Council of Governors 10 August 2020 Public
Council of Governors 10 August 2020 Public
COUNCIL OF GOVERNORS MEETING IN PUBLIC
To be held on 10 August 2020 at 10:50 Being held virtually following guidance on COVID-19
AGENDA
CG 06/20 INTRODUCTION ACTION
1050 CG 06 .1/20 Welcome, Introductions and apologies for absence
1050 CG 06 .2/20 To receive any declarations of interest
Questions from members of the public 1050 CG 06 .3/20 View guidance on submitting questions here
Minutes of the Public Council of Governors held in For 1050 CG 06 .4/20 Public on 02 March 2020 and matters arising A Approval Peter Molyneux, Chair
CG 07/20 CURRENT PRIORITIES
Sussex-wide Children & Young Persons' Emotional Health & Wellbeing Services Report For 1050 CG 07 .1/20 B Ruth Hillman, Service Director for Children and Young Assurance Peoples Services and Alison Wallis, Clinical Director
Recovery and Restoration Presen For -tation 1120 CG 07 .2/20 Sam Allen, Chief Executive Assurance C
Chair’s Report Peter Molyneux, Chair For 1140 CG 07 .3/20 D Progress Report Assurance Peter Molyneux, Chair
Lead Governor Report Mark Hughes, Lead Governor For 1145 CG 07 .4/20 E Achievements of the Council of Governors Assurance during 2019/20
CG 08/20 HOLDING TO ACCOUNT
Quality Committee Summary Gordon Ferns, Non-Executive Director For 1150 CG 08 .1/20 F Feedback from Governor Observers Assurance Alex Garner, Staff Governor and Di Hickman, Service User Governor
Finance & Investment Committee Summary Martin Richards, Non-Executive Director For 1155 CG 08 .2/20 G Feedback from Governor Observers Assurance Mark Hughes, Lead Governor
Audit Committee Summary Jo Larbie, Non-Executive Director For 1200 CG 08 .3/20 H Feedback from Governor Observers Assurance Glen Woolgar, Staff Governor and Alan Wells, Service User Governor
External Auditor Extension For 1205 CG 08 .4/20 Sally Flint, Chief Finance Officer and Jo Larbie, Non- I Decision Executive Director
Charity Committee Update For 1210 CG 08 .5/20 Oral Anne Beales, Non-Executive Director Assurance
CG 09/20 GOVERNANCE
Election Update For 1215 CG 09 .1/20 J Dom Ford, Director of Corporate Affairs Assurance
To receive an update from the Membership For 1220 CG 09 .2/20 Committee K Assurance Mark Hughes, Lead Governor and Chair of Committee
To receive an update from the Training and Development Committee For 1225 CG 09 .3/20 Terms of Reference for Approval L Decision Amy Herring, Service User Governor and Chair of Committee
1230 CG 10/20 ANY OTHER BUSINESS
Sussex Partnership NHS Foundation Trust Council of Governors: 27 April 2020 – Public Agenda Item: CG 06 .4/20 Attachment: A For: Decision By: Natalie Hennings, Corporate Governance Manager SUSSEX PARTNERSHIP NHS FOUNDATION TRUST
Minutes of the Council of Governors held in public on 02 March 2020 at 10:00 in The Chichester Room, Field Place, The Boulevard, Worthing, West Sussex, BN13 1NP
Present Peter Molyneux, Chair (Chair) Amy Herring, Lead Governor (AH) Gabrielle Gardner, Service User Governor (GG) Di Hickman, Service User Governor (DH) Mel Smith, Service User Governor (MS) Alan Wells, Service User Governor (AW) Stephanie Foster, Public Governor (SF) Elizabeth Hall, Public Governor (EH) Sarah Payne, Public Governor (SP) Mark Hughes, Carer Governor (MH) Gary Beecheno, Staff Governor (GB) Alex Garner, Staff Governor (AG) Louise Patmore, Staff Governor (LP) Glen Woolgar, Staff Governor (GW) Giles Adams, Appointed Governor (GA) arrived at 10.30am Sarah Gates, Appointed Governor (SG) Katie Glover, Appointed Governor (KG) Natasha Sigala, Appointed Governor (NS) arrived at 11.00am
In Attendance Anne Beales, Non-Executive Director (AB) Lewis Doyle, Non-Executive Director (LD) Jo Larbie, Non-Executive Director (JL) Martin Richards, Non-Executive Director (MR) Dom Ford, Director of Corporate Affairs (DF) Sam Allen, Chief Executive (SA) Sally Flint, Chief Finance Officer (SF) Rick Fraser, Chief Medical Officer (RF) Beth Lawton, Chief Digital and Information Officer (BL) Gavin Wright, Director of HR&OD Natalie Hennings, Corporate Governance Manager (minutes)
Observers Two members of public
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CG 01/20 INTRODUCTION
CG 01.1/20 Welcome, Introductions and apologies for absence
The Chair welcomed all those present to the meeting and apologies for absence were noted from: Angie Culham, Service User Governor (AC) James Domanic, Service User Governor (JD) Chrissie Granger, Service User Governor (CG) Jo Tompkins, Service User Governor (JT) Gillian Bowden, Public Governor (GB) Caitlin Hall, Public Governor (CH) Peter Haydn-Smith, Public Governor (PHS) Dr Duncan Shrewsbury, Public Governor (DS) Carl Domanic, Carer Governor (CD) Allison Fackrell, Carer Governor (AF) Alice Parr, Staff Governor (AP) Rachel Brett, Appointed Governor (RB) David Simmons, Appointed Governor (DS) John Holmstrom, Appointed Governor (JH)
The Executives had been invited to join the meeting to assist facilitate the Annual Plan discussion as part of a joint session.
CG 01.2/20 To receive any declarations of interest
There were no further declarations of interest.
CG 01.3/20 Questions from members of the public
No questions were submitted from members of the public. There were no further questions submitted from members of the public.
Minutes of the Public Council of Governors held in Public on 21 CG 01.4/20 October 2019 and matters arising Peter Molyneux, Chair
There were no comments or amendments. There were no actions outstanding.
Action(s) None.
Decision(s) Minutes of the Council of Governors held on 21 October 2019 were approved as an accurate record.
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CG 02/20 CURRENT PRIORITIES
Annual Plan CG 02.1/20 Sam Allen, Chief Executive
The Chair explained that the Council of Governors have had a number of sessions during the last 12 months to help shape the Trust Organisational Strategy and through this work governors are aware of the challenges facing the Trust. The Trust continues to be under extreme pressure; whilst mental health is benefiting from increased investment this can add pressure on organisational resources. With the development of the Integrated Care Systems and the Health and Care Partnerships there is a vast amount to achieve over the next few years. The Trust will need to think about what a local mental health system should look like whilst remembering to constantly look back to remind themselves of what is important for the people it serves and ensure the right systems and processes are in place to meet these needs. SA noted how valuable it is to have the input from the Council of Governors; their views helped shape the new vision for the organisation which has signalled a step change in the role of the organisation and how the Trust works in partnership to improve the quality of life for their communities. In order to improve services it is important for the Trust to do things differently, the new strategy is a key enabler by focusing on the 3 P's (People, Prevention and Partnerships) and enacting these through their culture and behaviours: The Trust is required to submit their Operating Plan next year; this must include the improvements completed as part of the Five Year Forward View (FYFV) and how the deliverables of the NHS Long Term Plan will be met. Whilst this plan will include a number of requirements such as 24 hour crisis services it will also detail the Trusts strategic goals and their deliverables. The Council was split into tables and had a discussion on one of the following strategic goals:
People: The following themes were identified: Broaden recruitment Maximise what the Trust does well for a better Employee Value Proposition Maintain a balance of recruitment and retention Learn from others and work together with external organisations.
Prevention: The following themes were identified: Set an example as an employer by helping staff manage their own mental health and access Individual Placement and Support (IPS) to reduce sickness absence and improve quality of life Build skills in the community by upskilling people in a position of influence, such as Vicars, Imams and leaders Link workers to connect to a range of services based on what matters to the individual Making sure community mental health services, third sector organisations, Experts by Experience etc. are inclusive and valuable. Thinking about ways to implement digital technologies into the community
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Partnerships: The following themes were identified: Build trust between partners Communication is essential Implementing culture across organisations Thinking about the devolution of power; having a balance and being able to challenge appropriately Implementing co-production by having a common goal that can be regularly reviewed Need capacity within the system to support Raising awareness across the system Well defined partnerships; champion vs lead, accountability and political reality vs the direction of the Long Term Plan.
Culture, values and beliefs: The following themes were identified: Think about psychological safety and how the values can be lived through the Trust Living the values and embed through supervision and appraisal process Create time to think, embrace and change the future Change and improve the narrative on change
Effective and efficient use of resources: The following themes were identified: Investment: money is always seen as the barrier and is allocated alongside a number of 'must dos' but these are not always in the best interests of the patients Include the use of ground breaking research to develop the workforce and introduce new treatments Educate the public Look after the wellbeing of the communities the Trust serves Grow expertise in the community Changing the culture of the community to help prevent service users from needing to access services Create a narrative that can better measure patient experience more accurately Invest in addressing underrepresented communities who often have a very different experience of accessing services.
The Chair summarised the discussion recognising the themes had highlighted interconnectedness between the three goals. It is evident that everyone recognises the powerful role of the community and the effects this can have on improving patients' wellbeing.
The Chair recommended that the Trust should reflect on progress with governors in 12 months. The output from this session will help inform the Annual Plan due to be submitted to the Board of Directors for approval at the end of the month.
Action(s) Circulate the Annual Plan to governors, once approved by the Board of Directors.
Decision(s) None.
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Chair’s Report & Progress Report CG 02.2/20 Peter Molyneux, Chair
Governors were asked to receive the Chair’s report as read. The Progress report sets out how the Trust is managing the demand for services and the increased investment whilst ensuring the needs of the people are accurately reflected across the health care system. The Chair is confident that the Board of Directors has a good grip on all areas and is in a good position to meet the Trusts key deliverables. Continued focus has been given to: Out of area placements: how delivering care within communities can help reduce the need for placing patients out of area. Recruitment and retention: to ensure the Trust can deliver services within the emerging system changes. Governors sought assurance on: Whether there is a deep dive into the 4 week wait for Hampshire CAMHS which is current achieving 35% against a target of 95%. In response, this relates to demand and is being looked into by the Quality Committee and monitored by the Executive Management Team. As the data suggests this is an area that receives the most complaints and concerns about waiting times however governors were reassured that staffs are working hard and keeping service users safe. The Trust has put a proposal to the Commissioners in Hampshire but as demand continues to be an issue the service will require a change of working or additional resources being met by the CCG.
Why there has been a decrease of care plans completed at the end of Q3. In response, the target has been extended until the end of Q1 and the Clinical Lead Group have provided assurance that a range of changes to the digital system have been prioritised; confirming it is high on the digital agenda and solutions are being worked through. Governors were reassured that the care plan process has been radically amended; this piece of work has been co- produced with people who use services; there has been no delay in amending the form on the system and training has been delivered to staff and service users. Every Team Leader has access to a case management tool where they can see their case load at a glance and the Trust regularly monitors the frequency of care planning. The Chair confirmed that governors should be able to see an improvement by the end of Q1, if this is not to the case the Executive Management Team will take this forward. Governors questioned: Whether service users were able to use digital mechanisms to view their health records. In response, the Trust is looking at implementing a patient portal which is currently in consultation. Whether staff well-being is measured on sickness absence rates and is the Trust confident that staffs who are unwell are not at work. In response, sickness absence rates are used as one proxy, along with the staff survey results which give the Trust the confidence they are moving in the right direction.
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Action(s) None.
Decision(s) None.
Lead Governor Report CG 02.3/20 Amy Herring, Lead Governor
Governors were asked to receive the Lead Governors report as read. AH advised the next Sussex Governors Network meeting has been rescheduled to take place on 3rd April 2020. AH noted this was her last meeting as Lead Governor and wanted to wish the next Lead Governor the best of luck. The Chair thanked AH for her support and leadership as Lead Governor for the last three years.
Action(s) None.
Decision(s) None.
CG 03/20 HOLDING TO ACCOUNT
Quality Committee Summary & Feedback from Governor Observers CG 03.1/20 Gordon Ferns, Non-Executive Director, Di Hickman, Service User Governor & Alex Garner, Staff Governor
Governors were asked to receive the Quality Committee Summary report as read. The governor observer felt this is one of the most interesting and well led committee they have attended.
Action(s) None.
Decision(s) None.
Finance and Investment Committee Summary & Feedback from Governor Observers CG 03.2/20 Martin Richards, Non-Executive Director & Mark Hughes, Carer Governor
Governors were asked to receive the Finance and Investment Committee Summary report as read. A governor asked if the expenditure on agency staff is indicative of the recruitment issues already discussed. It was acknowledged that the Trust had seen good traction throughout the year and continued to focus on recruitment in priority areas and ensuring best practice by drawing up rotas six weeks in advance; bank staff can then be sourced to cover any gaps.
Action(s) None.
Decision(s) None.
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Audit Committee Summary & Feedback from Governor Observers CG 03.3/20 Lewis Doyle, Non-Executive Director, Alan Wells, Service User Governor & Glen Woolgar, Staff Governor
Governors were asked to receive the Audit Committee Summary report as read.
LD confirmed the Trust is expecting to receive a favourable opinion from Auditors on the Annual Accounts for 2019/20.
The Chair advised that LD's term is coming to an end this month and he had decided not to seek re-appointment but instead take on new challenges. On behalf of the Council of Governors, the Chair thanked LD for his work as a Non-Executive Director and his commitment and service to the Trust.
Action(s) None.
Decision(s) None.
Charity Committee Summary & Feedback from Governor Observers CG 03.4/20 Anne Beales, Non-Executive Director, Amy Herring, Lead & SU Governor & Elizabeth Hall, Public Governor
Governors were asked to receive the Charity Committee Summary report as read. AH noted the committee Charity continues to strengthen and this was echoed by other governors.
Action(s) None.
Decision(s) None.
CG 04/20 GOVERNANCE
To agree the Governors Quality Indicator for 2019/20 CG 22.1/19 Sally Flint, Chief Finance Officer
The Chair explained the purpose of the item and reminded the Council that they were choosing a topic for data that would be audited for the 2019/20 period. SF presented the paper and gave some background for the new governors. The paper sets out some suggestions and the Council were asked to consider improving the recording of peoples' housing and employment status as their indicator in the context of the new organisational strategy, and the Trusts focus on people, prevention and partnerships. In discussion governors considered whether this indicator would be disproportionate as it would only predominately focus on adults and wouldn’t include children and young people. Last year's indicator focused on staff and therefore it was recognised it can be difficult to capture all areas under one indicator. Governors agreed the proposed indicator and recognised the groups audited in previous years would be considered when deciding on future topics to ensure these capture all areas across the Trust.
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Action(s) None.
Decision(s) The Council of Governors agreed to select ' the recording of peoples' housing and employment status' as their chosen Quality Indictor to be tested by the Trust’s external auditors.
To receive an update from the Membership Committee CG 22.3/19 Mark Hughes, Carer Governor and Chair of Committee
Governors were asked to receive the Membership Committee Summary report as read. MH highlighted the following items from the report The Committee received a guide that has been developed to help governors have the tools and confidence to engage with their constituents and local communities. The Membership Strategy Consultation will commence this year The governor election this year will include nine positions and governors were asked to engage with their constituents and encourage members to start thinking about whether they would like to stand as a governor.
Action(s) None.
Decision(s) None.
CG 04.3/20 To receive an update from the Training and Development Committee Amy Herring, Lead Governor
Governors were asked to receive the Training and Development Committee Summary report as read. AH advised that the Associate Director of People Participation will be running a session providing additional support to governors. The meeting has been set to explain what will be offered through the Council Clinical Informed Resilience Supervision and 1:1 Coaching/Mentoring. These sessions are voluntary and will be piloted for a period of time to see whether or not they are useful for governors.
Action(s) None.
Decision(s) None.
CG 05/20 ANY OTHER BUSINESS
There was no further business.
Reflections
The Chair encouraged governors to put forward their reflections on the meeting,
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Date and Venue for Next Meeting: 10 August 2020 Held virtually
Signed………………………………………………………. Date………………….. Peter Molyneux, Chair
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Sussex Partnership NHS Foundation Trust Council of Governors – 10 August 2020: Public Agenda Item: CG 06 .4/20 Attachment: A For: Approval By: Natalie Hennings, Corporate Governance Manager
MATTERS ARISING: ACTION POINTS FROM THE COUNCIL OF GOVERNORS HELD IN PUBLIC ON 02 MARCH 2020
Action Minute Action Points Lead Action Required Date Reference 02.03.2020 CG 02.1/20 Circulate the Annual Plan to governors, once approved by Dom Ford Complete: Circulated Annual Plan the Board of Directors. in the weekly
message on 10 July 2020 Action Minute Decision agreed at previous meeting Update
Date Reference 02.03.2020 CG 22.1/19 The Council of Governors agreed to select ' the recording Due to COVID-19, the annual requirements Governors of peoples' housing and employment status' as their for NHS organisations were revised in order Quality Indicator chosen Quality Indictor to be tested by the Trust’s to ease the burden on the leadership teams for 2019/20 external auditors. and staff. The annual Governors Quality Indicator was included in the requirements to be withdrawn for the year 2019/20 and therefore this data has not been tested.
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Report to Council of Governors Agenda item CG 07 1.20 Attachment B Data Quality Indicator N/A Date of meeting 10 August 2020 Format of Paper Title of paper Sussex-wide Children and Written Young Persons' Emotional Health & Wellbeing Services Review Author Steve Appleton, Independent Oral ☐ Chair of the Review Executive Sponsor Sam Allen, Chief Executive Presentation ☐ Committees where this item has been N/A considered
EXECUTIVE SUMMARY Please tick one For Assurance For Decision ☐
Context Foundations for Our Future is the independently authored report arising out of the Sussex Wide Children & Young Person’s Emotional Health & Wellbeing Service Review which was jointly commissioned by Sussex Clinical Commissioning Groups (CCGs), the three local authorities in Sussex and Sussex Partnership NHS Foundation Trust (SPFT). The Review was independently chaired throughout its duration. The full report is available on our public webpage. The Review was conducted to provide an in-depth and up-to-date picture of the services and support available to children and young people and was a listening and analytical exercise aimed at gathering a wide scope of information and feedback, from quantitative data to qualitative insights, of the emotional health and wellbeing services and support on offer to children and young people, aged 0 -18, and their families in Sussex. Key drivers and messages from the Review are summarised in section 2 below. The Review was not a formal public consultation and the communications approach developed was designed to support and promote targeted and meaningful stakeholder engagement work, making every effort to be as inclusive and wide-reaching as possible within the timescales and available resources. The scope of the Review was wide, taking a broader view of the services and support available and provided an opportunity to step back and consider not only what is offered currently but also, what might be offered in future and how organisations across Sussex can improve that offer, through working collaboratively or by making changes to their own structures, systems or practices. Governance, methodology and recommendations from the Review are described in section 3 below. Key findings which framed the recommendations are shown in the next summary section.
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Purpose Foundations for Our Future was completed in the weeks prior to the emergence of the coronavirus pandemic. The effects of the pandemic on children and young people are already emerging. They are directly experiencing social distancing, high levels of isolation, imposed absence from school and some support systems, and the wider social and economic dislocation COVID-19 will cause. A survey conducted by Young Minds1 in the early weeks of lockdown found that many children and young people reported increased anxiety, problems with sleep, panic attacks or more frequent urges to self-harm among those who already self-harmed. The Children’s Commissioner for England has suggested that the harm to children’s future prospects is likely to be particularly felt by the poorest and youngest. There have also been reports of falling referrals to specialist mental health services during the lockdown. These are of course issues of great concern, but there have also been positives across the country and in Sussex specifically. Organisations have collaborated, innovated and made changes to their ways of working that in other circumstances might have taken months or years to bring about. There are reasons to be encouraged that these positives can be maintained and built upon as we move forward into restoration and recovery of services. Within this context, Foundations for Our Future can now move forward to publication and implementation. It does so in a new landscape where the messages in the report about transformation and improvement are perhaps even more relevant than before the pandemic emerged. The implementation timeline for the recommendations in the report are those that developed before the pandemic caused work to be paused. That timeline will now be reviewed and adjusted to reflect the new context in which they need to be delivered. There will also be a re- consideration of the priority of each recommendation and where possible, particular aspects of work may be accelerated. The implementation will take place alongside the broader restoration and recovery process, and will feed into that work. The report can now act as a lever for change in this new landscape, driving transformation, including to specialist mental health services, and a renewed focus on the importance of population mental health and wellbeing approaches and the key role of schools. Doing this will not only respond to the issues raised in the report, but will contribute to the wider response to the impact of COVID-19. The mental health and emotional wellbeing of children and young people in Sussex, as well as supporting our workforce in this field, remains a priority for us and the partner organisations remain committed to implementing the recommendations in the report with vigour and pace. This report is presented to the Council of Governors in order that this can be formally received, and for discussion and endorsement that this moves to implementation through a partnership approach in addressing the recommendations of the report. Governance As the NHS and partner organisations move into restoration and recovery, Foundations For Our Future can now proceed through internal and external governance processes. Foundations For Our Future has been received by; CCG’s EMT, and the senior relevant leadership groups in all three local authorities. The Report was presented to Sussex
1 https://youngminds.org.uk/media/3708/coronavirus-report_march2020.pdf
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Partnership's Executive Management Team on 21 July and Board of Directors on 29 July 2020. A comprehensive communications plan has been developed with all partners to the Report and this plan will support the governance process and the formal publication of Foundations For Our Future.
Key findings The Review process was delivered by an independently chaired Review Panel (RP) and a review team. The RP included; clinical leaders (both local and regional), commissioners, experts by experience, engagement representatives, the third sector, schools and colleges representatives, Special Educational Needs and Disabilities (SEND) leaders, quality & safety leads and Public Health, all of whom possessed a depth of knowledge of children and young people’s experiences and perspectives, as well as issues relating to emotional health and wellbeing and children and young people’s mental health. Steve Appleton, UK Liaison for the International Initiative for Mental Health Leadership was commissioned as the independent chair of the RP and is the author of the final report. The RP was accountable to local organisations through the Oversight Group (OSG). The OSG, comprised of senior leaders from the local NHS CCGs, SPFT and the three local authorities, led the Review process. The OSG was chaired by Adam Doyle, Chief Executive Officer of the Clinical Commissioning Groups in Sussex and the Senior Responsible Officer for the Sussex Health and Care Partnership. The OSG has developed a Concordat Agreement as the partnership framework to act upon the recommendations and to implement change across the health and social care system. The Review Panel, gathered, considered, analysed and synthesized a wide range of evidence and information from the methodology described below. Drawing on this enabled the identification of a series of key findings, shown in full below, in relation to children and young people’s emotional health and wellbeing in Sussex. The key findings were presented to the Oversight Group in November 2019. Those key findings have been translated into the recommendations presented in section 3 below and in Foundations For Our Future. Findings in full I. Access to services is difficult and the current pattern of provision is complex and hard to navigate. There is a lack of knowledge about the range of emotional health and wellbeing services in Sussex and an over-reliance on referral to specialist mental health services. II. Referral criteria and thresholds (entry standards) for services are not well articulated and are not clear to either professionals or the public. Sometimes, services appear to work in isolation from one another and are not joined up. III. Children and young people often experience lengthy waits for assessment and the provision of services. This is the case in both statutory and third sector services. There are minimal support options for children, young people and their families while they are waiting. IV. Sussex faces a workforce challenge, both in recruitment and in retention but also in the professional and skill mix. V. In specialist provision, in contrast to national themes, there is a picture of lower levels of acceptance of referrals, lower levels of conversion from assessment to treatment and longer waits for assessment. The smaller waiting list numbers may be indicative of the factors outlined above.
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VI. A rapid process of SPFT specialist services modernisation to improve pathways, access and outcomes is required. VII. There was no direct evidence during the review that would demonstrate that specialist or other services are not safe. However, the data in Sussex shows that the number of children and young people admitted to hospital due to self-harm is higher than both the region and England average. It is not possible to evidence whether what the review found or heard has directly contributed to this position but there is a need to positively address, monitor and respond to the current trends. VIII. Commissioning of services is not consistent across Sussex and suffers from a lack of coordinated leadership, capability and capacity. Existing organisational structures mean that it has been hard to establish clear lines of responsibility. This has also hampered the connectivity between emotional health and wellbeing and the physical health needs of children and young people. There is no over-arching strategic vision for emotional health and wellbeing services or description of the need to integrate physical health and emotional health services across Sussex. There is a need for clear leadership and capability to drive transformation and integration. IX. Commissioning is not outcomes led and at present, it is difficult to determine the range of delivery outcomes, both positive and negative, in relation to children and young people’s emotional health and wellbeing. X. Distribution of current levels of investment does not take account of the levels of need across Sussex. There is a lack of clarity in relation to current reporting about expenditure and gaining understanding and being explicit about the level of investment remains a challenge. Investment is largely focused on reactive, treatment focused specialist services. The balance between investing in those services and investing in prevention, promotion, self-care and resilience and schools based support does not appear proportionate. XI. Schools and colleges do have, and should continue to have, a central role in relation to children and young people’s emotional health and wellbeing. However, at present, they are not uniformly equipped to do this, nor is it clear that they are sufficiently resourced. School leaders clearly see and understand the issues relating to emotional health and wellbeing. They want to respond to it, and to do so with urgency. They agree it is part of what they should do. What they need is the help, resources and support to do it in the best way possible. XII. The opportunities to engage children, young people and their families and carers and draw on their experiences and views have not yet brought about change they seek. The voice of children and young people is not being heard or used as effectively as it could be. The mechanisms for engaging them in a meaningful process of listening and responding, has not yet been demonstrated or featured in co-design and co-development. These key findings have been developed into the recommendations contained at section 3 below.
Recommendation The Council of Governors is asked to note the summary report and the findings of Foundations For Our Future.
Executive Sponsor
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1. INTRODUCTION
1.1 Across Sussex, NHS and local authority partners had increasingly become aware that the experience of children and young people, and their families and carers, who needed emotional and wellbeing support required improvement. 1.2 To better understand; the obstacles to access and to treatment; what needed to improve; and what worked well in the current system, the Sussex Wide Children & Young Person’s Emotional Health & Wellbeing Service Review was jointly commissioned by Sussex CCGs, the three local authorities in Sussex and Sussex Partnership NHS Foundation Trust (SPFT). The Review focused on obtaining an in depth understanding of the emotional health and wellbeing services and support on offer to children and young people, aged 0 -18, and their families in Sussex. The Review was established in January 2019 and the final report – Foundations For Our Future will be the published document from the review, coming at a time of unprecedented focus on children and young people’s mental health both locally and nationally. 1.3 The partners to the Review, requested that it should result in ambitious recommendations for action. Those recommendations are shown in full in section 3 below and can be seen in context in Foundations For Our Future. 1.4 The Review was conducted to provide an in-depth and up-to-date picture of the services and support available to children and young people and was a listening and analytical exercise aimed at gathering a wide scope of information and feedback, from quantitative data to qualitative insights. The Review was not a formal public consultation and the communications approach developed was designed to support and promote targeted and meaningful stakeholder engagement work, making every effort to be as inclusive and wide-reaching as possible within the timescales and available resources. The scope of the Review was wide, taking a broader view of the services and support available and offered an opportunity to step back and consider not only what is offered currently but also, what might be offered in future and how organisations across Sussex can improve that offer, through working collaboratively or by making changes to their own structures, systems or practices. 1.5 Oversight - An Oversight Group (OSG), comprised of senior leaders from the local NHS CCGs, the NHS mental health provider trust and the three local authorities led the Review process. A complete list of those leaders can be found in the full Report. The OSG was chaired by Adam Doyle, Chief Executive Officer of the Clinical Commissioning Groups in Sussex and the Senior Responsible Officer for the Sussex Health and Care Partnership. 1.6 Review Panel - The OSG was supported by an independently chaired Review Panel (RP) and a review team. The RP included; clinical leaders (both local and regional), commissioners, experts by experience, engagement representatives, the voluntary sector, schools and colleges representatives, Special Educational Needs and Disabilities (SEND) leaders, quality & safety leads and Public Health, all of whom possessed a depth of knowledge of children and young people’s experiences and perspectives, as well as issues relating to emotional health and wellbeing and children and young people’s mental health. Steve Appleton2 was commissioned as the independent chair of the RP and is the author of the final report. The RP was accountable to local organisations through the OSG. 1.7 Terms of Reference - The Review process was governed by a Terms of Reference (ToR) and supported by Key Lines of Enquiry (KLOE). The ToR in summary are;
2 http://www.contactconsulting.co.uk/
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How effectively are children and young people and families engaged? How effective is the pathway in terms of equality of access, reach of service provision, integration, knowledge of services within the system, quality of referrals and responses to referrers, families and young people? What is the quality and timeliness of services delivered to children and young people? How well do stakeholders understand current contractual arrangements, thresholds, services and monitoring data? What evidence is there of outcomes from interventions? Review of the children and young person’s journey. The story of children/young people as developed through case file audits and talking to children/young people and families. Experiences of all who are part of the system as referrers, sign-posters, practitioners and commissioners. Developing core points for future contracting. Setting the Sussex service provision in the context of regional and national delivery. Identification of key quality and outcome criteria with a robust reporting framework to allow robust assurance for statutory commissioning organisations i.e. Clinical Commissioning Groups, Local Authorities, NHS England/Improvement. Issues for future mental health strategy and commissioning of children and young peoples’ mental health (CYPMH) in Sussex i.e. how much should we be investing and where? How do we ensure best value for money in meeting the needs of children across Sussex? 1.8 Key Lines of Enquiry (KLOE) - The ToR were defined into a concise set of KLOE which enabled the RP to focus and consider a series of questions that informed the final report and its recommendations. The KLOE can be summarised under the following headings; Access to services: how easy is it to get a service and what could we do better? Capacity: how long do people wait to be seen, why is this and what can we do about it? Safety of current services: how are children kept safe when accessing services? Funding and commissioning: what are the available resources locally? The experience of children, young people and their families: what knowledge do our communities have of services and do they think their experiences are being heard? Effectiveness: do the current pathways deliver the care and support we need? Relationships and partnership: how well do services work together? Both the ToR and KLOE can be found in full in Foundations For Our Future at Appendices 3 and 4. 1.9 The final report from the Review, Foundations For Our Future is the culmination of the programme and marks the conclusion of a thorough process. The Report should be read as the definitive findings and recommendations from the Review. 1.10 Over the duration of the Review, more than 40 engagement events were attended and just under 1500 individual voices were heard through online surveys, open space events, visits to services and focus groups. Over 700 people responded to the five online surveys alone, with one in four Sussex GPs responding to their specific survey. This feedback contributed to the findings of the Report and the themes and recommendations that inform implementation.
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1.11 The Oversight Group developed a Concordat Agreement as the partnership framework to act upon the recommendations and to implement change across the health and social care system.
2. REPORT
The full report – Foundations For Our Future, is available on the Trust Public Website here: https://www.sussexpartnership.nhs.uk/whats-new/foundations-our-future-our-commitment- improving-emotional-health-and-wellbeing-children. A summary of the context, process and methodology is presented in this report. 2.1 National and local context 2.1.1 In 2015, the coalition government published Future in Mind3, a report of the work of the Children and Young People’s Mental Health Taskforce. Future in Mind outlines the transformation of design and delivery of the mental health offer for children and young people in any locality. It describes a step change in how care is delivered, moving away from a system defined in terms of the services organisations provide (the tiered model) towards one built around the needs of children, young people and their families. It described a five-year ambition to create a system that brings together the potential of the NHS, schools, social care the third sector, the internet, parents and of course children and young people, to improve mental health, wellbeing and service provision. As the end of that five-year period approaches, this Review has taken into account the work that Future in Mind has stimulated, together with more recent policy development including the Five Year Forward View for Mental Health (FYFVMH)4 and the NHS Long Term Plan5. 2.1.2 Locally, the Review drew on all local strategies and plans related to children and young people’s emotional health and wellbeing in developing the KLOE and enabling a better understanding of the challenges and context. These local plans included; Local Transformation Plans (LTP), SEND (Special Educational Needs and Disabilities) strategies, Suicide Prevention Plans, Early Years Plans and local joint needs assessments. 2.2 Prevalence and need 2.2.1 Nationally, 70% of children and young people who experience a mental health problem haven’t had appropriate support at an early enough age6 and reporting of emotional and wellbeing problems has become increasingly common. Between 2004 and 2017, the
3 Future in Mind, Promoting, protecting and improving our children and young people’s mental health and wellbeing, NHSE 2015, https://www.gov.uk/government/publications/improving-mental-health-services-for-young-people 4 Five Year Forward View for Mental Health, NHSE Taskforce, 2016 https://www.england.nhs.uk/wp- content/uploads/2016/02/Mental-Health-Taskforce-FYFV-final.pdf 5 https://www.longtermplan.nhs.uk/ 6 Children and Young People Mental Health Foundation accessed December 2019 https://www.mentalhealth.org.uk/a-to- z/c/children-and-young-people
Page 7 of 13 percentage of five to 15 year olds who reported experiencing such problems grew from 3.9% to 5.8%.7 2.2.2 Wellbeing has been shown to decline as children and young people get older, particularly through adolescence, with girls more likely to report a reduced feeling of wellbeing than boys do. As a group, 13-15 year olds report lower life satisfaction than those who are younger.8 2.2.3 Children from low-income families are four times more likely to experience mental health problems compared to those from higher-income families.9 Among LGBTQ+10 young people, seven out of 10 girls and six out of 10 boys describe experiencing suicidal thoughts. These children and young people are around three times as likely as others to have made a suicide attempt.11 2.2.4 In 2017, one in eight young people aged between five and 19 in England had a mental health disorder12. The World Health Organisation (WHO) describes mental health disorders as comprising a broad range of problems, with different symptoms. However, they are generally characterised by some combination of abnormal thoughts, emotions, behaviour and relationships with others. They can include depression, anxiety disorders and psychosis.13 2.2.5 In pre-school children (those under the age of five), the national prevalence of mental health disorders is one in 18, with boys 50% more likely to have a disorder than girls.14 Of the more than 11,000 14-year-olds surveyed in the Millennium Cohort Study in 2018, 16% reported they had self-harmed in 2017/18.15 Based on these figures, it is suggested that nearly 110,000 children aged 14 may have self-harmed across the UK in the same 12-month period.16 Young women in this age group were three times more likely to self-harm than young men.17 An estimated 200 children a year lose their lives through completed suicide in the UK.18 2.2.6 It is estimated that one in ten children and young people have a diagnosable mental disorder, the equivalent of three pupils in every classroom across the country.19 2.2.7 In England, the demand for specialist child and adolescent mental health services is
7 Mental health of children and young people in England 2018 https://digital.nhs.uk/data-and- information/publications/statistical/mental-health-of-children-and-young-people-in-england/2017/2017 8 State of the Nation 2019: Children and Young People’s Wellbeing Department for Education October 2019 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/838022/State_of_the_Nation _2019_young_people_children_wellbeing.pdf
9 Children and young people’s mental health: The facts Centre for Mental Health 2018 https://www.centreformentalhealth.org.uk/sites/default/files/2018- 09/CentreforMentalHealth_ChildrenYoungPeople_Factsheet.pdf 10 LGBTQ+ is used to represent those people who are lesbian, gay, bisexual, transgender, questioning and “plus,” which represents other sexual identities including pansexual, asexual and omnisexual 11 Children and young people’s mental health: The facts Centre for Mental Health 2018 https://www.centreformentalhealth.org.uk/sites/default/files/2018- 09/CentreforMentalHealth_ChildrenYoungPeople_Factsheet.pdf 12 Mental health of children and young people in England, ONS https://files.digital.nhs.uk/A6/EA7D58/MHCYP%202017%20Summary.pdf 13 World Health Organisation definition https://www.who.int/mental_health/management/en/ 14 Mental health of children and young people in England, 2018 https://files.digital.nhs.uk/A6/EA7D58/MHCYP%202017%20Summary.pdf 15 Millennium Cohort Study https://cls.ucl.ac.uk/cls-studies/millennium-cohort-study/ 16 The Good Childhood Report Children’s Society, 2018 https://www.childrenssociety.org.uk/good-childhood-report 17 Brooks et al 2015 in Children and young people’s mental health: The facts, Centre for Mental Health, 2018 https://www.centreformentalhealth.org.uk/sites/default/files/2018- 09/CentreforMentalHealth_ChildrenYoungPeople_Factsheet.pdf 18 Burton, M. Practice Nursing Vol. 30, No. 5 https://www.magonlinelibrary.com/doi/pdf/10.12968/pnur.2019.30.5.218 19 Supporting mental health in schools and colleges Department for Education/NatCEN Social Research and National Children’s Bureau, August 2017 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/634725/Supporting_Mental -Health_synthesis_report.pdf
Page 8 of 13 rising, with record levels of referrals being reported.20 2.2.8 Sussex - key messages from the Review In Sussex, the estimated prevalence of mental health disorders in children and young people aged 5 – 16 years as a percentage of the population of that age (2015 estimates) is; West Sussex 8.4%; East Sussex 8.8% and B&H 8.4%. The England figure is 9.2%. This means that all areas in Sussex report below the England average. In terms of emotional disorders as a percentage of the population aged five - 16 years (2015 estimates), all Sussex areas report below the England average of 3.6%; West Sussex (3.2%); East Sussex (3.4%); and B&H (3.3%). In contrast, for school pupils with social, emotional and mental health needs (primary and secondary school age combined), all Sussex areas report a higher prevalence of the England average at 2.31%; West Sussex (3.01%); East Sussex (2.52%); and B&H (2.47%). The percentage of 16 - 17 year olds not in education, employment or training (NEET) or whose activity is not known is; West Sussex (9.0%), East Sussex (4.9%) and B&H (4.5%). This is against an England average of 6.0%. Hospital admission as a result of self-harm for the age group 10 - 24 years per 100,000 population (2017/18) is 467 for the South East Region. In West Sussex the value is 536, in East Sussex it is 527 and in B&H it is 548. This means that all Sussex areas are above the region average. For completed suicide, the average rate per 100,000 of the population aged 10 - 34 years is measured over the period 2013 – 2017. For the region, the value is 10.5: in West Sussex it is 12.4; in East Sussex it is 13.2 and in B&H it is 11.8. This means that all areas are above the regional average. 2.3 Review methodology 2.3.1 The Review was conducted using a mixed methodology approach using both qualitative and quantitative evidence gathering. 2.3.2 Quantative data gathering included: A service mapping exercise to establish the number and type of emotional health and wellbeing services provided in Sussex and which organisations delivered those. An information gathering process collecting data relating to current demand, performance and quality. Analysis of quantative data and information was undertaken independently by the commissioned NHS Benchmarking Network (NHSBN)21. National data was sourced, analysed and compared by NHSBN and local data, where it was available, was provided to NHSBN for analysis and inclusion in the final data report. A review of published literature and grey literature (grey literature is research that is either unpublished or has been published in non-commercial form), research evidence, current national policy and local plans and strategies relating to children and young people’s emotional health and wellbeing and mental health was undertaken to inform the final report. 2.3.3 Qualitative data and information gathering across Sussex included: Five ‘open to all’ listening events, using the Open Space model. Open Space is a technique for engaging with the community where participants create and manage the
20 Children’s mental health services: the data behind the headlines Centre for Mental Health October 2019 https://www.centreformentalhealth.org.uk/blog/childrens-data 21 https://www.nhsbenchmarking.nhs.uk/
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agenda and discussion themselves. A series of focus groups, to discuss a range of issues in more detail. These focus groups included parent and carer representatives as well as professionals working in the NHS, local authorities and the third sector. A series of visits to provider services in Sussex. These visits focused on gaining insights into service locations and environments and to hear directly from those working in the sector. Direct engagement events where RP members undertook face-to-face meetings and event attendance with a number of different organisations, groups and networks. Development, publishing and analysis of a series of online surveys, each focused on a specific group including children and young people, their parents and carers, schools and General Practitioners (GPs). Direct feedback was also invited from members of the public, children and young people and professionals. This was submitted in a number of ways, usually from individuals, through a dedicated email address, telephone line, online or by letter. Organisations, including Healthwatch and those in the third sector also provided feedback and evidence in the form of structured reports that were considered as part of the review. 2.3.4 All of the data, evidence and experiential feedback contributed to the agreed key findings and the development of the 20 recommendations shown is section 3.
3. RECOMMENDATIONS
3.1 Recommendations - The 20 recommendations arising from the key findings, and supported by the quantative and qualitative evidence described in section 2 above are shown in full here; 1. The Oversight Group should become a body that takes responsibility for the implementation of the recommendations. Children and young people, parents and carers, third sector organisations and education services representatives should be part of this group. It should hold local organisations to account for implementation and take a role in enabling progress and unblocking any barriers to delivery. It should link to existing forums and governance groups to ensure a coordinated approach to delivery and communication. A new chair should be appointed before the inaugural meeting to take this forward. 2. A concordat agreement should be developed and agreed. It should ‘seal in’ the commitment of all partners to work together on implementation of the review recommendations and should produce a quarterly update on the implementation of these recommendations and an annual statement of progress. All leaders of the partners who commissioned the review and published with the report should sign it. It is incumbent on the partner organisations and their leaders to work collaboratively to deliver the recommendations together to bring about the change that is needed. 3. The NHS and local authorities should jointly create a post of Programme Director for Children and Young People’s Emotional Health and Wellbeing with dedicated resource for change. This post should take a pan-Sussex responsibility for the improvement of emotional health, wellbeing and specialist mental health services and the implementation of the recommendations in this report, providing clear leadership and
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accountability. 4. A job description and person specification should be developed and where possible, the post should be recruited and in place as soon as is practical. During this time, continuity of leadership should be secured through a suitable candidate. The dedicated resource for change should also be identified, secured and deployed in line with the timeframe for the Director post, to support the ambitious implementation time-scales. The Director post should be fixed term for a minimum of two years, to see through transformational change. 5. A coordinated commissioning structure should be established for children and young people’s emotional health, wellbeing and mental health across Sussex. As part of establishing that structure, consideration should be given to the capacity and capability that exists within current commissioning teams. It should also consider how to achieve better integration of physical and emotional health. The new structure should comprise commissioners from the NHS, local authority children’s leads and education to create a holistic approach that is cross-sectorial in nature. The underpinning approach should be one that ensures the commissioning of a range of services and supports needed across Sussex, in line with Future in Mind, as well as giving focus to localities where specific needs dictate that local variation in service is needed. A shadow form structure should be in place where possible ahead of formal establishment. 6. Specialist mental health services for children and young people should be commissioned on a pan-Sussex basis to provide improved consistency in terms of service expectations. This arrangement must consider and develop a clear understanding about how best to achieve the right balance between clinical consistency across Sussex and the flexibility to meet local, population needs, for example in rural and urban areas. 7. There should be one strategic plan for children and young people’s emotional health and wellbeing and mental health in Sussex. It should set a single strategic vision for Sussex, which is underpinned by a place-based approach to meeting local need. In so doing, it must set the overall strategic direction and provide a clear and demonstrable focus on addressing the diversity of need in specific localities through its strategic intentions. 8. Commissioning must focus on outcomes. There should be a Sussex-wide outcomes framework that is strengths-based and resilience-led with clear and auditable measures of quality and effectiveness across services, both pan-Sussex and at locality level. 9. The CCGs financial investment in children and young people’s mental health services should be re-based to ensure that the level of spending is commensurate with the level of need and that the national investment targets are met. The local authority partners must work with the CCGs to ensure a fuller and jointly understood picture of current investment and identify areas for similar re-basing and re-balancing. 10. This must include consideration of the opportunities to recast the investment in specialist services and ensuring appropriate investment from commissioners into early help, prevention and other non-specialist support services. This should be accompanied by a commitment to the transformation of specialist services to ensure a more effective system-wide pathway. To aid that process, SPFT should lead a rapid process of modernisation of their specialist services to improve pathways, access and outcomes. Given the scale of transformation across partner organisations, it is recommended that a transformation programme is initiated on inception of this work.
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11. The CCG and local authority partners should work together to determine and provide clarity about how much is invested and where, particularly the amount of investment in wellbeing support and commit to improving levels of financial resource being directed into public health, prevention, early intervention and promotion delivery. 12. The current landscape of provision requires further review by commissioners. The focus of this should be an examination of the number of providers and what they provide. It should have the aim of ensuring the right range of services and supports within a sustainable system that are more easily navigable for children, young people and their families. This should include the need to ensure a fuller understanding of the range of services that need to be commissioned to build the right pathway that includes universal services, prevention and early help as well as specialist services. 13. The Single Point of Access (SPOA) model should be swiftly developed and implemented across Sussex. The development of the model should draw on the current local experience as well as looking at models of good practice. It should provide improved and open access to universal services as well as targeted input, with minimum waiting times. It should be open to children and young people to refer themselves, as well as to their families, schools and colleges and general practitioners. 14. As part of the recommended specialist services transformation and modernisation process, the partners, led by SPFT should review and re-describe current thresholds and criteria for access to their services for children and young people. This should be done through a process of co-production between the partners to determine the most appropriate model so that it forms part of the overall pathway, which should include earlier help and support provided by non-specialist services. 15. To better support schools and colleges, the current piloting of Mental Health Support Teams in Sussex should be accelerated and expanded so that 20-25% of all schools and colleges have access to mental health professionals in-line with the Green Paper. 16. All commissioned services will be expected to deliver a demand, capacity and productivity review. 17. The organisations in Sussex should ensure service levels and capacity that are matched to local need. The changes required are likely to take some time to achieve. In the interim, the organisations must put in place the necessary pathways and interventions to support those children and young people who are waiting. 18. There should be a programme of awareness and education directed to statutory referrers that clearly describes the agreed pathway model and about when and to where to refer. This will include embedding the importance of, and confidence in, the full range of commissioned services. 19. To improve accessibility, and given the geography of Sussex, services must operate more flexibly. This includes working beyond traditional 9-5 working hours and school hours and should include evenings and weekends. In addition, services must be offered from a broader range of locations and where appropriate, in locations that are not necessarily based in statutory sector buildings. Exploration of on-line consultation, advice giving and support as well as the use of other digital options should be explored. This could include advice from specialist services to general practitioners and social prescribers. 20. A Sussex-wide audit and review of the targeted and specialist workforce should be undertaken. From this, plans should be developed to ensure that the number and mix of
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professionals working in services is appropriate. This audit should take account of any current or recent work conducted as part of the Local Transformation Plan process. 21. Children and young people should have a greater say in how resources are spent. An agreed proportion of the available financial resources should be delegated to children and young people to prioritise for their own communities and neighbourhoods. Commissioners and providers must also be able to demonstrate that children and young people have co-designed services and pathways. 22. A Children and Young People’s Panel should be created. It should be composed of children and young people, their families and carers. It must attract dedicated resource to support its operation. The panel should be independently facilitated and run. It should provide an opportunity for children and young people to contribute to, and participate in the development of local services, strategies and plans. Recruitment to the panel should have as wide a representation from across Sussex as possible. 3.2 Foundations For Our Future and its recommendations provides the opportunity for local partners to focus on the improvements and changes that are needed. 3.3 Next steps 3.3.1 The next steps for the Report and its recommendations are; a) Publication as and when agreed by the Oversight Group . b) A response to the recommendations to be developed and published and an implementation framework established.
Recommendation The Council of Governors is asked to note the summary report and the findings of Foundations For Our Future.
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Report to Council of Governors Agenda item CG 07 .3/20 Attachment D Data Quality Indicator N/A Date of meeting 10 August 2020 Format of Paper Title of paper Chair’s Report Written Author Peter Molyneux, Chair Oral ☐ Non-Executive Peter Molyneux, Chair Presentation ☐ Sponsor Committees where this item has been considered N/A
EXECUTIVE SUMMARY Please tick one For Assurance For Decision ☐ In this report the Chair will update the Board of Directors on a number of Trust developments, meetings and activities from the last two months.
Recommendation The Council of Governors is asked to note the content of the report.
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Non-Executive Sponsor
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1. INTRODUCTION
The purpose of this report is to provide a summary of key developments and meetings and activities the Chair has participated in.
2. REPORT
Report on activity since the last Council of Governors Meeting 1. Sussex Health and Care Partnership Chairs’ Meeting - 9th June 2020 Meeting focussed on the governance needed to capitalise on the accelleration that had been achieved through the response to the Covid 19 Level 4 Incident. It has been agreed to develop a piece of work taking the high level objectives for the ICS and looking at how the current governance arrangements enhance or inhibit delivery and to co-produce solutions to any barriers that are identified. In response to the equality and diversity agenda there was a recogntion that we probably have the research and outputs from listening exercises that we need to inform action. Whilst there is merit in further listening exercises it is important that we agree some action points. As Chairs we are agreed that there is a need for serious board ownership of these issues and not assume that they have been delegated to EDI leads. Given that Covid 19 has shone a bright light on long-standing health, housing, employment and other social inequalities. We need to ensure that we are addressing the structural, interpersonal and institutional factors that drive inequality. In particular we need to address:- Workforce - benchmark data across organisations on WRES, numbers of staff self-isolating, numbers with Covid 19; risk assessments completed by ethnicity as a proportion of workforce and outcomes of risk assessments; Development programme for BAME staff that supports talent management and supports delivery of WRES objectives; Inclusion - promote inclusion cafes to support discussion of wicked issues at the front-line ensuring a direct line of sight from the Board to the front-line and back again; bring BAME Network Chairs together to increase psychological safety and build confidence that things are improving; Board membership - benchmark data and introduce NEXT Director programme for Sussex; Population health - co-produce and target health promotion messages to BAME communities to reduce potential Covid 19 second wave; ensure population health management programmes have specific inequalities objectives; link into ICS population health management programme; Transformation - ensure all collaboratives have a health inequalities reduction. 2. Health and Care LGBTQ+ Leaders’ Network - 1st June 2020 Three themes were identified that will now provide the focus for activity. These were :- Leadership: How we design an inclusive organisation so that it is less dependent on the efforts and endeavours of specific individuals - who may then leave; how we promote / model authentic leadership to improve visibility but also to own challenges to build trust and confidence in colleagues.
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Safe Spaces: How to create safe spaces in a virtual world and how to connect to staff. Re- affirm meaning of the rainbow as a symbol of hope and inclusion, to encourage the connection of lanyards and badges to pledges and meaningful action. Promote listening exercises, inclusion cafes and advocate programmes. Emerging Need: Shared concerns about the levels of need that have emerged during lock- down and those that may be hidden. This reinforced the importance of responding rapidly to risk assessment guidance, NHS Blood and Transplant policy and practice, insisting on full Equalities and Human Rights impact assessments on policies and plans for the reset. Identified the need to work on the toxic environment for that exists for trans people at this time and build stronger allies. 3. Regional Chairs’ Meeting - 10th June 2020 Anne Eden, Regional Director, South East Region NHSI/NHSE did a broadcast for Chairs of Trusts across the region. There were a number of issues that were raised: There had been a significant amount of work responding to the Covid 19 pandemic. She singled out SPFT for praise in introducing “attend anywhere” and the speed in which we moved to on-line consultations. Contingencies have been put in place to cope with a second surge of Covid 19. Whilst everything is being put in place to prevent this there is likely to be a long ‘tail’ in infections through to the Autumn; A Recovery Board has been put in place to manage a return to elective care and to seek to minimise the negative impact of the pandemic on disease outcomes for other groups of patients. Acknowledgement of likely surge in mental health crises, anxiety about coming into in-patient settings and particular issues with mental health investment levels. 4. Centre for Mental Health Blog I have published a blog as part of the Centre for Mental Health's work on inequalities in the light of Covid 19. It can be accessed here: https://www.centreformentalhealth.org.uk/blog/commission-equality/nothing-can-be- changed-until-it-faced-facing-inequalities-covid-19 5. Other Meetings and Events IPS Grow Task and Finish Group - 2nd June 2020 BAME Staff Engagement Event - 5th June 2020 NHS Reset Meeting - 8th June 2020 Primary Care Network / Mental Health Network Webinar - 16th June 2020 Board of Directors Development Session - 23rd June 2020 NHS Confederation "Hand in Hand" Connecting mental health statutory and voluntary sectors - 26th June BAME Staff Network Meeting - 30th June 2020 NHS Providers BAME Meeting - 30th June 2020 Mental Health Network Board Meeting - 21st July 2020 NHS Providers Chairs' and CEO Meeting - 2nd July 2020 NHS Employers Well-being of LGBTQ+ Staff post Covid 19 webinar - 21st July
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I have also been involved in discussions with the Chairs of Surrey and Borders NHS Foundation Trust, Merseycare, Lincolnshire Partnership and Croydon Healthcare. 6. Upcoming Meetings and Events Anuual General Meeting - 10 August 2020 Annual Members Meetings - 23 September 2020 Further details of these meetings can be found here: https://www.sussexpartnership.nhs.uk/council-governors-meetings
3. RECOMMENDATION
The Council of Governors is asked to note the content of the report.
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Report to Council of Governors Agenda item CG 07 .3/20 Attachment D Data Quality Indicator N/A Date of meeting 10 August 2020 Format of Paper Title of paper Q1 Progress Report on 2020/21 Written Annual Objectives Author Nicola Chegwidden, Project Oral ☐ Manage Executive Sponsor Sally Flint, Chief Finance Officer Presentation ☐ Committees where this item has been considered N/A
EXECUTIVE SUMMARY For Assurance For Decision ☐ Purpose - The purpose of this report is to update on progress at Q1 of 2020/21 Annual Objectives. The 2020/21 annual objectives are part of a Strategy Implementation Framework. The Trust has aligned the planning process in a driver diagram format set out in Appendix 1. The format sets out the Trust's mission, strategic goals and enablers and shows how this is driven by Annual objectives covering our main deliverables for the next 12 months A set of Core Standards such as care plans, risk assessments, staff wellbeing, recruitment and retention and agency targets Longer Term Programmes which are largely based around the NHS Long Term Plan The 2020/21 Strategy Implementation framework and Annual Objectives have been formally agreed by the Executive Management Committee and Board of Directors. There are 4 breakthrough objectives for 2020/21 which are our highest priority objectives, these are:- delivering 24/7 crisis and urgent care services delivering a new model for adult community services developing a Learning System delivering the Digital Adoption Programme The Covid-19 pandemic has accelerated some objectives such as 24/7 crisis services but has impacted areas like Research & Development as research was paused. However, at the end of Q1 the summary position on 2020/21 Annual Objectives is Green x 11, Amber x 3, Red x 0. Recommendation The Council of Governors is asked:- To note the key achievements in Q1 2020/21 To note the impact of Covid-19 To review the progress of the 2020/21 annual objectives Executive Sponsor
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1. INTRODUCTION
This report tracks the implementation of our 2020/21 Annual Objectives which have been formally agreed by the Executive Management Committee and Board of Directors. The objectives are consistent with our Organisational Strategy 2020-2025 People, Prevention & Partnerships launched in October 2019 so show progress against our long term strategy. This is the Q1 report which covers the period from 1st April to 30 June 2020.
2. REPORT
The 2020/21 Annual objectives are part of a Strategy Implementation framework. The Trust has aligned the planning process in a driver diagram format set out in Appendix 1. The format sets out the Trust's mission, strategic goals and enablers and shows how this is driven by: Annual Objectives covering our main deliverables for the next 12 months. A set of Core Standards such as care plans, risk assessments, staff wellbeing, recruitment and retention and agency targets. These will be managed through the CDS Quality Assurance process with monthly reviews and reports taken to the Executive Management Committee and Board of Directors by the Chief Operating Officer. There will also be a half year self-assessment of the performance of Support Services. Longer Term Programmes. We have a set of longer term programmes largely based around the NHS Long Term Plan. Although these have deliverables that are pulled out into the 2020/21 objectives they have a longer timeframe. Progress against the annual objectives is reviewed on a quarterly basis at Executive Management Committee, Council of Governors and Board of Directors. There are 4 breakthrough objectives for 2020/21 which are our highest priority objectives. These are delivering 24/7 crisis and urgent care services delivering a new model for adult community services developing a Learning System delivering the Digital Adoption Programme It has been agreed that the standard trust RAG rating definitions are used as set out in the table below
RAG status Definition
Green On track or delivered
Amber There are some issues, being managed, needs to be closely monitored
Red Serious issues, dates being missed, needs corrective action
The Covid-19 pandemic has accelerated some objectives such as the delivery of 24/7 crisis services but has impacted areas like Research & Development as research was paused.
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2020/21 Annual Objectives - see Appendix 2 At the end of Q1 the summary position is Green x 11 Amber x 3 Red x 0
Key Achievements in Q1 2020/21
As part of the management of Covid-19 the delivery of 24/7 rapid assessment hubs for people experiencing mental health crisis (Havens) was accelerated resulting in 5 facilities across Sussex being operational
The Sussex Mental Health Line (SMHL) has been significantly enhanced in response to Covid-19 and NHSE directives and the service is receiving an average of 357 calls per day with service users experiencing minimal if any waits for their call to be answered
The community services model was presented at the Integrated Care System (ICS) Mental Health Strategy & Quality group in June 2020
The Trust is the leading user in England of the digital consultation service Attend Anywhere with over 20,000 consultations to date
In response to Covid-19 the remote access capacity was increased to enable 4,000 staff to work securely from home
The trust has developed guidance for staff and managers on managing abuse and harassment which will now be communicated out to the organisation
On new roles 34 Nursing Associates are employed or are in the pipeline, 19 Graduate Mental Health Workers are employed and 2 Physician Associates are attending placements
Good progress has been made to establish the Mental Health Collaborative as part of the Sussex Health & Care Partnership (SHCP)
For East Sussex inpatient services development, the year 1 budget has been approved and programme governance has been established
33% of community teams have completed triangle of care self-assessments for including family and friend carers against the target of 100% by June 2021
We have undertaken a significant research project learning from the organisation's response to the Covid pandemic and identified 7 areas for follow up and have completed a survey on working from home and are currently engaging with staff on improvements to wellbeing
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Progress on delivery of the four 2020/21 breakthrough annual objectives as at Q1 Progress on the four 2020/21 breakthrough annual objectives is described below 1.0 Crisis Services In quarter 1 2020/21 the key areas of work have been the following:- Sussex Mental Healthline & NHS 111 The Sussex Mental Healthline (SMHL) has been significantly enhanced in response to Covid- 19 and NHSE directives. The SMHL now has enhanced staffing over a 24/7 rota resulting in far improved performance in answering calls with minimal waits if any waits for service users. The service has seen an increase in demand which has levelled at an average of 357 calls per day. The service now has senior clinicians as part of the team which has enabled referral pathways into urgent care services such as the Haven. This has meant a reduction in the numbers of people directed to A&E. Work is now underway to re-establish links with South East Coast Ambulance (SECAmb) so the Mental Healthline can be accessed by calling 111. Once connected the SMHL will have increased resilience as 111 clinical staff will be available to receive call escalations in the absence of SPFT employed senior clinicians. What's more once connected, calls will become free for service users.
Rapid development of Havens in response to Covid-19 As part of the management of Covid-19 the delivery of 24/7 Havens was accelerated resulting in 5 facilities across Sussex being operational offering urgent care assessment 24/7. Feedback on these facilities has been positive from colleagues in acute trusts and service users alike. An estates programme is planned which will see all areas having suitable high standard accommodation for Havens. Urgent Care Hub Model Learning from the success seen during our response to Covid-19; there is clearly value in having urgent care teams which can work flexibly across the entire urgent care pathway. To capitalise on this the trust is formalising its structures of urgent care services to enable this flexibility on-going. This is anticipated to mitigate current risks to the urgent care programme associated with recruitment challenges by having larger teams with greater resilience and
Page 4 of 10 flexibility. Core 24 50% of vacancies are filled and recruitment is on-going to fill the remaining vacancies to be able to provide 24/7 coverage. Staying Well (crisis cafés) Staying Well services are operational in Hastings, Coastal West Sussex and Eastbourne In Brighton & Hove the anticipated go-live is September 20. North West Sussex Staying Well is awaiting procurement. The operational model for these services has been modified in response to the Covid-19 guidance with services offered virtually or by telephone. Children and Young People's 136 suite at Chalkill This was put in place in quarter 4 2019/20 and it continues to be staffed with a mix of agency and substantive staff whilst we continue to try to recruit. 2.0 Community Services In quarter 1 2020/21 the key areas of work have been the following:- Integrated Care System (ICS) - Community ICS Community Mental Health Redesign Board Meeting took place on 30th June 2020. Work underway developing community services road map, community services model (see below), key tasks in relation to model development such as the system and place, terms of reference for key system meetings (Community Mental Health Redesign Board and Community Redesign Place Based Meetings) have been drafted. A high level programme plan for the Mental Health Transformation Programme has been developed and as part of this Adult Community has outlined 3 key project areas - (1) Integrated Community Development, (2) Enhancing Existing Services and (3) Developing the Infrastructure. High level deliverables and milestones for 2020/21 have been developed as part of this. The Mental Health Transformation Programme Plan is being presented to Sussex Health & Care Partnership (SHCP) Planning & Delivery Group on 30th June 2020 and will then go to the Mental Health Transformation Programme Board on 23rd July 2020. Sussex Partnership - Community Monthly Community Steering Groups have taken place in April, May and June 2020. Meetings have reviewed key project plan tasks for quarter 1. Progress has been made in starting to identify key milestones for the community work stream. Key achievements for the period include:- identifying Expert by Experience members to support the co-production of community work stream work creating a register of community pilots that have taken place or are taking place so that the outcomes can be evaluated to support community services development review of referral criteria (awaiting outcome) commencing work on outlining a standard outcome measure commencing work on a data flow information plan Preparing for the start of Mind District pilot in East Sussex Evaluation of the use of digital technology within the Community Services (Attend Anywhere, patient held records) to support a blended model of delivery
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Engagement Within the Community work stream engagement has included:- Series of internal work stream meetings with staff internally within the trust have further developed the model and proposals - community transformation, clinical pathways and outcomes, and digital workstreams being key Review and sign off of the initial model in the ICS Adult services transformation group (includes representatives from service user and carer groups, commissioners, local authority reps, public health, NHS organisations and the third sector) Model has been updated (see below) and the next tasks have been identified (key tasks relating to system and place) which will need further work to articulate details of the model Model presented at Executive Management Team (EMT) meeting 16th June 2020 Model presented to new ICS Mental Health Clinical Strategy and Quality group on 24th June
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3.0 Trust's Learning System The Trust's Learning System, designed to be the cultural enabler for the Trust to realise its strategy consists of six "inclusive practices" which are: Talent Management Leadership & Management Development Human Resources (HR) Practices People Participation (utilising experts by experience and staff networks to develop culture) Workforce Race Equality Standard (WRES) & Workforce Disability Equality Standard (WDES) Succession Planning Work has begun on talent management and succession planning. Talent management / succession planning arrangements are now in place at Executive level and work has begun on developing clear arrangements for Black, Asian & Minority Ethnic (BAME) colleagues. Increasing the number of BAME staff in roles at Band 8a and above is a specific area of focus. The creation of a management development programme for operational managers in order to give them the skills to develop psychological safety, trust and cultural awareness in their teams has been delayed by the outbreak of Covid-19 but work has now recommenced. It is anticipated that the programme will be based on the work of Professor Michael West Developing Effective Team. As far as possible the Trust will be using internal expertise to both develop and run the programme, particularly drawing on the expertise and experience of the Organisational Development (OD) Practitioners. HR practices continue to be reviewed to ensure they are reflective of a culture which is based on trust, learning and accountability. This has had a marked impact on the Trust's overall employee relations agenda with a reduction in the number of cases and the likelihood of BAME colleagues entering the disciplinary process being the lowest since this information started to be recorded as part of WRES. We have 3 well established staff networks, Disability, BAME and LGBTQI. As part of our expansion for staff health and wellbeing, we are going to be launching a Wellbeing Network, including wellbeing champions, mental health ambassadors and mental health first aiders across the Trust. The results of the 2020 WDES and WRES processes are currently being collated and are being reported to EMC and Board in July 2020. 4.0 Digital Adoption Programme Since March 2020, we have increased the capacity of the remote access solutions to allow over 4000 staff to work securely from home, either from Trust or their own equipment. We increased our use of GoToWebinar and introduced GoToMeeting to bring people together virtually. Our Trust training courses were moved on-line, and new courses introduced (such as safe use of Personal Protective Equipment) with the assistance of the Digital Team. Our adoption of Attend Anywhere as a virtual consultation offer has been the highest in England with over 20,000 consultations to date (see graph below) and we continue to average 500 virtual consultations each week. During Covid-19, this has helped keep staff, service users and carers safe, and has allowed clinical staff that are self-isolating but asymptomatic to
Page 7 of 10 continue to work from a safe place. A fully functioning web based system architecture was introduced to support the introduction of the 24 hour Mental Health Line. This included web-based telephony, remote access solutions so both phones and systems could be used from home, and the development of a database to record call information. We also developed automatic notification of lead practitioner if someone known to services calls the helpline. This system has also been created to allow integration with the 111 service once they are ready. The service user facing Global Digital Exemplar (GDE) workstream has acquired the rights to System Training for Emotional Predictability and Problem Solving (STEPPS) therapy and we are developing a digital version. The Team are also working with Primary Care & Wellbeing service to develop digital therapies and resources. Consultation for the development of a Patient Portal is well underway and it is expected that this will form part of a wider Digital Mental Health offering at ICS level. After a slow start the PowerBI project is bearing fruit, and is struggling to keep up with demand for new dashboards. It has been particularly useful in providing information about the take up of new technologies in response to Covid-19 so that resources can be allocated effectively to support users. Underpinning this work has been an extensive training programme to ensure that all staff were comfortable working in new ways using digital technology, particularly in clinical settings. Graph showing the increase in consultations to 20,232 from April to June 2020
Progress on the delivery of the 2020/21 non- breakthrough annual objectives as at Q1 Progress on the 2020/21 non-breakthrough annual objectives is described below
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Inpatient services. For East Sussex the year 1 budget has been approved by Finance and Investment Committee. Programme governance, Clinical Working Group, Communications and Involvement Working Group have all been established. Identification of Experts by Experience to join the Assurance Group is underway and procurement strategies for advisory support have been confirmed. There has been positive engagement with the Board and NHS E/I and relationships have been established. For West Sussex reconfiguration plans were temporarily suspended in light of Covid-19. The Decision Making Business Case remains to be approved by NHS E/I and discussions are ongoing with Surrey and Borders Trust. There will be therefore be delays to the implementation plans which are currently being reviewed and considered alongside the urgent requirement to eliminate dormitories. New roles. New roles increased by more than 10% with more roles in the pipeline. 34 Nursing Associates are employed or are in the pipeline with 3 already employed, 5 completing final paperwork and 26 in training. Nursing Associates is a new role for SPFT. We employ 19 Graduate Mental Health Workers. 2 Physician Associates are attending placements.. Workforce/recruitment plans have been developed for year one of the Long Term Plan where possible and action is being taken to draw up plans which look further ahead. Patient experience. A task and finish group was set up to work on this, and has been running since December 2019. We now have a reporting process in place for Friends & Family Test (FFT) feedback across all Care Delivery Service (CDS) groups. We have now started work to improve uptake of FFT and enhance digital solutions around this. During Covid-19 FFT has been used little due to NHS England guidance and infection control restrictions, and so we have been using the Covid-19 experience survey. We will start transitioning back to FFT (keeping the survey in place) in June 2020. We have now aligned workstreams from Patient Related Experience Measures (PREMs) and Patient Related Outcome Measures (PROMs) work to increase impact. Children & young people and Perinatal. For youth population, workstream chairs have been identified and model development is beginning in Q2 in line with expected submission for business case in line with Integrated Care System (ICS) expectations. For both Early Intervention in Psychosis and the expanded perinatal service the plans are in place and agreed as per ICS milestones and recruitment is underway. Suicide prevention. 81% of clinical and 88% of non-clinical staff are trained in suicide prevention. The target of 95% is a challenging target to achieve given the number of new starters. CDS Suicide Prevention leads have been asked to encourage teams to complete the training. Suicide Prevention lead role has been expanded to include self harm lead for the trust and has also had an extended role approved by Executive Management Committee to commence Q2 2020/21. The role continues to link in with ICS Suicide Prevention programme. Triangle of care. 33% of community teams have completed self-assessment and 13% of inpatient teams have reviewed the self-assessments already completed for stage one accreditation. The target is to achieve 100% by June 2021. These figures are reflective of information and guidance received from Carers Trust that due to the ongoing coronavirus situation that we could set a pause in the self-assessment process to allow teams to deal with Covid-19. A quarterly trajectory will be set by end of Q2. Provider Collaboratives. The Trust agreed that we progress our Provider Collaborative development towards our being Lead Provider for Adult Secure across Kent, Surrey and Sussex and for Child and Adolescent Mental Health Service (CAMHS) Tier 4 Services across Kent, Sussex, Wessex and Dorset. We worked with NHSE/I extensively to agree the transaction process as the size of the contract is above the threshold that requires regulator
Page 9 of 10 sign-off to ensure that the viability of the Trust is not compromised before reaching final stages of self certification and sign off. The final business cases are due to be submitted to NHSE for both Adult and CAMHS Collaboratives for a 1st October 20 commencement. We await the outcome of final discussions with NHSE relating to the year-end figures and impact of those on the overall budgets moving forward in July 2020 which will inform the final timetable and go live dates for Adult Secure and CAMHS. Integrated Care System. Good progress has been made to establish the Mental Health Collaborative as part of the Sussex Health & Care Partnership (SHCP). The governance for the Mental Health element of the SHCP has been agreed and is in place. This will support the system in delivering the Long Term Plan requirements and the SHCP objectives. Research. The majority of research studies were suspended in line with national guidance at the onset of the Covid-19 pandemic. This has adversely affected completion of the Participant Research Experience Survey (PRES) as new participants were not being recruited at the pre- Covid-19 rate. Some research studies are starting to resume and we anticipate an increase in completion of the survey next quarter. We have undertaken a significant research project led by the Director of R&D learning from the organisation's response to the Covid pandemic and identified 7 areas for follow up and have completed a survey on working from home and are currently engaging with staff on improvements to wellbeing. Reduce bullying & harassment. The Trust has developed guidance for staff and managers on managing abuse and harassment which will now be communicated out to the organisation. Operation Cavell (an agreement between SPFT and Sussex police on response to assaults) has also been promoted again to raise awareness and support through the Trusts counselling service and Mental Health Line. The success of these initiatives will be reflected in the staff survey results published in Q4 2020/21 Appendix 1: Strategy Implementation Framework Appendix 2: Report setting out progress against the 2020/21 trust annual objectives
3. RECOMMENDATIONS
The Council of Governors is asked:- To note the key achievements in Q1 2020/21 To note the impact of Covid-19 To review the progress of the 2020/21 annual objectives
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Progress of Sussex Partnership Annual Objectives 2020-21 People will feel valued, supported and cared for Annual Objectives for 2020-21 Progression as at Q1 2020-21 Exec RAG * Breakthrough objectives (30 June 2020) Lead *Deliver 24/7 Crisis services • Core 24 50% of vacancies filled, recruitment on-going to fill Core 24 operational: Worthing and St remaining vacancies to be able to provide 24/7 coverage Richards • Crisis cafes operational in Hastings, Coastal West Sussex and Crisis café operational: Hastings embed the Eastbourne. Brighton & Hove anticipated go live Sept 20, North new service, Coastal West Sussex March West Sussex awaiting procurement 2020, Eastbourne April 2020, Brighton & • Havens All areas now have facilities available 24/7 which can Hove June 2020, North West Sussex January offer assessment for people experiencing crisis. Work is on-track Simone 2021 to enhance the accommodation for these facilities in line with Button Green Havens openings: Brighton & Hove June original timeframes 2019, North West Sussex October 2020, • Single point of access Sussex Mental Healthline enhanced in Coastal West Sussex November 2020, East response to Covid-19. Work underway to re-establish integration Sussex March 2021 with NHS 111 following pause due to Covid-19 Single point of access for Trust by end Q2 • Chalkhill 136 suite put in place Q4 2019/20 and continues to be Children & Young People 136 suite staffed with mix of agency and substantive staff while recruitment Chalkhill continues Inpatient services. Develop and deliver an East Sussex (RAG=green) effective and successful programme to • Year 1 budget approved improve inpatient services in East Sussex, • Programme Governance, Clinical Working Group, making them fit-for-purpose for the future; Communications & Involvement Working Group all established complete West Sussex inpatient • Identification of Experts by Experience to join the Assurance transformation Group underway • Positive engagement with Board and NHSE/I Sally West Sussex (RAG=amber) Flint Green • Reconfiguration plans were temporarily suspended in light of Covid-19 • The Decision Making Business Case remains to be approved by NHSE/I and discussions are ongoing with Surrey & Borders FT • There will be therefore be delays to the implementation plans which are currently being reviewed and considered alongside the urgent requirement to eliminate dormitories People will feel valued, supported and cared for Annual Objectives for 2020-21 Progression as at Q1 2020-21 Exec RAG * Breakthrough objectives (30 June 2020) Lead New roles. To expand new roles across the workforce by • New roles increased by more than 10% with more at least 10% by employing more Nursing Associates, roles in the pipeline Graduate Mental Health Workers & Physician Associates. • 34 Nursing Associates are employed or are in the Trust is in the process of developing workforce plan that pipeline with 3 already employed, 5 completing final will inform the numbers of each of these staff to be paperwork and 26 in training. This is a new role for recruited SPFT • 19 Graduate Mental Health Workers employed Gavin • 2 Physician Associates are attending placements Wright Green
• Workforce/recruitment plans have been developed for year one of the Long Term Plan where possible and action is being taken to draw up plans which look further ahead
Patient experience. Each Care Delivery Service (CDS) • Task and finish group set up Dec 19 to have a robust process for collecting, looking at and • Reporting process in place for Friends and Family responding to experience feedback from a variety of Test (FFT) feedback across all CDSs different sources by end Q2 • Started work to improve uptake of FFT and enhance digital solutions • During Covid-19 FFT has been used little due to NHS England guidance and infection control restrictions, Acosia and so the Covid-19 experience survey has been Nyanin Green used • Will start transitioning back to FFT (keeping the survey in place) Jun 20 • Aligned workstreams from Patient Reported Experience Measures (PREMs) and Patient Reported Outcome Measures (PROMs) to increase impact Prevention of ill health will promote community wellbeing
Annual Objectives for 2020/21 Progression as at Q1 2020/21 Exec RAG * Breakthrough objectives (30 June 2020) Lead
Children & young people and Perinatal. • For youth population, workstream chairs have been identified and Agree model of delivery for our youth model development is beginning in Q2 in line with the expected population including but not exclusive to submission of the business case. This is in line with Integrated those identified within the Long Term Plan Care System (ICS) expectations Simone 18-25 range, further develop Early Button Intervention in Psychosis service delivery • For Early Intervention in Psychosis, the plan is in place and agreed Green and expand the perinatal service offer to as per ICS milestones and recruitment is underway 6.4% of the live birth rate • For the expanded perinatal service, the plan is in place and agreed as per ICS milestones and recruitment is underway
Suicide prevention. 95% of staff trained in • 81% of clinical and 88% of non-clinical staff trained in suicide Rick suicide prevention prevention Fraser • Care Delivery System (CDS) Suicide Prevention leads have been Amber asked to encourage teams to complete the training Partnerships will provide people with services to help them thrive Annual Objectives for 2020/21 Progression as at Q1 2020/21 Exec RAG * Breakthrough objectives (30 June 2020) Lead *Community services. Engagement and • Series of workstream meetings within the trust have further sign-off of community model across the developed the model and proposals system by end of Q2 and implementation • Model presented at Integrated Care System (ICS) Mental Health Nick Green plan by end Q3 Clinical Strategy & Quality group and at Executive Management Lake Team (EMT) in June 20 • Implementation plan being progressed as planned Triangle of care. 100% of community • 33% of community teams have completed self-assessments teams complete triangle of care self- • 13% of inpatient teams have reviewed the self assessments assessments/action plans for including • These figures are reflective of information & guidance from Carers Acosia family/friend carers by June 2021 & 100% of Trust that due to Covid-19 the self-assessment process could be Nyanin Green inpatient/related teams review triangle of paused to allow teams to deal with Covid-19 care self-assessments/action plans already • A quarterly trajectory will be set by end of Q2 completed for stage one accreditation by June 2021 Provider collaboratives. Take on • Working with NHSE/I extensively to agree the transaction process delegated commissioning responsibility from before reaching final stages of self certification and sign off Sally NHSE for Adult Secure and CAMHS • Discussions in July 20 with NHSE/I relating to the year end figures Green Flint services (circa £120m per annum) and impact of those on the overall budgets will inform final submission timetable and go live dates for Adult Secure and CAMHS Integrated Care System (ICS). Anchor • Good progress has been made to establish the Mental Health organisation for the ICS for mental health Collaborative as part of the Sussex Health & Care Partnership Dom and learning disabilities services across (SHCP) Green Ford Sussex during 2020/21 and deliver agreed • The governance for the Mental Health element of the SHCP has ICS shared objectives been agreed and is in place Research. Increase the % of research • Majority of research studies suspended in line with national guidance participants who complete a Participant at the onset of the Covid-19 pandemic Research Experience Survey (PRES) who • This has affected completion of the Participant Research Experience Rick Amber are aware that SPFT is a research Survey as new participants not recruited at the pre-Covid-19 rate Fraser organisation prior to taking part in studies • Research studies are starting to resume and an increase in from 50% to 60% by 31/3/21 completion of the survey next quarter is anticipated Culture, values & behaviours Annual Objectives for 2020/21 Progression as at Q1 2020/21 Exec RAG * Breakthrough objectives (30 June 2020) Lead *Trust’s learning system including Leadership • Although progress has slowed due to Covid-19, work has Development begun on developing the Trust's Talent Management Develop the Trust's learning system in support of a process/succession planning arrangements starting with culture of psychological safety, trust, compassion Black, Asian & Minority Ethnic (BAME) colleagues in and inclusive practices collaboration with SHCP. Increasing the number of BAME Gavin Wright staff in roles at Band 8a and above is a specific area of focus It consists of six "inclusive practices" which are: • The Leadership development programme for operational managers as part of the Learning System was stalled due to • Talent Management Covid-19. Work has now recommenced and the programme • Succession Planning is being developed based on Developing Effective Teams. Amber • Leadership & Management Development The programme will be supported by Organisational • Human Resources (HR) Practices Development (OD) practitioners • People Participation (utilising experts by • HR practices continue to be reviewed and this has resulted in experience to develop culture) a significant reduction in employee relations cases • Workforce Race Equality Standard (WRES) & • We have 3 established staff networks, BAME, Disability and Workforce Disability Equality Standard (WDES) LGBTQI and are setting up a new wellbeing staff network • Results of the 2020 Workforce Race Equality Standard (WRES) & Workforce Disability Equality Standard (WDES) process are currently being collated and are being reported to EMC and Board in July 2020
Reduce bullying & harassment. Develop a suite • The Trust has developed guidance for staff and managers on of interventions to reduce bullying and harassment managing abuse and harassment which will now be against staff and ensure support arrangements for communicated out to the organisation. those staff who experience these behaviours in the • Operation Cavell (an agreement between SPFT and Sussex Gavin Wright course of their work police on response to assaults) has also been promoted Green again to raise awareness and support through the Trusts counselling service and Mental Health Line • The success of these initiatives will be reflected in the staff survey results published in Q4 2020/21 Use of resources Annual Objectives for 2020/21 Progression as at Q1 2020/21 Exec RAG * Breakthrough objectives (30 June 2020) Lead
• The digital response to Covid-19 has enabled the trust to *Digital adoption programme. Deliver a step move to a significant level of remote working, using digital Green change in the way the Trust delivers its services Beth tools to maintain contact with service users and each other Lawton through its digital adoption programme • These new ways of working include digital consultation where we are the leading user of Attend Anywhere in England with over 20,000 consultations to date
* We have 4 breakthrough objectives. These are marked above and are our highest priority objectives for 2020-21.
RAG Status Key RAG STATUS Definition Green On track Amber Some issues, being managed, needs to be closely monitored Red Serious issues, dates being missed, needs corrective action “To improve the quality of life for the communities we serve ” Trust Strategy through our three strategic goals: 2020-25 People, prevention and partnerships
Enabled by our culture, values and behaviours; and our efficient use of resources
Core Standards Annual Objectives 2020-21 Longer Term Strategic Quality Assurance goals for 2020/21 We have 4 *Breakthrough objectives. These are marked below and are our highest priority objectives for 2020-21 Developments Long Term Plan and Clinical Strategy • 72 hour follow up - 80% • Risk assessments complete - 95% • Perinatal - 1,689 women treated per annum by 2023/24 - take on delegated • Care plans in place - 95% People • Provider collaboratives • Children & Young People - improving access by treating 12,302 per • No mixed sex breaches • Crisis services*- deliver Core 24, crisis cafes, Havens & commissioning from NHSE for adult secure & CAMHS annum; eating disorders services in place and 24/7 urgent cares services • Physical health assessments - 95% single point of access specialist services (circa £120M per annum) in place by 23/24 • Inpatient services - complete West Sussex inpatient • Cluster reviews - 95% • Integrated Care System - Sussex Partnership to be - work with local partners to continue to develop transformation, develop programme to improve East • Learning disabilities • Out of area placements - zero by 31/3/21 an anchor organisation for mental health and learning an integrated service in line with the national Transforming Care Sussex inpatient services disability services • Routine assessments within 4 weeks - 95% strategy & complex physical health • New roles - expand the number of new roles by at least • Research - 60% of research participants aware that • IAPT access - 75% • Psychological therapies (IAPT) 53,811 people accessing treatment 10% we are a research trust • EIP access - 60% • Patient experience - robust process in place for collecting per annum by 23/24 • Delayed Transfers of Care - 4% and responding to experience feedback • Neurodevelopmental - to develop a strategy and comprehensive • Timely complaints responses - 85% Culture, values and behaviours pathway for neurodevelopmental services • Trust’s learning system* develop a new learning • Improve friends and family response rate in line with the national Prevention • Community - Integrated model of community & primary care in place system for the Trust with a 11,282 capacity by 2023/24; 12,518 accessing physical health average • Children & young people and Perinatal - agree a Reduce bullying & harassment - develop a suite of checks; 1,677 people in accessing employment support • Essential training - 85% youth services model, enhance Early Intervention in • interventions and support • Crisis care and liaison services - 24/7 services in place • Appraisals complete - 95% Psychosis services , expand perinatal to 6.4% of births • Leadership development - develop and implement a • Therapeutic inpatient care - reduce length of stay and eliminate out • Supervision in last month - 85% • Suicide prevention - train 95% of staff at Sussex leadership programme of area placements; transform inpatient services in East Sussex • Staff turnover - 14.5% Partnership • Suicide prevention - local suicide prevention and bereavement • Sickness - 4% Use of resources support plans rolled out by 23/24 • RMN fill rate - 85% Partnerships • Digital adoption programme* - deliver a • Older peoples’ mental health - develop in line with the Trust’s • Triangle of care - 100% of community teams to • Agency use - 3% transformation in the use of digital technology to strategy for Older People’s and Dementia services with support based complete self-assessments, 100 % of inpatient teams • Live within our means by delivering a £62K surplus improve care, treatment and efficiency on needs not age to review their self-assessments by June 2021 • Deliver our £15.8m capital programme • Rough sleeping - prioritised developments in Brighton and Hove in • Community services*- engagement, sign off and 20/21 with the rest of Sussex reviewed in 21/22 begin our implementation plan • Provider collaborative - Sussex Partnership to take on the role of Lead Provider across adult secure and CAMHS • Digital - using digital technology to deliver better care and greater CDS and Support Service Plans efficiency • Estates - high quality, efficient estates across the Trust
Report to Council of Governors Agenda item CG 07 .4/20 Attachment E Data Quality Indicator N/A Date of meeting 10 August 2020 Format of Paper Title of paper Lead Governors Report Written Author Mark Hughes, Lead Governor Oral ☐ Governor Sponsor Mark Hughes, Lead Governor Presentation ☐ Committees where this item has been considered N/A
EXECUTIVE SUMMARY Please tick one For Assurance For Decision ☐ Purpose: In this report the Lead Governor will update the Council of Governors on a number of Trust developments over the last three months.
Key findings: The Lead Governor has been in contact with members of the Council to discuss their interests and goals. The Council of Governors will implement a 'Buddy System' following the 2020 Election for new Governors. The Lead Governor is reaching out to the other Sussex Lead Governors to discuss the impact of Coronavirus. The Achievements of the Council of Governors during 2019/20 is attached as Appendix 1.
Recommendation The Council of Governors are asked to note the report and the Achievements of the Council of Governors attached as Appendix 1.
Governor Sponsor Mark Hughes, Lead Governor
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1. INTRODUCTION
Since the last Council of Governors meeting, I have made several pledges as Lead Governor. Most of them come under a broad umbrella of support for governors.
2. REPORT
Governor Interests and Goals I sent out an email to most of the governors asking them to tell me why they wanted to become a governor and what their goals are. Many of you responded. Out of this response a small group of governors have formed with an interest in children and young people’s services. I have asked Ruth Hillman, Director for Children’s Services, to meet with these governors to ensure that involvement benefits the service and the Trust. If any of you have not received my email on this topic and would like to have a discussion on your reasons for becoming a governor and your goals, do contact me. Buddy System One of my suggestions in my pledge was to introduce a mentoring scheme. The idea being that a new governor is paired up with an existing governor. One who already has experience and can answer questions that a new governor will have. At a recent discussion with last year’s intake of governors, it was suggested that this mentor was called a “Buddy” and that the experienced governor was from another constituency other than the one the new governor is from. There by mixing governors up but also sharing knowledge and experience. I want to thank last year’s new governors for sharing their experiences, which echoed my thoughts on the matter. Hopefully, this will improve how this year’s successful candidates in the elections are supported and that we won’t lose motivated people due to the overwhelming induction to the NHS and the Governor role and responsibilities. Sussex Governor Network I have contacted the Lead Governors of a neighbouring Trusts, to arrange a virtual meeting to discuss how our Trusts have handled the coronavirus crisis and how this has impacted on the governors. If you have any thoughts around this and want to share them do pass them onto me.
3. RECOMMENDATION
The Council of Governors are asked to note the report and the Achievements of the Council of Governors attached as Appendix 1.
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Report to Council of Governors Agenda item CG 07 .4/20 Attachment E Data Quality Indicator N/A Date of meeting 10 August 2020 Format of Paper Title of paper Achievements of the Council Written of Governors Author Rebecca Holden, Corporate Oral ☐ Governance Business Manager Governor Sponsor Mark Hughes, Lead Governor Presentation ☐ Committees where this item has been considered N/A
EXECUTIVE SUMMARY Please tick one For Assurance ☐ For Decision ☐ Purpose The purpose of this report is to highlight the achievements of the Council of Governors during 2019-20.
Key findings The Council of Governors collectively and individually have completed or participated in a number of Trust developments, meetings and projects.
Recommendation The Council of Governors are asked to note the report.
Governor Sponsor Mark Hughes, Lead Governor
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1. INTRODUCTION
The Council of Governors are required to fulfil a number of statutory duties throughout the year, however they are also involved in a number of different Trust developments, meetings and projects. This report will highlight the statutory duties they have fulfilled throughout the last year and the extraordinary achievements.
2. REPORT
The Council of Governors: Held a Governor election in April 2019 and was pleased to welcome the following twelve new Governors in July 2019: o Jo Tompkins, Service User Governor o Chrissie Granger, Service User Governor o Alan Wells, Service User Governor o Peter Haydn-Smith, Public Governor o Caitlin Hall, Public Governor o Duncan Shrewsbury, Public Governor o Gillian Bowden, Public Governor o Sarah Payne, Public Governor o Stephanie Foster, Public Governor o Carl Domanic, Carer Governor o Gary Beecheno, Staff Governor o Alice Parr, Staff Governor Hosted a successful Annual Members Meeting and Annual General Meeting (AGM): Mind and Movement was the theme for this year and we were delighted to welcome over 100 people to the seaside resort of Butlins, Bognor Regis for a sunny start to the day. The formal meeting began with our Annual General Meeting. The Chair opened the meeting and our Chief Executive gave an update on the Trusts achievements throughout the last 12 months. Our Chief Finance Officer presented the Annual Report and Accounts and members heard from the Chair with an update on progress against our Membership Strategy. The session finished with an opportunity for members to ask our Board questions. The afternoon session gave guests an overview of the Trusts’ new Organisational Strategy. This led into our presentations, starting with Team Springwell on assisting people with learning disabilities to have a say in their care. Following this was our Director of Transformation who spoke about the benefits physical activity can have on mental health and we heard a heart- warming story from Jeremy on how running has helped her mental health recovery journey and how he now delivers running groups, through the Sussex Recovery College, into services to help other patients. Our final presentation of the afternoon was from the Chief Executive of Capital Projects who explained how the Pathfinder partnership is transforming access to mental health and wellbeing support for local people. Closing the afternoon off were two fun-filled and interactive workshops; Poetry with Rob Gee and Movement to Music with Natalie Butt.
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Approved the re-appointment of a Non-Executive Director and Associate Non- Executive Director: Professor Gordon Ferns and Nick Juba were appointed for a further 1 year term. Successfully recruited two new Associate Non-Executive Directors: Amanda Jones and Nitin Mehta were appointed on a 1 year term. Expended the Council Group Agreement to include a section on 'health and wellbeing' for Governors: For both the purposes of understanding it is ok to take time away from their role if they are not feeling well and also to make clear the boundaries between the care they may be receiving through the Trust and their role as a governor. Attended the NHS Providers Governor Focus Conference 2019: The Trust was selected to showcase the support we provide to service user Governors. Chaired eight Consultant Interviews: Six additional Governors were trained in 2019 to Chair the interviews. Established a Quality Improvement Group to provide guidance and clarity to Governors when visiting services: This supports Governors attending services and hospitals and now forms part of the Governors Induction information. Undertook a number of Quality and Safety Reviews: A review undertaken with members of staff and senior leadership to look at Service User Experience, Staff Experience, Medicines Management, Environment and Equipment, Care Records and Management and Leadership. Elected a new Lead Governor and Deputy Lead Governor: Mark Hughes, Carer Governor was elected as Lead Governor and Di Hickman, Service User Governor was elected as Deputy Lead Governor. Carers Support Q&A: A Carer Governor took part in a public Q&A with Carers Support. The Council of Governors participated in the following: o Organisational Strategy refresh o Membership Strategy Consultation Survey o West Sussex Redesign: through a dedicated Working Group to provide Governor and Member representation o Chair and Non-Executive Director appraisals o a session with the Board of Directors to help shape the Trust's Annual Plan o NHS Providers' GovernWell Core Skills Module (x3 individual Governors) The Council of Governors held the following: o four formal Council of Governors meetings o four Membership Committee meetings. o three Nomination and Remuneration Committee meetings. o three Training and Development Committee meetings. o four Governor Development Sessions 3. RECOMMENDATION The Council of Governors is asked to note the report.
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Report to Council of Governors Agenda item CG 08 .1/20 Attachment F Data Quality Indicator N/A Date of meeting 10 August 2020 Format of Paper Title of paper Quality Committee Summary Written Report Author Theresa Dorey, Associate Oral ☐ Director of Nursing Standards and Safety Non-Executive Professor Gordon Ferns, Presentation ☐ Sponsor Non-Executive Director Committees where this item has been considered N/A
EXECUTIVE SUMMARY Please tick one For Assurance For Decision ☐ Purpose This report summarises the key issues arising from the Quality Committee which met on 17th June 2020. The Committee: Were provided with an update of the response and work undertaken in relation to the management of the Covid-19 pandemic and noted the significant amount of work that continues to be delivered to monitor and manage ' the basics' of quality and safety across the Trust. Received a report that set out the proposed quality governance of the Provider Collaborative programmes, specifically the quality governance of commissioning in the Trust's role as Lead Provider and noted that the quality of those services which are provided by the Lead Provider will continue to be monitored through the existing SPFT quality governance framework. Received the safer staffing internal audit report which provided the Quality Committee and Trust Board with reasonable assurance that the controls in place to manage this risk are suitably designed and have been consistently applied. The Committee received and approved the revised Quality Impact Assessments (QIAs) for 2020-21 SIP Proposals for the Acute CDS and were assured that all QIA for 2020/21 had been reviewed by the Acute CDS leadership team to provide further clarity regarding any possible quality impact for patient safety, clinical effectiveness and patient experience. Received a briefing on the current position of the Capital Programme for 2020-21 and the impact of the Covid-19 Pandemic at the end of month 1 of the financial year 2020-21.
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The report provided information on the revised Capital Plan forecast going forward and the likely effect this may have on quality, safety and regulatory improvement plans, as well as a number of schemes to support service redesign.
Recommendation The Council of Governors is asked to note the report from the Quality Committee, with particular reference to the key risks and issues arising from the Committee.
Non-Executive Professor Gordon Ferns, Non-Executive Director Sponsor
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1. INTRODUCTION
The purpose of the Quality Committee is to enable the Board and Council to obtain assurance that high standards of care are provided by the Trust and in particular that adequate and appropriate governance structures, processes and controls are in place to: Promote safety and excellence in patient care Identify, prioritise and manage risks arising from clinical care Ensure the effective and efficient use of resources through evidenced-based clinical practice 2. REPORT
The Quality Committee met on the 17th June 2020 chaired by Professor Gordon Ferns, Non- Executive Director. In summary, the meeting considered the following sub–committee Chairs Reports: Positive Experience Committee (PEC) Chair's Report Effective Care and Treatment Committee (ECAT) Chair's Report Safety Committee Chair's Report In addition, the following reports were received by the Committee for discussion, agreement and/or assurance: Audit Committee Key Issues Update COVID -19 Update Provider Collaborative Quality Governance Report Safer Staffing Internal Audit Report Quality Impact Assessments against Service Improvement Plans for the Acute CDS 2020/21 Deep Dive Review of the Quality Improvement Plans for Crawley Road - with specific focus on Medicines Management Capital Programme Update Trustwide Quality and Patient Safety Report Quality and Safety Reviews Quality Governance Oversight Group Update Serious Incident Assurance Report Learning from Deaths Q4 Report Langley Green and Meadowfield Quality and Safety Plan Key developments: COVID -19 Update - The Quality Committee were provided with an update on the Trust response and management of the Covid-19 Level 4 Major Incident. The update provided by the Chief Nursing Officer and Chief Medical Officer is intended to support Board assurance of the Trusts ongoing response. The committee were advised that the Trust continues to focus on phase two of its work plan which is our ' recovery and restoration'. A core element of this phase is about ensuring that the Trust is able to sustain the positive changes made whilst also preparing for any potential surge in demand for mental health and LD services.
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In addition, this update reflected that Gold Command are currently focused on the delivery of work streams that relate to: . Working safely - which includes the work place safety assessments of all our buildings to identify any changes we need to make to support safe working are underway. These are being led by the Estates and infection Control and Prevention team working alongside Operational leads and Staff side. . Face Masks and face coverings - to ensure that, as per the national guidance issued on 12 June, facemasks and face coverings are now being used across the Trust Hospital settings. The Committee heard that through the Chief Nursing Officer the Trust has contributed to this national workstream to ensure the guidance issued considered the needs of MH and LD services including those with hearing impairments where the wearing of masks can be quite overwhelming. . Antibody testing - this programme of work offered staff the opportunity to have a Covid-19 antibody test between Mon 22 June and Fri 10 July 2020. . Risk assessment for Black Asian and Minority Ethnic (BAME) staff - this programme of work is underway at the time of writing this report 76% of BAME colleagues have had their risk assessment completed. Provider Collaboratives Quality Governance - In March 2020, the Board approved the Trust taking on the role of Lead Provider and contract holder for Adult Secure Services. This was planned to be effective from 1st April 2020, although implementation has been delayed because of the COVID-19 outbreak. The Committee were provided with a report that set out the proposed quality governance arrangements of the Provider Collaborative programmes, specifically the quality governance of commissioning in the Trust's role as Lead Provider. The proposed approach will: . Utilise the existing quality governance framework, including the Quality Committee and Commissioning Management Board (CMB) . Apply a combination of periodic reporting, incorporated in the work plans of the Committee and CMB; reporting by exception and deep dive as required . Reflect national guidance and best practice . Provide a clear escalation route for issues of concern across the collaborative The Council is asked to note that the quality of those services which are provided by the Lead Provider will continue to be monitored through the existing SPFT quality governance framework. Safer Staffing Internal Audit Report - In January 2019 a piece of work was commissioned by the Chief Nursing Officer to look at staffing levels across inpatient services. The review was concluded in July 2019 with a recommendation brought through Trust Board to make the necessary adjustments to inpatient staffing establishments to support safer staffing levels. This resulted in an investment of £610,000 across the Adult Acute Inpatient services. Through internal audit, the Quality Committee sought assurance that the associated investment was reflected in clinical services budgets and that all staff were aware of the changes in their services and had the appropriate uplift in their rosters. The internal audit review confirmed that the Board can take reasonable assurance that the controls in place to manage this risk are suitably designed and have been consistently applied. However, notes the requirement
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for the CDS leadership teams to ensure that safer staffing boards are installed and maintained in a prominent position on each ward and that clarity is provided on reporting breaches. The Lead Nurse for safer staffing has been asked to develop an action plan, which will be monitored through the Quality Committee. Quality Impact Assessments 2020/21 for SIP - The Committee received and approved the revised Quality Impact Assessments (QIAs) for 2020-21 SIP Proposals for the Acute CDS. The Committee were assured that all QIA for 2020/21 had been reviewed to provide further clarity regarding possible quality impact for patient safety, clinical effectiveness and patient experience. The effect of Covid-19 on the Capital Programme and the implications on the Trusts Quality Improvement Plans - The committee received a summary update on the current position of the Capital Programme for 2020-21 and the impact of the Covid- 19 Pandemic at the end of month 1 of the financial year 2020-21.The report provided information on the revised Capital Plan forecast going forward and the likely effect this may have on quality, safety and regulatory improvement plans, as well as a number of schemes to support service redesign. The committee were advised that as part of the capital programme the Trust are looking at the changes required to environments including mixed sex accommodation; this work is being considered as part of the West Sussex redesign. The Chief Financial Officer and Executive Director of Estates will take any changes to this plan, through the Executive Management Committee to monitor and mitigate any risks to safety and regulatory improvement plans.
3. RECOMMENDATION
The Council of Governors is asked to note the report from the Quality Committee, with particular reference to the key developments arising from the Committee.
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Report to Council of Governors Agenda item CG 08 .2/20 Attachment G Data Quality Indicator N/A Date of meeting 10 August 2020 Format of Paper Title of paper Finance & Investment Written Committee Summary Author Sally Flint, Chief Finance Oral ☐ Officer and Deputy CEO Non-Executive Martin Richards, Non- Presentation ☐ Sponsor Executive Director Committees where this item has been considered Finance & Investment Committee
EXECUTIVE SUMMARY Please tick one For Assurance For Decision ☐ Purpose The purpose of this report is to provide a summary of the Finance & Investment Committee meeting held on the 15th May 2020. It should be noted that the meeting was held virtually due to the Covid pandemic.
Key findings This report provides a summary of the papers and discussions from the Finance & Investment Committee meeting. The agenda for the meeting covered a number of areas including: the Month 1 financial position an update on the use of agency staff and workforce the Transformation Programme for 2020/21 the Redesign of Inpatient Services in East Sussex Capital programme update for 2020/21 Finance and Investment Committee Annual Report the agenda also included the regular reports on Contracting and Commercial Activities. The next Committee meeting is due to be held on the 24th July 2020.
Recommendation The Council of Governors is asked to note this report.
Non-Executive Martin Richards, Non-Executive Director Sponsor
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1. INTRODUCTION
The purpose of the Finance & Investment Committee is to drive excellent financial performance and ensure that the Trust has an investment strategy that supports the business and is financially deliverable. The Committee is responsible for ensuring that robust scrutiny is in place, taking action to commission further work as required in the achievement of this objective. This paper provides a summary of the Finance & Investment Committee meeting held on 15th May. It should be noted that the meeting was held virtually due to the Covid pandemic. Mark Hughes, the Governor observer for the Committee attended the meeting. It should also be noted that a summary of the Finance and Investment Committee is reported to the Board on a regular basis and the paper is in the public part of the Board and therefore the paper is available on the Trust’s website. It should also be noted that the full minutes of the meeting are circulated to all members of the Board for information.
2. REPORT
Overview The meeting in May covered a number of areas. A brief summary of the reports discussed at the meeting is set out below. Month 1 Financial Position The Committee received the financial report for month 1 of the new financial year, noting that the finance report is set in the context of the new Covid Financial Regime. The regime sets out an expectation that every organisation will have its costs covered over the Covid period, and therefore will be able to report a breakeven position. The Committee were advised that the Trust is therefore reporting a breakeven position for Month 1. However, this position includes £0.8m of costs the Trust has incurred in response to Covid and an accrual of £0.19m for top up income. The report also sets out the key areas of focus for the year ahead. It is important that the Trust uses this unprecedented time to work through a number of long standing issues and embraces new opportunities with a view to improving the its underlying financial position. The key areas of focused work are:- Use of Agency and Workforce Service Transformation Review of Support Services Use of out of area placements The Committee noted that in relation to use of out of area placements, the Trust is now in a better position due to the reduction in length of stay. However, it was noted that despite new measures we have in place the Trust is beginning to see increased demand on services. The Committee also discussed the Trust’s cash balance at the end of April, reporting a cash position of £73.9m which was £34.4m ahead of plan. However, it was noted that the main reason for the significant favourable variance is the impact of the Covid financial regime, with all providers receiving two months of income in April to assist cashflows.
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The Committee discussed the Month 1 position, particularly in relation to the work being undertaken to address a number of longstanding issues. Agency and Workforce Update The Committee received a paper on Agency and Workforce noting that a number of areas of work are being developed to reduce reliance on temporary staff. These areas of work include:- In-patient staff and use of Allocate, the Trust's e-rostering system Recruitment to the Bank Recruitment to Support Business as Usual Recruitment to Support Service Transformation Focus on the use of New Roles. The Committee noted that the Agency Ceiling set for the Trust for 2020/21 is £6.8m, which equates to an average spend of £567k per month. Expenditure on agency staff in April 2020 was £1,042k, which is 91% over the ceiling. The Committee discussed the report and noted that workforce is a key risk for the Trust and therefore requested a further updated paper to the next meeting in July. 2020/21 Transformation Programme and Financial Delivery Plan The Committee received a verbal update on the Transformation Programme for Mental Health for 2020/21, noting that there is £19.2m new funding available for the Sussex Health and Care Partnership Integrated Care System (ICS) of which £12.1m is earmarked for the Trust. The Committee noted that it will receive a reported position against the programme at the end of Q1 and this will be included in the finance report going forward. Redesigning Inpatient Services in East Sussex (RIS:ES) The Committee were briefed on the Case for Change for the redesign of in-patient services in East Sussex and the key aspects of the redesign programme, including the elimination of dormitory accommodation. It was noted that a Programme Director has been appointed and the Programme Board established, jointly chaired by the Trust and commissioners. The Committee recognised that this is a significant piece of work and one of the largest programmes the Trust has ever undertaken. It was noted that the Trust will need to work closely with NHSE/I and that it was anticipated that the capital funding will either come through the ICS Capital route or a nationally funded scheme. The Committee were asked to:- Note the initial Whole Life Budget for the Programmes Approve the first tranche of funding required to support the Programme Note that the Programme Board will have oversight of this Budget. The Committee supported the paper and approved the first tranche of funding. It was noted that the Board will be fully briefed on the scheme at the meeting in July and requested to approval the first tranche of funding for the scheme. Capital Programme Update for 2020/21 The Committee received a paper setting out the Capital Programme for 2020/21, noting that in response to a national request, the Trust has reforecast its capital programme for the year ahead to take account of the implications of Covid. The revised forecast for the year has reduced the capital programme from £15.8m to £14.7m.
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It was noted that the Trust had spent £0.52m on its capital programme in Month 1, which was £0.9m under plan. The main areas of spend in the month were investment in the IT Global Digital Exemplar (GDE) Programme, the Operational Capital Programme and costs to support the Trust's response to Covid. It was noted that the Trust is in the third year of the IT GDE programme and the Trust's Chief Digital and Information Officer was requested to provide an update on the Programme at the next meeting in July. Contracts Update The Committee received a contracts update noting that contracting environment had changed due to Covid. It was noted that the normal contract management meetings and processes had in the main been suspended. There was also no requirement to agree and sign contracts for 2020/21 as payments would be made centrally on the block basis for the period April to July. Commercial Report The Committee received the Commercial Report providing an update on the work undertaken since the last meeting, including:- The Provider Collaborative expansion, with NHSE devolving Adult Secure, Eating Disorder and CAMHS Tier 4 budgets from 2020 (with a date still to be confirmed) Contract awarded and mobilisation of the bid for the IAPT & Wellbeing service procurement in Brighton & Hove Joint work with Brighton Metropolitan College in a bid for Health Education England Strategic Support Funding to deliver three new access to Higher National Diploma courses in mental health. Finance and Investment Committee Annual Report The Committee were asked to review the Finance and Investment Committee's Annual Report for 2019/20, which provided assurance on the Committee’s performance and compliance with its terms of reference during 2019/20. It was also noted that Committee members had undertaken its annual Self-Assessment Effectiveness Survey for 2019/20. The results of the survey were mainly favourable, with positive responses to 14 of the 19 questions. The Committee noted the report and survey results and signed off the Annual Report. Key Issues and Risks to Escalate to the Board or Other Committees The Chair and Committee agreed that the following would be highlighted to the Board:- The workforce challenge for the Trust The reforecasting of the capital programme for 2020/21 The case for change for the redesign of in-patient services in East Sussex Acknowledgement of the reasons for the increase in the Trust's cash position. 3. RECOMMENDATION
The Council of Governors is asked to note this report.
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Report to Council of Governors Agenda item CG 08 .3/20 Attachment H Data Quality Indicator N/A Date of meeting 10 August 2020 Format of Paper Title of paper Audit Committee Summary Written Author Sally Flint, Chief Finance Oral ☐ Officer and Deputy CEO and Corin Ansted, Head of Financial Accounting Non-Executive Jo Larbie, Non-Executive Presentation ☐ Sponsor Director and Audit Committee Chair Committees where this item has been considered Audit Committee
EXECUTIVE SUMMARY Please tick one For Assurance For Decision ☐ Purpose This report provides a summary of the papers and discussions from the Audit Committee meeting held on the 19th May 2020. The agenda for the meeting was mainly focused on the requirements of the year end in relation to the Annual Accounts and Report and included discussion of the following reports; Internal Audit progress report Final 2020/21 Internal Audit Plan Final Head of Internal Audit Opinion LCFS Final 2020/21 Counter Fraud Plan LCFS - Self Review Tool (SRT) confirmation External Audit Progress report, including draft audit opinion Going Concern Assessment Draft Annual Accounts for 2019/20 and analytical review Losses and Compensations Final Annual Governance statement Audit Committee Annual Report Covid-19 Update Clinical Records Interactive Search System Approval. The next Audit Committee is due to be held on the 27th July Recommendation The Council of Governors is asked to note this report.
Non-Executive Jo Larbie, Non-Executive Director Sponsor
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1. INTRODUCTION
The Audit Committee is responsible for monitoring and reviewing matters such as the integrity of financial statements, internal controls and overseeing the internal audit function. It is also focused on providing assurance to the Board that the systems and processes are functioning effectively (so that the Board is discharging its duty) and that those committees that are reviewing quality information in more detail are doing so effectively. Minutes of the meeting are circulated to all Board members. The Audit Committee’s annual work plan is designed to cover these responsibilities and sets the agenda for each meeting, which is built around the following areas; • Internal Audit and Counter Fraud • Financial Controls and External Audit • Internal Controls and Risk Management • Corporate Governance • Accountability and Other Matters. This paper provides a summary of the Audit Committee meeting held on 19th May. It should be noted that the meeting was held virtually due to the Covid pandemic. Glen Woolgar, the Governor observer for the Committee attended the meeting.
2. REPORT
The agenda for the meeting held in May included discussion of the following reports:- Final Internal Audit 2020/21 Workplan The Internal Auditors presented the final audit plan noting that this had been updated to reflect the additions following the Covid-19 Pandemic response, thus a new Covid financial governance audit had been added to the plan. The plan had also been updated to cover data quality across various in year audits rather than one specific data quality audit. It was also noted that the plan would need to continue to be flexible, in the light of how the Covid- 19 pandemic response evolves. The Committee agreed the plan. 2019/20 Head of Internal Audit Opinion, Progress Report and Audit Management Actions The Committee noted that given the number of positive reviews and reasonable assurance opinions during the year, the Trust had received a favourable Head of Internal Audit Opinion. It was also noted that there were a few audit recommendations that were being worked through for partial opinion audits, including the audits covering Service Improvement plans, overtime and costing, but the latter had now been actioned and closed. The Committee thanked management for the focus they had given to closing down the recommendations in a comprehensive and timely manner. Internal audit again praised the Trust for using them in the right way during the year to help resolve areas where there were concerns or control issues. Local Counter Fraud Service (LCFS) 20/21 workplan – The Committee received the report and subject to a minor change approved the plan.
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Thanks were given to LCFS for producing a comprehensive plan and it was again noted that the focus and timings may need to be altered going forwards given the Covid-19 events. External Audit Progress Report – the Committee received a report from the External Auditors, KPMG, setting out their draft audit opinion. It was noted the audit to date had gone well and thanks were given to the finance team for their support and that the Trust was on track to deliver a clean unqualified audit opinion for the core aspects of the audit. It was noted that the main area outstanding related to the valuation, in that KPMG may need to add an emphasis of matter statement to their opinion given the national uncertainty from the Covid-19 pandemic on the valuation of the estate. The emphasis of matter statement is in relation to national uncertainty and not in relation to the full valuation that the Trust had undertaken during the year. It was confirmed that KPMG were planning to issue their opinion by the end of that week, subject to resolving the final points. Going Concern Assessment - The Committee approved the paper which supported the conclusion that the Trust is clearly a going concern and it is appropriate to prepare the accounts on that basis. 2019/20 Annual Accounts and Analytical review - The Committee discussed the accounts and would be recommending them to the Board for approval at Board meeting due to be held on the 20 May 2020. Final 19/20 Annual Governance Statement The Committee reviewed the report and agreed the content. Review of Losses and Special Payments and Schedule of Aged Debtors & Creditors over 6 months old and Policy Review – the paper noted the good progress in clearing down debtor and creditor balances at the year end. Clinical Records Interactive Search System (CRIS) – The Committee review the paper which recommended that the Trust subscribe to the adoption of CRIS, a research database containing anonymised data from a number of trusts across the UK. It was noted that CRIS would provide the Trust's researchers with access to significantly larger datasets than are currently available from Trust data alone, together with sophisticated analytical tools and resources. The Committee agreed to the proposal. Action Log, Forward Look and Any Other Business – The Committee reviewed the action log, noting that most items were either closed or in progress. An update on Fire training was given, noting the plan to develop online training. Key issues / updates from the Quality Committee The Quality Committee had several points of note, including those on the action log, which would be picked up outside of the meeting. Key Issues and Risks to Escalate to the Board or Other Committees The Committee recommended the 2019/20 Annual Accounts to the Board for approval.
4. RECOMMENDATION
The Council of Governors is asked to note this report.
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Report to Council of Governors Agenda item CG 08 .4/20 Attachment I Data Quality Indicator N/A Date of meeting 10 August 2020 Format of Paper Title of paper Extension of External Audit Written Contract Author Corin Ansted, Deputy Oral ☐ Director of Finance - Financial Services and Governance Executive Sponsor Sally Flint, Chief Finance Presentation ☐ Officer and Deputy CEO Committees where this item has been considered Private Audit Committee meeting
EXECUTIVE SUMMARY Please tick one For Assurance ☐ For Decision Purpose: It is a statutory responsibility for the Council of Governors to appoint and / or remove the Trust's external auditors at a general meeting of the Council. KPMG, the Trust's External Auditors have just completed the fifth year of their contract. However, there is an option under the contract framework to extend for a further year. The Audit Committee have carried out a review of the external auditor's performance over the past 5 years and have concluded that the Trust should extend the contract with KPMG for a further year. The Council of Governors are asked, as part of their statutory responsibilities, to consider the recommendation from the Audit Committee to extend the current contract of the Trust's external auditors (KPMG) for a further year. The contract will then be subject to a further review, with the intention to retendering the contract next year.
Recommendation The Council of Governors is asked to approve the extension of the KPMG contractor for the delivery of external audit services for a further year. Executive Sponsor
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1. INTRODUCTION
The NHS 2006 Act made it a statutory responsibility for the Council of Governors to appoint and / or remove the trusts external auditor at a general meeting of the Council. The Audit Committee run the process and are required to make a recommendation to the Council of Governors who should then consider whether to retain or remove the auditor.
2. REPORT
KPMG, the Trust's External Auditors have just completed the fifth year of their contract, i.e. the audit of the 2019/20 accounts. The contract is for a period of 3 + 2 year duration, with the full 5 year contract ending on 30th November 2020. However, there is an option under the contract framework to extend for a further year. The former and current Audit Committee Chair and Deputy Director of Finance - Financial Services and Governance have carried out a review of the external auditor's performance over the past 5 years. The review of the External Auditor's performance took into account the following:- A high quality audit provision has been provided annually over the past 5 years KPMG continue to demonstrate their high quality performance in delivering against the service provision as set out within their tender submission, interview and presentation KPMG were subject to an independent review by the regulator during 2019/20, whereby their audit work undertaken at the Trust selected for review. The outcome of independent review was a clean and favourable result, which was reported to the Audit Committee on the 19th November 2019 Access to technical support and training, including seminars, technical updates and briefings is made available to the Trust The Audit Committee Chair has direct access to KPMG at a pre-meet before every Audit Committee meeting KPMG have also carried out some good quality additional work during their term, which related to the review of the Trust's Compliance with its Constitution Over their contract term the Trust has raised some minor points with KPMG at the post audit review meetings in order to help them enhance their service further. These points have always been accepted and addressed in the planning of the audit for the following year. Neil Hewitson (the KPMG partner responsible for the Trust audit) has been the Trust's engagement lead for five years. Under the Firm’s rotation requirements for non-listed, non EU Public Interest Entities, such as the Trust, he is able to complete a further five years. However, KPMG are undertaking a restructure of their audit functions to soft ring- fence the external audit business and creating a new business in consulting to focus on Internal Audit, Risk and Compliance. As part of this restructure Neil Hewitson, the audit partner and Paul Cuttle, audit manager have decided to move over to their internal audit business from 1 October 2020. The Trust has therefore been assigned a new audit partner and manager for the 2020/21 audit. This will aid with partner rotation and providing a new teams perspective over the Trust's audit. Having undertaken this review and consulted with other stakeholders, the Audit Committee have concluded that the Trust should extend the contract with KPMG for a further year.
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3. RECOMMENDATION
The Council of Governors is asked to approve the extension of the KPMG contractor for the delivery of external audit services for a further year.
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Report to Council of Governors Agenda item CG 09 .1/20 Attachment J Data Quality Indicator N/A Date of meeting 10 August 2020 Format of Paper Title of paper Governor Election Update Written Author Natalie Hennings, Corporate Oral ☐ Governance Manager Executive Sponsor Dom Ford, Director of Presentation ☐ Corporate Affairs Committees where this item has been considered Membership Committee
EXECUTIVE SUMMARY Please tick one For Assurance For Decision ☐ Purpose: The Trust holds an annual election to its Council of Governors for those positions that are coming to an end of their three year term; this year the election process includes nine positions.
Key findings: The election was delayed due to COVID-19. A revised timeline for the election has been produced. The process for election is explained in this paper. Greater focus on generating awareness of the election will be through social media The nomination stage is now open and due to close on 14 August 2020 Governors who's position form part of the election are will become Associate Governors from 11th September until the end of the election in accordance with the Constitution.
Recommendation The Council of Governors are asked to note the report and the revised timeline. Executive Sponsor
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1. INTRODUCTION
The Governor election this year is taking place for seven governors whose term of office ends on 10 September 2020, and two vacant positions. An elected Governor is eligible for re- election, but may not hold office for longer than nine years. This paper provides the Council with an overview of the process of our election campaign.
2. REPORT
2.1 Delay to the election campaign Due to COVID-19 it became nessecary to delay the start of our election campaign. As current legislation does not allow for governors current terms of office to be extended; it was agreed that those governors who are coming to the end of their term remain in post as an Associate Governor until the election can be held. This required a changes to the Constitution which was approved by the Council of Governors and Board of Directors in April 2020. The situation was recently reviewed by the Chair and Lead Governor who agreed the election needed to be run so that the governor positions are filled in time for the Council of Governors meeting in October. This four week delay help gave both exisiting governors who are part of the election and the new members thinking about becoming a governor the time to adapt to the changing situation with COVID-19 and more time to consider whether or not they would like to re/stand and engage in the process. 2.2 Timetable The revised timetable for our election this year is set out below: Election Stage Date
Trust to send nomination material and data to Election provider Friday, 3 Jul 2020 Notice of Election / nomination open Friday, 17 Jul 2020 Nominations deadline Friday, 14 Aug 2020 Summary of valid nominated candidates published Monday, 17 Aug 2020 Final date for candidate withdrawal Wednesday, 19 Aug 2020 Electoral data to be provided by Trust Monday, 24 Aug 2020 Notice of Poll published Monday, 7 Sep 2020 Voting packs despatched Tuesday, 8 Sep 2020 Close of election Thursday, 1 Oct 2020 Declaration of results Friday, 2 Oct 2020 The election provider continues to be Civica (formally known as the Electoral Reform Service) in accordance with the ‘Model Rules for Elections’ which form part of Annex 5 of the Trust Constitution
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2.3 Vacancies Nine vacancies form part of the election this year and these are detailed by constituency below: Service User, East Sussex – 1 position Service User, West Sussex - 3 positions Public, West Sussex – 1 position Carer – 1 position Staff – 3 positions 2.4 Election Stages Stage Description Nomination Postcard mailing to members (email and postal) Online Library for statutory documents and timetable On-request nomination form (for those without access to the internet) Fillable nomination form online Easy Read nomination forms available on request. Ballot Email notification with instructions to vote online Postal ballot papers 2.5 Engagement The Corporate Governance Team have a detailed enagagement plan in order to achieve contested elections and ensure we have a diverse range of nominations to support representation of all the communities the Trust serves. This includes an increased use of social media given any face to face awareness is not possible this year due to restrictions put in place by the pandemic. Along with the usual materials such as the pre-nomination postcard, website, partnership matters, partnership bulletin and posters we have been communicating closely with our external partners and staff networks. We are pleased to have seen the support of West Sussex MIND and local Carer organisations in helping us promote and raise awareness of social meda. Since nominations opened on the 17th July the Corporate Governance Office has been contacted by a number of members asking for more information about the role, this is encouraging and shows the current push through social media is generating a good level of awareness. All governors have been encouraged via their weekly messages to communicate with their constituents where possible and help circulate information and materials, all of which will be available on SharePoint and printed copies upon request. At 3rd July 2020 our membership database shows we have a total of 9,261 members. 7,270 of these are in the constituencies that fall within our election this year with 878 with a postal preference 6,392 with an electronic preference and valid email address.
3. RECOMMENDATION
The Council of Governors are asked to note the report and the revised timeline.
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Report to Council of Governors Agenda item CG 09 .2/20 Attachment K Data Quality Indicator N/A Date of meeting 10 August 2020 Format of Paper Title of paper Membership Committee Written Summary Report Author Natalie Hennings, Corporate Oral ☐ Governance Manager Governor Sponsor Mark Hughes, Lead Governor Presentation ☐ and Chair of Membership Committee Committees where this item has been considered None
EXECUTIVE SUMMARY Please tick one For Assurance ☐ For Decision Purpose This report summarises the meeting of the Membership Committee held on 16 July 2020.
Key findings The Committee discussed: the membership Q1 report, how members were engaged throughout the pandemic and what engagement will look like in the next period, an update on the arrangements for the Annual General Meeting and Annual Members Meeting, the Membership Annual Report for 2019/20 and approval for the updated Membership Strategy for 2020-2025. Highlights include: The Committee have recommended the Membership Strategy 2020-25 to the Council of Governors for approval. The 2020 Governor Election vacancies and revised timetable. The first edition of the Membership Annual Report. The Annual General Meeting and Annual Members Meeting.
Recommendation The Council is asked to note the report.
Governor Sponsor Mark Hughes, Lead Governor and Chair of the Membership Committee
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1. INTRODUCTION
The Membership Committee held a meeting on 16 July 2020; its purpose is to oversee all membership related areas of the Trust and to look at ways of promoting greater engagement and involvement of members. The following report highlights some of the topics considered at their latest meeting.
2. REPORT
At their meeting the Committee discussed: Membership Report, Activity and Engagement (including progress against the Membership Strategy). The Committee received a report on the membership activity for Q1 which reported a slight decrease (of 61 from Q4) in overall members to 9,236. A breakdown was provided on the membership involvement levels which reported that 52% of members are at the 'Be informed' level, 37% 'Be involved' and 11% 'Take a Lead'. The Committee were updated on methods of support that had been offered to members throughout the pandemic, which include: A Membership Resource pack including top tips, maintaining a healthy routine, hand hygiene, ideas to occupy your time, movement exercises, relaxation exercises, the importance of sleep and activities including mindfulness colouring. The pack is attached as appendix 1). Keeping members updated through Twitter on service improvements during Covid-19, such as our enhanced urgent care lounge in Hastings Reinforcing the 'stay at home' message through social media Supported Mental Health Awareness Week (18 May 2020) by participating in an 'Act of Kindness' and encouraging members to get involved. Advertised the Youth PPI Café which launched on 19th May. Membership featured in a Live Twitter Talk for Carers during Carers Week, hosted by our Trust Carers Lead. Raising awareness of virtual Mindfulness drop in sessions for staff members Advertising Working Together Groups for members to get involved in Reminding members that the Mental Healthline is available for help and support Encouraging members to share their stories on the importance of friendships during lockdown for Learning Disabilities Week. Circulating information to support carers of adults with a learning disability. Circulating leaflets produced by our Experts by Experience for service users explaining how services are being provided throughout Covid-19. Circulating guidance for hospital visits. Advertising Heads On Rainbow Race and encouraging members to get involved Service User and Carer members were given the opportunity to apply for a Covid-19 Hardship Grant through Heads On.
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Partnership Matters The next edition of Partnership Matters is scheduled for release at the beginning of August, so the Committee were updated on the content and stories contained with the publication. Committee members were pleased with the breadth of topics and the inclusion of services and geographical areas. Governor Election Campaign 2020 The Committee received an update on the current Governor Election Campaign and engagement methods. Due to COVID-19 the election timetable has been revised to conclude on 01 October 2020 with the declaration of results posted on 02 October 2020. The 9 vacancies included in this election are as follows: Service User, East Sussex – 1 position Service User, West Sussex - 3 positions Public, West Sussex – 1 position Carer – 1 position Staff – 3 positions Committee members discussed the Governors Induction Programme, and the Corporate Governance Office have since held a meeting to hear the views of Governors who joined in 2019 and their experience of their induction. The outcome of this feedback will be reported to the Training and Development Committee in September, ahead of the Governors Induction for those elected through the current election. Membership Strategy 2020-25 The Committee received the Membership Strategy 2020-25, the revised timetable for the strategy and the feedback received from the public consultation. There was a positive response rate to the public consultation, with 117 responses received, compared to 55 responses during the previous strategy consultation. The overall responses were very positive, in summary of those members who responded: 114 members knew what being a member means with 82% being aware that membership consists of patients, public and staff. 86% felt kept up to date with what is happening in the Trust Members rated their focus of membership over the next five years in the following priority: 1. Establishing Associate Memberships for voluntary and community organisations 2. Continue developing a diverse membership 3. Improving engagement 4. Addressing under-represented areas 5. Recruiting and retaining members Members rated ideas to further improve membership over the next five years in the following priority: 1. Ensuring communications better reflect their target audience 2. More community engagement 3. Develop greater support from local companies and organisations
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4. Hold more events for members 5. Offer more opportunities for members to meet and speak to their Governor The survey results have been used to establish three objectives which were recognised as priority areas for our members, these are detailed on pages 4-7 of the Membership Strategy. Under each objective is an identified aim and a set of detailed priorities to support the delivery of each objective. Committee members were overwhelmingly positive of the strategy and recommended it's approval to the Council of Governors. The full Membership Strategy 2020-25 is attached as Appendix 1. We have also developed a Membership Strategy 'on a page' which is attached as Appendix 2. Annual General Meeting and Annual Members Meeting The Committee received an update on the Annual General Meeting, taking place on 10 August 2020 and the Annual Members Meeting, taking place on 23 September 2020. The Committee were informed that both meetings will be held virtually due to COVID-19, however the Corporate Governance Office have come up with an imaginative way to ensure that an engagement opportunity is still available for members at the Annual Members Meeting. Details for the Annual General Meeting and Annual Members Meeting are available to view on the public website here: https://www.sussexpartnership.nhs.uk/council-governors-meetingsm Membership Annual Report 2019-20 The Committee received the first edition of the Membership Annual Report. The report provides an overview of the Trust’s membership from 1 April 2019 until 31 March 2020, alongside a full overview and assessment of the Trust's membership program and processes. The report highlighted the following aspects of membership performance during 2019/20: Overall membership number increased by 297 from 2018/19 The staff constituency remains the largest with 4136 members, followed by Public, West Sussex with 1.054 members The overall number of Service User members across all constituencies decreased by 1% compared to 2018/19 The Trust has taken steps to broaden the diversity of our membership but we recognise there is much work still to do and therefore building a membership that is representative of the communities we serve The majority of our members are on the 'Be Informed' involvement level 515 members left during 2019/20. The Committee noted the good progress that has been made towards the Membership Strategy and the areas for continued improvement which have been identified. The Membership Annual Report is attached as Appendix 3.
3. RECOMMENDATION(S)
The Council is asked to note the report
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Membership Strategy
Working together to improve mental health 2020-2025 Table of Contents
Why we need a Strategy 3
Developing our Strategy 3
Our Vision 3
Objectives for 2020-2025 4
Our Members & the Landscape 7
Membership Involvement Levels 8
Accountability to our Members 10
Council of Governors 11
Strengthening the links between Members & Governors 11
Strengthening the link between Governors & the Board 12
Strategy Governance 12
Continuous Learning 12
Give Feedback 13
Why we need a strategy
Sussex Partnership NHS Foundation Trust provides NHS mental health and learning disability services across Sussex and a developing range of specialist services across the South East of England.
The Trust gained Foundation Trust status in 2008 and has a long history of active involvement with patients, the public and its staff in how it plans, develops and delivers services. The organisation has always fostered strong patient and public engagement both Trust-wide and through individual Care Delivery Services.
This strategy outlines the Trusts vision for membership over the period 2020- 2025 and builds on the success of our previous strategy and work of the membership office. The Trust has recently reviewed its organisational strategy which focuses on People, Prevention and Partnerships so we wanted to work with our members to build a strategy that incorporates these objectives and responds to the local needs and national priorities, including the NHS Long Term Plan.
Through this strategy we will set out the methods that will be used to continue to develop an effective, responsive and representative membership that will assist in ensuring the Trust “Improves the quality of life for the communities we serve”.
Through our membership, the Trust can be closer to the people who access our services and more accountable to them than ever before. We intend to see our members becoming an increasingly active and valued component, building on existing partnerships and supporting new ones.
Developing our strategy
Our members are vital to the development of our strategy and through a consultation we managed to capture their views and suggestions for improving and developing our membership over the next five years.
Our members told us they want us to focus on engaging members from voluntary and community organisations and improving the diversity of our membership to ensure the voices of everyone in our community.
Our vision
Working together to improve mental health
Objectives for 2020-2025
This section outlines the membership objectives that we have set ourselves to achieve our strategy; and our priorities for delivery over the next five years, in order to provide focus and clarity.
There are three objectives to the 2020-2025 membership strategy
To improve engagement with members
To build a membership that is representative of the communities we serve
To effectively communicate with members
These objectives form the framework by which we hold ourselves to account. They recognise and build on the systems and processes which the Trust has in place to grow, engage and involve its membership.
Objective 1: To improve engagement with members
Aim: For members to feel part of the Trust and be aware of opportunities and how to be involved in helping to improve the way services are provided.
As a Foundation Trust we are accountable to our local population and an active and engaged membership helps us work together with our communities. We understand that the value of membership is not in the numbers of people who have joined but in the quality of members who are engaged. We recognise it is more beneficial to build an engaged and active membership rather than a large but passive one, and this is reflective of how our current members feel.
We want to broaden our membership and include voluntary and third sector organisations through Associate memberships; this will enable us to build a greater awareness and support for mental health in the community. Through innovative engagement approaches we want all our members to feel involved and supported to add value to the Trust; this will also help us to support our governors in representing the interests of members and the public.
We have identified seven priorities that will help us achieve improved engagement with members, these are:
To improve engagement with members
Build on our relationship with members to harness their experience and enable them to help improve services Improve and increase community engagement Develop and Implement Associate Memberships Develop events that are tailored to members Priorities Build on existing relationships with the People Participation Team and Head's On, the Trust Charity, to further support a single view of the Trust Recognise members achievements Encourage members through the tiers of membership to support them becoming governors
Objective 2: To build a membership that is representative of the communities we serve
Aim: To ensure our membership reflects the broad diversity of our local communities.
It is important to regularly analyse our membership to make sure we understand its composition and take steps to ensure, as far as possible, it is representative of the people we serve. From our analysis we understand there are some groups who are less well represented and we want to try new ways of engaging with them.
We will strategically align our recruitment and engagement programme to coincide with other key events throughout the year, for example Pride, Black History Month and Mental Health Awareness week. These opportunities will help us to raise awareness amongst seldom heard communities and address under-representation.
Mental health is a big issue for young people, roughly 3 children in every classroom have a diagnosed mental health problem and therefore we are going to develop relationships with local schools to help engage and better support young people and their parents.
Using the data we hold on our members we have identified five priorities to support us to deliver objective 2.
To build a membership that is representative of the communities we serve
Analyse our membership on a regular basis
Develop relationships with schools to increase younger peoples representation Priorities Increase LGBTQ+ and BAME community representation
Increase carers, in particular young carers representation
Increase learning disability representation
Objective 3: To effectively communicate with members
Aim: For members to feel well informed and receive communications that are targeted towards their interests.
Members are a vital link between the Trust and our communities. We want to establish methods for two way communication and respond to the increased demand of the digital landscape to meet the expectations of those who interact with us.
We need to adapt our communications to meet expectations and introduce new techniques to enable members' opinions to be heard.
To effectively communicate with members
Continue building and maintaining an accurate database
Identify opportunities for two-way communication between members and governors Priorities Continue providing appropriate information to members
Communicate the benefits of membership
Target communications with the desired audience Ensure Partnership Matters and the Membership e-Bulletin are member focused
Expand our social media presence
Explore the use of digital platforms to communicate with members
Our Members and the Landscape
The Trust covers a broad geographical catchment area; however our patient and carer population must be reflected in our membership base and we must draw on the experience of people who access the full range of services we provide.
Our members join the Trust to have their voices heard and to help us better understand the views of those who access our services so that we can improve the quality, responsiveness and development of services.
Members may only join the Trust in one category of membership. No skills or experience are required to be a member of our Foundation Trust but members should be interested in our services and compassionate towards the people who access them. We are committed to encouraging everyone who is eligible to become an active member of Sussex Partnership. We currently have four constituencies:
For people who have within 5 years preceding the date of application attended the Trust as a service user and live in West Service User Sussex, Brighton & Hove, East Sussex and South East England and Greater London.
For people who have within 5 years preceding the date of Carer application attended the Trust as the carer of a service user.
For people interested in our services who live in West Sussex, Public Brighton & Hove, East Sussex and South East England and Greater London.
All Sussex Partnership permanent staff, those on a fixed term contract of at least 12 months and social care staff who work in Staff the Trust are automatically offered membership. (Membership is not mandatory for staff)
Membership Involvement Levels
The Trust recognises that members will have differing levels of interest, time and availability for involvement. Members choose the degree to which they would like to be involved at the point at which they sign up as a member. This is set across three tiers;
Be Informed • Receive regular newsletters (Partnership Matters) • Receive regular communications • Receive invitation to the Annual General Meeting of the Council of Governors and the Members Annual Meeting. Be Involved (as above, plus) • Participate in surveys, questionnaires, consultations • Participate in focus/discussion/advisory groups • Be involved in volunteering for the Trust • Be involved in our “Expert by Experience” programme
Take a lead (as above, plus) • Encourage new members and support the campaign to tackle stigma and discrimination associated to Mental Health Services • Invitation to stand for election as a governor to represent the views of their constituency, raising views on behalf of their members • Collect and feedback the views of their constituency on service quality and provision. • Attend formal meetings of the Council of Governors
All members retain their statutory rights e.g. to vote or stand as a governor in Council of Governor elections and to vote on any changes to the constitution involving governor powers.
Accountability to our Members
The Health and Social Care Act (2012) states that the fundamental duty of a Foundation Trust Board is to promote the success of the organisation so as to maximise its benefits to members of the Trust and the wider public. To ensure we are doing this as a Trust we have clear lines of communication between the Board and Members. This enables the Board to have a continuous “line of sight” to the views and priorities of members and the public, and so that members and the public are assured that the Board is performing as an effective steward of public assets. Much of the accountability of the Board to its members is through the Council of Governors, which has two fundamental statutory duties
- To represent the interest of the membership and the wider public; and - To hold the Trusts Non-Executive Directors to account for the performance of the Board.
Board of Directors
Council of Governors
Public Patient / Carer Staff Appointed Governors Governors Governors Governors (Key
Accountability Elected from NHS Foundation Trust Members Stakeholders)
Members Members Members
It is vital to ensure that the links between members and governors, and governors and the Board are robust so that a gap does not emerge between member and public interests and Board decisions. Focusing on strengthening these key links is the Foundation Trust Governance model and therefore a priority area within this strategy.
Council of Governors
The Council of Governors is comprised of 34 Governors, consisting of 24 elected Governors (including service users, public, carers and staff) and 8 Governors who are appointed to the Council by key stakeholder organisations that share a close relationship with the Trust.
The Council is chaired by the Trust Chair, who ensures that the council is made aware of the relevant issues in sufficient depth to enable them to fulfil the needs of public accountability.
- Brighton & Hove (2) Service User Governors (10) - East Sussex (3) - West Sussex (4) - Outside of Sussex (1)
- Brighton & Hove (1) Public Governors (7) - East Sussex (2)
- West Sussex (3)
- Outside of Sussex (1)
Carer Governors (4) Represent Carers in all geographical areas
Staff Governors (5) Represent the views of staff across the Trust.
The appointed Governors are nominated as Appointed Governors (8) representatives for their organisation. Examples are local councils, universities, local voluntary groups and charities
Strengthening the links between members and Governors
The Trust will promote governors ability to represent the interests of the membership and the wider public by:
- Investing in development days with a particular focus on membership engagement and accountability. - Keeping members well informed about their Governor representative - Bringing Governors together with members at public meetings and inviting members to attend the Council of Governors - Encouraging Governors to participate in the Trusts well established site visits to speak with service users and carers about their experience. - Involving governors in membership recruitment - Publishing Council of Governors papers publically - Enabling members to evaluate the effectiveness of Governors in representing their interests.
Strengthening the links between Governors and the Board
The Trust will promote the ability of Governors to hold Non-Executive Directors to account for the performance of the Board through:
- Investing in joint Board and Council days with a particular focus on accountability - Facilitating communication between Governors and the Non- Executive Directors whom they hold to account through o Observing Board Committees o Attending Board of Directors meetings o The attendance by designated Non-Executive Directors at Governor Committees and Working Groups o Regular access to the Trust Chair
Strategy Governance
The Council of Governors delegates authority to the Membership Committee to make decisions on behalf of and be accountable to the Council of Governors for recruiting, engaging and communicating with the Trusts membership and representing the interests of patients, carers, families and the general public in the areas served by the Trust.
The Membership Committee will review progress against the objectives of this strategy quarterly reporting back on progress at the Council of governors through a written or verbal update from the committee Chair. An annual report of progress against this strategy will also be available at the Annual Members Meeting.
Continuous Learning
To ensure that both members and the Trust get the best out of membership, we will build mechanisms for learning and improvement into all membership initiatives. Members will be able to provide feedback at any stage - [email protected] - 0800 0153357
The Trust will also actively seek to learn lessons through:
- An annual membership survey - An annual Governor survey - Feedback from Governors through the annual Chair’s appraisal process - Feedback forms at events - Membership database reports (e.g. meeting attendance, membership growth, membership demographics)
Give Feedback
To provide feedback on this strategy or to request further information, please contact the Trust’s membership office at Email: [email protected] or Telephone - 0800 0153357
` with members To effectively communicate communicate effectively To Continue building and maintaining an accurate database Continue building and maintaining an accurate between Identify opportunities for two-way communication members and governors information to members appropriate Continue providing Communicate the benefits of membership audience communications with the desired Target Partnership Matters and the Membership e-Bulletin Ensure focused member are Expand our social media presence the use of digital platforms to communicate Explore with members • • • • • • • •
2020 - 2025 2020 Priorities representative of the representative communities we serve Membership objectives Membership To build a membership that is build To Analyse our membership on a regular basis Analyse our membership on a regular younger with schools to increase Develop relationships peoples representation LGBTQ+ and BAME community representation Increase representation in particular young carers carers, Increase learning disability representation Increase Working together to improve mental health mental improve together to Working • • • • • Our vision: Membership Strategy Membership members Assist the Trust in improving the quality of life for the communities we serve the quality in improving Assist the Trust To improve engagement with engagement improve To Build on our relationship with members to harness their Build on our relationship services experience and enable them to help improve community engagement and increase Improve Develop and Implement Associate Memberships to members tailored Develop events that are with the People Build on existing relationships to Charity, On, the Trust and Head’s Participation Team further support a single view of the Trust Recognise members achievements the tiers of membership to Encourage members through support them becoming governors • • • • • • •
Membership Annual Report 2019-20
@withoutstigma @SPFTmembership
CONTENTS
1. Introduction
2. Our Membership 2.1 What does Membership mean for us? 2.2 Council of Governors 2.3 Membership Strategy
3. Membership Performance 3.1 Member Recruitment 3.2 Member Demographics 3.3 Membership against the Population 3.4 Involvement Levels 3.5 Removed Members 3.6 Progress Against the Membership Strategy
4. Governance 4.1 Governor Elections 4.2 Membership Committee 4.3 Annual Members Meeting
1. Introduction
The purpose of this annual report is to provide an overview of the Trust’s membership from 1 April 2019 until 31 March 2020, alongside a full overview and assessment of the Trust's membership program and processes.
This report includes a breakdown of current membership statistics, the geographical areas they reside and highlights the work that has gone towards recruiting new members.
Our members have told us that they would like to hear about our membership achievements, therefore we have detailed the progress we have made towards the objectives of our membership strategy, what engagement opportunities we have made available and our newly developed communication tools.
2. Our Membership 2.1 What does membership mean for us?
As a Foundation Trust, we are accountable to local people who can become members and governors. Members are our staff, our patients and members of the public who have an interest in mental health.
Members can help the Trust develop services which will best suit the needs of the people we serve. Members are represented by a Council of Governors comprising elected public and staff members (who are elected by members), together with representatives of partner organisations and local authorities.
A representative and engaged membership will help our Trust to continue to maximise its potential as a Foundation Trust and is an important objective for the Council of Governors.
2.2 Council of Governors
The Council of Governors is comprised of 34 Governors, consisting of 24 elected Governors (including service users, public, carers and staff) and 8 Governors who are appointed to the Council by key stakeholder organisations that share a close relationship with the Trust.
The Council is chaired by the Trust Chair, who ensures that the council is made aware of the relevant issues in sufficient depth to enable them to fulfil the needs of public accountability.
Members of the Council of Governors are listed in the below tables and biographies of our governors can be found online here: https://www.sussexpartnership.nhs.uk/council-governors
Several governors have changed mid-year following our election, more details on our election can be found in section 4.1
Service User/Carer Constituency
Name Constituency Term of office end Jo Tompkins Brighton & Hove 31 July 2022 Di Hickman Brighton & Hove 07 July 2021 James Domanic East Sussex 10 September 2020 Alan Wells East Sussex 31 July 2022 Gabrielle Gardner West Sussex 07 July 2021 Angie Culham West Sussex 10 September 2020 Mel Smith West Sussex 10 September 2020 Judy Abbot West Sussex 12 June 2019 Amy Herring Outside of Sussex 07 July 2021 Mark Hughes Carer 31 July 2019 Brian Goodenough Carer 31 July 2019 Allison Fackrell Carer 07 July 2021 Carl Domanic Carer 31 July 2022
Public Constituency
Name Constituency Term of office end Duncan Shrewsbury Brighton and Hove 31 July 2022 Phyllida de Salis East Sussex 31 July 2019 Peter Haydn-Smith East Sussex 31 July 2022 Caitlin Hall East Sussex 31 July 2022 Elizabeth Hall West Sussex 10 September 2020 Gillian Bowden West Sussex 31 July 2022 Sarah Payne West Sussex 31 July 2022 Stephanie Foster Outside of Sussex 31 July 2022
Staff Constituency
Name & Job Title Term of office end Jayne Bruce, Associate Director of Nursing 31 July 2019 Louise Patmore, Senior Peer Trainer 07 July 2021 Shannon Guglietti, Clinical Effectiveness Facilitator 30 June 2019 Alex Garner, People Participation Lead 10 September 2020 Glen Woolgar, Head of Incident Management and 10 September 2020 Safety Gary Beecheno, Interim Clinical Team Leader 10 September 2020 Alice Parr, Matron for Coral & Jade Ward 31 July 2022
Appointed Governors
Name Organisation Term of office end Giles Adams NHS South East Coast 31 July 2020 Ambulance Service Brian Doughty Brighton & Hove City Council 31 August 2019 David Simmons West Sussex County Council 31 July 2020 Sarah Gates Sussex Police 31 April 2021 Natasha Sigala University 31 July 2020 Rachel Brett Sussex YMCA Downs Link 31 August 2019 John Holmstrom Turning Tides 31 October 2019 Katie Glover Coastal West Sussex MIND 30 September 2022
2.3 Membership Strategy
Our membership strategy 2018-2020 sets out a series of objectives for the Trust to continue to maintain, grow and engage its membership, including a set of priorities that will help achieve these objectives. It also describes how the Trust will evaluate the delivery of the strategy.
The strategy has been delivered within the wider framework of Trust strategies, which address the issues of equality and diversity, public, patient and carer involvement, user engagement, and communications.
The strategy built on the success of membership management to date and outlined the Trust’s vision for membership over the period 2018- 2020. It set out the methods that will be used to identify and build an effective, responsive and representative membership body that will assist in ensuring that our Trust is fit for its future in the changing NHS environment.
This strategy was informed by the results of a public consultation; it was reviewed by the Membership Committee and approved by the Council of Governors.
The objectives from this strategy which we have been working towards include:
Engaging & Involving our Members
Identifying and Addressing Under Representation
Developing Communications
Throughout 2019-20 the Membership Committee have regularly reviewed and contributed towards our progress to achieve these objectives through a number of identified priorities and this is captured in section 3.6 of the report.
3. Membership Performance
3.1 Member Recruitment
Our members join the Trust to have their voices heard and to help us better understand the views of those who access our services so that we can improve the quality, responsiveness and development of services. Members may only join the Trust in one category of membership, service user, public, carer or staff.
During 2019-20 our overall number of members increased, below shows a comparison to last year, broken down by constituency
April 2019 April 2020 Public 2,669 2,736 Patients 2,024 2,003 Carers 413 422 Staff 3,894 4,136 Total 9,000 9,297
The graph below shows our total membership at 31 March 2020, this is broken down by constituency and geographical area.
4500 4,136 4000 3500 3000 2500 2000 1500 1,054 849 1000 681 769 532 380 500 194 242 232 59 124 45 0
The table below shows the total number of members at the end of 31 March 2020 compared to the end of the previous year 2018/19.
Constituency Public Service User Carers Staff 18/19 19/20 18/19 19/20 18/19 19/20 18/19 19/20 Brighton & Hove 679 681 395 380 60 59 3894 4136 East Sussex 760 769 544 532 121 124 West Sussex 1023 1054 861 849 192 194 Out of Area 207 232 224 242 40 45 Totals 2,669 2,736 2,024 2,003 413 422 3,894 4136 Percentages 2.5% 1.0% 2.1% 6.2%
The table below shows the number of new members recruited in each constituency per quarter broken down by geographical location, throughout 2019/20.
Constituency Public Service User Carers Staff Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Brighton & Hove 3 3 8 5 1 1 5 0 2 1 2 0 129 65 270 129 East Sussex 4 6 4 10 2 2 1 1 1 4 0 0 West Sussex 5 2 25 13 1 8 14 5 1 0 5 2 Out of Area 2 1 2 6 0 0 4 1 0 0 1 0 Totals 99 46 19 593
3.2 Member Demographics
It is important to have a diverse membership so we are confident that we have representation of the people we serve. Over the past year our Membership Office has taken steps to broaden the diversity of our membership but we recognise there is much work still to do and therefore building a membership that is representative of the communities we serve remains a key objective in our membership strategy for 2020-25.
This data is currently available for our public, patient and carer constituencies.
Ethnicity
Our 2019/20 breakdown of members by ethnicity is consistent with the 2018/19 data. It highlights that although there are some minor over and under representations across the ethnicity categories against the census profile. The following observations can be made:
There are 7.0% of BME members against the 2011 census population where the average across the regions is 6.2% Gypsies and Travellers are still underrepresented amongst members across all regions
The graph shows our total membership percentage by ethnicity for 2019/20.
7%
11%
4% A –White British 1% B – White Irish
C – Any other White Background 77% Z – Prefer Not to Say / Undefined
D-U (BME)
The table shows the current percentage by ethnicity against the local population (data from the ONS - Office for National Statistics) over the past three years.
Total Total Total ONS 2019/20 2018/19 2017/18 % % % % White British 76.8 78.6 79.8 89.4 White Irish 1.3 1.3 1.4 0.7 Any other White Background 3.8 3.8 3.8 3.5 Prefer Not to Say / Undefined 11.1 9.3 7.9 n/a BME 7.0 7.1 7.2 6.2 Total 100 100 100 100
Age
Members are eligible to join from the age of 14. Our 2019/20 data shows that the largest percentage of members are aged 50 -59 (20.1%). Only 26 members accounted for 15 - 19 year olds and the Membership Office continues to work working with our Children and Young Peoples Care Delivery Service to establish new ways of engaging with young people regarding the role of members.
The graph shows our total membership percentage by age for 2019/20.
1% 6%
15% 11% 15-19 20-29 30-39 40-49 15% 15% 50-59 60-69 70+ Undefined
17% 20%
The table shows the current percentage by age against the local population (data from ONS) over the past three years.
Total Total Total ONS 2019/20 2018/19 2017/18 % % % % 15-19 0.6 2.0 1.6 7.5 20-29 15.0 16.0 16.4 13.8 30-39 14.9 14.7 13.2 14.6 40-49 16.6 17.0 17.2 18.1 50-59 20.1 18.8 19.1 15.2 60-69 15.2 19.1 13.8 14.5 70+ 11.2 4.9 10.4 16.3 Undefined 6.5 7.4 8.4 n/a Total 100 100 100 100
Gender
Our 2019/20 breakdown of members by gender shows that male members are underrepresented across each constituency against the 2011 census baseline and the gap has slightly increased. The Membership Office needs to look at ways to increase membership from individuals that identify as transgender and non-binary. The Trusts Sexual Orientation and Gender Identity reference group regularly hears the views and experience of this marginalised community and the membership office will need to work more closely with this group going forward to ensure this community is fairly represented in our membership.
The graph shows our total membership percentage by gender for 2019/20.
0%
Male Female 34% Undefined Transgender 65%
The table shows the current percentage by gender against the local population (data from ONS) over the past three years.
Total Total Total ONS 2019/20 2018/19 2017/18 % % % % Male 33.8 34.8 34.3 49.0 Female 64.7 63.9 64.8 51.0 Undefined 1.4 1.4 0.8 n/a Transgender 0.0 0.0 0.0 n/a Total 100 100 100 100
Sexual Orientation
Our 2019/20 breakdown of members by sexual orientation shows that only 51.4% have disclosed this information. The following observations can be made about the data we have collected.
The lesbian, gay and bisexual community are well represented across our constituency of members with a large increase in membership There is a higher percentage of LGB members in Brighton and Hove and this reflects the demographics of the area but there has been an increase in all other regions There is a lower percentage of LGB members amongst the carer membership
The graph shows, for those members who have disclosed this information (51.4%) the percentage by sexual orientation for 2019/20;
4% 3% 3% Heterosexual Bisexual 7% Lesbian Gay Undecided
83%
The table shows the current percentage by sexual orientation over the past three years.
Total Total Total
2019/20 2018/19 2017/18 % % % Heterosexual 43.0 43.8 44.3 Bisexual 3.5 3.6 3.6 Lesbian 1.6 1.6 1.6 Gay 2.0 2.0 2.0 Undecided 1.3 0.7 0.7 Prefer Not to Say/Undefined 48.6 48.2 47.8 Total 100 100 100 *Please note the ONS data is not available for a population comparison
Religion and Belief
Our 2019/20 data shows that 46.6% of our members have disclosed a religion or belief, this has steadily increased over the last five years however the data should be interpreted with care . The following observations have been made about the data:
The community accounting for other than Christian, Atheist and Agnostic are well represented across our constituency of members
The graph shows, for those members who have disclosed this information (46.6%) the percentage by religion and belief for 2019/20:
3% 1% 1% 1% 4% Agnostic Atheist 2% 14% 1% Buddhist Christian
Hindu Humanist
20% Jewish Muslim
Pagan Spiritualist 51% Any Other 2%
The table shows the current percentage by religion and belief against the local population (data from ONS) over the past three years.
Total Total Total ONS 2019/20 2018/19 2017/18 % % % % Agnostic 6.6 6.7 6.9 n/a Atheist 9.5 9.8 9.7 28.0 Buddhist 0.8 0.8 0.8 0.5 Christian 23.6 24.0 24.4 60.6 Hindu 0.5 0.5 0.5 1.2 Humanist 1.0 1.0 1.1 n/a Jewish 0.5 0.5 0.5 0.2 Muslim 0.7 0.6 0.7 1.1 Pagan 0.5 0.6 0.6 n/a Spiritualist 1.7 1.7 1.7 n/a Any Other 1.3 1.7 1.3 0.9 Prefer Not to Say/Undefined 53.4 52.1 51.8 7.5 Total 100 100 100 100
Disability
Our 2019/20 data shows that 39.3% of our members have declared a disability.
Mental Health disability accounted for 19% of all members. This is a positive indication that disabled members of the community have an interest in the work of the Trust. Some members have declared more than one disability; this is reflected into the figures.
The graph shows the percentage by disability for 2019/20:
1% 0% 2% 2% 3% 1% 6% 1% Asperger’s or Autism Unseen Disability 19% 4% Mobility impairment Blind / Partial Sight 1% Deaf/Hard of Hearing Dyslexia No Disability Learning Disability Mental Health 60% Personal Care Other Prefer Not to Say/Undefined
The table shows the current percentage by disability against the local population (data from ONS) over the past three years.
Total Total Total ONS 2019/20 2018/19 2017/18 % % % % Asperger’s or Autism 1.9 1.9 2.0 - Unseen Disability 6.0 7.3 7.7 - Mobility impairment 2.6 3.2 3.3 - Blind / Partial Sight 0.5 0.6 0.6 - Deaf/Hard of Hearing 1.4 1.8 1.9 - Dyslexia 3.7 4.3 4.3 - No Disability 60.4 0.0 0.0 82.8
Learning Disability 1.4 1.9 1.9 - Mental Health 19.0 44.1 24.7 - Personal Care 1.6 2.0 2.2 - Other 1.3 2.2 1.8 17.2 Prefer Not to Say/Undefined 0.3 30.6 49.6 - Total 100 100 100 100
3.3 Membership against the population
We regularly review how our membership compares with the local populous and this is detailed below for the period ending 2019/20.
Constituency Number of Population Percentage members (Office of members (Public, Patient & National Statistics Carer) 2018) Brighton & Hove 1,134 290,395 0.39% East Sussex 1,425 554,590 0.25% West Sussex 2,559 858,852 0.29% Totals 5,589 1,703,837 0.32%
Currently only a small proportion of our local population are members, this indicates we have much work to do in order to build awareness of both mental health and what membership has to offer.
Our membership office will continue to engage with members of the public and partner organisations to increase the awareness of mental health services and our membership scheme. This will be driven by our Membership Strategy for 2020-25 which is being developed with the Membership Committee for release later this year.
3.4 Involvement Levels
The Trust recognises that members will have differing levels of interest, time and availability for involvement so during 2018 we introduced levels so members were able to choose how much involvement they would like.
This is set across three tiers;
Be Informed
•Receive regular newsletters (Partnership Matters) •Receive regular communications •Receive invitation to the Annual General Meeting of the Council of Governors and the Members Annual Meeting.
Be Involved (as above, plus)
•Participate in surveys, questionnaires, consultations •Participate in focus/discussion/advisory groups •Be involved in volunteering for the Trust •Be involved in our “Expert by Experience” programme
Take a lead (as above, plus)
•Encourage new members and support the campaign to tackle stigma and discrimination associated to Mental Health Services •Invitation to stand for election as a governor to represent the views of their constituency, raising views on behalf of their members •Collect and feedback the views of their constituency on service quality and provision. •Attend formal meetings of the Council of Governors
The majority of members join on a 'Be Informed' or 'Be Involved' level and are then encouraged to progress to a 'Take a Lead' member, especially those who are considering standing as a governor. Only members themselves can decide what involvement level is appropriate for them.
A breakdown of involvement levels is detailed below:
Constituency Be Informed Be Involved Take a Lead Public 2184 1209 318 Service User 1431 1338 419 Carer 316 247 70
3.5 Removed Members
Throughout 2019-20 we had a total of 515 members who left. The majority of these were staff as when they leave employment they are unable to continue as a staff member. We do write to each person to see whether they would like to continue supporting the trust in another constituency.
The graph below shows how many members were removed in each quarter during 2019-20
Public Service User and Carer Staff
103 103 99 97
17 19 14 15 13 14 12 9
Q1 Q2 Q3 Q4
We managed to capture the below reasons for why some of our public, patient and carer members left us during 2019-20
30 28
25 21 20 20 Q1 15 Q2 Q3 10 10 Q4 7 7
5 5 4 2 0 0 0 0 0 0 0 0 Deceased Opted-out Moved away Other
3.6 Progress against the Membership Strategy
Throughout 2019-20 the Membership Committee have regularly reviewed and contributed towards our progress to achieve these objectives through a number of identified priorities and these are captured in the table below:
Priorities Progress during 2019/20
Objective 1: Engaging and Involving our Members
P1 To continue to harness the experience, knowledge Attendance at Trust Induction Sessions. and skills of our membership community and Attendance at workshops and events - NHS Birthday Celebrations, actively engage them in the development of the Admin Conference, Research and Development Conference, Expert by Trust and its activities. Experience Summer Celebration, Carers Festival, Time to Talk. Members were regularly made aware of events via email, social media and the E-Bulletin. Creating awareness of membership in GP surgeries across all geographical locations. Establishing music performance events to be held at Hellingly by service users (put on hold due to covid-19). Circulating opportunities for members to get involved in activities through the People Participation Team. Introduced a process for staff that leaves the organisation to remain as a member in another constituency. Held a successful Annual Members Meeting with the highest level of members in attendance.
Held membership stalls at Christmas in our inpatient services to help engage and generate awareness of membership.
P2 To support a single view of the Trust from partners Regularly promoting and attending Working Together Groups. organisations and members by working closely with Advertising Heads On events. the People Participation Team and the Trusts Charity, “Heads On”. Built strong relationships with partner organisations many of whom held a stall at the Annual Members Meeting. Supporting members to apply for the Heads On Hardship Grant during Covid-19.
P3 To encourage a partnership approach between Engagement with Southdown Housing, increasing membership the Trust, its membership, and other likeminded awareness and discussing opportunities for a stall at the T2T event and organisations, working together to address mental Children's Mental Health Week. health stigma. Working towards the introduction of Associate Memberships by researching other similar programmes and liaising with NHS Providers about compliance with NHS legislation.
P4 Develop new and innovative ways to involve our Working with services at Hellingly Centre to arrange Music Performance members that enable them to play an increasingly Events held by service users. active and important role in the evaluation and Members were invited to take part in numerous surveys throughout the improvement of services. year to help develop services and participate in research projects. Members were invited to take part in the Membership Strategy consultation survey which provided a vital input into the development of the new strategy.
P5 To develop and support members to progress Email communications sent to members highlighting the difference through the tiers of membership, supporting between involvement levels and the benefits of having more potential new governors. involvement. Supported the Governor Election campaign by generating awareness to our Take a Lead members, circulating information booklets and posters.
Objective 2: Identifying Under Representation
P6 To maintain an accurate membership Continued to maintain an accurate database consistently throughout database 2019/20. P7 To increase the membership of young people Liaising with internal departments to understand the areas where by; promote membership and its benefits. Achieving 5% increase of members aged Membership forms and materials are available in all welcome packs at 16-18 Chalkhill Hospital. Focused recruitment drives for youth membership Establishing initial contacts to understand how to effectively promote and generate awareness of memberships in schools. Work underway with children's services to redesign young people's membership materials. P8 To increase the membership of people who Membership awareness generated within the Trans community through identify as Trans the LGBT Switchboard, TransEquip and AllSorts Youth Project. An article on membership was published in the LGBT Switchboard's newsletter. P9 To increase the membership of carers, Raised awareness and recruited members at the Carers Festival held in specifically those caring for people accessing June 2019. mental health services. Attended Carers Right Day Event at Meadowfield. Built strong relationships with Changes Ahead, Carers Hub and Carers Centre. Attended Carer Network Meetings and Workshops to raise the profile and understanding of membership. Membership forms and information available in Carer Welcome Packs on hospital wards. Worked closely with Carer Governors, attending local meetings and promoting carer organisations news and information on Twitter.
Objective 3: Developing Communications
P10 To provide appropriate information to Development and implementation of the Membership E-Bulletin members and the Council of Governors to circulated in the months between Partnership Matters. promote understanding and ensure they are able to make informed decisions P11 To communicate the benefits of membership The membership Twitter page continues to be a valuable source of and create new engagement opportunities to sharing information both internally and externally. The page now has 350 a wider audience. followers which has increased significantly during 2019/20 and there have been 621 tweets since the page for set up in June 2018. Membership materials are available in GP surgeries across all geographical locations. Membership materials being available and visible in Trust services. Developing a process with the Bank office to make our bank members of staff aware of membership and the opportunities they have to join. P12 To build more awareness, communication, Held a session on membership including 'engaging with constituents' as and interaction between governors and their part of the governor induction programme. constituents (including events and use of Developed an 'Engaging with your Constituents' information booklet for social media). all governors. Continued to encourage governors to use the #spftgovernors on twitter. Greater governor involvement and attendance at the Annual Members Meeting. P13 To ensure Partnership Matters is member The Deputy Director of Communications regularly updates and seeks focused by encouraging members to share governors recommendations for articles. their experiences and direct how the Partnership Matters is shared with the Membership Committee prior to publication develops over time publication. Members have been encouraged via email communications to share their stories and experiences for inclusion in the magazine.
4. G overnance
4.1 Membership Committee
The Membership Committee focus on member engagement; as it is Governors statutory responsibility to represent the views of their constituents.
The Committee is formed of governors and supported by Trust representatives; the membership of the committee during 2019/20 is detailed below:
Name Role Mark Hughes* Lead Governor and Chair of the Committee Mel Smith* Service User Governor James Domanic* Service User Governor Elizabeth Hall* Public Governor Sarah Payne* Public Governor Duncan Shrewsbury* Public Governor Carl Domanic* Carer Governor Dominic Ford* Director of Corporate Affairs Natalie Hennings* Corporate Governance Manager Steve Perrott* Membership Co-Ordinator Angie Culham Service User Governor Alison Fackrell Carer Governor Gary Beeheno Staff Governor Under the review of the Council of Governors the membership for the committee changed in November 2019. Those marked with an * are current committee members.
The Committee met four times during 2019/20 received reports on:
Membership recruitment activity Progress against the membership strategy Membership Publications Governor elections Annual Members Meeting Development of Associate Memberships Engagement events Membership Strategy Consultation
4.2 Governor Elections
Our governors are elected by members and have an important part to play by listening to the views of the trust’s members, the public and other stakeholders, and representing their interests in the trust. This means, for example, gathering information about people’s experiences to help inform the way the trust designs, reviews or improves services effectively. Governors also have a role in communicating information from the trust to members and to the public, such as information about the trust’s plans and performance. Successful engagement calls for an ongoing working relationship between the trust and our members and the public, with patients and service users at the heart of this.
During 2019/20, one general election was held for places on the Council of Governors created as a result of Governors coming to the end of their terms of office or leaving the Council. The results of these elections were:
Constituency Number of Turnout Outcome Term Candidates of voting commenced Service User, Brighton & Hove 1 n/a 1 elected August 2019 1 vacancy Service User, East Sussex 4 8.9% 2 elected August 2019 2 vacancies Public, Brighton and Hove 1 n/a 1 elected August 2019 1 vacancy Public, East Sussex 3 7.8% 2 elected August 2019 2 vacancies Public, West Sussex 11 5.9% 2 elected August 2019 2 vacancies Public, Outside of Sussex 1 n/a 1 elected August 2019 1 vacancy Carer 2 n/a 2 elected August 2019 3 vacancies Staff 2 7.7% 1 elected August 2019 1 vacancy
4.3 Annual Members Meeting
The Trust held their Annual Members Meeting on 21st September 2019 at Butlin's Shoreline Conference Centre in West Sussex. The event also combined our Annual General Meeting and we were pleased to welcome over 100 members and guests.
The event opened with an array of market stalls; we were joined by many of our partner organisations and internal departments showcasing their service.
Stalls included, Research and Development, Suicide Awareness for Everyone (SAFE) Campaign, One Step at a Time Run Club, Heads On our Trust Charity, Education and Training, Triangle of Care, The Haven, Pathfinder, Rethink, Open Strings, Shine for Life and the Sussex Mental health Line.
Our Chair opened proceeding with our formal AGM, thanking our members and governors for their support throughout the year and presenting the annual report and accounts. This was followed by our AMM where we were delighted to welcome services and patients who spoke about their experiences and personal journeys.
We heard Lucy, Sarah and Nicola describe how ‘Team Springwell’ were developed and how they continue to help people with learning disabilities to have a voice in their care. Jeremy Sandford talked about how running has helped his recovery and saved his life. Jeremy spoke passionately about how he has worked with the Trust to deliver running groups to service users as a way of helping others.
The day concluded with a choice of interactive workshops; one was Poetry and Creative Writing run by Rob Gee, Poet and Mental Health Nurse and the second was a Movement to Music workshop that had delegates up on their feet having lots of fun.
BLANK BOX
Report to Council of Governors Agenda item CG 09 .3/20 Attachment L Data Quality Indicator N/A Date of meeting 10 August 2020 Format of Paper Title of paper Training and Development Written Committee Update Author Natalie Hennings, Corporate Oral ☐ Governance Manager Governor Sponsor Amy Herring, Service User Presentation ☐ Governor and Chair of Training and Development Committee Committees where this item has been considered None
EXECUTIVE SUMMARY Please tick one For Assurance ☐ For Decision Purpose This report summarises the meeting of the Training and Development Committee held on 18 June 2020.
Key findings The Committee discussed: the governors questionnaire results, governor development programme for 2020, digital solutions for training and development, governor induction, the Committeess terms of reference and the review of the Council's group agreement. Highlights include: A development session to enable governors to contribute to the Partipcation Strategy Consider holding shorter but more frequent development sessions digitially Review the content of the governor induction session and consider other methods, such as workbooks to help support understanding. Amendments to the committees terms of reference were approved, including having the Lead Governor listed within its membership requirements Establish a Task and Finish Group to review the Council Group Agreement
Recommendation The Council is asked to note the report
Governor Sponsor Amy Herring, Service User Governor and Chair of the Training and Development Committee
Page 1 of 3
1. INTRODUCTION
The Training and Development Committee held an additional meeting on 18 June 2020; its purpose is to oversee all the training and development needs of the Council including the induction programme for new governors. The following report highlights some of the topics considered at their latest meeting. the te of Heads On
2. REPORT
At their meeting the Committee discussed:
Governor Questionnaire Results The Committee recognised that the response rate to the questionnaire was low and therefore could not provide an a true view of the Council as a whole. The Committee made suggestions to tackle some of the areas highlighted in the survey results, some of these included: Encourage governors to keep referring to their induction booklet which contains a wealth of information Introduce an informal meeting for new governors shortly after their induction so they have the opportunity to get to know each other Consider increasing the number of joint Board and Council session with agreement from the Board.
Governors Development Programme for 2020 The Committee discussed the development programme for the council; with the Partcipation Strategy being developed, the Committee felt that governors could provide some valuable input into its development and confirmed this as their next session. The Committee also discussed how continued development can be made available to governors during the pandemic; to aid their knowledge and keep them engaged. The Lead Governor is looking into having a series of development sessions about services which are led by service leaders and more information on these will be available to governors shortly.
Digital solutions for training and development The Committee considered digital solutions for development sessions including live webinars; recorded webinars for governors unable to attend to view later, and pre-record sessions. These would be shorter but more frequent sessions. There were a number of consent issues that need to be worked through but the Committee noted the importance of keeping governors engaged and updated whilst meetings in person are not possible. All governors would be offered training on any digital platforms used for training and meetings.
Governor Induction It was recognised that a new approach would be needed for the governor induction this year. The Committee asked that the views of our last governor cohort were sought and considered as part of the revised programme this year. The content of the induction session will be revised to ensure the complexity of the information is digestable especially to those who may not be familiar with the intricacies of the NHS. Other methods outside of the initial induction session such as workbooks are being considered and drawn up.
Page 2 of 3
Training and Development Terms of Reference The Committee approved two change to their terms of reference for recommendation to the Council, these are attached as appendix 1. The two changes are: To include the Lead Governor within the membership of the committee, as it is important for this individual to shape the development of the Council. To remove reference to governors serving 1 year with the option to self-nominate for one additional terms - the Council of Governors approve to remove this rule when they last met to review the membership of its committees in October 2019.
Council of Governors Group Agreement The Committee agreed to form a Task and Finish Group to review the agreement and bring their recommendations back to a future meeting.
3. RECOMMENDATION(S)
The Council is asked to note the report
Page 3 of 3
Appendix 1
Training & Development Committee Terms of Reference
Constitution
The Training & Development Committee is a Committee constituted by the Council of Governors subject to Standing Order 5.1
The Committee is responsible for making recommendations to the Council of Governors relating to: Regularly Identifying Governor training needs Setting the agendas for the Governor Training and Development Days Regularly reviewing the Governor Code of Conduct and Group Agreement Maintaining and developing the Governors Induction Manual in conjunction with the Governance Support Office
Duties
The duties of Training & Development Committee are categorised as follows:
Contribute to Governor elections campaigns and related publicity Assist with Governor Induction meetings. Contribute to and maintain the content of the Governor Induction Manual. Annually review and recommend any necessary revisions to the Code of Conduct Organise the agendas of Governor Training and Development Days. Oversee and organise other Governor training initiatives as necessary Identify Governors training needs via regular issues of the survey, particularly after an influx of new Governors following elections Contribute to and maintain the training needs survey To evaluate its own membership and performance on a regular basis. To ensure that the Committee membership is refreshed and that undue reliance is not placed on particular individuals when undertaking the responsibilities of the Committee To review and update annually these Terms of Reference, recommending any changes to the Council of Governors.
Authority
The Committee is authorised by the Council of Governors to carry out any activity within its Terms of Reference.
Members Quorum
Not less than three Governors, to include the The Chair (or agreed Chair in their absence) plus a minimum of two Lead Governor (Any constituency) governors.
Membership will be by self-nomination; and
Governors will serve a 1 year term with the option of self-nomination for one additional term.
Aall appointments to the Committee will be approved by the Council of Governors and will be reviewed annually. The Committee will elect one of its members Appendix 1
as Chair
The Committee may ask any member of staff to be in attendance for all or part of a meeting to advise the Committee
The Corporate Governance Office will provide administrative support for the Committee, including producing the agenda and papers and taking notes at the meetings.
The Head of Corporate Governance or their nominee will be in attendance to provide an essential link to the Governance support office
Frequency Calling Meetings
Meetings will take place as frequently as it Meetings will be called at the request of the Chair. may determine to be necessary to undertake its duties but as a minimum at least twice a Notice of each meeting, including an agenda and supporting papers year. will be sent to the members of the Committee 5 clear days before the date of the meeting. All meetings are in accessible venues, taking into account the needs of all attendees. Reporting Communication
The Committee will agree key messages for communication to the The Committee reports to the Council of Council of Governors at the end of each meeting Governors and will present an update to the next meeting of the Council of Governors. All papers, minutes and documents are available in alternative
formats, if requested A statement regarding the Committee’s activities will be included in the Annual All members of the Committee are required to observe the strictest Report. confidence regarding the information presented to the Committee
and must not disclose any confidential information either during or The notes of the meeting will be agreed by after their term of membership. Failure to comply with these the Chair within 5 working days of the requirements could result in the termination of membership of the meeting. Action points will be circulated to Committee and/or could be deemed a breach of the Governor Code members within 10 working days of the of Conduct meeting.
Review
These terms of reference will be reviewed annually.