Crisis? What crisis? New chief sets his priorities for mental health trust improvements
06:30 03 July 2014
The new boss of a mental health trust refuted suggestions that his organisation is in crisis, despite financial concerns and intense pressure on inpatient and community services.
Pledge on out of area beds
More than 100 NSFT patients were sent to out of area beds during 2013/14 to private hospitals as far afield as Darlington, Harrogate, Bristol and Brighton because there were no beds available locally.
Mr Scott said: “I have made it a priority from when I started to focus on out of area placements. When I began they were in the high 20s, they are different every day, but today [Tuesday] it is 12. It is coming down and that is because we have improved the management of beds in central Norfolk.”
“It is a central Norfolk problem and there are no out of area placements in Suffolk. I asked for an action plan and we are working with partners and stakeholders to get the number down. Our goal is to reduce that to zero and it is an attainable goal. This is a national problem, but for Norfolk people it is important we look after them in Norfolk,” he said.
Does there need to be more beds in Norfolk? He added: “For me it is too early to say. I know we can get those placements down and we need to invest in community services and we are already looking at new positions in the community. We are putting new investment into out of hospital alternatives. In King’s Lynn, we are working with Mind on alternatives to admissions. It is early days, but it is already successfully keeping people out of hospital.”
Michael Scott said he had witnessed many positives at Norfolk and Suffolk NHS Foundation Trust (NSFT) since he became chief executive four weeks ago.
However, he admitted that there was work to do to address pressure on beds, particularly in central Norfolk, and pledged to invest more in community services to reduce inpatient admissions.
Campaigners say that services at NSFT are in turmoil with some mental health patients having to be admitted to private hospitals 200 miles away because no beds are available and concerns about high case loads for community teams. Union members from Unison also issued a formal grievance to the NHS trust in February, calling the organisation to halt its redesign of services over fears about unsafe staffing levels and unmanageable workloads.
However, Mr Scott, said he did not agree with members of the Campaign to Save Mental Health Services in Norfolk and Suffolk who said that NSFT was in crisis.
“I have recognised we have pockets where we need to improve, but it is not a trust in crisis. I can take you to services in Northgate Hospital in Great Yarmouth where it is rated independently as excellent, Hammerton Court in Norwich is where we have state of the art facilities for people with dementia and there are youth services that have been commended nationally. It is a trust with some issues to tackle, but not in crisis,” he said.
Mr Scott, who has worked more than 30 years in the NHS, joined the mental health trust at the end of May after being CEO of Norfolk Community Health and Care NHS Trust. He said that his key priorities were to stop patients from being sent across the country for a non-specialist beds. He added that improving staff morale and providing new services were other key priorities.
“I have made it a priority to get out and meet front-line staff and services. I have found a very dedicated and caring bunch of staff, some excellent services and really committed and caring people,” he said.
The mental health trust has reduced bed numbers by 20pc and cut around 400 jobs as part of a restructure of services to find £40m of efficiency savings over the last two years.
Plan to raise staff morale
NHS staff survey results revealed earlier this year that more than half of mental health staff in Norfolk and Suffolk said they had suffered work-related stress in the last year. More than 40pc of mental health workers said they had witnessed potentially harmful errors or near misses at NSFT and the percentage of mental health workers feeling satisfied with the quality of work and patient care they are able to deliver dropped from 71pc in 2012 to 66pc in 2013.
Mr Scott said he was keen to improve staff engagement to increase morale and reduce high sickness levels amongst the workforce.
“It is difficult times in the NHS nationally. Mental health services are having to make efficiencies and in some places staff have understood that and in places they have not. It is my job to make sure we listen to staff and act upon what they say. I believe very much in devolved management. The front-line often know what is best for service users if you need to make changes and improve, the people that do that job are best placed to make those decisions. In my previous role I improved staff morale year on year. It is not something you can do overnight and we will look to make improvements over the coming year.”
Mr Scott added that he was undecided about whether NSFT needed more inpatient beds.
He added: “I want to take the trust into new areas of work. We want to continue to provide the wellbeing service in Norfolk, we want to provide substance abuse services in Suffolk. We want to work with the Norfolk and Norwich University Hospital with people who come to A&E and work with people in the criminal justice system.”
A report last week warned that the mental health trust will need to find further efficiency savings of £44m over the next five years, if it does not receive a major increase in funding. The draft strategic plan for NSFT warned that workforce numbers could be reduced from 3,500 to 3,300 by 2019.
Mr Scott said: “It is my job to lobby locally and nationally for more funds for mental health. There are national rules and payment mechanisms that do not support mental health. Payment by results means more money is paid to acute hospitals and the difference is something like 20pc.”
“We need to work together with commissioners to encourage parity of esteem. The government are saying all the right things and it is my job to turn that rhetoric to a reality.”
Mr Scott added that he was looking to meet with members of the Campaign to Save Mental Health Services in Norfolk and Suffolk in the next week.
“I want to listen to what they have to say. I suspect we share some similar aims to improve mental health services, but I am not sure we have the same methods,” he said.
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