Report to: Council of Governors Paper number: 2 Report for: Information Report type: Strategy and Operational Performance Date: 13 December 2016 Report author(s): Ms Angela McNab, Chief Executive Report of: Ms Angela McNab, Chief Executive FoI status: Report can be made public

Title: Chief Executive’s Report

Executive Summary This report provides updates on a number of key meetings with staff and external stakeholders and information on key national developments. In addition, this report provides news of internal events, media interest and the use of the trust seal.

Recommendations to the Board

The Board of Directors is requested to:

 RECEIVE and ACCEPT the contents of this report for information.

Trust Strategic Priorities Supported by this Paper The chief executive’s report supports all of the Trust’s strategic and corporate objectives.

Risk Implications The paper covers developments in areas already identified within the risk register.

Legal and Compliance Implications The report includes a summary of national developments which will affect the Trust’s compliance requirements.

Finance Implications There are no specific financial implications identified by this report.

Single Equalities Impact Assessment This report does not require a SEIA.

Requirement of External Assessor/Regulator NHS Improvement is responsible for ensuring that foundation trusts are well governed. Best practice guidance concerning board governance includes an expectation that the Board and Council are kept appraised about the external environment, the strategic implications for the Trust and internal matters. This report contributes to this requirement.

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CHIEF EXECUTIVE’S REPORT

GENERAL UPDATE

Camden Overview and Scrutiny Committee The Camden Council Overview and Scrutiny took place on Wednesday 9 November and one of the agenda items was Camden and ’s CQC report. I attended the meeting with my colleagues, Dr Vincent Kirchner, Claire Johnston and Sarah Papworth-Heidel and we were delighted that some of our service users also came to the meeting. I presented the key findings of the inspection, the changes that had taken place since the previous CQC report and the main areas of focus for improvement. The members were pleased to hear of the journey of improvement that the Trust has been on and recognised many of the areas which had positively changed such as falls management. They heard first hand from service users about the positive support they received and about some of the areas where there is more to be done including streamlining information sharing between different parts of the health service. Overall it was a very constructive discussion and the Council have asked us to return in six months to give an update on the CQC actions and improvements that are underway.

Retendering of the Improving Access to Psychological Therapy Camden CCG has ceased the re-tendering of Improving Access to Psychological Therapy (IAPT) services, and plan to extend our existing contract to provide these services. We are pro-actively developing an innovative model, including digital pathways, to increase access and improve outcomes, meeting Five Year Forward View for Mental Health expectations. We will also be working with commissioners and other local partners to integrate IAPT, along with a number of other services and interventions, into a seamless primary care mental health service.”

The Mental Health Five Year View Dashboard NHS published The Mental Health Five Year Forward View Dashboard to identify metrics for monitoring key performance and outcomes data and that that will allow them to hold national and local bodies to account for implementing the Five Year Forward View for Mental Health. The data covers CCGs rather than providers of healthcare. It includes a suite of metrics based on the proposals in the Implementation Plan and is structured around the core elements of the mental health programme:  children and young people’s mental health;  perinatal mental health;  adult mental health: common mental health problems;  adult mental health: community, acute and crisis care;  secure care pathway;  health and justice;  suicide prevention; and  meeting the commitment to improve mental health funding. The data is drawn from published datasets and is available at the national level, with

scope for regional breakdown and content will be developed in waves, and will improve as robust data on mental health services becomes more available. Quarter 1, 2016/17 data are available. Areas where residents of Camden & Islington, where C&IFT provide services, and who fare rather better than the median are:  early intervention psychosis – people starting treatment within 2 weeks of referral;  physical health check for people with serious mental illness – proportion of people receiving complete checks;  proportion of people in stable accommodation;  hospital admissions for people with self-harm; and  commitment to increase mental health funding met by both commissioners. Areas where residents of Camden & Islington fare rather worse than the median are:  proportion in employment;  crisis care pathway combined score;  proportion of patients on CPA followed up within 7 days of discharge; and  IAPT recovery rates (Camden 6% below median and Islington 3% below median).

Preceptorship and Capital Nurse Event The nursing development team in the Trust, led by our Preceptor Manager, Dean Gimblett, were invited to present a poster on the Trust’s preceptor programme for newly qualified nurses at the wide Capital Nurse event this month. 250 nurses reviewed the poster and it attracted a lot of interest because of the success of the Trust’s programme in improving retention of nurses in their critical post qualifying year. The evaluation has found that nurses increased their confidence as well as their clinical skills. We are now exploring offering this programme to all staff nurses and not just those who we recruit from Middlesex University.

SERVICE DEVELOPMENTS & OPERATIONS As of 1 November, the Assessment service has changed its model of operation, moving to focus on swifter and more effective triage, with a fast tracking of people previously known to services back to those services. The aim of this change is to improve both the process and experience of entry into services.

The Transcranial Magnetic Stimulation service for people with treatment resistant depression is now fully operational as part of the CDAT team. This service is the only such NHS service in London, and offers a new treatment for people with depression.

Within the IPU, we are working with Camden GPs and the CCG to introduce increased levels of mental health nursing into primary care in order to improve links between teams and primary care, help deliver the physical and mental health outcomes of the IPU, and support a more effective pathway of treatment for service users.

Unfortunately, it has not been possible to secure funding for the 24 hour mental health nursing service at Royal Free Hospital Emergency Department. As a result, the service reverted to historic arrangements with junior doctor only cover at night from 25 November. It is hoped that with the national policy requirements for 24 hour mental health services, funding will be forthcoming in future to enable this service to be re-instated.

The annual Emergency Planning assessment from NHS England was undertaken during the month of November. The Trust’s position has improved, as compared to 2015, with an overall rating of “green” in relation to emergency planning and preparedness.

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Inpatient Clinical Development The inpatient team manager clinical development programme began last month. It is co- run by Karen Jones, Senior Service Manager and Caroline Harris-Birtles, Deputy Director of Nursing, with support from the Organisational Development and Learning and Development team. The programme concerned to support inpatient and crisis team managers to maximise their role in leading a team, so that they are clear about their responsibilities but also have the opportunity to develop their clinical and professional leadership. It is a peer learning programme, using co-production principles. Even at this stage of the programme the managers are responding very positively to the chance to build a mutually supportive network across divisions, through better connections with one another.

Nursing Associates – new transformation roles The Trust was selected as one of the national test sites for the new Health Education England Nursing Associate role, recruitment has taken place and there were 250 applicants for the 75 places on the scheme. This is a great result and will mean we will have high quality applicants on the two year training programme. Many of the applicants were internal to the trusts involved, providing career progression opportunity. The places are shared across the nine organisations which form a consortium to develop the programme and they will provide work placements in the community, primary care as well as hospitals. The Nursing Associates will be prepared to work in a range of clinical settings to deliver care across patient pathways.

EXTERNAL PROFILE Labour Leader , MP, visits Camden and Islington NHS Foundation Trust Labour Leader, Jeremy Corbyn, praised Trust staff during a visit on Monday 28 November, saying they were doing “an amazing job”. Mr Corbyn said: “I was very impressed by the essential work staff are doing to help some of the most vulnerable members of our society. During the visit, Trust Chief Executive, Angela McNab, outlined our plans to transform the Trust’s ageing St Pancras site – a proposal which has won commitment in the recently-published Sustainability and Transformation Plan. Plans would entail developing the site, in conjunction with Moorfields, to make the mental health care provided, and the environment in which it is delivered, fit for the 21st century and beyond. Next stop on Mr Hunt’s visit was to our iCope service which offers evidence-based psychological therapies for people with depression, anxiety or other mental health problems. As well as talking to two service users and staff, he heard iCope lead, Judy Leibowitz, describe how the service was increasingly going out into the community to make contact with hard-to-reach groups, such as young people, our BME communities and individuals with long-term physical health conditions. Final stop on Mr Corbyn’s visit was to the Trust’s Traumatic Stress Clinic where heard about our work with asylum seekers, veterans, and those diagnosed with traumatic stress disorder as a result of sexual or physical abuse. Mr Corbyn said: “It is very difficult times we are in and such services are needed more than ever.”

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The Secretary of State, Jeremy Hunt MP, visit to C&I We were delighted to welcome the Secretary of State for Health, Jeremy Hunt MP to St Pancras on Thursday 17 November. We had the chance to share our strategic priorities, discussed some of our challenges and set out our ambitious plans for the St Pancras site. There were several opportunities for staff to engage with the Secretary of State and he had wide ranging discussions with staff from iCope, Older People’s Services, Community, Drug and Alcohol Services, Acute, Occupational Therapy, our Integrated Practice Unit for Psychosis and our Social Work Department. The visit was very positive indeed and we were very pleased to hear support for our overall plans and particular interest in how we might be enabled to work more closely in areas such as employment.

Short videos help raise awareness of the work of the London Veterans’ Service A series of five videos has been made to highlight the work of the London Veterans’ Service (LVS), featuring short interviews with ex-servicemen about their experiences of the service and insights from psychologists on supporting veterans. The short films have been made by the LVS Supporters Group of ex-servicemen in conjunction with Dai4Films, whose CEO and executive producer Neil Davies is himself a veteran who has received support from the LVS. The films have been posted on the recently-revamped LVS website and are aimed at further promoting the work of LVS and raising awareness of mental health issues in former members of the Armed Services. They will be promoted through C&I’s Twitter account and with a feature in the forthcoming Xmas edition of the quarterly C&I News.

C&I Twitter followers The Communications Team’s target of reaching 1,000 followers on its Twitter account before Christmas has been achieved almost two months early - the number of followers currently standing at 1,014. This 60% increase in followers since the start of the year reflects focused, daily Tweets and Retweets in support of key Trust events and developments.

New “Beauty and the Beast” art exhibition at St Pancras Hospital A new art exhibition on the theme of Beauty and the Beast had its opening night and preview show at St Pancras Hospital last month. Service users are among the ten artists whose work will be displayed in “The Shapes and Lines of Beauty”, including striking images by a former soldier who received treatment at the Trust for post-traumatic stress disorder. Shaun Cole’s work evokes the colours of the Middle East, where he served as a soldier and he credits his works’ striking use of repetitive dots, reminiscent of aboriginal art, with helping him to “bring order” to his experience of PTSD (Post-traumatic stress disorder). The aim of this latest exhibition in St Pancras Hospital is to encourage people to consider the nature of so-called ‘beauty’ and to question pleasing appearances.

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INTERNAL EVENTS/ACTIVITY

Star of the Month presentation Kerry Bourke, Project Support Officer at Greenland Road, has been named as our latest Star of the Month. Kerry has varied responsibilities both in the Assertive Outreach Team and Early Intervention Service, but was acknowledged as being continuously supportive of her colleagues. One regular challenge for Kerry is reminding the team of their CareNotes deadlines, but she was praised for managing to do this in an informative, simple way so that clinicians can keep on top of their workloads. Kerry received a certificate, C&I pin badge and a £25 M&S voucher in a presentation Trust Chair Leisha Fullick in October. Former colleague Pam Hodge, who nominated Kerry, said: “If anyone ever needs a kind word or to be heard, Kerry is there and looks after us all well. “She is always cheerful around the office and has great relationships with everyone, improving morale and making both staff and service users feel welcome. Kerry massively contributes to Greenland Road being a positive place to visit and work. “If you knew Kerry, you would understand the important work and social role she provides within the team, as well as how excellently she upholds and demonstrates the Trust values every day.”

Internal communications to support the CQC improvement plan An internal communications drive to support our improvement plan following our Care Quality Commission report this year has been addressing the second key theme in the programme - Safeguarding. Useful background information about safeguarding, particularly recording safeguarding information and knowing the process for referrals has been distributed via the internal weekly bulletin iConnect, and a series of roadshows providing mandatory training started in November. They will run through to March 2017. Lone Working and how to stay safe has already been the subject of an internal programme of awareness-raising, following the CQC inspection. Future monthly topics will be Core Skills training, Care Planning, Record Keeping, Managing Your Environment. The key message for each of the monthly themes is being presented on eye-catching screen savers installed on all Trust computers.

MEDIA PROFILE A focus for pro-active media relations in the last couple of weeks has been to start raising external understanding and awareness of the Trust’s initiative to better integrate physical and mental health care for those with psychosis. A press release emphasising the number of years lost to premature death in this group compared with the general population has been issued to selected media outlets including the Health Service Journal, specialist and issues-based radio programmes and local news outlets.

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The Ham and High has run a positive piece on the initiative so far and further coverage is anticipated in the Health Service Journal and Camden New Journal; contact with radio programmes that expressed an interest is ongoing. A second wave of media contact, including selected national newspapers and nursing and social work trade titles, is being planned. Separately, BBC London filmed several of our service users diagnosed with dementia who are being inspired to eat in a way that can improve or slow down the progression of their condition. The Brain Food project is the idea of Anna Betz, a lead practitioner with our Camden Memory Service. Both the Ham and High and Camden New Journal ran positive preview stories of the new “Beauty and the Beast” art exhibition at St Pancras Hospital, keeping up the Trust’s reputation for strongly supporting art and creativity.

CEO STAKEHOLDER MEETINGS AND SERVICE VISITS Visits: 20 October - Islington Practice Based Mental Health Service 29 November – Hanley Gardens

Meetings: 28 September Camden and Islington NHS Foundation Trust and the Partnership meeting 5 October Nubian Users Forum (NUF) 7 October NHS England (London) Trust Chief Executives and CCG Chief Officers meeting. 3 November Planning and Guidance (NHSE) 3 November Current Challenges and Priorities (NHSE) 14 November C&I and London Borough of Camden Partnership 14 November UCLP Executive Meeting

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