Our Trust Strategy 2021 - 2026 was launched in September 2021. Our vision and values are clearly stated and are supported by six strategic priorities, which outline key areas of focus for our Trust. This report provides an overview of progress against the six priorities since the last Board meeting.
1. We will put SERVICE USERS at the heart of all we do, supporting effective care, recovery and wellbeing
Although District Nursing demand is 28.6% higher than pre-Covid, we are still seeing high CAMHS demand 52.3% higher than pre-Covid. This is a similar picture with Eating Disorders where demand is 118% higher than pre-Covid.
Community mental health and urgent care pathways are experiencing a 20% increase in demand.
Our plans are focusing on reducing people waiting for treatment and reducing demand through our transformation work in partnership with our different partners we have seen a reduction in demand for admissions but an increase in service users being discharged from hospital.
Maternal Mental Health Awareness Week ran from 3 May to 8 May. It was a week long national campaign run by the Perinatal Mental Health Partnership UK (PMHP) nationally and was dedicated to talking about mental health problems during and after pregnancy and raising awareness.
LSCft proudly supported the week with The Lancashire Telegraph carrying the story of former service user, Jade, who praised staff at Ribblemere Mother and Baby Unit, who helped her recovery after having her baby. Jade’s story also featured on BBC Radio Lancashire.
The Trust also used the week to launch the Down in the Bumps Podcast by Perinatal Psychiatrist Dr Laura Bladon where she chats to perinatal service users. Listen to Down in the Bumps on Spotify.
Patients from Guild Lodge and Wesham Rehabilitation Unit created beautiful imaginative works which were recently displayed in the PR1 Gallery at UCLan.
The unique, 'Being Human – past, present and future’ exhibition showcased various works of art created as part of occupational therapy sessions, done in conjunction with students from UCLan Counselling, Coaching and Psychological Interventions BSc programme.
The creative works are a powerful exploration of who we are as humans, how we make sense of our past, how we live in the present and our hopes and fears for the future.
LSCft has opened a new Recovery College in partnership with Preston North End Football Club and Preston North End Community and Education Trust (PNECET).
The Hub was officially opened by Chief Nurse and Quality Officer Maria Nelligan and Lancashire County Council Director of Public Health Sakthi Karunanithi.
Based next to the Minerva Centre in Deepdale, the Recovery College will provide a fantastic space for educational workshops, training opportunities and community projects.
The College will help to tackle health inequalities across Preston by supporting people to lead a healthier and more active lifestyle, connecting people with each other and inspiring them to achieve their goals.
2. We will employ and retain the best STAFF because our work culture will be inclusive and a supportive place to work
The results for the annual NHS Staff Survey were published last month and show a continuing picture of improvement for LSCft - over two thirds of themes now at or above average making the Trust the second highest performing mental health Trust in the North West.
The Trust had the biggest response rate to the survey in seven years with almost 50% of our workforce (more than 3500 people) completing it. This is a significant improvement for the Trust and is the result of ongoing work to engage with our staff, demonstrate their value and listen to their feedback.
The results recognised LSCft as a compassionate and inclusive place to work (our highest scoring theme) demonstrating that our strong focus on this is having a positive impact on the working experience of our staff.
LSCft’s other most improved scores since 2020 related to better relationships and support between managers and their teams.
The Trust saw an increase in staff saying their managers give feedback (scoring 70.5%) and managers asking the opinion of their staff increased to 64.9%.
The theme of recognition and reward also scored highly for the Trust with an increase in score for staff feeling managers valued their work, and staff showing appreciation to one another scoring above sector average at 77.4%.
A further key area of improvement this year is a significant increase in staff feeling able to raise concerns which has gone up by 4.5% to 78.5%. This is incredibly important and contributes greatly to our commitment to safety in our services, higher standards of care and valuing our staff. It reflects a growing confidence in our workforce that they will be listened to.
Continuing work around Freedom to Speak Up Guardians and Listening into Action as a means of capturing and acting on regular feedback is reflected by this much improved score.
The survey also highlighted areas for improvement, including flexible working, individual learning and development (relating to appraisals and training) staff wellbeing and staff experiencing violence from patients and service users.
We are already working to improve several of these areas with the imminent introduction of a new flexible working policy and an assessment of the quality of our appraisals process, including the introduction of a new wellbeing section. Our next wave of Listening into Action has a programme on reducing violence which is a key priority.
I am delighted that LSCft is now a People Promise exemplar site. This means we will be working closely with NHSE over the next 12 months to ensure our staff’s experience of working here is the best it can be.
We will be working with NHS England and NHS Improvement’s People Directorate and a People Promise Manager will be within our organisation to lead our work as an exemplar site.
This work will be aligned to the NHS People Promise, developed in response to NHS staff who have set out what will most improve their working experience and make the NHS the workplace we all want it to be.
The Promise focuses on seven key elements (below) that align well with our own Trust values;
- We are compassionate and inclusive,
- We are recognised and rewarded,
- We each have a voice that counts,
- We are safe and healthy, we are always learning,
- We work flexibly, and
- We are a team
I was delighted to open a fantastic event organised by our Chief Nurse Chief Nurse, Maria Nelligan at Preston North End Football Club to mark and celebrate International Nurses Day on Wednesday 11 May.
We were joined by Andrea Sutcliffe CBE (CEO, Nursing and Midwifery Council) and Joanne Bosanquet, MBE RN (CEO, The Foundation of Nursing Studies) who, together with many of our own nurse leaders, shared their stories, inspiration and reflections.
Some themes for focus became apparent across the day, including the importance of delivering person centred care, our improvement journey and how we need to look after the wellbeing of staff.
Thank you again to all our nurses and everyone who took part in the event.
The Pulse Check is an important tool to check in with staff and get a snapshot view of how engaged and valued they are feeling.
We introduced Listening into Action (LiA) and the related Pulse Checks in 2019 and this year is the third time we have run the survey (we had a break during the pandemic).
Over 1,600 staff took part and told us how they were feeling and also, identified specific areas for change.
The results indicate that staff continue to feel significantly more positive in almost all of the 15 questions compared with the baseline when we started with Listening into Action in 2019.
Since then, we’ve seen a 6% increase in people feeling valued for their contribution; 11% rise in effective communication between senior management and staff; 11% increase in staff feeling the organisation supports them to develop and grow in their role; a 4% jump in staff feeling that the quality and safety of patient care is our top priority and a huge 17% improvement in the belief that day to day issues and frustrations are quickly identified and resolved.
We also had a significant improvement in our leaders views. The survey results from 2019 showed 9 areas that were above average out of 20 themes, the recent survey showed 17 above average out of the 20 themes. The 3 themes for improvement include, eliminating non-value added activities, prioritising important issues over urgent issues and having management system that enables staff to do their jobs well.
We received a phenomenal 1,270 ideas for change suggested through the free text comments. These included comments around patient care, leadership, staff health and wellbeing, IT, staffing and progression which have been fed into the themes for our wave three improvement programmes:
- Response to violence, aggression and abuse
- Healthcare Support Worker (HSCW) development
- Admin and clerical career pathway
- Meaningful co-production
- Shifting the balance (making the best use of time and focusing on more meaningful tasks)
3. We will deliver SAFE care and we will embrace an open and learning culture, ensuring we continually improve
The National CAMHS GIRFT (Getting It Right First Time) has highlighted good practice at The Cove following the success of its new inpatient model.
Based in Heysham, The Cove is our 14 bed General Adolescent Unit providing inpatient care to young people. The service’s new inpatient model has been hailed in the national report as an example of good practice.
The report highlights how The Cove improved through a change in the admissions process, redesigning its environment and improving flow and capacity.
The Cove co-designed areas of the unit in co-production with young people, ensuring it is safe, comfortable and age appropriate.
As a result, the report reflected, we’ve upgraded notice boards and signage and focussed on eliminating potential ‘flash points’ and conflict. Lounge areas and a readily accessible quiet space away from the ward together with co-produced wall murals have created an environment to meet young people’s sensory needs.
The changes are improving a clear and positive impact on the experience of young people at the point of discharge, evidenced in reduced readmission rates.
Miranda Budd, Consultant Clinical Psychologist and the TAPPs/APPs team have been nominated for the Ruth Young award for research implementation at the North West Coast Research and Innovation awards. The award recognises research initiatives or partner collaborations that have enhanced or improved frontline delivery to service users.
Miranda and the TAPP team have been recognised for their work with general practice and community settings to implement findings about effective mental health prevention and promotion interventions.
The winner will be announced at an awards ceremony on Thursday 23 June.
Good luck to Miranda and the team.
4. We will respond to people’s needs by striving for the highest STANDARDS of quality, proactively reducing health inequalities
Lancashire and South Cumbria ICS, of which we are part, has now achieved the national standard for Urgent Community Response (UCR) which was introduced in the NHS Long Term Plan, to ensure that rapid services are available to all people within their homes or usual place of residence including care homes. The achievement of this national standard includes the completion of the following actions by March 2022:
- Providing a consistent service at scale: ensuring full geographical coverage of a two hour UCR
- Providing services from 8 am to 8 pm, seven days a week, as a minimum
- Accepting referrals into two hour UCR services from all appropriate sources
- Submitting complete data returns to the CSDS to demonstrate the achievement of the two hour standard
The new Urgent Community Response (UCR) service and Single Point of Access (SPoA) covering Greater Preston, Chorley and South Ribble launched on 28 March 2022.
The service based at Leyland House, is staffed by care navigators and clinical triagers, made up of advanced clinical practitioners, therapists and nurses.
Embedding and enhancing clinical pathways has been a key focus, and the service continues to work closely with partners to maximise referrals from primary care clinicians, NHS 111, North West Ambulance Service, Lancashire Teaching Hospitals Emergency Department, MAU and SDEC. Between 28 March and 30 April the service received a total of 444 referrals, of which 354 were appropriate for the 2 hour UCR pathway. 82% (versus a 70% target) were responded to within 2 hours.
The ICS will now begin to work on the next set of two hour UCR requirements set out in the 2022/23 national planning guidance.
Mental Health Awareness Week (9 to 15 May) is an annual opportunity to raise awareness of mental health, give people the chance to share their stories and provide resources so that people can access help or improve their wellbeing.
The week helped to raise awareness of the impact of loneliness on mental health and the practical steps we can take to address it.
LSCft used the week as an opportunity to highlight the work of some of our key services.
Our Resilience Hub appeared on ITV Granada Reports and Perinatal Consultant Psychiatrist Gill Strachan featured on Rock FM, Smooth FM and Heart Radio discussing our Perinatal Partner Pathway.
The Trust is delighted to announce that Dr Heba Elrafei, has been appointed as the LSCft Royal College of Psychiatrists - College Engagement Network representative.
Dr Heba is an Acting Consultant Psychiatrist in the South Ribble and Chorley START team and has been appointed into the role for three years.
The College Engagement Network (CEN) is a team of representatives from mental health trusts and College regional divisions, who act in an advocacy role working with local decision makers, stakeholders and the College to help support implementation of the NHS long term plan.
The CEN will help RCPsych increase its understanding of views and concerns that trusts have on mental health policy to help inform national level stakeholder work. The benefits of the CEN is having more direct access to College expertise and advice as they translate NHS England and Improvement priorities into workable plans.
5. In order to support our local communities by excelling at everything we do together, we will always collaborate with our SYSTEM partners
The Care Quality Commission (CQC) has recently completed a system wide inspection of urgent and emergency care (UEC) pathways.
The inspection process lasted approximately 8 weeks (from mid-March) and was a themed system review around the patient journey through the urgent and emergency care pathways encompassing all services, including primary care, community dental, out of hours, 119/111, emergency departments, community services and mental health services.
The CQC looked at aspects including handover of patients, handover of risk and how shared risk works, access to different organisational IT systems and sharing patient information, timeliness of access to services, environment etc.
As a provider involved in this system wide inspection, LSCft will receive feedback and inspection reports in the usual way, with an additional system wide finding summary to highlight how our services work as part of urgent and emergency care pathways. Early feedback from the CQC was positive about our services and staff involved in the urgent care pathway, and the improvements made were noted.
The Lancashire and South Cumbria New Hospitals Programme has announced its shortlist of proposals for new hospital facilities in the region, marking an important milestone in transforming care and reducing health inequalities for local people.
The shortlist of proposals is a significant development in the programme, which plans to develop new, cutting-edge facilities, offering the absolute best in modern healthcare and addressing significant problems with the ageing Royal Preston Hospital and Royal Lancaster Infirmary buildings.
The shortlisted proposals are:
- A new Royal Lancaster Infirmary on a new site, with partial rebuild/refurbishment of Royal Preston Hospital
- A new Royal Preston Hospital on a new site, with partial rebuild/refurbishment of Royal Lancaster Infirmary
- Investment at both Royal Lancaster Infirmary and Royal Preston Hospital, allowing partial rebuilding work on both existing sites
- Two new hospitals to replace Royal Lancaster Infirmary and Royal Preston Hospital (new sites)
In line with NHS guidelines, the shortlisted proposals will be benchmarked against options for no change to, and/or limited investment in, Royal Lancaster Infirmary and Royal Preston Hospital to address the list of tasks that need to be performed to repair or maintain the buildings and keep them in a suitable working condition.
The shortlist reflects extensive feedback gathered from more than 12,000 local people, patients, NHS staff, community representatives and stakeholders over the last year, using online workshops and surveys, public opinion research, focus groups, and in-person events and meetings.
Following detailed analysis of each shortlisted option’s feasibility, the programme will follow a clear process over the coming months, with scrutiny and approvals needed from decision makers within the NHS, the government and local authorities, and ongoing patient and public involvement, before the preferred option is agreed.
6. We will provide SUSTAINABLE services that are delivered in an effective and efficient way, at the time people need it
Every month we host an ‘Engage’ event where around 200 of our leaders from across the Trust come together to share good practise and key messages. The April event focused on health inequalities.
We have a role in positively affecting health inequality through means other than direct care. For example, through our support to the local economy, recruitment efforts and employment initiatives, service user and carer involvement, and our policies.
We welcomed Pastor Mick from Church on the Street to the event as our guest speaker. Born out of Mick’s own lived experience as someone in recovery from drug and alcohol addiction, Church on the Street (CoTS) works to tackle poverty and improve access to food, support and health and care services for some of the most vulnerable members of our communities.
Mick gave a raw, moving and honest description of the reality of life for many people the extraordinary lengths that his charity are going to, to help people in need.
Our Burnley Community Mental Health Team have been supporting CoTS with weekly drop in sessions and they have had a huge impact.
During the event LSCft made a commitment that we would look at putting in place more ways that we, both as a Trust and as individuals, can offer support to Pastor Mick, CoTS and the people he helps and continue to be proactive in reaching out to our service users when they may be at their most vulnerable.
The work our Health Advice Resilience Recovery and Information (HARRI) Bus does in helping tackle health inequality in Muslim communities across Lancashire features in a new free online university short course.
Recovery and Resilience Senior Operational Manager Hasan Sidat worked in conjunction with Cardiff University’s Centre for the Study of Islam in the UK, to deliver a free Future Learn ‘Understanding Muslim Mental Health’ course.
Hasan has visited local mosques with the HARRI Bus to talk about mental health and help #SmashTheStigma, engaging Imams and at the same time educating them, discussing concepts like mindfulness, or Muraqabah, empowering them to educate Muslims worshipping at the mosque.