Annual Report Summary 2016/17
Contents
Who we are 3
Our work 3
Our vision, values and strategic objectives 4
Highlights of 2016/17 5-7
Transforming for the future 7
Quality and performance 8-9
Our workforce 10
Strong financial management 11
The Trust Board Back page
Welcome Thank you for reading this summary report of our work in 2016/17.
It provides an overview of how we served communities in south west London and further afield with high quality, patient-centred mental health services; our performance and challenges.
You can find out more in our full Annual Report and Accounts which is available on our website: www.swlstg-tr.nhs.uk South West London and St George’s Mental Health NHS Trust 3
Who we are We are the leading provider of mental health services across south west London, serving more than a million people in We made the boroughs of Kingston, Merton, 383,000 We received Richmond, Sutton and Wandsworth. individual contacts with our patients 28,000 Our headquarters are in the grounds of Springfield referrals University Hospital in Tooting and we operate from several other locations in London and the south east.
We have been providing mental health services to the people of south west London for more than 160 We admitted years. Today we are a modern and forward-thinking 46 mental health provider. COMMUNITY 1,992 SITES people into our We gained Trust status in 1994, and are a centre 22 wards of excellence for several national mental health services.
Our work We work in partnership with colleagues in primary care, local authorities and the non-statutory sector to:
• Promote mental health and improve awareness of its importance • Support people with mental health problems and their families • Provide care and treatment to the highest standards • Help schools and employers to challenge stigma
We aim to serve the mental health needs of everyone in our diverse communities.
Making life better together 4 Annual Report Summary 2016/17
Our vision, values and strategic objectives
We are a cost-effective centre of excellence; a place where patients choose to be treated; where clinicians want to train and work; and where our stakeholders want to work with us.
We aim to provide the best possible clinical care Our values outline how we treat our patients, and support to people who use our services and and work with partners and colleagues. their carers in the communities we serve.
We work in partnership with service users, their relatives, carers and friends, and other Respectful stakeholders, to meet our strategic objectives. We are respectful so you feel appreciated and included These are to improve:
• Quality and value Open • Partnerships We are open so you feel • Co-production informed and involved • Recovery • Innovation • Leadership and talent Collaborative We expect teamwork so you feel connected and supported
Compassionate
We are compassionate and kind so you feel valued and cared for
Consistent We are consistent in our quality of care so you feel safe and reassured
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Highlights of 2016/17
Innovation and partnership working continue to play a key role in our efforts to improve the services we deliver and ensure they meet our patients’ needs.
The Care Quality Commission’s (CQC) report We won £800,000 from Health Education published in December 2016 rated our overall England jointly with South London and services as ‘good’. Maudsley Foundation Trust and Oxleas In September, its inspectors said they were Foundation Trust to recruit mental health impressed by the improvements in our supervision, nurses. administrative and medicines management processes. The funding will help to promote: • Mental health nurse recruitment and retention In November, we launched an innovative new across south London unit that provides enhanced mental health • Better career development pathways assessments for patients having mental health crises. • Secured funding from the Burdett Trust to support The Lotus Assessment Suite, opened by Justine the development of BME nursing staff. Greening MP, provides a safe and calming environment away from A&E, allowing mental We supported a successful bid by Shaw Trust to health staff to carry out in-depth assessments of deliver Aim4Work in south London. these complex patients. With money from the Building Better Opportunities programme – jointly funded by Big Lottery Fund We were the first mental health trust to be and the European Social Fund - Aim4Work uses the awarded the British Deaf Association’s British principles of the Individual Placement and Support Sign Language Charter. (IPS) model to help people with mental health This highlighted the tremendous work of our problems into education, training or work. Our role deaf mental health services, and in particular is to provide employment specialists to deliver IPS in the deaf recovery tool, which shows how visual Kingston, Merton, Richmond and Sutton. communication methods and appropriate language are vital in assessing and providing therapy for deaf IAPT at home in Wandsworth service users and staff. Battersea Healthcare CIC and the GP Federation commissioned us to deliver Improving Access A team of artists from Hospital Rooms installed to Psychological Therapies (IAPT) interventions artwork in our wards. to people with anxiety and depression who are The project took place at the Springfield University housebound or in domiciliary care. Hospital site’s Phoenix Unit, a secure psychiatric rehabilitation ward for patients diagnosed with Following a robust commissioner-led schizophrenia. Each of the ten artists renovated procurement process, NHS Wandsworth CCG a communal area, with residents and clinicians commissioned us to provide a new service, Talk suggesting colours and potential designs. Wandsworth. This offers a broad range of support for people with The team then turned their talents to the Recovery mild mental health conditions such as anxiety, low College. mood and stress. The service has a wide presence across Wandsworth and involves a range of partners including The Awareness Centre, SilverCloud and Ieso.
Making life better together 6 Annual Report Summary 2016/17
South London Mental Health and Community We commissioned two recovery cafés for Partnership (with South London and people who struggle with mental health and Maudsley NHS Foundation Trust and Oxleas find it difficult to cope. NHS Foundation Trust) The Tooting recovery café is run by Hestia, and • Forensics pathway - As part of NHS England’s the Sunshine recovery café in Merton is run by New Models of Care, we are taking responsibility CDARs. They are safe and supportive spaces, and for managing care budgets for secure mental help people to find treatment closer to home. health services from 1 April 2017. The aim is to improve services for adults with mental health Kingston co-ordinated care (KCC) problems who need care in a secure setting and/ We are working with five other providers (Your or specialist forensic mental health service, and Healthcare; Kingston Hospital NHS Foundation ensure that people do not have to move out Trust; Kingston GPs Chambers and Staywell; of the south London area to receive forensics and the Royal Borough of Kingston adult social services. services) to co-design and deliver new ways of working in: • Backoffice - As part of the South London Mental • Proactive care Health Partnership we have looked to identify • Enabling and improving independence how we can make best use of the resources we currently commit to areas such as legal advice • Maintaining independence and preventative care and purchasing pathology, to ensure we are • Crisis intervention delivering best value for money. • Healthy living and wellbeing We continue to involve and engage all our stakeholders, including patients, carers, Richmond mental health outcome-based partner organisations and other local bodies. commissioning We worked through a rigorous assessment • The London Assembly health committee process to become part of a new outcome-based investigated the challenges the deaf community commissioning (OBC) contract for delivering faces in accessing mental health services. We mental health services in the London Borough of submitted a report from our clinicians and Richmond from September 2017. The OBC is a service users that provided an insight into the partnership-based approach that rewards better many issues deaf people encounter and that also outcomes for patients, consisting of eight partner offered recommendations to encourage greater organisations for health, social care and the awareness across London. We will continue to voluntary sector. work with the London Assembly and share best practice with other providers such as GPs, local authorities and acute services.
• To raise awareness of mental health, we have been working with ThriveLDN, a programme that brings together agencies and providers, and voluntary, business and community partners, to do more to improve the mental health and wellbeing of Londoners.
• We ran and supported more than 50 events for Innovation and Mental Health Month in October to encourage partnership working discussion on mental health and stamp out continue to play a key stigma and discrimination. This also included role in our efforts to our popular digital photography competition, improve the services. #upliftingimage, which invited local primary schools, staff and members of the public to send in images that made them smile and lifted their moods.
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In the last few years we have been leaders in • Learning disabilities conference - raising awareness co-production, and have started to change how of learning disabilities in local communities. people think about mental health. Several co- Over 100 people attended the conference which production initiatives have brought our services continues to build momentum. The conference aims and patients closer together. to develop a local network to facilitate seamless care with partners. • ‘Healing our broken village’ conference - looking at inequality and black communities in mental health • The community network for family care - Local services. leaders have been trained in systematic family therapy so they can support their communities with early family support where this is needed.
Transforming for the future
Service Line management Estate modernisation
One of the biggest changes the Trust has seen this Drawing on an investment of £160m, we have year is the move to a Service Line Management continued to transform our facilities. We will move (SLM) model. outpatient services into local communities across the five boroughs we serve, and we will reduce our estate Led by clinical directors, supported by heads of to two main sites delivering acute inpatient mental service delivery and heads of nursing and quality, healthcare – the new state-of-the-art hospitals at this new way of working will allow us to ensure Springfield and Tolworth. we can deliver a consistent level of quality and share best practice across south west London more We will also establish a new crisis-response team effectively. to support people in the community. It will work alongside the existing crisis and home treatment The new model will provide the best outcomes for teams and street triage services. our patients and service users and will help us to focus even more closely on supporting people with Work has begun on the first phase of development, their individual needs. and we expect to complete 26 new homes at Springfield by October 2017. We held several events involving our local partners aimed at keeping our colleagues from external We started the procurement process to select a organisations up to date with the changes relating master developer and hope to announce a preferred to the new SLM model and provided all colleagues bidder in September 2017. We will then submit our with new Trust contacts to ensure a smooth full business case for approval by the Department of transition into the new service lines. Health and the Treasury, which we hope to have by summer 2018. Whilst SLM is very much about putting the patient at the heart of what we do, it will also empower our Site disposals: we are currently selling land at clinical staff in a very real and tangible way. Richmond Royal Hospital and Barnes Hospital where inpatient services are no longer provided. All proceeds will go back into the NHS helping to fund our two new state-of-the-art hospitals.
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Quality and performance
Performance against our targets Clinical performance monitoring We continued to perform well in 2016/17 against Our key clinical performance indicators 2016/17 national and internal targets. where we need to have a continued focus on are:
Summary of our performance against 2016/17 Our Clinic indicator Target key targets performance Our performance is measured against NHS Improvement metrics covering effectiveness, % CPA patients with a patient experience, quality and safety. We achieved collaborative crisis plan 90% 87.8% all key targets. recording
Waiting times performance – referral to % patients with treatment a physical health We continued to manage waiting times and met assessment attempted 98% 94% all monthly targets for the time patients wait to within 48 hours of admission start treatment (the referral to treatment (RTT) incomplete pathway). Adult acute emergency readmissions within 30 8.5% 8.7% Access to adult secondary care days We improved access to adult secondary care. Our average performance of 83% is above the 80% % cluster accuracy and threshold for seeing non-urgent referrals within 28 95.0% 84% quality days.
More young people have accessed CAMHS We are required to see 80% of new referrals within eight weeks. In 2016/17, access to Tier 3 CAMHS was further improved – we met the target throughout the year.
Factors affecting performance – increased demand for inpatient beds Demand for adult acute beds remained high. In November 2016 the Lotus Assessment Suite opened. The suite provides a more comprehensive assessment of clients and helps to prevent admission to an adult acute ward.
Monitoring and managing performance We strengthened reporting to the board. Our performance will be further enhanced in 2017/18 by the move to service line reporting.
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Commissioning for quality and innovation • Coordinated inpatient discharge planning (year two (CQUIN) and the Trust quality priorities of a two-year priority) - The inpatient discharge These promote good clinical practice and are standards were updated to include the new important drivers for improvements in safety, gatekeeping tool as well as the new national effectiveness and patient experience. A proportion guidance for e-discharges. of our income in 2016/17 was conditional on achieving goals agreed with commissioners for the Priorities for quality improvement 2017/18 provision of NHS services. We either met or partially Following an engagement programme and met all the CQUIN targets for local and national discussion with the Trust Board, the areas of quality services in 2016/17. improvement for 2017/18 are: • Improve the consistency and capability of clinical Last year we identified the following priorities care in community services in our quality account: • Patient Experience - Improving the way we collect • Adult autism – fulfilling and rewarding lives - We and make use of feedback introduced basic training for all clinical staff and • Preventing suicide enhanced for learning disability champions and staff • Reducing violence and aggression in assessment teams. We piloted the use of Skype within an LDMH community team, and configured • Improving physical health for service users the electronic care record to promote the recording • Improving supervision for staff of learning disabilities/autism.
• Improving safety – reduce level of serious self harm and suicide - Initiatives included introducing the family liaison service. We also developed desktop reviews and a tool to enable regular reviews of themes and trends.
• Safety: reducing violence – We continue to perform root-cause analysis following serious incidents. This informs any changes to process, policies and training. We co-produced a ‘Making safeguarding personal’ report and set up the reducing restrictive practice group to ensure we adhere to latest national guidance and best practice.
Making life better together 10 Annual Report Summary 2016/17
Our workforce
Staff attitude survey results The annual NHS Staff Survey is intended for NHS organisations to review and improve staff experience so they can provide better patient care.
Our response rate for the 2016 survey was 52.5% Workforce performance – up from 44.2% last year. The average response We monitor key performance measures across rate for mental health trusts was 46.1%. our staff monthly. The workforce performance summary 2016/17. In comparison with our 2015 results, we improved in three key findings. The findings where we have Workforce Metric Target 2016/17 improved are: • % of staff appraised in last 12 months Sickness rate 4.6% 4.4%
• Fairness and effectiveness for reporting errors, Mandatory Training 95.0% 82.0% near misses and incidents • Effective team working Turnover 15.0% 15.0%
Vacancy 12.4% 18.3% Our staff engagement score, rated between 1 (low) and 5 (high), was 3.68. This is an improvement on 2015 and is in line with the average for mental We have introduced a staff supervision metric for health trusts. 2016/17 after feedback from the CQC. We have set an 85% threshold of staff to receive supervision We will be undertaking further work and every six months. Compliance was achieved in exploration of the reasons behind staff working August 2016. However, performance has since extra hours, and whether this has been affected dipped a little and an action plan to recover the by our work to reduce agency spend across the position is in place. organisation. The vacancy rate for the year was higher than the Overall, while we have a lot of work to do to target, though the position improved in the final improve overall staff engagement, we were the quarter. Staff turnover decreased during the year. second most improved mental health trust in this year’s survey.
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Strong financial management Financial Review 2016/17
Making life better together
The Trust Board The Board leads the Trust and provides a framework of governance within which high quality mental health and social care services are delivered to the communities we serve in south west London and nationally.
Chief Executive and Chairman
Chief Executive Chairman David Bradley Peter Molyneux
Executive Directors Non - Executive Directors
Medical Director Director of Nursing and Director of Finance Non - Executive Director Non - Executive Director Non - Executive Director Mark Potter Quality Philip Murray Barbara Greenway Dr Ali Hasan Jean Daintith Vanessa Ford
Director of Strategy Interim Director of Director of Communications Non - Executive Director Associate Non - Non - Executive Director and Commercial Clinical Services and Stakeholder Executive Director Professor Andy Kent Jonathan Thompson Development Engagement Eileen Doyle Sola Afuape Suzanne Marsello Ranjeet Kaile
The following were also members of the Board during the year:
• Dawn Chamberlain – Chief Operating Officer • Emma Whicher – Medical Director • Michael Parr – Director of Finance & Performance
Director of HR, OD Director of HR, OD • Mandy Stevens – Director of Nursing & Trust Secretary Non - Executive Director and Workforce and Workforce Quality Standards Tamara Cowan Transformation Transformation Richard Flatman • Dave Tomlinson – Interim Director of Finance (Job share) (Job share) & Performance Asha Hoque Alfredo Thompson • Clive Field – Interim Director of Finance & Performance
Non-voting members
Our values
South West London and St George’s Mental Health NHS Trust Springfield University Hospital, 61 Glenburnie Road, London SW17 7DJ Telephone: 020 3513 5000 Connect with us Website: www.swlstg-tr.nhs.uk @swlstg Copyright © 2017 South West London and St George’s Mental Health NHS Trust Published and distributed by: Communications Department