, we free holistic therapies – often very AXIS, a community-based service that expensive and unobtainable for many. impressed the panel with our supports black and minority ethnic
Helping people get better At accepting and understanding
Actor blesses new drama series Jewel in the Crown, said: “A multi-faith blessing ceremony on mental health unit the site where new mental health A multi-faith ceremony to bless the facilities for the local community are site of the new mental health unit at to be developed, is such a positive Showell Green Lane, Sparkhill, was way to start the life of the new attended by actor Art Malik. centre.” A keen supporter of mental health Following the blessing, Art and other services in Birmingham, the actor guests attended a lunchtime joined local representatives of faiths, community celebration at the including Islam, Sikh, Hindu and Bordesley Centre, Stratford Road, Christian, at the event on February 22. Camp Hill. Pakistani-born Art, whose TV credits include Holby City and the 1980s Art Malik and Lakhvir Rellon at Showell Green Lane 27512_BSMHT 18/9/06 6:13 pm Page 7
Birmingham and Solihull Mental Health NHS Trust Annual Report 2005-06
Helping people get better Meeting diverse needs
A universal challenge All this activity has attracted a great encouraging. Hopefully, people will deal of recognition as well as a follow up their initial interest by Our Diversity service has made number of prestigious local and applying for jobs with us.” continuous progress towards national awards which have been The initiative to promote employment achieving our aim of developing a mentioned throughout this report. Trust-wide diversity and equality team with our Trust among Bangladeshis that works cohesively with our Bangladeshi recruitment was welcomed by both members of mainstream services. drive the community and its leaders. A year-long programme to attract Alfu Miah, of the Bangladeshi Youth more people from diverse Forum in Lozells, Birmingham, In the last 12 months, we communities to work for the Trust is comments: “The Bangladeshi paying off. community is changing. It’s not just have taken positive steps the men who go out to work these Lakhvir Rellon, says: “Through days. An increasing number of women towards engaging with analysing the current ethnic mix are looking for jobs and showing both diverse communities and within the Trust we identified a need men and women what opportunities to take positive action to recruit from are available in the health service is sustaining and our Bangladeshi community.” very useful.” 7 consolidating our In excess of 400 enquiries from Fatima Khanam, an 18-year-old relationship with faith Bangladeshi men and women, ranging student, adds: “I’m studying for A- from teenagers to people approaching leaders, communities and levels but am very keen to work in the voluntary organisations
“We have made steady progress in addressing issues of diversity,” explains Lakhvir Rellon, Director of Diversity. “These issues have not changed over the years but we are more determined than ever to continue adopting diverse strategies to meet the exciting opportunities we have to improve mental health services for Birmingham’s multi-ethnic, richly diverse population. “In the last 12 months, we have taken positive steps towards engaging with diverse communities and sustaining and consolidating our relationship with faith leaders, communities and voluntary organisations.” As well as developing and extending psychological therapies through partnerships with other organisations Recruitment drive in the Bangladeshi community exceeds expectations to help meet the needs of black and minority ethnic communities, a great retirement age were received health service. This event has told me deal of work has gone into improving following a jobs fair at Birmingham what career opportunities there are communication systems and processes City FC’s St Andrew’s Stadium. and it’s been very helpful.” within our Trust. A greater emphasis “We were not sure what sort of has been placed, for example, on The recruitment drive has not only turnout there would be and this developing information in sign helped highlight employment exceeded our expectations,” adds language, running courses for opportunities within our Trust but has Lakhvir. interpreters and creating a better further strengthened the understanding of some of the 100 “Mental illness is still a taboo subject representation of all communities in languages spoken across Birmingham in many communities and to get this our workforce. and Solihull. sort of response is extremely 27512_BSMHT 18/9/06 6:13 pm Page 8
Helping people get better Through having their say
USER VOICE The long term aim is to offer a range of opportunities for all users and carers User Voice is an ‘arms length’ service to get involved. User Voice, North user led organisation funded by, but The long term Birmingham Carers Group and others separate to Birmingham and Solihull have helped ensure a host of regular Mental Health Trust. Focusing on group aim is to offer social activities this year. Joint work advocacy, service user involvement between User Voice, Positive Mental strategies, and wider support and self a range of Health Group and Heart of Birmingham help systems, User Voice has paid Teaching PCT has led to a weekly workers and many additional opportunities for community swimming session, which is volunteers working across each of our free to users and carers – followed by nine service directorates. Each year, a tea and samosas. wide ranging and comprehensive all users and stakeholder review of services is held, More work is needed to improve the and forward plans and priorities are set carers to get flow of information to patients, users based on the feedback from these and carers. However, this year time has events. involved been spent on developing the training 8 skills of a pool of users, and it is hoped The User Voice Action Plan for 2005- that they will go on to offer dedicated 2006 outlined some key goals, In addition, a piece of joint work was training to Trust staff and encourage a including the provision of a User Voice undertaken with the Positive Mental better understanding of users’ Development Worker for each of our Health Group and our Mental Health perspectives. Additionally, User Voice services. This means that the User Voice Promotion Department to provide a has provided trained User Recruiters to team is now able to help more users framework for the many users and work alongside Human Resources to than ever to become involved in the carers who volunteer to help with help select the right staff. planning and delivery of services. mailings, events, festivals, meetings and more. Launched this year, the At the end of 2005, plans were made Another key achievement was improving Champions scheme provides training to employ a dedicated Head of Patient the monthly communication with users, and the chance to participate in a host and Public Involvement. This position groups and centres by providing: of activities. There are currently will help to draw together the key • A news-sheet; opportunities for Community learning from users, carers and the Involvement, Training, Information, public, and will also head the PALS • A summary of the key issues for each service. A number of tasks will be forum’s users; Media and User Representative Champions. Many users have charged to this role, including the • Information on new services / groups expressed how much they have development of an information service / conferences / opportunities; enjoyed becoming more involved and to users, carers and the public. • A calendar listing the month’s events, learning new skills. and also regular weekly groups.
Helping people get better With wider health issues
SMOKE FREE NHS Implemented on June 1, 2006, the The former four smoking rooms – one reduction in smoking is the result of per ward – have since been Our Trust has made great strides in 12 months’ hard work in service user redecorated and transformed into meeting – and exceeding – the Smoke forums to prepare clients for the ‘healthy living rooms’, where Free NHS Policy, with some services change, which has been positively information and advice are available having totally removed smoking in all received. on subjects such as obesity, weight inpatient wards and community management and smoking cessation. services. This was a key area “First, we asked staff to stop smoking highlighted by service user feedback anywhere in the building, before “Implementing this smoking reduction to us. Although many still smoke, implementing the policy with service has not been as difficult as we there are a growing number who do users on a ward-by-ward basis, imagined,” adds Bernadette. “We not. The result is a cleaner although there are designated have a range of service users, from environment for both staff and service smoking areas in the grounds,” says acute and long stay to rehabilitation, users. Bernadette Byrne, Service Director for but they’ve all worked really hard to North Locality. abide by this policy.” 27512_BSMHT 18/9/06 6:13 pm Page 9
Birmingham and Solihull Mental Health NHS Trust Annual Report 2005-06
Helping people get better Patient experience
Illuminating challenge To date, no other forensic facility in the valuable opportunity to collect their country has asked BME service users to ideas and views in a way that does not Reaside Clinic’s pioneering project, lead and respond to an internal audit of put them under pressure to respond,” Letting Through Light, has proved to be this kind, aimed at delivering high says Sophia Feurtado, Operational a valuable, non-threatening tool in quality services and improving diversity Manager for the Forensic Service. ascertaining black and minority ethnic and equality at Reaside. (BME) service users’ thoughts and The reader-friendly report is set for opinions about the quality of care they “We have tried to reflect the views of distribution to both service users and are receiving. BME service users as honestly and staff at Reaside and more widely over openly as possible as we believe it is a the coming months.
Helping people get better Through person centred work
Spiritual healthcare Boyd (Solihull), Revd. Rob Farnham In addition, the service delivers religious (Queen Elizabeth Psychiatric Hospital) or spiritual instruction and provides 9 for all and Revd. Dr Claude Lombart person-centred support and counselling In response to service user requests for a (Northcroft Hospital). All members of the in times of crisis, such as bereavement, dedicated place to pray and worship, the team are trained ministers of religion, marital problems and family issues. face of BSMHT’s spiritual care workforce and many have degrees and professional Counselling is also provided to those has undergone a remarkable qualifications in disciplines such as who have had, or are having, transformation over the past 12 months. psychology, nursing and teaching. paranormal experiences, while training Volunteers have also been recruited, for and presentations on spirituality and Now, under the banner of ‘spiritual example a chaplain for the deaf services, spiritual healthcare, as well as multi-faith healthcare for all’, a new strategy is a musician Joana who plays the violin inspirational materials and resources, are being worked up by the spiritual regularly for the service users. available too. healthcare team, led by Head of Spiritual Healthcare Services (Chaplaincy), Revd. Rastafarian priest, Rastread Sandra Thomas. (Colin Bradford), is one of the newest members of the It is envisaged that this evidence-based, team. He will minister to the person-centred, holistic approach will 25 per cent of the 90 meet the multi-ethnic, multi-faith Reaside patients and those religious and spiritual needs of service at Mary Seacole Unit who users, staff, carers and their relatives. In are Rastafarian. the near future, spirituality will be an integral part of the multi-disciplinary “Our chaplaincy is growing team (MDT) process. in line with the faiths Some of the faith leaders based throughout the Trust at followed here,” explained the opening of the multi-faith room at Reaside, a medium Before extending the strategy across the Sophia Feurtado, Reaside’s secure unit for men Trust, a pilot site at Heart of Birmingham Operations Manager and “The spiritual needs of both the patients Teaching PCT will incorporate the Care Chairman of the Diversity Committee. Programme Approach (CPA) in the and staff have to be met,” explained delivery of spiritual healthcare. “As yet we do not have a Sikh priest but Revd. Sandra Thomas, who, after 20 funds are available and we are trying to years as a nurse and manager in the In addition to several multi-faith quiet recruit one.” NHS, is the first Head of Spiritual rooms already in use, Reaside and Healthcare appointed by a trust in the Romsley Unit have opened their own, A recent away day for the spiritual West Midlands. “If we ignore the with more to follow. A former healthcare team, became the platform spiritual needs of those we care for then hairdressing salon on the Reaside site has for team-building and discussions on the recovery may be jeopardised. been painted and decorated by service way forward, and underlined the team’s users and transformed into a prayer aims and objectives. In addition to “The opening of the multi-faith centre room, which was officially opened by the working closely with all directorates, the proves the Trust is committed to the Lord Mayor of Birmingham, Councillor team actively listens and offers a non- diverse needs of its staff and service John Hood. judgmental, confidential service. users. I’m very excited about what’s Sacraments are given to those who happening here. It’s something I want to The spiritual healthcare team represents request them and services – worship, see repeated across the Trust.” five mainstream faiths – Christian i.e. baptisms, funerals and memorials – are Anglican, Baptist, Pentecostal and offered to individuals who are unable to Catholic, plus Muslim, Sikh, Rastafarian attend church. and Jewish – and is led by Revd. Alan 27512_BSMHT 18/9/06 6:13 pm Page 10
Helping people get better Right place: Right time
Working with and treatment and support, and to ensure Health Practitioner workers in the this is available quickly when it is Eastern part of Birmingham, meaning through primary care required. Consultations can take the that every GP surgery has access to Extensive work with our colleagues in form of triage, telephone, one to one or one Gateway Worker and one Primary Primary Care Trusts (PCTs), local authority, group sessions. Care Mental Health Practitioner for service users and carers, and voluntary every 20,000 of the population. and independent sector organisations • Although South Birmingham PCT has has paved the way for a fresh look at had Primary Care Mental Health how services are shaped and organised. The role of Gateway Practitioners in place for some time, With one in four people of the general the distribution across GP practices population experiencing mental health Workers is to provide was uneven, and not all practices were problems, numbers are growing. In mental health covered. Through their investment this Birmingham and Solihull alone this could year, all GP practices now have Primary be as many as 300,000 people. assessments for people Care Mental Health Practitioners in who are thought to need place, and satisfaction rates from GPs People experiencing common mental and services users are high. The health problems, for short periods of more specialist treatment 10 supporting Gateway Worker system is time, or those with ongoing but stable and support, and to ensure not yet funded but we are hopeful mental health problems, can be treated that this will become a PCT priority for very effectively and often more quickly this is available quickly next year. by their local GP, provided the right support and back up to the local GP when it is required • A similar new system is being piloted practice is available. in Solihull with five volunteer GP practices. Part of a National Primary This is why we have worked with our Care Collaborative, key steps in the Our Primary Care Trusts differ in the local Primary Care Trusts to invest money pilot have included: collection of data extent to which this model has been into mental health in primary care, which to identify those service users who may implemented at the moment, but all are is complementary to the community need more support in primary care; working towards these common mental health services our Trust provides. application of learning from multi- principles. Each PCT in Birmingham has developed disciplinary case reviews to shape Primary Care Mental Health Practitioners, • In East Birmingham, where the model individually-tailored care pathways; and (PCMHPs), working alongside their local is further advanced, Gateway Workers agreement of a data collection GPs, who can see service users for short- and Primary Care Mental Health standard in General Practice to term psychological support. This Practitioners have proved their weight evaluate outcomes. approach enables more people to be in gold. Not only have they received • The main thrust of this model is also seen more quickly. positive feedback from GPs and service being pursued by the Heart of users, the proportion of people being To support and strengthen this system, Birmingham Teaching PCT. Having successfully treated in primary care has community mental health teams within initiated an independent review of significantly increased, keeping waiting our Trust will have named designated mental health care services across the times for consultation to a minimum. workers (Gateway Workers) to link patch during 2005/06, we are now in This also means that capacity within directly with the primary care mental the process of agreeing the key our Trust’s community mental health health workers and GPs. The role of priorities for implementation with teams is appropriately focused on Gateway Workers is to provide mental them, during the next two years. health assessments for people who are people with complex needs. There are thought to need more specialist new Gateway/Primary Care Mental
Helping people get better Intensive Support and Treatment
When people do need the specialist homes or in a short-term respite home, number of “Crisis/Respite Houses” services our Trust provides we have, rather than needing admission to one where people can stay for a short time, through the Primary Care and Gateway of our acute hospital wards. Where supported by our community home Worker systems, been able to ensure possible, we have tried to do so, treatment services. these are more easily accessible and thereby enabling close links with family In South Birmingham, a new crisis focused. People can often be helped and friends to be maintained. house, catering for four people at any through intensive nursing and medical Our Trust already contracts for a one time, was opened this year. support whilst staying in their own 27512_BSMHT 18/9/06 6:13 pm Page 11
Birmingham and Solihull Mental Health NHS Trust Annual Report 2005-06
The house caters for people who support.” This approach has had the Authority colleagues early in 2005 to benefit from a short period away from thumbs up from service users in the address these mounting pressures. home, but who do not need the full locality. Bernadette Byrne, who has overseen support of inpatient admission. Our this work, says “We had over 100 Trust contracts with Future Health and service users on our inpatient wards Community Care Housing Association who could and should have been for this important service. discharged to alternative provision “Backed up by our local home Overall, our home when we first started these discussions. treatment services, this crisis house With some additional funding made offers our service users a much-needed treatment services available by all parties, including our break away from their own homes and Trust, we developed an action plan to family in a time of crisis. Being able to met the Department target the main reasons behind the avoid unnecessary admission to hospital of Health targets for delays in these people being by intervening much earlier on in an discharged.” A variety of measures individual’s crisis has been very home treatment have been set up including: important for the people involved and is • a centralised bed-management and a better use of resources.” says Jo workloads admission system across the whole Beale, Service Director. Trust • a dedicated set of discharge follow-up Home Treatment Successes teams All of the Trust’s nine home treatment • new placements being developed and 11 teams have been working hard to Solihull Home Treatment Team is now funded with voluntary/independent create a unified approach to their work, fully operational with 14 multi- sector providers whilst trying to remain responsive to disciplinary staff providing the full range • enhanced senior clinical staff being their own PCT-specific requirements. of home treatment interventions. The available on a 24-hour basis to team is based in the Acute Mental oversee admission requests Health Inpatient Unit within the main • an overarching resource directory (in Solihull General Hospital, which real time) of all non-hospital facilitates excellent communication and placements which is currently being We have worked liaison with Solihull A&E as well as the developed. Solihull GP on-call service, housed extremely hard to directly opposite the mental health wards. keep people in their Overall, our home treatment services own homes, met the Department of Health targets for home treatment workloads. wherever possible Improving Admission, and appropriate Resolving Delays When someone is poorly enough to need admission to an inpatient unit, prompt access is important. Over the past few years, this has proved an In our North Locality, this has been ongoing difficulty for the NHS as a particularly successful, with the whole, and our Trust has been no numbers of people being given home different. The number of inpatient beds treatment exceeding Department of we have overall is relatively low, Health targets by almost 40%. compared to many Trusts, so efficient The view of Bernadette Byrne, Service use and throughput is all the more Director for North Locality is that this is important. due to a number of changes and We have seen an increasing number of improvements that have been inpatient beds remaining occupied by The actual outcomes are measured and implemented throughout the year. people who could/should be discharged shared across agencies on a weekly basis. A year on, there had been a “We have worked extremely hard to – either to residential care or to their significant reduction in the number of keep people in their own homes, home with a support package, or delayed discharges – down from 100 to wherever possible and appropriate, she alternative healthcare facilities because 59. Although this number is still too says “We have also put a lot of effort of their long-term needs. For every bed high, the efforts from this multi-agency into better discharge arrangements for occupied in this way, we have fewer task group has made important people admitted to hospital, so that options available for people requiring headway, and efforts will continue on they can go home earlier with the safe admission to hospital in an emergency. this basis. backup of home treatment team We met with our PCTs and Local 27512_BSMHT 18/9/06 6:13 pm Page 12
Helping people get better In their later years
Older People: Onwards For our services, it offers the chance to In order to move forward with the develop new service models and build Strategy and introduce new service and Upwards upon the recommendations of the models, a lot of hard work has been Since Mental Health Services for Older successful Service Development Forum, undertaken by clinical staff on the People (MHSOP) was established in chaired by Lead Psychologist Nicola ‘shop floor’, combined with January 2004, challenges have Bradbury. monitoring visits by commissioners, families and other external review included the launch of various national “The Development Forum has teams. For the past 18 months, the guidelines, an increase in service user provided the opportunity for Senior Inpatient Improvement Group has expectations and growing clinical Clinicians and Service Managers to focused on developing standards, demand on our resources. undertake focused pieces of work that promoting patients’ privacy and dignity A significant amount of work has been done with the Birmingham PCTs and Social Care and Health, in the development of a city-wide Joint Commissioning Strategy for older people suffering mental health 12 problems in Birmingham. Work is also under way with health and social care colleagues in Solihull, on the development of their own local Physiotherapy staff at the Older People’s Services Celebration Day have helped to inform the broad strategy. and consolidating areas such as tissue strategy developed by local viability and nutrition. In addition, “This is an exciting time for our local commissioners,” explains Nicola. Older People’s Services,” explains Brian more concise multi-agency clinical Toner, Service Director. “At last we records have been established, have a multi-agency strategy, which encompassing the development of will guide future, joint decision-making auditing and monitoring processes, processes and influence future service which enable staff to regularly delivery in a more integrated way. We This is an evaluate their own and their peers’ have been waiting a long time.” performance. This work has been led by Nurse Consultant, Linda Playford The important themes of the strategy exciting time and Lead Nurse, Norah Foster. from a service user perspective are: service integration, working in for our local In addition, the more recently partnership and local community established Community Service developments, all aimed at enabling Improvement Group has been reviewing older people to stay in their own Older People’s the effectiveness of Community Mental homes whenever possible. Health Teams (CMHTs) and how the Services service can move forward, in particular with CMHT integration, as set out in national targets. Performance has further been One area to be reviewed by the enhanced by our Rowans Oversight strategy is the present use of inpatient Committee which, for the past 18 beds. An in-house review group has months, has been carrying out regular been implemented, led by Professor reviews of the service by inspecting all Mohan, with a view to establishing aspects of inpatient service delivery. how many beds will be needed in the Using a ‘Traffic Light’ system of 63 future, their location and their specific criteria highlighting positives and function. negatives, all patient areas have “A small multi-disciplinary group has consistently scored well, attaining met to look at the current provision of greens and ambers in all but one case, inpatient beds and how these could and attracting favourable comments, currently and in the future be re- particularly in the area of patient- modelled to meet the changes centred care. Low staffing levels supported within the MHSOP remain the sole red light in all areas. Brian Toner, Service Director, Commissioning Strategy,” explains The committee is chaired by Tony Older People’s Services, with Professor Mohan. Ruffell, Lead Mental Health Jackie Mallett, Head of Commissioner for North and East PCTs. Occupational Therapy for Older People’s Services 27512_BSMHT 18/9/06 6:13 pm Page 13
Some of our Older People’s Services Team
Chaired by the Training Lead for Older it on the road to each base. “As well as making better use of our People’s Services, Caroline Fortune, the existing resources, we are tasked with “Our key success over the past two 13 Training Focus Group provides a developing services that will attract years has been bringing together three discussion forum for the analysis of new investment through the strategy. separate Older People’s Services – staff training needs. The key objective for our older Solihull, North Birmingham and South people’s services over the next 12 “The main role of the group is to Birmingham, and creating a Trust-wide months will be the implementation of ensure equity in the distribution of the service with more than 550 staff across new service models, particularly in training budget, while considering the 19 separate sites and 38 bases. relation to the development of wide-ranging developmental needs of Although only established since community services and the more than 500 staff working in these January 2004, we are already working integration of Community Mental services,” says Caroline, who explains well as an integrated service. Health Teams (CMHTs).” that all individual requests for funding for external courses are processed Finally, the Joint Commissioning through the Focus Group. The key objective Strategy for Working Age Dementia in Birmingham 2006-2011 is currently Caroline also maintains a training nearing the end of its consultation database, which includes the dates of for our older stage. Led by Dr Peter Bentham, this is appraisals/development reviews and people’s services the only service of its kind in the city reports generated for senior managers. for people under 65 with dementia. “In the midst of all this activity, it is over the next 12 This area of the population represents important that we take stock of our a growing problem in Birmingham and successes,” adds Brian Toner, who months will be the poses many challenges in terms of underlines the value of Celebration implementation assessment, treatment and the Days for pulling people together, provision of long-term care. We improving communication and sharing of new service welcome this strategy and look best practice. The most recent featured forward to implementing it. 24 different stalls, and was so models successful that there are plans to take
Helping people get better Through wider horizons
The Birmingham City Council Scrutiny and social care staff in the Trust to Solihull adult social care staff have Committee’s review of our partnership further integrate our services and been working closer with NHS for integrated adult mental health provide a seamless service for service colleagues over the last year and services reaffirmed the City Council's users. benefiting from the training and other commitment to the partnership opportunities offered by the wider This was the first year of our formal between the Trust and the Council. Trust. As a Trust, we have welcomed partnership with Solihull MBC, with We continue to work with their secondment and contribution to social care staff seconded from the Birmingham City Council colleagues mental health services in Solihull. Council to the Trust from April 2005. 27512_BSMHT 18/9/06 6:13 pm Page 14
Helping people get better Earlier treatment: Better outcomes
Early Intervention Service Our Early Intervention Service (EIS) is justifiably proud of its pioneering work from the 1990s onwards, which led to the award of Department of Health (DoH) ‘Beacon’ status and persuaded the Government to make early intervention in psychosis national policy. With a new base in Aston, EIS focuses on detecting and treating psychosis. Birmingham PCT, has focused on enable us to have vocational workers training GPs in how to recognise on the staff who can access resources “Psychosis is a young person’s illness potential psychosis cases and ‘fast track’ in our partner organisations and from and there is now overwhelming access. across the city.” evidence suggesting that the earlier it is detected, and the more aggressively Awareness raising is an important part In conjunction with the University of 14 and intensively you can provide help, of our work: in the past year, a member Birmingham, our Trust is leading a of our staff, Dr Amanda Skeate, national evaluation of early intervention appeared on the BBC’s Panorama for the Department of Health. The programme to talk about the links ‘National EDEN’ project, a £2m research Psychosis is a young between cannabis and psychosis, and programme, links centres in Manchester the team has been interviewed on and Lancashire, Cornwall, Norwich, person’s illness and there several radio programmes. Our services Cambridge and Birmingham – the is now overwhelming have also worked closely with the benchmark location. The Medical national mental health charity Research Council has invested more evidence suggesting that ‘RETHINK’ in anti-stigma campaigning. than £3m in supporting collaborative research. This trial, in conjunction with the earlier it is detected, Over the last year our services have Manchester, will be evaluating the formed important partnerships. The and the more aggressively impact of specialised intervention on North/East teams will pioneer preventing young people at risk of and intensively you can collaboration with Child and Adolescent developing psychosis and a further Mental Health Services (CAMHS) to provide help, the better project will provide the infrastructure to provide care from age 14 upwards. The support multi-centre research into early the outcome Birmingham service is now also psychosis, and will link Birmingham commissioned as collaboration between with nine centres around the UK. An the Trust and two voluntary sector EU collaborative project EPOS – co- partners in Birmingham: FUTURE Health ordinated by Dr Paul Patterson – aims the better the outcome,” explains Max and Social Care provides respite care for to identify the best prediction of which Birchwood, Director of Birmingham young people in crisis in low stigma young people are likely to develop a Intervention Service. settings and PRIME FOCUS (recently psychosis. There has been significant investment in merged and renamed ‘Midland Heart’) the service from the Birmingham PCTs are now joint providers of the in the last two years. Solihull PCT has community early intervention teams. recently announced an investment Our partners have a strong reputation programme for 2006/07, which will in the city for innovative social inclusion fund an additional early intervention programmes, particularly among black Our early team bringing the total to five ‘sub and minority ethnic (BME) communities. teams’ across the patch within the “Our service works hard to engage intervention overall service providing specialist care people in low stigma settings to help to all young people in Solihull. These them control their illness,” continues services work hard are targeted at young people at high Max. “The team’s major focus is on to engage people in risk of developing psychosis and aim to getting people back into education, reduce any delay in treatment. We training and employment, working with low stigma settings achieve this by working with the city’s Connexions, LearnDirect and our education and youth agencies and voluntary sector partners. We have to help them control providing primary care training in the many success stories of people with early detection of psychosis. psychosis who have gone on to their illness ‘REDIRECT’, a project within Heart of university or secured good jobs Birmingham Teaching PCT and Eastern following treatment. Our partnerships 27512_BSMHT 18/9/06 6:13 pm Page 15
Birmingham and Solihull Mental Health NHS Trust Annual Report 2005-06
October 4-6th 2006 sees the service biggest challenge in the year ahead old for Birmingham Children’s Hospital hosting a major international will be working in a time of financial and too young for Adult Services. conference – ‘Beyond the Crossroads’ constraint with the PCTs to provide “This is something our Trust has – on the science and practice of early early intervention in line with DoH worked hard to resolve and it has intervention at Birmingham’s ICC. policy – it has been the main growth been very helpful having the clinical area in mental health in the city this As part of these developments in the time to get to know and understand year, and we are grateful for the help East of the City, we have recently 16-17 year olds and their pathways and support given by the PCTs to embarked on a new initiative – and learn about their needs.” developing services for young people tendering for a voluntary sector with this major mental illness.” Future plans include expanding the partner to provide eight assistant care team with the aim of setting a coordinators and three vocational 16 and 17 Year Olds: national benchmark – no other trust workers. FOCUS Futures, the mental New territory in the country operates such a service health and learning disability arm of in this way. Midland Heart (the merger of the April 2005 saw the launch of a unique Prime Focus and Keynotes service, specialising in a client group “The major challenge we face organisations), secured the contract, previously not catered for effectively concerns getting a consistent and it is hoped the workers will soon by the Trust. approach to mental health so that be in post, providing clients with Under the umbrella of the overall early CAMHS and Adult Services talk the additional opportunities, such as intervention services and working out same language, ensuring a more access to youth, homeless, housing of Miller Street, the Youth Support seamless transition from Young 15 and vocational services. Clinical Team – a staff of three, lead People’s to Adult Services,” adds Anne. Tim Newbold, Deputy Service Director by Consultant Psychiatrist Dr Anne highlights the excellent work resulting Jasper – make up the service for 16- “Our key objective in the next six from another successful partnership. 17 year olds. months is to work with the PCTs to The link-up with CSV Media has It was envisaged the requirement achieve an age-appropriate inpatient provided media training courses for would be for inpatient beds only, but solution across Birmingham and to service users, who have made three on further investigation we found a provide a comprehensive range of DVDs: an introduction to Early huge variability of young people in support for all young people who are Intervention, a pop video, a beds at any one time. coping with the double pressure of documentary on ID cards with a mental illness and the transition to further one about to start on So, a new model of working was adulthood. understanding psychosis – an developed offering outpatient, “Early intervention and ensuring that awareness tool for secondary schools. intensive support and inpatient a young person’s first episode of Two more DVDs are planned, while management when there’s no other psychosis is not a bad experience is CSV Media is also helping service help available. important in achieving a positive users produce a newsletter. “The gap in service for young people outcome.” Max Birchwood concludes: “For the aged 16-17 has presented a long-term immediate future, the new teams will challenge for Birmingham,” explains be building up their caseloads and Anne. “We now have a workable partnerships and reaching out to every solution, which provides for previously single person in Birmingham. Our excluded 16-17 year-olds, who are too 27512_BSMHT 19/9/06 3:35 pm Page 16
Helping people get better Substance misuse services: Taking action
It is estimated there are between In the last two years, SMS has reduced We provide four Throughcare and 6,000 and 7,000 drug users in waiting times for treatment from an Aftercare teams working across the Birmingham with a greater number of average of 40 weeks to under the four PCTs, one Drug Rehabilitation problematic drug users concentrated national target of three weeks. Other Requirement (DRR) provider team and in the Heart of Birmingham Locality, achievements include modernising the a Detox and Treatment Unit within where many areas are some of the appointment system to provide open HMP Birmingham, Winson Green. most deprived in England. access/drop in appointments; Approximately 60 new staff have been successfully decentralising stimulant In Birmingham, the Drug Action Team recruited to SMS over the past 18 services with plans to run the Mother has merged with the Community months to provide the DIP services, and Baby Services along similar lines in Safety Partnership, which in turn whose teams work in close the autumn; and a recent overhaul of reports to the Birmingham Strategic partnership with the police, probation, IT systems to provide electronic Partnership. The Community Safety prison and court. databases across all of our services Strategy aims to increase the number (we are the only SMS provider that “Part of our Trust’s core principles is to of people in drug treatment and boost submits data to the National put patients first and one of the ways public perception to result in a Treatment Agency electronically). in which we have approached this is cleaner, safer city and happier to develop a user involvement communities. In addition, the DASS (Detoxification 16 strategy,” adds Paul. “SMS has and Stabilisation Services) community- embraced this strategy and adapted it based team became fully operational to meet the unique demands of users in 2005, following a review of who have a substance misuse need.” inpatient services. The DASS 12-bed inpatient unit has a multi-disciplinary A recent example of this has been team, under the supervision of a 24- the recruitment of Martine Evans, User The city has an hour medical clinical led team, to co- Voice Development Worker, a service ordinate a single point of entry and user lead post with the brief of average retention ensure effective discharge, care developing and providing effective rate of 77% planning and appropriate aftercare and efficient services that retain drug support between social care partners. users in a meaningful way. against a national “A key challenge this year is the We also provide services to HMP relocation of the DASS inpatient Birmingham, which is the second average of 75% service from Church Road, largest remand prison in England with Edgbaston,” explains Paul Stewart, 1,450 inmates. Services include a 28- SMS Service Director. “Complex multi- bed detox unit, two 17-bed commissioning arrangements currently psychiatric units and a psychiatric in- exist for inpatient drug and alcohol reach team to cover the prison wings. services, which span two DATs and six Developments this year include the The overarching principle for drug PCTs. Commissioners have recognised introduction of a reception-based treatment in Birmingham is that an increased requirement for this qualified nurse offering mental health services meet the needs of the service and Tier 4 (inpatient and and detox assessments for new individual and operate as a ‘Treatment residential rehabilitation) has been prisoners. A Consultant Psychiatrist System.’ The focus of planning and identified as a priority for commissioning is therefore on commissioners within their Local ensuring that the individual’s Delivery Plans and Adult Treatment ‘treatment journey’ is effective, holistic Plans.” and accessible. The Drug Intervention Programme Part of our Trust’s Drug users are encouraged by the (DIP) – an important part of the core principles is to Birmingham Treatment Plan to enter, Treatment Plan in Birmingham – is engage in and complete treatment. now fully operational, a significant put patients first and The city has an average retention rate achievement given that it is the largest of 77% against a national average of DIP in the country spanning more one of the ways in 75% and significant progress has than 20 treatment providers. It seeks which we have been made by our Substance Misuse to reduce drug related crime by Services (SMS) in developing and engaging an increasing number of approached this is to redesigning services to meet the offenders in drug treatment and national and local targets and to provides ‘seamless’ treatment services develop a user improve the quality of treatment to those engaged in the criminal involvement strategy intervention. justice system (Throughcare) and those exiting structured treatment (Aftercare). 27512_BSMHT 18/9/06 6:13 pm Page 17
Birmingham and Solihull Mental Health NHS Trust Annual Report 2005-06
and a Prison Discharge Co-ordinator successful completions has risen to been demonstrated at the Norman have also been appointed to the 155 from a previous target of just Imlah Centre in Nechells. This service mental health services, funded by under 120. Birmingham district is helps and supports people with Heart of Birmingham Teaching PCT on responsible for 47.57% of the overall alcohol problems. behalf of the four PCTs, with the aim workload across the West Midlands of introducing IDTP (Integrated Drug region. Treatment Programme) in the autumn. Paul adds: “In order to meet this The Drug Intervention This will enable drug users in prison to target, the DAT has supported an receive 24-hour drug treatment Programme (DIP) – an expansion of the treatment provider interventions with bolted on aftercare team, which translates into one important part of the arrangements linked to our Trust’s Assertive Outreach Worker, an existing local services and monitored Treatment Plan in Administrator and sessional through the care co-ordination complementary therapy provision. Birmingham – is now fully process. These posts are aligned to reduce operational, a significant For the Birmingham DRR team, two attrition and increase retention in main Home Office targets, concerning treatment not only by targeting those achievement given that it is the number of new commencements who do not attend assessment, but by the largest DIP in the and successfully completed DRR re-engaging those who drop off the orders, have to be met over the caseload. This is enhanced by offering country spanning more course of the financial year. specific interventions to women, than 20 treatment stimulant users and other under- 17 The target for new commencements represented groups on the DRR providers for Birmingham in 2005/06 was 499, caseload.” and for the forthcoming year it has been increased to 507. The number of Significant user involvement has also
Clare Short MP opening the Trust’s drug treatment centre
Helping people get better New Facilities: Better Environments
It’s official! Our new hospital facilities in end of eight years’ hard work, Chief Executive, Sue Turner, explains: South Birmingham will be built. In planning, consultation and debate. “Mental health issues are something partnership with University Hospital we all face at some time – either These state of the art mental health Birmingham Foundation Trust, contracts ourselves directly or through our family, facilities will include two new mental have been signed to create new, friends and neighbours. The health centres in Edgbaston, a new modern hospital facilities. Our share accommodation we have had to work mental health centre in Sparkhill, and a creates a £70 million boost for new with over these past 10 years has been centre for older people’s services mental health facilities in Edgbaston, poor, and not of a standard I have been planned in Moseley. They all include Moseley, and Sparkhill. happy with – but we now have the single en suite bedrooms, separate opportunity of creating fantastic new The signing off in London was facilities for men and women, facilities services which we can all be proud of, completed by Glynis Markham where children can visit, enhanced and happy to recommend.” (Executive Director) and Stan Baldwin activity areas and an overall therapeutic (Non-Executive Director) and marks the and safe environment. 27512_BSMHT 18/9/06 6:13 pm Page 18
Helping people get better Complex care: Closer to home
Local solutions for The Community Liaison Group, whose during the 15-week consultation members include key individuals from period, which ended on January 6, complex needs the Bordesley Green community, along 2006. A wide range of meetings, at Our Trust is set to further improve with representatives from NHS which the project team was available forensic services to patients in the organisations and the police, provides to answer questions or concerns, were West Midlands following a positive a forum for discussion and a means also held with interested parties and outcome on February 9, 2006, when for residents to share their views. It local forums. also offers information on mental proposals for the new £37 million Karen Helliwell, director of the NHS health awareness and promotion, the mental health hospital in Bordesley West Midlands Specialised Services design of the new hospital and related Green, Birmingham, were approved. Agency (WMSSA), said: “We hope security issues and community that ultimately local people will The plans mean that many male regeneration, as well as equipping the understand that this unit is much- patients who are currently being cared NHS with a greater understanding of needed and could be an asset to their for miles away from their family and the local community. Meetings are area, creating jobs and regenerating a friends will be closer to home, which held bi-monthly and are supported by derelict site that is currently a target can be a major factor in treatment a range of on-going events and for vandalism – and be reassured by success. activities aimed at promoting mental the security measures in place.” 18 Following extensive public health awareness, employment consultation, the Heart of Birmingham opportunities and design features of It is anticipated that this hospital Teaching PCT Board – host PCT on the building. development would form part of a ‘health campus’ development on the behalf of all West Midlands PCTs – In addition, the development of the site, which would include primary care gave the green light on condition that hospital will depend upon services provided by Eastern the local community is kept informed consideration by Birmingham City Birmingham PCT, also working with and involved at every stage of the Council’s planning department – the Heart of England Foundation Trust, as development. Local communities still stage when local people can put well as the provision of adequate car have concerns about how this will forward their views on planning parking to meet both the existing work, so we have stepped up our aspects, both at outline and detailed needs of the site and future demands. collaborative work with them. planning stages. An outline planning application for Our strategy, including the The proposed hospital, on the derelict the site will be submitted this autumn establishment of a Community Liaison site of the former Yardley Green to the planning department for Group, has been developed by the Hospital, will accommodate 75 to 85 consideration. Subject to the project team to underpin ways of male patients as part of a West necessary approvals being in place, enhancing communication and Midlands region-wide plan to improve construction would start in 2008 with engaging more effectively with local specialist mental health services for the new hospital being operational in residents and groups. Tanveer this particularly vulnerable group of 2010. Choudhry has been appointed to the people. role of dedicated community The new hospital could create more More than 20,000 leaflets have been development worker, to forge than 300 permanent jobs. The project distributed in the Bordesley Green stronger links with the community and team has pledged that the recruitment area inviting local people to give their enable meaningful and sustained of local people would be encouraged, views about the development and involvement with local people and key both for the construction phase and three public meetings were held stakeholders. to work in the unit.
Helping people get better Small steps: Big impact
Heather Bartlett, Team Manager at the Stratford Road Centre, recently managed to secure funding from a local group to make a DVD, available through GP practices, for men experiencing depression. Other success stories include Pulse awards for the Small Heath Day Service for their work around outpatient clinics, and Small Heath Health Centre, for the innovative work carried out by Darren Smith with service users. Small Heath inpatients can now benefit from on- site activity groups, a gardening group and a shop. Members of staff from the Stratford Road Centre 27512_BSMHT 19/9/06 3:35 pm Page 19
Birmingham and Solihull Mental Health NHS Trust Annual Report 2005-06
Helping people get better Beyond barriers
This year we have placed a greater emphasis on language and communication with our staff, service users and local communities. Here are just two examples of how we have done this: Sign of the times A Deaf Awareness Day on May 4 enabled Trust staff to learn more about sign language.
This year we have Spelling out the words ‘deaf awareness’ in sign language are Vicky Sanders, freelance sign language interpreter, with Joe Taylor, Support Services Manager for BSMHT’s Specialties placed a greater Directorate 19 emphasis on the need for using facial expressions Speaking as one when talking to a deaf person.” A course aimed at equipping our language and Joe Taylor, co-organiser of the interpreters with a better communication with Awareness Day and Support Services understanding of service users’ needs, Manager, adds: “It would be helpful if proved useful in improving overall our staff, service reception staff could at least say communication skills. ‘hello’ or ‘goodbye’ or ‘can I help?’ in users and local sign language, and communicate via Mental Health Training For Interpreters, Typetalk. held at the Uffculme Centre, was communities organised to help overcome the challenges presented by working in a multi-cultural city such as Birmingham In an effort to encourage better and as part of our communication with deaf people, the commitment to diversity. event taught staff some basic signs and how to use Typetalk, a system of The course stressed that phone communication. there’s more to interpreting than merely The Birmingham Institute for the Deaf translating a service user’s (BID), the Royal National Institute for words. Likewise, those of Deaf People (RNID) – which offered our staff when an Trust staff free basic hearing tests – interpreter relays their and RNID Typetalk all had information words back to the service stalls at the Awareness Day, held at user. the Uffculme Centre. Mohammed Yassar, from Neil the Diversity Directorate, Patterson, explained our need for a Social large pool of interpreters Worker at to help translate the 100- Denmark plus languages that are House, spoken across the city. says: “We wanted to Mohammed Yassar (centre) and the interpreters Mir Iffat, an interpreter raise who attended the course, says: “They made it clear you don’t people’s “Our ultimate aim is to have at least think of just one point of view – either awareness one person in every unit who has the patient’s or medical person’s. of some basic knowledge of sign deafness language.” “You have to look at things from both and alert sides, judge how each one is reacting them to to the conversation and empathise with them.” 27512_BSMHT 18/9/06 6:13 pm Page 20
Helping people get better Maximising our resources Practice makes perfect for more work on standard six – important initiative for staff. The learning and development – before second stage was Practice Level, which Congratulations are in order after our awarding the Practice Plus standard. was gained by both previous Trusts just Trust attained Improving Working Lives prior to merger. (IWL) Practice Plus status in March And such were the efforts to meet the 2006. validation team’s requirements that we Although the initiative is now scored the highest marks possible in complete we will continue with the While the Strategic Health Authority training and development – recording work and ethos of IWL, which is seen had validated us in November, it asked perfect sixes for each of the six as fundamental to the well being of indicators. staff and for improvement in patient care. “The validation team was very This is a complimentary about all the work we The IWL infrastructure is now being have done,” said Jenny Wray, Assistant used to work on action plans to great piece of Director, Workforce IWL Project Lead. address the issues that have been raised by staff in the 2005 National They noted that we had used the Staff Survey. IWL service groups are news and Practice Plus initiative in a positive way looking at issues at a local level and to bring about changes and build our the Trust-wide steering group is 20 congratulations new organisation. working at a strategic level. “This is a great piece of news and Divided into the seven IWL standards, are due to congratulations are due to everyone work for the action plans is monitored involved.” everyone by the Staffing and Staff Management The journey started with Pledge, Sub-Committee, which reports involved where our Trust made a public through the clinical governance statement to work to the aims of this structure.
Treble celebration Just one of the ways we acknowledge the hard work and dedication our staff give to the Trust and the people we treat, was showcased at a major event organised by the Frantz Fanon Service on October 27. The event jointly marked World Mental Health Day, Black History Month and the bi- centenary of Mary Seacole, one of British history’s unsung heroines. Prizes at the Mary Seacole Achievers Award ceremony were presented by actor Nicholas Bailey (Dr Truman in BBC soap EastEnders) to members of staff and carers who were voted the most worthy of recognition by service users. There were three categories of award: 13 were received by service users; seven by carers and three by staff. “The event was extremely successful, with around 260 people attending,” explained organiser Camella Flemming. “It was a delight to see the excitement on the winners’ faces and from the feedback I received, everyone had a wonderful time.” Anjna Chavda and Nicholas Bailey at the Mary Seacole Achievers Award Ceremony 27512_BSMHT 18/9/06 6:13 pm Page 21
Birmingham and Solihull Mental Health NHS Trust Annual Report 2005-06
Helping people get better In our practice
Ward manager standards for better health, emergency Additionally, a group of six to eight Ward care and Agenda for Change. Managers have worked in project groups development called ‘learning sets’ under the In June 2005, our Trust held its first ‘in- mentorship of one of our Modern house’ conference for Ward Managers. Attendees evaluated Matrons and received further supervision Starting from a benchmark position that and support for their daily practice. would enable us to measure and the events very In terms of service improvement, this demonstrate our improvements, the programme has supported the conference’s aim was to create a service positively, especially development of our Emergency Care profile, reinforce the message of one in terms of peer processes; helped establish a pan-Trust service across our whole Trust, and be Delayed Discharge team; brought highly interactive and engaging. networking and the together Inpatient Rehabilitation Driven by the views and real concerns of Managers; identified minimum standards service users, carers and staff, this was senior commitment for nurse-led activities on inpatient areas; the start of a project led by Patrick created a ‘DiversiTeam’ to promote and Cullen, Inpatients Manager and Lead shown by our celebrate diversity in our inpatient Nurse for North Locality, to enable Ward services and developed a draft strategy 21 Managers to receive support and work Executive Team for Inpatient Rehabilitation Services with collaboratively with their peers to plans for a National Inpatient improve service. Rehabilitation Conference to put our These updates have been supplemented Trust at the forefront of this area of The four two-day mini-conferences by a number of question and answer mental health services. covered temporary staffing, finance, bed sessions with some of the most senior “Attendees evaluated the events very management developments in inpatient members of our Trust putting positively, especially in terms of peer care, risk management, human themselves in the hot seat to discuss the networking and the senior commitment resources management, Improving issues of the day. Working Lives, introduction to learning shown by our Executive Team,” sets, care programme approach, explains Patrick.
Helping people get better By being included
Charitable funds help “I’ve found that football helps service “If the staff get involved in the games, users forge relationships both with each as we do, it means everyone is equal. to fly the flag for other and Trust staff,” explains Alan It’s not a case of us and them and we football and mental Parker, a Community Project Officer, can establish trust between us.” health who led the trip with work colleague Delroy Edwards. The World Cup proved the perfect platform for Trust footballers banner at Birmingham International Airport promoting the SHIFT campaign – Football Fans against Stigma and Prejudice in Mental Health. Fanon FC, consisting of 20 of our Trust’s soccer- mad service users, was one of two teams of UK mental health patients who took on their German counterparts in a four-day competition in Frankfurt. The squad finished fourth out of 11. 27512_BSMHT 18/9/06 6:14 pm Page 22
Helping people get better By raising high standards
Measuring success In particular, we have gained standards: management of records; accreditation from the Institute of access to information and major Clinical Negligence Scheme Occupational Safety and Health (IOSH) incident planning. These areas of non- for Trusts (CNST) to run the ‘Healthcare Risk and Safety compliance were identified at the draft Management’ course in-house. declaration stage in October and Through its Clinical Negligence actions put in place to ensure that we Scheme, the NHS Litigation Authority Aimed at managers who have were compliant by March 2006 when (NHSLA) seeks to promote its operational responsibility for the health the final declaration was made. ➔ standards and the implementation of and safety of their area and staff risk management procedures and within it, this nationally accredited five- policies aimed at reducing risk. day course is spread over five weeks Birmingham and Solihull (one day per week). The final day Mental Health NHS Trust includes a written examination and the Equality Statement candidate has to prepare and submit a Birmingham and Solihull Mental The pass rate required health and safety project. Health NHS Trust is committed to for each of the standards Annual Health Check promoting equality of opportunity is 75 per cent and we for everyone, in the provision of 22 This year saw the introduction of the services and the employment of staff. achieved 100 per cent in Annual Health Check, a new performance assessment regime for Our Trust seeks to provide services four of the eight standards, NHS organisations conducted by the and employment in an environment with a fifth at 96 per cent. Healthcare Commission. free from discrimination, which It is designed to help us answer two benefits from the diversity, Our overall average questions: participation and involvement of staff percentage per standard • Are healthcare organisations getting and users. The Trust is strongly the basics right? opposed to all forms of unlawful, equated to 92.5 per cent unfair and unjust discriminatory • Are healthcare organisations making practice. and sustaining progress? We believe it is a fundamental In this first year of the new system, the We were assessed for compliance at principle that the Trust should act to Healthcare Commission has focused Level One of the CNST Mental Health promote equality of opportunity in on ensuring that basic standards are and Learning Disability Standards on the delivery of services and the being met. In future years, they will March 16 2006 and attained excellent employment of staff. Recognising look for evidence of continuous results. These new standards were that inequalities exist within our improvement as well as making sure introduced in April 2005. society, we are committed to looking that basic standards are being at ways to remedy this. The pass rate required for each of the maintained. standards is 75 per cent and we Our Trust will not discriminate Annual performance ratings for achieved 100 per cent in four of the directly or indirectly through applying 2005/06 are due to be published in eight standards, with a fifth at 96 per conditions or requirements that October 2006. The ratings will consist cent. Our overall average percentage cannot be shown to be justified. It is of two summary elements: Quality and per standard equated to 92.5 per cent. our policy to treat all job applicants Use of Resources. Both elements will and employees in the same way, The CNST Mental Health and Learning be given a score on the scale: regardless of race, gender, nationality Disability standards are currently under Excellent; Good; Fair; Weak. or national origin, marital status, review, with new standards being The assessment of Core Standards disability, sexual orientation, age, developed that will incorporate both requires us to make a declaration of Trade Union membership and clinical and non-clinical risk, such as compliance against 24 standards that political or religious belief. organisational, clinical and health and cover seven key areas or ‘domains’: Furthermore, we will monitor the safety risks. Safety; Clinical & Cost Effectiveness; composition of the workforce and We have applied to be a pilot site for Governance; Patient Focus; Accessible introduce positive action if it appears these new standards, which will come and Responsive Care; Care that this policy is not fully applied. into force in summer 2007. Environment & Amenities and Public Health. Health and Safety update We have maintained the For 2005/06, we have been cautious Employment Services Disability To underline our commitment to the and declared ourselves compliant with ‘Two Ticks’ (✓✓) symbol, which health and safety of our employees, 21 standards and non-compliant (in recognises our ongoing service users and visitors, we have some parts of the Trust for some part commitment to recruit and retain boosted training in this area for all of the year) in relation to three staff with disabilities. our staff. 27512_BSMHT 18/9/06 6:14 pm Page 23
The Healthcare Commission will cross- overall service quality. Performance management is all about check self-declarations for consistency making sure we deliver the standard A new Performance Management and against a range of national data sets of service that our users and the wider Monitoring Group has responsibility and information from other regulatory public expect. During 2006/07 we will for working with directorates to bodies, such as the Mental Health Act continue to develop our performance ensure that the source data for these Commission, before assigning us an processes, refining our internal reports is validated, that trends are overall score for this element of the measures to ensure that they are analysed and that recovery plans are 23 Annual Health Check. indicative of best practice and implemented if appropriate. supporting clinical teams in driving Performance against national targets Our information team (IM&T) are through real and sustainable is assessed largely by reference to integral to our performance improvements. nationally-collected data. Compared improvement, working with clinical to 2004/05, we performed better teams to improve the quality of the NICE across a range of targets but as yet data they are collecting and we do not know how our The National Institute for Clinical developing tools to enable areas of performance compares to that of Excellence (NICE) is the independent under-performance to be investigated other organisations and this will organisation responsible for providing and appropriate targeted action to be influence the score we are given. national guidance on the promotion taken. of good health and the prevention We also participated in two Through this collective approach, we and treatment of ill health. improvement reviews: one relating to have been able to reduce average community mental health services and We are working with other Trusts in a waiting times for first outpatient another relating to aspects of range of joint arrangements to ensure appointments, improve levels of ethnic substance misuse services (Community that health economy wide approaches origin and diagnostic coding Prescribing and Care Planning). For are made in implementing NICE (important for service planning) and, the Substance Misuse Review, we guidance. by addressing under-reporting of received an overall assessment of ‘fair’ activity, significantly improve our Our Trust has so far implemented all (as were 78 per cent of the performance against the national 12 technology appraisals which relate organisations reviewed). Feedback target for numbers of home treatment to the Trust and is working to meet from the Community Mental Health episodes. the standards required of 22 clinical Review is not yet available. guidelines relating to mental health. Our service improvement team has We will use our experience of the Significant work has been undertaken been working with directorates to 2005/06 Annual Health Check to in relation to meeting clinical simplify and standardise the Care develop plans and processes to ensure guidelines for self harm, nutrition and Programme Approval (CPA) process in that the Trust is able to demonstrate violence. our Trust. This means it is easier to further improvement in its ensure there is information for performance for 2006/07. Emergency Preparedness patients and through the treatment Internal Performance process there can be prompts to BSMHT has a well developed Major Incident Plan managed through the Management remind staff to make specific efforts to make sure users of the service Major Incident Planning Group This year we have continued to build understand their care plan and receive chaired by Alan Kenny, Director of on the processes put in place during a copy. Mental health issues are rarely Commercial Services and Asset 2005/06. experienced in isolation; this means Management. Our Major Incident Plan has been BSMHT Trust Board Each service area is provided with not all identified needs are met by approved and is regularly updated. In monthly reports showing performance mental health services but users can addition our Trust liaises with the against an agreed set of be supported to access mainstream wider NHS family to ensure our plan targets/indicators, designed to provide services, thus ensuring they remain complements acute and primary care a broad assessment and benchmark of included members of their community. NHS organisations. 27512_BSMHT 18/9/06 6:14 pm Page 24
Helping people get better Staff say...
We have again taken part in the • The number of reported errors, near In order to address the concerns National Staff Attitude Survey, misses or incidents, and the fairness raised by staff in the 2005 survey, conducted in autumn 2005 and and effectiveness of the procedures an Action Plan has been drawn up compiled for the Healthcare for reporting them by the Trust-wide Improving Commission by Aston University. All Working Lives (IWL) Steering Group • The percentage of staff suffering scores are compared to other mental to deliver the following initiatives: work-related injuries and stress health trusts nationally. • IWL healthy living events to be held • The quality of work life balance and Encouragingly, as a result of our for staff at different locations, job design (clear job content, proactive work and coordinated starting in September feedback and staff involvement), promotion and communication with although encouragingly, there has • Harmonisation of terms and staff, the overall response rate has been an improvement from 2004-05 conditions for temporary staffing risen to 70%. • The extent of positive feeling within • A new Trust policy on preventing The Healthcare Commission report the organisation, in terms of harassment and bullying, launched focuses on 28 key areas. communication, staff involvement, in June 2006 with associated While there were many positive innovation and patient care – again, training for staff responses, there are still areas that a positive change compared to 24 • On-going consultation on the need further work and improvement. 2004-05 development of a Race Equality Areas where our Trust scored well • The availability of hand washing Scheme with the launch of a Disability included: materials Equality Scheme planned for November 2006, to be followed by a • A good proportion of staff are • Staff job satisfaction Gender Equality Scheme early in 2007 taking advantage of flexible working • The intention of staff to leave their options • Partnership agreement with staff jobs side, including the appointment of • Many staff are receiving well Areas where there is room for two additional staff side colleagues structured appraisals with personal considerable improvement: to ensure that full use can be made development plans of the agreement • Few staff believed that they had • A high proportion reported working received training or development in • Further implementation of Continuous in teams the previous 12 months – the same Personal Development (CPD) / • Compared with the previous year, a applies to health and safety training Development Review Portfolios for all greater number felt they received Trust staff, including training • Many felt that they worked extra support from their immediate programmes to support their use hours due to the pressures and managers demands of the job • Identifying additional training for MAPA • There was an increased perception and risk assessments of potential • A good proportion reported of effective action from our Trust assaults on staff by service users witnessing potentially harmful towards violence and harassment errors, near misses or incidents • Piloting a ‘time bank’ for carers to Areas we scored well but where enable them to ‘save’ working time • A high number of staff experienced there’s room for further for occasions when they need time harassment, bullying or abuse from improvement included: off to care for dependant relatives either patients/relatives or colleagues • The percentage of staff working in a • Reviewing the flexible retirement well structured team policy, writing guidelines on working past retirement age and providing information and courses
THE WORDS OUR STAFF HAVE CHOSEN WHICH BEST REPRESENT THE VALUES OF OUR ORGANISATION ARE: Value Health Diverse Listen Human Educate OurSupport Understand TrustPositive These are at the heart of our corporate identity and set the tone for the way we do things in our day to day work. 27512_BSMHT 18/9/06 6:14 pm Page 25
Birmingham and Solihull Mental Health NHS Trust Annual Report 2005-06
Each service group has also put Already, the following initiatives • In South Locality and Specialities the forward an action plan detailing are being put in place in each Health and Safety group will review work they will undertake in service: all reported incidents of bullying and response to the individual harassment to establish themes and • North Locality has identified directorate reports of survey any underlying causes Champions for equality and diversity results in the following areas: to take their work forward • Heart of Birmingham Locality and • Raising awareness of childcare Older People’s Services are involved in • Forensic’s ‘Learning Lessons’ initiatives and caring for carers an Audit Commission pilot, looking newsletter will improve into reasons for sickness absence • Closer monitoring of excess working communication and ensure that the time and examining the reasons for learning from near misses is PALS staff working over their contracted cascaded to all staff Our Patient Advice and Liaison Service hours, as well as introducing (PALS) team is one of our vital supervision and workshops to resources to ensure that service users, address the high levels of stress carers and staff are able to gain access reported to information, specialist advocacy • Further initiatives concerning the services and problem resolution involvement of staff in decision- We communicate services. making and recognition of their PALS has helped in excess of 220 achievements regularly with our teams of workers within our Trust in 25 • Further delivery of anti-harassment staff through a the past year. More than 10,000 and cultural awareness training leaflets have been provided in folders – allowing teams to copy up-to-date • Looking behind the reasons for the variety of different literature for patients and carers. The perceptions about lack of health and PALS team has also worked with our safety training methods IT department to ensure leaflets are • Better internal communication, stored electronically for staff to print including Trust-wide road shows off immediately. We intend to develop focusing on the application for this work further in the coming year. Foundation Trust status and • Senior managers in East Locality will continued regular walkabouts at the Communications with staff attend team meetings on a regular New Hospital Project site basis, focusing on achievements and We communicate regularly with our • Further promotion of hand washing sharing with staff the service/Trust’s staff through a variety of different to staff, including posting the hand current priorities methods. These include a monthly washing decontamination policy on Team Talk – a verbal briefing system • Our Older People’s Services have the Trust intranet and launching which cascades Trust-wide information initiated a staff recognition award hand washing road shows across the to all staff and our bi-monthly for the ‘Unsung Hero’ Trust in October 2006 newsletter Trust Talk. Helping people get better Learning right from wrong
During the year, our Trust received a total • Communication improvement where delivered, are now logged in the post of 341 complaints – of which 306 (90%) patients will receive an book and noted where they are were resolved within 20 working days. acknowledgement letter from the sent to This is an improvement on the previous Medical Director upon receipt of a • Improvements have been implemented year, when 79% were resolved within 20 request for a change of Consultant, in Heart of Birmingham Locality working days. assuring patients that this will be concerning the referral to services considered As a Trust which encourages feedback • Following a review with Forensic (good and bad), our formal complaints • The decision to continue with a service Services, a procedure has been procedure is an invaluable method of user event within our East Locality, adapted so that patients are now identifying areas where services can be previously withdrawn due to cost. The searched before being allowed on improved, embarking on ways to solve event was adapted to the satisfaction leave. Also, during the ‘missing problems or issues and learning from any of patients, while reducing overall cost persons’ process, the family will be shortfalls in service quality. • Transfer arrangements for inpatients offered a sole point of contact Examples of improvements made in the have been changed in South Locality • Facilities at our North Locality have service over the last 12 months as a • Record keeping at East Locality has been looked at and as a result, direct result of investigating complaints, been improved so that all letters, individual storage lockers for patients include: including those that are hand have been purchased 27512_BSMHT 18/9/06 6:14 pm Page 26
Helping people get better Going for gold – Foundation Trust Application
By this time next year, BSMHT and our back to the people who use them, plans to improve them and how wider stakeholders could be enjoying work within, and live alongside activities will be monitored to ensure greater financial freedoms and services in the communities. they are of the highest standard. autonomy from the Department of “There is now a genuine Health if our application to attain determination by the Government to Foundation Trust status is granted. involve Mental Health Trusts in Although this will take considerable becoming FTs and we believe it will effort and work by everyone involved We believe it will help us in our development as a high as well as commitment and quality provider of mental health involvement from all staff, the Trust help us in our services,” explained Karen Martin, will no longer be accountable to Executive Director of Organisational traditional NHS hierarchies but to the development as a and Workforce Development and FT local community instead. high quality provider project director. Foundation Trusts (FTs) – like those at “Preparatory work has already begun Birmingham’s University Hospitals and of mental health and the involvement of service users the new Heart of England NHS FT – and stakeholders at every stage is 26 allow staff, users, carers and partner services crucial in preparing for FT status. Their agencies a greater say in how the input is a vital element of the organisation is run. preparation for our application and their thoughts, comments and queries FTs are governed by a new corporate are welcomed as we take this journey structure, which is still within the NHS If approved, BSMHT could become together. There will be a programme framework, but typically includes licensed as an FT by April 1, 2007. of communication specifically around more than 10,000 ‘members’ However in the first instance , a FT with regular updates on the comprising local residents and robust business planning process with intranet. patients, who elect some of the Trust’s detailed financial projections must be governors. worked up, as this will be the key to a “Our Trust Board believes that the successful application. additional flexibilities and the Our FT would have an Assembly of improved governance arrangements Governors elected by the members The financial regime for FTs is very offered by FT status make it from public, staff and stakeholder different to NHS Trusts, with a more something worth attaining and we are ‘constituencies’, such as local commercial approach to financial therefore pursuing this with vigour.” authorities, universities, staff and management and greater significance patient groups and representatives. placed on cash flow and risk If you would like to apply for management. Plans must therefore Foundation Trust membership This means that the Board and show how the Trust intends to complete the form inserted or governors are directly accountable to manage its affairs in this commercial telephone 0121 301 1229. the FT’s ‘members’ – giving greater climate, as well as being clear about ‘ownership’ of the NHS organisations the services it aims to provide, how it
Jenny Wray at the Foundation Trust consultation launch 27512_BSMHT 18/9/06 6:14 pm Page 27
Birmingham and Solihull Mental Health NHS Trust Annual Report 2005-06
OPERATING AND FINANCIAL REVIEW 2005/06
This section gives a “business-like” assessment of the Trust’s performance in 2005/06. It follows good practice guidelines published by the Department of Health following requirements of the Companies Act 1985 and the Accounting Standards Board’s Reporting Standard 1.
1. The business of the Trust BSMHT is a specialist provider of services to people suffering from mental ill health. It undertakes this role mainly for people in the Birmingham and Solihull conurbations – but also provides more specialist services to a wider population extending into the West Midlands and beyond.
organised into five directorates:- c. About our Trust – What a. KEY FACTS Eastern Birmingham, Heart of we have achieved so far Birmingham, North Birmingham and Income – approx £180 million. Solihull and South Birmingham. The Trust was formed in 2003, from a merger of North and South OLDER ADULTS – Older People’s Staff – 4000, one of the largest Birmingham Mental Health Trusts. In 27 and most complex mental health Services provide mental health services the last three years we have: NHS Trusts in the country. to people aged 65 and over who are experiencing either functional or • Achieved financial balance every year. Area – we serve a culturally and organic mental health problems. We socially-diverse population of 1.2 also provide a working age dementia • Ensured that crisis and home million spread over 172 square service. treatment services are now available miles. SUBSTANCE MISUSE SERVICES – 24/7 across the whole of Substance Misuse Services provide a Birmingham and Solihull. Sites – 110 sites around range of services that aim to prevent • Opened a new specialist forensic unit Birmingham and Solihull including and treat substance misuse and for women and young people at hospitals, secure accommodation, improve community safety. Ardenleigh. community based facilities and • Developed the Meriden family daycare services. Most of these are based within the local community. programme to support families and Referrals – around 50,000 adults FORENSICS – Our Forensic Service service users. with a range of mental health provides assessment, treatment and • Taken on the provision of mental issues. On a typical week day we rehabilitation to people with severe health services in HMP Birmingham see 1500 different people in a mental health problems who have Winson Green in partnership with variety of settings across committed a criminal offence or who Heart of Birmingham teaching Birmingham and Solihull. have shown seriously aggressive or Primary Care Trust. threatening behaviour. • Encouraged service users and carers Hospital treatments – over to get more involved in the 3,000 every year. SPECIALTIES – Our Specialty Services provide very specialised care for people organisation, through the with highly specific mental health development and expansion of User b. The services we provide problems, both to local people and Voice. those living outside the Birmingham Our services are organised into nine • Achieved the final go-ahead to and Solihull area. These include:- clinical directorates, focusing on a develop new hospital facilities across service for deaf people, service for particular locality or the needs of a the city, to replace the outdated people with eating disorders, support particular group of service users. facilities at QEPH. for people with problems resulting • Developed plans and building work ADULTS – within general adult mental from injury to the brain, psychotherapy health services we have a number of for three new hospital sites across service, a service for mothers and the city. teams providing local services in a babies and a service for people with • Expanded the new Drug Intervention variety of inpatient and community personality disorders. based settings. Our adult services are Programme within the criminal justice network. • Integrated health and social care services in Birmingham and Solihull with over 300 social care staff joining the Trust. • Developed new Gateway and Primary Care Graduate Worker roles in partnership with our PCTs. 27512_BSMHT 18/9/06 6:14 pm Page 28
d. Key Performance Indicators As a Trust with very diverse services, it is difficult to break down our workload into different categories in a meaningful way. In this year’s report, we have chosen to highlight the key Department of Health targets and how we have fared. These are major factors in successful delivery of the Mental Health National Service Framework (NSF). Some summary charts are shown below to illustrate various aspects of performance.
On average every day in 2005-06 there were: • Over 700 inpatient beds occupied • Over 200 Day Care sessions attended • Nearly 400 Clinic attendances • Over 800 Community Contacts
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In 2005-06 there were over 42,000 service users of the Trust’s services – an increase of 4% over the previous year. 27512_BSMHT 18/9/06 6:14 pm Page 29
Birmingham and Solihull Mental Health NHS Trust Annual Report 2005-06
Waiting times for an Out-Patient appointment fell from an average of 31 days at the start of 2004-05 to under 26 days at the end of 2005-06.
This shows the target and actual workloads for assertive outreach teams. These consistently exceeded national targets. 29
This shows the target and actual workloads for home treatment teams. These consistently exceeded national targets.
This shows the target and actual workloads for early intervention services. These were overall below target, due to the funding phasing of developments which meant new teams came on stream later in the year. 27512_BSMHT 18/9/06 6:14 pm Page 30
2. The financial position of the Trust The Financial Summary which starts on Page 31 shows the detailed financial statements of the Trust’s financial performance in 2005/06. In summary the in-year financial position can be shown as: Against an income target of £175m in 2005/06, the Trust broke even in 2005/06 2004/05 increase income and expenditure terms. More £000 £000 % details are shown in the financial summary section and in more detail in Income 175,061 165,369 5.9% the annual accounts 2005/06 which Expenditure 175,061 165,369 5.9% can be obtained from the Finance (Surplus)/ Deficit 0 0 Department at the Trust. At the end of 2005/06 the “value” of the Trust in terms of land, buildings, In terms of the Trust’s “worth” as shown in the Balance Sheet in the equipment and monies owed and Financial Summary. It may be summarised as follows: owing is £127m. This is nearly 2% higher than the year before – 2005/06 2004/05 change represented by a rise in the value of £000 £000 % fixed assets and a number of building Fixed Assets 128,794 126,505 1.8% projects. 30 Current Assets 11,068 13,092 -19.9% In liquidity terms the Trust has sufficient cash to meet all known Current Liabilities -11,802 -10,615 11.2% liabilities in 2006/07. Provisions -1,037 -4,305 -75.9% TOTAL ASSETS EMPLOYED 127,023 124,677 1.9% Financed by: Public Dividend Capital 97,057 99,020 -2.0% Reserves 29,966 25,657 16.8% 127,023 124,677 1.9%
3. Prospects for the Future The Trust has set a balanced budget for 2006/07. This includes an ambitious recurrent savings target of £8m – which has largely been identified and withdrawn from budgets. We have devised and are currently consulting on our key objectives to improve and develop services over the next five years to meet the needs of our diverse geographical, social and cultural communities.
Our service development plans to combat stigma. already agreed are: • Community Mental Health Teams • Third forensic service – we are • Mental health for older people (CMHTs) – we will work with primary developing a third forensic unit for strategy – the implementation of care partners to ensure people men on the Yardley Green NHS site the city wide strategy for mental receive the most appropriate care in in Eastern Birmingham (see page 18). health services for older people to the most appropriate settings (see • Child and Adolescent Mental provide more support at home (see page 10). Health services (CAMHS) – we aim page 12). • New Hospitals Project – the re- to develop local services for young • Review of daycare facilities and provision of acute inpatient services people aged 16-17 years rather than strategy in partnership with currently on the Queen Elizabeth site young people having to travel a Birmingham City council – to in order to provide modern services distance away from family and provide services that support the social at the Queen Elizabeth site friends (see page 15). inclusion, employment and wider Edgbaston, Showell Green Lane, citizenship of service users while trying Sparkhill and Moseley Hall, Moseley. 4. Principal Risks and Uncertainties The Trust receives over 75% of its income from the Birmingham and Solihull PCTs. The key risk to the Trust’s sustained future financial viability is the financial position of these PCTs. The change to the NHS financial regime in 2006/07 has put pressures on the local PCTs’ finances and the Trust continues to work closely in partnership with local PCTs to ensure this does not prejudice the future financial position of the Trust. 27512_BSMHT 18/9/06 6:14 pm Page 31
Birmingham and Solihull Mental Health NHS Trust Annual Report 2005-06
FINANCIAL SUMMARY
You will find on pages 31 to 37 a summary of the accounts of our Trust for the financial year 2005/06. They follow closely the accounts of private companies and can appear complex. If we look at the principal factors of the financial performance of our Trust it is measured against four targets: • To balance expenditure with income: Our Trust achieved this target. • To achieve a capital absorption rate of 3.5%. Our Trust achieved 3.4%; this is within the target range set by the NHS Executive. • To achieve an external financing limit agreed with the NHS Executive. This governs the level of borrowing and capital expenditure and is effectively a cash limit. The target for our Trust was – £1.963 million, which it achieved. • To achieve a capital resource limit agreed with the NHS Executive. This governs the amount of capital expenditure the Trust has to spend. The target for our Trust was £1.261 million, which it achieved. Further summary analysis can be found in the accompanying notes to the financial statements. A full set of accounts including a statement on internal control is available from Mr. C Walker, Deputy Director of Finance, BSMHT Trust Headquarters, Finance Department, Unit 1, B1, 50 Summerhill Road, Birmingham, B1 3RB. Our Trust also has a connected charity, Birmingham & Solihull Mental Health NHS Trust General Charity. A separate annual 31 report and a full set of accounts for the Charity are also available on request.
Independent auditors’ report to the Directors of the Board of Birmingham and Solihull Mental Health Trust I have examined the summary financial statements set out on pages 31 to 37. This report is made solely to the Board of Birmingham and Solihull Mental Health Trust in accordance with Part II of the Audit Commission Act 1998 and for no other purpose, as set out in paragraph 36 of the Statement of Responsibilities of Auditors and of Audited Bodies prepared by the Audit Commission. Respective responsibilities of directors and auditors The directors are responsible for preparing the Annual Report. My responsibility is to report to you my opinion on the consistency of the summary financial statements within the Annual Report with the statutory financial statements. I also read the other information contained in the Annual Report and consider the implications for my report if I become aware of any misstatements or material inconsistencies with the summary financial statements. Basis of opinion I conducted my work in accordance with Bulletin 1999/6 ‘The auditors’ statement on the summary financial statement’ issued by the Auditing Practices Board. Opinion In my opinion the summary financial statements are consistent with the statutory financial statements of the Trust for the year ended 31 March 2006.
Mark Stocks, Engagement Lead, No. 1 Friarsgate, 1011 Stratford Road, Solihull, West Midlands B90 4EB Date: 4th September 2006 27512_BSMHT 18/9/06 6:14 pm Page 32
FINANCIAL SUMMARY
2003/2004 2004/2005 2005/2006 £000 £000 £000 Income 147,656 165,369 175,061 Expenditure (144,822) (162,304) (171,145) Operating Surplus 2,834 3,065 3,916 Interest Net Dividends Payable (2,834) (3,065) (3,916) Surplus for the Year 0 0 0 Financial Target Performance 3.7% 3.2% 3.4%
Our Trust’s external auditors are the Audit Commission. During 2005/06, the auditors performed both statutory and further assurance audits. The statutory audit, which includes the audit of the Trust’s statutory accounts and further assurance audits, which include governance and performance management audits, cost the Trust £165,000 (£141,000 2004/05). The audit work programme for the year is overseen by the Audit Committee, a statutory sub-committee of the Board. The Audit Committee was chaired by Andrew Nicholls (non Executive Director) and its membership includes Patricia Brookfield, Athelston Sealy, Rubina Mian, Anne Reid (all non Executive Directors). This is supported by external and internal Audit representatives and the Finance Director. 32 BETTER PAYMENT PRACTICE CODE – MEASURE OF COMPLIANCE
2005/2006 2004/2005 Number £000 Number £000 Total bills paid in the year 43,086 35,649 34,206 24,850 Total bills paid within target 39,378 34,296 30,794 23,507 Percentage of bills paid within target 91.39% 96.20% 90.03% 94.60%
The NHS Executive requires that Trusts pay their non-NHS creditors in accordance with the CBI Prompt Payment Code and Government accounting rules. The target is to pay non-NHS creditors within 30 days of receipt of goods or a valid invoice (whichever is the later) unless other terms have been agreed with the supplier.
INCOME AND EXPENDITURE ACCOUNT FOR THE YEAR
2005/2006 2004/2005 £000 £000 Income from activities: Continuing operations 157,359 146,724 Other operating income 17,702 18,645 OPERATING EXPENSES: Continuing operations (171,145) (162,304) OPERATING SURPLUS Continuing operations 3,916 3,065 Cost of fundamental reorganisation/restructuring 0 0 Profit on disposal of fixed assets 0 6 SURPLUS BEFORE INTEREST 3,916 3,071 Interest receivable 397 297 Interest payable 0 (3) Other finance costs – change in discount rate on provisions (128) 0 SURPLUS FOR THE FINANCIAL YEAR 4,185 3,365 Public Dividend Capital dividends payable (4,185) (3,365) RETAINED SURPLUS FOR THE YEAR 0 0 27512_BSMHT 18/9/06 6:14 pm Page 33
Birmingham and Solihull Mental Health NHS Trust Annual Report 2005-06
STATEMENT OF TOTAL RECOGNISED GAINS AND LOSSES FOR THE YEAR
2005/2006 2004/2005 £000 £000 Surplus for the financial year before dividend payments 4,185 3,365 Fixed asset impairment losses 0 0 Unrealised surplus on fixed asset revaluations/indexation 4,370 18,116 Increases in the donated asset and government grant reserve due to receipt of donated and government grant financed assets 0 0 Additions/(reductions) in “other reserves” 0 0 Total recognised gains and losses for the financial year 8,555 21,481 Prior period adjustment 0 0 Total gains and losses recognised in the financial year 8,555 21,481
33 BALANCE SHEET AS AT 31 MARCH 2006
2005/2006 2004/2005 £000 £000 FIXED ASSETS Intangible assets 12 32 Tangible assets 128,782 126,473 128,794 126,505 CURRENT ASSETS Stocks and work in progress 408 429 Debtors 10,528 12,531 Investments 0 0 Cash at bank and in hand 132 132 11,068 13,092 CREDITORS: Amounts falling due within one year (11,802) (10,615) NET CURRENT ASSETS (LIABILITIES) (734) 2,477 TOTAL ASSETS LESS CURRENT LIABILITIES 128,060 128,982 PROVISIONS FOR LIABILITIES AND CHARGES (1,037) (4,305) TOTAL ASSETS EMPLOYED 127,023 124,677 FINANCED BY: CAPITAL AND RESERVES Public dividend capital 97,057 99,020 Revaluation reserve 27,048 22,968 Donated Asset reserve 2,572 2,538 Government grant reserve 148 151 Income and expenditure reserve 198 0 TOTAL CAPITAL AND RESERVES 127,023 124,677 27512_BSMHT 18/9/06 6:14 pm Page 34
MANAGEMENT COSTS
2005/2006 2004/2005 £000 Percentage of £000 Percentage of Income Income Management costs 8,413 4.81% 10,782 6.52% Income 175,061 165,369
CASH FLOW STATEMENT FOR THE YEAR ENDED 31 MARCH 2006
2005/2006 2004/2005 £000 £000 OPERATING ACTIVITIES Net cash inflow from operating activities 7,169 5,292
34 RETURNS ON INVESTMENTS AND SERVICING OF FINANCE: Interest received 396 293 Interest paid 0 (3) Interest element of finance leases 0 0 Net cash inflow/(outflow) from returns on investments and servicing of finance 396 290 CAPITAL EXPENDITURE Payments to acquire tangible fixed assets (3,591) (13,413) Receipts from sale of tangible fixed assets 2,174 3,077 (Payments to acquire)/receipts from sale of intangible assets 0 0 Net cash inflow (outflow) from capital expenditure (1,417) (10,336) DIVIDENDS PAID (4,185) (3,365) Net cash inflow/(outflow) before management of 1,963 (8,119) liquid resources and financing MANAGEMENT OF LIQUID RESOURCES Purchase of investments 0 0 Sale of investments 0 0 Net cash inflow (outflow) from management of liquid resources 0 0 Net cash inflow (outflow) before financing 1,963 (8,119) FINANCING Public dividend capital received 0 8,119 Public dividend capital repaid (not previously accrued) (1,963) 0 Public dividend capital repaid (accrued in prior period) 0 0 Loans received 0 0 Loans repaid 0 0 Other capital receipts 0 0 Capital element of finance lease rental payments 0 0 Cash transferred from/to other NHS bodies 0 0 Net cash inflow (outflow) from financing (1,963) 8,119 Increase (decrease) in cash 0 0 27512_BSMHT 18/9/06 6:14 pm Page 35
Birmingham and Solihull Mental Health NHS Trust Annual Report 2005-06
CERTIFICATES
35 27512_BSMHT 18/9/06 6:14 pm Page 36
PENSION ENTITLEMENTS OF SENIOR MANAGERS
Real increase Lump sum at Total accrued Lump sum at Cash Cash Real Increase Employers in pension at age 60 pension at age 60 related Equivalent Equivalent in Cash Contribution age 60 related to real age 60 at 31 to accrued Transfer Transfer Equivalent to increase in March 2006 pension at 31 Value at 31 Value at 31 Transfer Stakeholder pension March 2006 March 2006 March 2005 Value Pension (bands of (bands of (bands of (bands of £2500) £2500) £5000) £5000) To nearest Name and Title £000 £000 £000 £000 £000 £000 £000 £100
Dr J Shapiro n/a n/a n/a n/a n/a n/a n/a n/a (Chairman)
Ms A Reid n/a n/a n/a n/a n/a n/a n/a n/a (Non-Executive Director)
Mr A Nicholls n/a n/a n/a n/a n/a n/a n/a n/a n/a (Non-Executive Director)
Mr WS Baldwin n/a n/a n/a n/a n/a n/a n/a n/a n/a 36 (Non-Executive Director)
Mr A Sealey n/a n/a n/a n/a n/a n/a n/a n/a n/a (Non-Executive Director)
Dr R Mian n/a n/a n/a n/a n/a n/a n/a n/a n/a (Non-Executive Director)
Mrs P Brookfield n/a n/a n/a n/a n/a n/a n/a n/a n/a (Non-Executive Director)
Prof P Marquis n/a n/a n/a n/a n/a n/a n/a n/a n/a (Non-Executive Director)
Ms S Turner 2.5 - 5 7.5 - 10 35 - 40 110 - 115 500 431 41 0 (Chief Executive)
Dr N Deuchar 0 0 15 - 20 45 - 50 216 196 10 0 (Medical Director)
Mr P Chew 2.5 - 5 12.5 - 15 10 - 15 35 - 40 126 92 22 0 (Finance Director)
Ms G Markham 0 - 2.5 2.5 - 5 0 - 5 5 - 10 41 19 15 0 (Director of Strategic Development)
Ms N Carder 0 - 2.5 2.5 - 5 0 - 5 5 - 10 33 17 11 0 (Director of Operations)
Mrs K Martin 2.5 - 5 10 - 12.5 25 - 30 75 - 80 317 258 37 0 (Director of Organisational & Workforce Development)
Ms R Alstead 5 - 7.5 20 - 22.5 30 - 35 95 - 100 448 331 76 0 (Director of Nursing)
Mr A Kenny* 0 2.5 - 5 0 - 5 0 - 5 22 7 11 0 (Director of Commercial Services & Asset Management)
*This director commenced in post in October 2004. The remuneration and terms and conditions for Executive directors were set by the Remuneration Committee, based on national guidelines where appropriate. The Remuneration Committee is chaired by Jonathan Shapiro and its membership consists of all non-executive directors. 27512_BSMHT 18/9/06 6:14 pm Page 37
Birmingham and Solihull Mental Health NHS Trust Annual Report 2005-06
SALARY AND ALLOWANCES OF SENIOR MANAGERS
2005-06 2004-05 Salary Other Benefits in Salary Other Benefits in Remuneration kind Remuneration kind (bands of (bands of (Rounded to (bands of (bands of (Rounded to £5000) £5000) the nearest £5000) £5000) the nearest £100) £100) Name and Title £000 £000 £ £000 £000 £
Dr J Shapiro 20 - 25 0 0 20 - 25 0 0 (Chairman)
Ms A Reid 5 - 10 0 0 5 - 10 0 0 (Non-Executive Director)
Mr A Nicholls 5 - 10 0 0 5 - 10 0 0 (Non-Executive Director)
Mr WS Baldwin 5 - 10 0 0 5 - 10 0 0 (Non-Executive Director) 37 Mr A Sealey 5 - 10 0 0 5 - 10 0 0 (Non-Executive Director)
Dr R Mian 5 - 10 0 0 5 - 10 0 0 (Non-Executive Director)
Mrs P Brookfield 5 - 10 0 0 5 - 10 0 0 (Non-Executive Director)
Prof P Marquis 5 - 10 0 0 5 - 10 0 0 (Non-Executive Director)
Ms S Turner 125 - 130 0 0 120 - 125 0 0 (Chief Executive)
Dr N Deuchar 80 - 85 15 - 20 0 90 - 95 20 - 25 0 (Medical Director)
Mr P Chew 70 - 75 0 0 0 0 0 (Finance Director)
Ms G Markham 85 - 90 0 0 75 - 80 0 200 (Director of Strategic Development)
Ms N Carder 85 - 90 0 0 85 - 90 0 0 (Director of Operations)
Mrs K Martin 85 - 90 0 0 75 - 80 0 600 (Director of Organisational & Workforce Development)
Ms R Alstead 85 - 90 0 0 80 - 85 0 0 (Director of Nursing)
Mr A Kenny* 90 - 95 0 0 30 - 35 0 0 (Director of Commercial Services & Asset Management)
The benefits in kind relate to the provision of a lease car. *This director commenced in post in October 2004. 27512_BSMHT 18/9/06 6:14 pm Page 38
TRUST BOARD AND MANAGEMENT
All members of the Trust subscribe to the Code of Conduct for NHS Boards. Our directors, managers and staff are required to adopt high standards of corporate and personal conduct in respect of offers of hospitality, declaration of interests and prevention of fraud and corruption. Policies relating to these matters are available from the Legal Department. Our Chief Executive (appointed 1st April 2003) and Executive Directors were appointed via rigorous nationwide recruitment processes which were in line with national and local guidance. All Executive Directors are appointed on a permanent basis to posts which are subject to six months’ notice. Trust Board Sub-Committees Our Trust Board has a number of statutory sub-committees which are chaired by Non-Executive Directors, as follows: Remuneration Sub-Committee – Jonathan Shapiro Clinical Governance Sub-Committee – Peter Marquis Audit Sub-Committee – Andrew Nicholls Mental Health Act Lay Managers – Patricia Brookfield Complaints Sub-Committee – Athelston Sealy Charitable Funds Sub-Committee – Andrew Nicholls Trust Board – Declaration of Interests
Non-Executive Directors Independent Consultant Director, 38 Practice in Organisation & Apricot Blue Ltd. Senior Fellow, Health Manager Development. Services Management Associate Consultant of Centre, University of The British Association of Birmingham. Anne Reid Medical Managers. Nette Carder Director, Policy Non-Executive Director Associate Fellow of the Director of Operations Dr Jonathan Shapiro Development Partnership Institute for Employment (PDP) Consultancy. Studies. Chairman No interests to declare.
Director of Oxford Stress No interests to declare. Diagnostics. Director of Oxford Medistress. Glynis Markham Patricia Brookfield Director of Strategic Dr Rubina Mian Development Non-Executive Director Non-Executive Director
No interests to declare. Director, West Midlands Executive Directors Development Agency. Board Member, Advantage No interests to declare. West Midlands. Chairman, Black Business Karen Martin Athelston Sealy in Birmingham. Director of Workforce Non-Executive Director Franchisee, McDonald’s and Organisational Sue Turner Restaurant. Development Chairman, Sandwell Chief Executive African-Caribbean Development Agency. No interests to declare. No interests to declare. Employee, MIND in Birmingham. Director, Asian Advice and Housing Services. Alan Kenny Paul Chew Andrew Nicholls Director of Commercial Director of Finance Services and Asset Non-Executive Director Management
Board Member, Centre Dean of Life and Health for Health & Healing, St. Sciences, University of Director, Women and Martin’s Church, Theatre. Birmingham. Birmingham Bull Ring. Chairman, CPD HQ Limited. Dr Neil Deuchar Professor Peter Marquis Medical Director Lakhvir Rellon Non-Executive Director Director of Diversity
Self-employed consultant. No interests to declare.
Stan Baldwin Ros Alstead Non-Executive Director Director of Nursing 27512_BSMHT 18/9/06 6:14 pm Page 39
Birmingham and Solihull Mental Health NHS Trust Annual Report 2005-06
SERVICE DIRECTORATES AND MAIN TRUST SITES
Forensic Services Specialty Services Substance Misuse Services (tel: 0121 678 3000) (tel: 0121 678 2000) (tel: 0121 301 1600) Service Director – Dave Newnham Acting Service Director – Pat Service Director – Paul Stewart Acting Clinical Director – Dr Jeremy Hemmings Clinical Director – Dr Alex Copello Kenney-Herbert Clinical Director – Jan Birtle Orsborn House Reaside Clinic Queen Elizabeth Psychiatric Hospital The Bridge Hillis Lodge Main House Mary Street Centre Ardenleigh Devon House Slade Road Centre Denmark House Azaadi Centre Mental Health Service for Older Bridger House Norman Imlah Day Centre People (tel: 0121 678 2066) Denis Shilston House North DIP Team at Bridge House Service Director – Brian Toner Annexe Acting Clinical Director – Ros Alstead East Locality HoB DIP Team at Summerhill Terrace 39 Ashcroft House (tel: 0121 301 5500) East DIP Team at Cartland House Calum Lodge Service Director – Diana Morgan South DIP Team at Imperial Court Little Bromwich Centre Clinical Director – Dr Vidya Sagar For your information, The Prison Reservoir Court Newbridge House Mental Health Service and Prison Marsh Lane Centre Riverside Detox Service based at HMP Queen Elizabeth Psychiatric Hospital Northcroft Birmingham also come under this Maple Leaf Drive Unit Underwood Centre directorate as well as the COMPASS team at Frantz Fannon Centre. John Black Day Centre Old Fire Station Solihull Hospital (Ward 10) Morcom House North Locality Hollyhill (tel: 0121 301 5500) Avonside South Locality Service Director – Bernadette Byrne Nightingale House (tel: 0121 678 2000) Clinical Director – Dr Robert Wall Service Director – Jo Beale Patrick House Heart of Birmingham Locality Clinical Director – Dr Mohan George Bridge House (tel: 0121 685 6972) Queen Elizabeth Psychiatric Centre Phoenix Day Centre Service Director – Ken Jackson Ten Acres Centre Highcroft site inpatient units Clinical Director – Dr Peter Lewis Spring Road Northcroft Mary Seacole Warstock Lane Health Centre Harry Watton House Yewcroft Centre Small Heath Centre Longbridge Health Centre Morcom House Shenley Fields Resource Centre Ladywood Centre Radclyffe House Main Street Resource Centre Greenbank Stratford Road Day Centre Grove Road, Rehabilitation and Soho House Recovery Magnolia House Ross House Scarborough House Grove Avenue
Solihull Locality (tel: 0121 678 4800) Acting Service Director – Marie Tolster Clinical Director – Dr Prakash Naik Newington Resource Centre Lyndon Clinic Dan Mooney House David Bromley House Hertford House Solihull Hospital 27512_BSMHT 18/9/06 6:14 pm Page 40
BIRMINGHAM AND SOLIHULL MENTAL HEALTH NHS TRUST www.bsmht.nhs.uk telephone: 0121 301 1111