The role of the Trust Board is to provide leadership and development of the Trust strategy, oversight and facilitation of service delivery, sustainability and transformation.

The meeting was chaired by David Eva, Chair.

Service user story

The Board heard from Charlie, a service user from Guild Lodge who shared his experience of mental illness which began following the death of his grandmother when he was twelve years old.

Charlie used cannabis to suppress his emotions and after years of suffering poor mental health he finally received the dual diagnosis of personality disorder and paranoid schizophrenia.

Charlie felt that his symptoms weren’t picked up as early due to poor communication between the services he was in contact with.

Charlie is now an inpatient at Guild Lodge and has really benefitted from the care he receives there including one-to-one support from a named nurse, one-to-one psychological interventions and work with a specialist occupational therapist.

He is grateful for the support he has had to help him break his cycle of addiction and for the hard work, dedication and effort of the team at the Guild for putting him on his recovery pathway.

He has also been instrumental in setting up an LGBTQ+ service user group who meet weekly to offer peer support. Groups like this are a really important way in which LSCft works with service users to develop fully inclusive mental health services as part of our commitment to equality and diversity.

Chief Executive Update

The Trust Board was updated on the successful launches of the two Initial Response (IRS) services in Pennine and Central and West which are already having a huge impact. The services are receiving an increasing volume of self-referrals freeing up capacity in Primary Care and they have seen a reduction in mental health attendances at acute trusts. Calls are routinely answered within 10 seconds.

Our community mental health transformation programme is making good progress. In partnership with Lancashire Mind we are working with service users and carers to understand what they would like the future model to look like. As part of this transformation DIALOG+ - a new model to move from the Care Programme Approach (CPA) towards a more person-centred approach - is planned for implementation in October 2022.

For children and young people we now have the newly designed Rapid Assessment and Intensive Support Team (RAIST) giving seven day a week support for the first time. In the first two months there has already been an immensely positive impact on both our children and young people and the wider system.

The update also highlighted several recent award shortlistings and wins for the Trust including the Nursing Times, HSJ Patient Safety, ICS apprenticeship awards, North West Coast Innovation Agency Awards and the Design in Mental Health Network –showcasing the really positive improvement work happening across the Trust.

Read the full Chief Executive update.

Complaints

The Board received a paper highlighting improvements made since the introduction of an improvement plan in 2019 with the Trust experiencing a 50% reduction in complaints over the last two years.

The Patient Advice and Liaison Service which was established last year continues to see a high level of activity.

Our quality improvement work is having a positive impact, with initiatives like the improvement management groups across Eating Disorder services resulting in increases in compliments and reductions in complaints which is a very positive outcome for our improvement work.

We are maintaining a high level of compliments across the organisation with seven compliments for every one complaint which is incredibly positive.

We listen to the feedback we receive and continue to do a range of learning around complaints across teams to ensure ongoing improvement.

Apprenticeships

The Board received an update on our hugely successful apprenticeship programme which is offering a vast range of high quality apprenticeship opportunities giving routes into several different career pathways within the Trust.

The national target for undertaking apprenticeships in NHS Trusts is 2.3% of the workforce, a target which LSCft has well exceeded with 4.2% of our overall workforce currently enrolled on an apprenticeship programme. This represents an investment in developing our workforce of over £1 million pounds.

The programme is currently supporting the development of a range of clinical and non-clinical apprenticeship standards for staff to access across twelve disciplines including nursing, finance and HR.

The programme is supporting the Trust to focus apprenticeship standards in areas where they are most needed and over the last three years an impressive 96% of apprentices have stayed with LSCft. Of those 71% have progressed further in the Trust - enabling us to develop home grown talent within teams.

Medical workforce transformation

The Board received an update on the ten point plan and associated actions in relation to recruiting and retaining doctors over the next five years.

Work is ongoing around those actions including the launch of new job planning software and better data on workforce and finances to share with associate medical directors.

Figures show that our medical recruitment remains healthy; we are increasing the number of trainees and we are recruiting approximately one consultant per month.  We have made three recent appointments in South Cumbria which has historically been difficult to recruit to.

This transformation work is being undertaken in partnership with Nursing and Quality to ensure we have the right workforce in place for our service delivery. 

Mental Health Improvement Plan

The Board received an update on progress made to deliver the Mental Health Improvement Plan.

In our urgent care pathway the ‘Break the Cycle’ week (Monday 23 to Friday 27 May) gave additional focused support to improving patient flow resulting in increased discharge rates (56 discharges from Trust and out of area placement (OAP) beds) and a 33% reduction in patients waiting for beds.

The Trust will be continuing with some of the key improvement drivers identified during that week and the recent OPEL 4 escalation.

Our mental health liaison teams are experiencing huge increases in demand but very positively are maintaining excellent performance with one hour response time at 93% and four hours at 99%.

Both the national picture and our position in relation to 12 hour breaches at A&E remain challenged.

Our inappropriate out of area placements (service users admitted to placements the furthest away) have reduced from 65 in May to 32 this month and we continue to focus on reducing this further to improve service user and carer and family experience.

Care Quality Commission 

The Board was updated on the final written report from the Care Quality Commission (CQC) following the recent inspection of Psychiatry Liaison Services in March and April 2022, as part of their system-wide review of emergency and urgent care.  

They inspected three domains – safe, responsive and well-led and the report details the significant improvements made in these services since they last inspected in 2019, confirming a much higher quality of care and patient experience. 

An update was also given on the action plan put in place following the inspection of The Harbour in 2021. All actions within the plan have been addressed and this has been fed back to CQC during ongoing relationship management meetings who were assured around the improvements made.

Health Inequalities Strategy

The draft strategy was presented to Board following significant engagement with staff and Voluntary, Community, Faith and Social Enterprise Sector partners.

Their feedback has shaped the draft strategy which focuses on three main pillars with LSCft as:

  • A provider of health and care services
  • A commissioner of health and care services
  • An anchor institution in our communities

These 3 pillars are translated into six enabling priorities to deliver demonstrable activity. The Trust recognises that we have a lot of work to do in reducing health inequalities across our population and this strategy brings forward our response to that challenge.

Following Board endorsement, further engagement on our plans will take place with our communities to ensure we put health inequalities at the centre of our strategic intent across the organisation.