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Annual Repor T and Accounts ANNUAL REPORT AND ACCOUNTS 2018/2019 Camden and Islington NHS Foundation Trust Annual Report and Accounts 2018/19 Presented to Parliament pursuant to Schedule 7, paragraph 25 (4) (a) of the National Health Service Act 2006. © 2019 Camden and Islington NHS Foundation Trust Contents Case study: How the art of therapy helped Sybil and her recovery 4 1.0 PERFORMANCE REPORT 6 Performance Overview Chair and Chief Executive’s Statement 6 Our purpose and activities 9 Our services and how they have performed 15 Case study: Helping our Service Users within Primary Care 16 Performance analysis 26 Case study: Clean of drugs addiction and experimentation after 20 years 32 2.0 ACCOUNTABILITY REPORT 34 Directors’ report 34 Working with our stakeholders and service users 34 Public consultations 38 Well-led governance review 38 Trust membership report 39 Our governance 44 Case study: Developing our Quality Improvement approach across the Trust 67 Staff report 68 Remuneration Report 80 Statement of the chief executive’s responsibilities as the accounting officer of Camden and Islington NHS Foundation Trust 86 Annual governance statement 87 Case study: Nurturing recovery through gardening 92 3.0 QUALITY REPORT 94 Part 1 Statement on quality from the Chief Executive 94 Part 2 Priorities for Improvement 2019/20 99 Part 3 What we have achieved in 2018/19 106 Statements of assurance from the Board 116 An overview of the quality of care offered by the NHS foundation trust: Key indicators of safety, effectiveness and patient experience 116 Quality and Innovation: the CQUIN Framework 124 Reporting against core indicators 128 Key quality initiatives in 2018/19 134 NHS Improvement targets 145 Annex 1: Statement of the Directors’ responsibility for the Quality Report 152 Annex 2: Independent Practitioners’ Limited Assurance Report to the Council of Governors of Camden and Islington NHS Foundation Trust on the Quality Report 153 4.0 SUMMARY FINANCIAL STATEMENT 156 Independent auditors’ report to the Council of Governors of Camden and Islington NHS Foundation Trust 162 Other disclosures 170 APPENDIX 171 Annual accounts for year ended 31 March 2019 Front cover image, Joy Anamuehan, a support worker on our Women’s Psychiatric Intensive Care Unit CASE STUDY FEELINGS OF DEPRESSION AND ANGER were channelled into artworks by a former service user who created an exhibition at the mental health centre she had attended. “All of the paintings in the gallery were inspired by a particularly tough time of my life when I was a patient receiving care for my mental health issues. When I was HOW THE ART feeling depressed or angry, rather than shout or scream, OF THERAPY I would put my feelings into the canvases,” explained Sybil HELPED SYBIL Adelaja. AND HER RECOVERY 4 Annual Report and Accounts 2018/19 Her works were displayed at Highgate Mental Health Centre, part of Camden and Islington NHS Foundation Trust. Whilst “Looking at these paintings in hospital, Sybil worked with the Occupational Therapy now, I can feel a sense of time team, attending weekly art therapy groups off the ward, and creating artwork with activity workers on the ward. passing and that difficult After leaving hospital, Sybil stayed in touch with Laura Harrison, an Occupational Therapy Clinical Support Worker, time in my life being over. and Hannah Ravenscroft, an Art Therapist, to create the Through this exhibition, I hope exhibition. Hannah said Art Therapy encourages self- to inspire others to expression and communication through a creative process that can be supported paint and encourage and reflected upon with a therapist or in a them to exhibit their group session. She explained: “Art can have the power to paintings and get heal, providing an outlet to help process and explore difficult experiences, and it can the attention they give a voice to thoughts and feelings that deserve.” may be difficult to express through words.” Sybil wanted her paintings to be exhibited in the centre so that they could give hope to others. PERFORMACE REPORT 5 1.0 PERFORMANCE REPORT 1.0 PERFORMANCE REPORT Performance Overview Chair and Chief Executive’s statement THERE HAS BEEN STRONG PROGRESS during the year to equip our Trust well into the future, ensuring we offer first class mental health within the most effective environment. The unveiling of the NHS Long Term Plan in January set the future focus of care for NHS trusts and offered reassurance that we are on track to deliver its vision of prevention and early diagnosis with a shift away from hospital care. Our clinical strategy has continued to underpin this, focusing on early and effective treatment, helping service users to live well, and offering evidence-based care developed with world-class research. Crucial to this approach is the transformation of our estate by relocating inpatient beds from St Pancras Hospital to a new purpose-built facility on the Whittington Hospital site; developing new integrated community mental health centres in our boroughs; and redeveloping the St Pancras site. Following a public consultation and formal approval of our plans, design planning for the new inpatient facility is now well underway, with input from staff, service users, carers and local residents. There will be wider engagement, too, from summer 2019 on the functionality and look of the new integrated community mental health centres. Another significant development to our estate has been the start of building work on a new place of safety suite at Highgate which will be the first port of call for any adult detained in Camden or Islington by the police under Section 136 of the Mental Health Act (MHA) 1983. The new suite will address concerns raised in the past by the Care Quality Commission about 136 provision at our acute hospital partners, providing additional capacity to support service users in crisis, and improving staff experience. Operationally, we have focused on more rigorous and sophisticated bed management, reducing costly out-of-area placements, as well as those patients on wards for more than 50 days without clinical justification. The appointment of a Director of Clinical Information Management earlier this year has been key to improving our performance further by strengthening the quality of our clinical information. We know from our latest Staff Survey that there are still challenges we need to address, including bullying and discrimination, staff safety and wellbeing, culture and morale and motivation at work. A two year workforce strategy is underway to look at tackling all these areas. We continue to have high levels of violence and aggression on our wards and are committed to seeking to change this. We have had some early success involving such events through our QI project and also see potential better use Chief Executive Angela McNab of technology supporting us in keeping everyone safe. We are determined to learn openly from these initiatives and from all serious incidents including the 6 Annual Report and Accounts 2018/19 tragic homicide that occurred this year, and make any necessary changes to strengthen our quality and safety Notwithstanding this dreadful incident, the overall quality of our care has received praise and endorsement. Following an unannounced visit by the Care Quality Commission in January, our Stacey Street Nursing Home for older adults with dementia was rated ‘Good’, a resounding endorsement of 27 years’ hard work as residents moved to a new home in April. We won additional funding for a range of services for veterans and in February, we welcomed Defence Minister Tobias Ellwood MP who heard first-hand about our success in psychologically supporting service personnel who are suffering trauma – often years after they have left the armed forces. In March, we were very proud to mark the 10th anniversary of the Trust’s iCope psychological therapy services with a celebratory event attended by 200 staff, service users, commissioners and health partners. And the quality of our research partnership with University College London was emphasised this year when Helen Killaspy, an Honorary Consultant in Rehabilitation Psychiatry at C&I and Professor at UCL Division of Psychiatry, was named by the European Psychiatric Association (EPA) as winner of the Constance Pascal-Helen Boyle Prize. This honour is for “Outstanding Achievement by a Woman in Working Chair Leisha Fullick to Improve Mental Health Care in Europe”. Finally, we would like to thank all our partners across Successfully developing the role of volunteers in Camden, Islington and Kingston for their support and offering emotional support to our service users was also collaboration over the last year. Your collaboration, support acknowledged in the year, when we won a £75,000 grant and advice are never taken for granted and play a huge part to join a new Volunteering Innovators Programme. We are in the success of our Trust. the only NHS mental health trust of 12 NHS trusts to join the Helpforce scheme, which supports the roll-out of the most successful initiatives across the NHS. Kind regards Our therapeutic approach to art and gardening was acknowledged when we won a Royal Horticultural Society (RHS) “Feel Good” garden in a competition beating 39 other NHS mental health trusts as part of the NHS 70th birthday celebrations. Now relocated to our Highgate site, it is already providing a haven for service users, staff and local residents, hopefully for many decades to come. We are delighted that work is currently underway to get Angela McNab Pippa Aitken the Trust’s dormant charity up and running. There has Chief Executive Deputy Chair been huge energy and support shown by colleagues across (on behalf of Leisha the Trust for the charity and we believe the projects it will Fullick, Trust Chair) engage in will be of significant and lasting benefit to both 28 May 2019 28 May 2019 our service users and our staff.
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