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Annual Review 2011/2012. Caring for the capital.

Your partner in care & improvement


02_Camden and Islington NHS Foundation Trust

Introduction C&I transformed its services this year to further develop our high quality care, increasingly tailored to people’s needs, with reduced funding from our commissioners. We developed a new clinical pathway for our community-based services, re-organising our teams in line with a specialised model based on service user needs. We also transformed our inpatient provision. Over 97% of people using our services are seen in a community setting, including their own homes. The Care Quality Commission rated C&I as performing ‘as expected’ or ‘above expected’ in the five core measures, and we achieved all of our CQUIN targets for quality and innovation. In addition, we are pleased to report that we achieved all our financial targets, delivered £12.2m of savings and ended the year with a healthy £2m surplus. We are very proud of what we have achieved, thanks to all the incredible hard work and dedication of our staff.

Your partner in care & improvement

Dr Sylvia Tang Medical Director and Deputy CEO


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Contents

Chairman’s & CEO’s Letter......04 Integrated Care........................06 Calendar....................................08 Quality and Innovation............10 People........................................14 Financial Summaries................16 About C&I..................................18

Annual Review 2011/2012. Caring for the capital. Claire Johnston Director of Nursing and People


04_Camden and Islington NHS Foundation Trust

Chairman’s and CEO’s Letter. “None of these achievements would be possible without the hard work and professionalism of our staff.”

A Year of Integration and Innovation 2011/12 saw more change than almost any other in the trust’s history and we are very proud of what we have accomplished. Last year, the government announced and began to implement a wide range of changes to the NHS, including the transfer of the commissioning of services to new GP-led bodies. In this uncertain period, we faced a wide range of challenges, including the need to make substantial savings, which we believe to be the highest in percentage terms of any Foundation Trust. Growth and Innovation

Community Services

We continually innovate across all our service lines and we are very proud of our achievements this year:

During the year, we developed and published a new clinical pathway for our community-based services. Over 97% of people using our services are seen in a community setting, including their own homes.

• Our Head of Psychological Therapies, Professor John Cape, chaired the working group that updated the NICE Anxiety clinical guidelines; • We now have Improving Access to Psychological Therapies (IAPT) workers linked to every GP practice across both Camden and Islington; • We implemented a joint mental health and social care case record and introduced electronic links to GP systems to automate the delivery of discharge letters and assessments; and • We have played a crucial role as an executive partner of UCL Partners, one of only five Academic Health Science Centres in the country.

This innovative model includes the adoption of assessment and advice teams in both boroughs, as the key point of referral for GPs and other professionals and as the key point of access to our services. This means that we have more specialist expertise, with a focus on achieving recovery for people in various groups.


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Inpatient Services Following the public consultation at the start of 2011, we have transformed our inpatient provision and reduced our inpatient beds by 30%. New wards were created at both Highgate Mental Health Centre and St Pancras Hospital, to accommodate inpatients transferred across from Queen Mary’s House and the Grove Centre. These offer better facilities, including specialist provision for older people and more en-suite rooms.

Rehabilitation Pathways We held a public consultation on the future of our rehabilitation inpatient provision in the Woodside Houses on the St Luke’s site in Muswell Hill. The outcome of this was a recommendation to invest in creating new wards on the St Pancras Hospital site to replace the dated houses, which no longer meet modern standards.

Efficiencies in Estate and Facilities 2011/2012 saw significant changes in our estate, aimed at both improving the working environment, as well as cutting unnecessary costs. As well as the changes detailed above, we have moved the Elthorne Community Mental Health Team into Lowther Road, to work alongside the Archway and Drayton Park Community teams. We also vacated our Bath Street site by moving the South Islington Crisis Team to Highgate Mental Health Centre and the Assertive Outreach Team to Greenland Road. We sold the historic St Luke’s site to Hanover Housing Trust, releasing £26m in funds for future capital investment. They are planning an innovative co-housing development for St Luke’s. We integrated a large number of back office services across all our sites, awarding a contract to Balfour Beatty Workplace to provide a wide range of services from catering and security to maintenance.

A rewarding place to work None of these achievements would be possible without the hard work and professionalism of our staff. We recognise that this has been an exceptional year of change and we thank them for their forbearance, dedication and the invaluable service they provide to all our service users, carers and families. We would also like to thank the Governors for their active support this year.

“It’s always a frightening and desperate experience when you are first admitted, but Dunkley Ward felt like a safe place. The staff were open and willing to listen to me whenever I needed them. They wanted the best for me and it made a difference knowing that someone was there. The consultant discharged me only when she was satisfied that I was well enough to go home, and that made a great, long-term difference. I’ve been on other wards in the past where I’ve been discharged more quickly, and that is not always helpful.” Two years ago, Sally Jacobs was an inpatient on Dunkley Ward at the Huntley Centre at St Pancras Hospital, where she was treated for bipolar disorder. Richard Arthur Chair

Wendy Wallace Chief Executive


06_Camden and Islington NHS Foundation Trust

Integrated Care “Thank you so much for everything. I feel empowered and strong. Don’t know what tomorrow will bring, but I know I’ll try my best.”

IAPT: Success and National Pathfinder Status 2011/12 was a successful year for the IAPT (Improving Access to Psychological Therapies) team. Not only has C&I become a national pathfinder for the provision of IAPT to support Long Term Health Conditions and the treatment of Medically Unexplained Symptoms, but the Islington IAPT service is one of two London services piloting IAPT Payment by Results. In 2012, every GP practice in Camden and Islington has linked IAPT workers, making psychological therapies much more accessible. In addition, C&I is now developing clinics in a range of community venues. C&I actively works with GP practices to offer a whole range of easily accessible interventions, in order to encourage self-management and wellbeing among service users. This is particularly important when supporting service users who have long term health conditions or medically unexplained symptoms as these groups are at greater risk of mental health problems. The IAPT team is also working closely with Substance Misuse Services (SMS) in order to develop more integrated pathways so that patients don’t get bounced from service to service.

Working together to reduce the rate of recall to prison of offenders with a personality disorder The IMPACT project was originally funded by the Impact Fund of the Ministry of Justice and is now funded by the London Probation Trust. The services are jointly managed and provided by C&I and London Probation Service. The project works with a range of agencies including third sector organisations - Public Protection Unit (Islington and Camden Police) and Social Services - to reduce the rate of recall to prison of offenders with a personality disorder living in the community on license. The project has been very successful and funding has been extended. In addition to delivering a service to Camden and Islington, the project has now been extended to cover Brent. The success in reducing the re-offending rate was still maintained in 2011/12.


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Kidstime: Supporting young carers The distinct needs of children who care for a parent with mental illness remain relatively hidden - and often misunderstood. As a result, children often fail to receive an adequate explanation of their parent’s illness and may feel that they are in some way responsible, or at risk of developing the illness themselves. For this reason, in 1999, Consultant Psychiatrist Dr Alan Cooklin established Kidstime Workshops, which are monthly family group sessions lasting for 2.5 hours. Originally created to help parents explain mental illness to their children, the service now provides information, resources and support for children and young people who are affected by mental health issues in their family. A total of 27 families attended workshops in Camden and Islington this year, of which 15 were new referrals, compared to 21 families who attended in 2010/11. Recent evaluations show that these can significantly diminish the children’s levels of distress and disturbance. An adolescent’s group called Teen Talk was established in November 2011, after an evaluation showed that the Kidstime workshops weren’t addressing the needs of older children and teenagers. This has been well-received with14 young people attending the Teen Talk workshop in the six months from November to May. The Experience Counsellor model has also been established this year. Experience Counsellors are young people who are graduates of the Kidstime programme who are now acting as helpers and running some of the groups.

Working with partners to establish an integrated care pathway for rehabilitation and recovery Historically, significant numbers of service users who need accommodation have been placed out of the area, a long way from home. The Hostels Pathway has been set up to establish a pathway back into local services. Working in partnership with the local authorities, C&I has spearheaded a number of innovative projects, including the development of a small block of one-bedroom flats with 24-hour, on-site support. In the last few years, the trust has established 36 units of housing and this has massively reduced the number of people living in out of area residential placements. These measures have helped to establish an integrated care pathway for rehabilitation and recovery, which assists service users in the transition from hospital to outpatient and community placements. This pathway is tailored to individual needs and the trust has put a lot of intensive work into helping people live in less restrictive environments.

“When you go to the Kidstime Workshop you feel like you have somewhere where you’re not alienated or an outcast from people at school whose parents don’t have the issues that your parents have. Another important thing for me was to learn about mental illness in a very gentle way from people who know exactly what they’re talking about.” Kirsty, Experience Counsellor, Kidstime.

“The Crisis Team were very helpful and worked with my GP, CMHT and UCH. It helped to know they’re there for me at all times.”


08_Camden and Islington NHS Foundation Trust

Calendar May 2011 - Spiritual care and mental health April 2011 - Integrating Care We welcomed former NHS Islington employed staff of iCope Islington Psychological Therapies and Wellbeing Service into the Trust on 1 April. This integrates care from GPs through to our full range of services in a ‘single care pathway’.

More than 100 people, a balance of service users, staff and people from the wider community, attended our Spiritual Care and Mental Health conference. The day comprised presentations from people of different faiths and with different experiences encompassing the service user, hospital chaplain, faith leader in the community, and psychotherapist perspectives.

Apr’11 May

Oct

October 2011 - Raising awareness of mental health Our Annual Members Meeting at the Emirates Stadium showcased three remarkable services for local people: • ‘Down Your Drink‘ - a web-based initiative which has helped people reduce the amount of alcohol they consume; • The Trust’s unique work with young men in local gangs (in partnership with MAC-UK). Outreach to these young people at street level cut reoffending rates by 70%; and • The Impact project has cut prison recall rates among offenders with personality disorders by 49%, helping them to safely integrate into the community.

Nov

November 2011 - Developing our workforce The first direct care worker forum was specifically developed for bands 2 to 4 workers in direct care roles. A variety of workshops, presentations and discussions focused on role development, personal development, career pathways, role accountability and regulation.

June 2011 - Supporting our nurses Nearly 200 mental health and substance misuse nurses attended the annual Nursing Forum. The packed day included a keynote address from Jan Goldsmith, Professional Adviser, Education, Nursing and Midwifery, along with a number of workshops.

June

Dec

December 2011 - Recognising excellence We celebrated our staff, service users and carers at our C&I Awards, where the trophies were presented by Bill Oddie, conservationist and TV presenter.

- Celebrating our women-only services Drayton Park – our women-only crisis house – held an open day to mark their 16th anniversary.


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August 2011 - Embracing technology July 2011 - Effective leadership The Health Service Journal featured a report on research by Manchester Business School on board effectiveness. Just 19 NHS organisations were highlighted as highly effective; C&I was one of four mental health trusts to receive this accolade.

July

C&I were chosen to be the first trust to implement the latest version of the electronic patient record system, RiO. The ‘First of Type’ Trusts to go live are selected because they have robust systems and a successful track record in deployment. The new upgrade tracks compliance with the Mental Health Act, supports CPA reviews and risk assessments and can manage the care pathway from referral to discharge.

September 2011 - Improving staff wellbeing We held the Employee Health and Wellbeing Event to help support the health and wellbeing of our staff. Attendees had the opportunity to engage on a one-to-one basis with a wide variety of organisations, all offering extensive information and support around all aspects of health and wellbeing.

Aug

Sep

Jan’12 Feb

Mar

January 2012 - Involving carers

We held a well-attended event for carers, which was organised in conjunction with our Governors. People heard how we are involving carers more with people in crisis (Triangle of Care) and also about our Carers Strategic Work Plan.

- How are you feeling today? Every household in Islington received an iCope flyer as part of our successful advertising scheme. This led to an increase in referrals to this IAPT service.

February 2012 - Improving community services Our staff consultation on Improving Community Services concluded. Our proposals included setting up a single assessment and advice team per borough; removing agerelated barriers to accessing our services and increasing the capacity of our assertive outreach services, something service users have told us they value highly.

- Working with veterans We start providing specialist psychological support to combat veterans commissioned by NHS Kingston in partnership with a voluntary provider, Combat Stress, and South London and Maudsley NHS Trust.

March 2012 - Integrating Care Our public consultation into a proposal to develop a new community service for older people concluded. This was undertaken in order to provide an alternative to hospital admission and to support early discharge from hospital, merging the services provided at Camden Mews and Piercy Day Hospital into the Camden Mews site.


10_Camden and Islington NHS Foundation Trust

Quality and Innovation Quality

During a year of great structural change within the Trust, in which we developed new clinical pathways for community-based services, C&I has continued to successfully meet all the standards of care set out by the Care Quality Commission (CQC), Monitor and NHS Litigation Authority Risk Management Standards. In addition, the trust has achieved AIMS-Rehab accreditation. This new rehab-focused accreditation process for mental health services was launched by the Royal College of Psychiatry in 2011/12 and of the 16 pilot services included in the process, two were the Trust rehabilitation wards. Both Montague Ward and Malachite Ward were successfully accredited, which is a testament to the excellent care they provide. The further development of clinical care pathways has also been a great success and Department of Health figures in 2011/12 have shown that, relative to need, C&I is the most effective Trust in London in avoiding hospital admission and enabling service users to receive care in community settings. This has been achieved despite the fact that Camden and Islington have the highest rates of psychosis in the country. Since the implementation of the CQC registration system in April 2010, the Trust has been assessed on three occasions with visits to three different locations. On each occasion, the CQC found the Trust compliant with all sixteen quality standards. The CQC’s primary tool for assuring safety in healthcare providers on a continual basis is its Quality Risk Profile (QRP). The Trust has continued throughout 2011/12 to show a very positive picture in its QRP. As with previous years, the Trust had agreed with its commissioners a very ambitious set of quality targets and initiatives through its 2011/12 Commissioning Quality and Innovation (CQUIN) programme, and has met the great majority of these. In 2011/12 the Trust has set up a further Clinical Quality Group. This group, chaired jointly by senior clinicians, has further developed effective processes for ensuring that national best practice is implemented and monitored. In addition, the Trust has further developed its set of online quality and performance management dashboards available to staff to allow them to monitor performance in a more dynamic way than ever before.


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Physical Health (CQUIN) This was a CQUIN area identified by commissioners across London in 2011/12. This concern relates to extensive evidence that mental health service users suffer significantly worse physical health outcomes than the national average. A table below provides information on the specific indicators used to monitor this CQUIN and results achieved throughout 2011/12: Target 2011/12 Result % of service users with full mental health and physical health diagnoses recorded

90% 90%

% of service users with a high mortality physical health diagnosis recorded who have been helped to access relevant physical health checks

60% 90%

% of inpatients with documented medicine reconciliation within care plan within 72hours of admission % of service users for whom discharge letter has been sent to GP within 1 week of discharge

100% 100% 70% 83%

Research excellence as part of UCL Partners C&I is a member of University College London Partners, one of the world’s leading academic health science partnerships. In 2011/12, Trust researchers have been successful in gaining research grants. This has enabled C&I to receive £466,170 in Flexibility and Sustainability Funding, which is a significant increase on the £266,372 received in 2010/11. The number of patients receiving NHS services provided or sub-contracted by Camden and Islington NHS Foundation Trust that were recruited in 2011/12 to participate in clinical research approved by a research ethics committee was 1187 from 21 trials, an increase of 51% on last year’s recruitment figures of 786. 29 new projects were registered in the past year (16 non-funded studies and 13 funded), bringing the total number of projects registered as being active in the Trust that year to 79 (48 unfunded and 31 funded). Staff associated with the Trust have published 242 articles in peer reviewed journals over the past year; the significant number of projects and publications that the Trust supports demonstrates our continuing commitment to improving patient care through research. There have also been some important clinical impacts as a result of the work undertaken. From 2007 to 2010, Dr Helen Killaspy was the Chief Investigator for a pan-European study involving ten countries that developed the Quality Indicator for Rehabilitation Care (QuIRC), a quality assessment tool that is completed by managers of longer term mental health units. The QuIRC has been incorporated into the Royal College of Psychiatrists’ accreditation system for inpatient rehabilitation units (AIMS-Rehab) and the European Commission are interested in using it as a European quality benchmarking tool.

“Thank you for the work you do. You are all very caring people, and it’s great to know you’re there”


12_Camden and Islington NHS Foundation Trust

Quality and Innovation (cont.) “Assessment and Advice Teams in Camden and Islington are the key point of referral for GPs and other professionals”

Innovation Integrating Services In 2011/12, C&I began to realign services into care pathways, based on NICE evidence and current commissioning. In order to achieve this, C&I has allocated staff so that their skills are best used to deliver the necessary interventions. Many support tasks can be done safely by trained support workers under the supervision of a care coordinator and the Trust has also reduced the number of staff managing services in order to increase the number of staff delivering care and skilled treatments. The remodelled community teams were successfully piloted in 2011/12 and have been reconfigured to offer more focused support to people being treated in the community. Now, all service users coming into the system are assigned a care pathway based on need. The Assessment and Advice Team now act as the first point of contact for most referrals in Camden and Islington. These improvements created easier and quicker access to the right service, making evidence-based treatments more available to the people who need them. This helps to sustain recovery through increased access to education and employment opportunities and developing a substance misuse model that re-orientates the treatment philosophy away from a harm reduction model to a recovery model. The new teams and services have already delivered financial results. The second Quality, Innovation, Productivity and Prevention (QIPP) programme was launched in 2010, with the aim of delivering efficiencies in excess of the national average over a three-year period for the Trust. The QIPP has completed its second year, achieving savings of £12.2m in 2011/12.

Working flexibly to meet people’s needs Assertive Community Treatment (ACT) or Assertive Outreach Treatment (AOT) is a welldefined service delivery model for the care, support and treatment of severely mentally ill (SMI) people in the community. The service delivered by C&I in Islington currently holds national demonstration centre status for social inclusion and recovery. The main function of this service is to engage service users who have experienced difficulties maintaining an ongoing therapeutic relationship. The ACT team is multi-disciplinary and operates with smaller caseloads, placing an emphasis on practical engagement strategies that encourage the development of strong therapeutic relationships and evidence-based clinical interventions. In 2012, the Community Outreach Service was remodelled, based upon a stepped care model from the Netherlands. It will provide high intensity intervention for the most severely mentally ill service users (ACT) and a less intensive rehabilitation and recovery orientated service (FACT) for those who are in a better position to self-manage their illness. FACT (Functional Assertive Community Treatment) is a rehabilitation and recovery orientated clinical case management model, which is based on the ACT model but is more flexible and able to serve a broader range of service users with SMI. The ACT model involves all workers acting together, thinking together in decision making and sharing responsibilities towards all service users. It is based on the idea that continuity of service is best offered by shifting the fostering of dependency of the service user from the individual worker to the team as a whole. This means that staff burnout can be reduced and the team focus offers greater long-term dependability and reliability for service users.

“Thanks for doing what you did. Your help and caring calmed me down and gave me soothing relief. I’ll always think of you with a grateful heart. You are very special people.”


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Substance Misuse Services: A new approach Substance Misuse Services (SMS) manages drug and alcohol services across Camden and Islington. In December 2010, the Government unveiled a new drug and alcohol strategy with the intention of helping more service users to achieve abstinence and recovery and cease treatment. This differs from the previous method, which was focused on getting service users into the treatment process and retaining them in long-term care to protect them from harm. This change has resulted in a large practise and culture shift as SMS now use more empowerment training to help service users to think about what life after treatment will entail. This recovery focus means that C&I is integrating treatment with employment, training and education support and making sure that there is adequate after care provision to prevent relapses. In addition, Camden Alcohol Service now offers a new service in collaboration with Crime Reduction Initiatives (CRI). It involves outreach - finding drinkers - filtering them and providing community detox and/ or day programmes, and/or residential rehabilitation, depending on their needs.

The Memory Service: Early diagnosis helping people get the care they need Memory Services in Camden and Islington were fully established three years ago in line with the recommendations of the National Dementia Strategy. Since then, Memory Service activity in both boroughs has exceeded expectations. In 2011/12 over 900 people were referred to the Memory Service and in March 2012 over a 1,000 patients were receiving a service, from the two teams. In addition to assessment and diagnosis the service provides a range of multi-disciplinary therapeutic interventions including Cognitive Stimulation Therapy, one-to-one Psychology for carers and access to assistive technology. Memory Service Advisors work within the Teams from Age UK and the Alzheimers Association to support service users and carers after diagnosis through signposting to a wide range of external support services. As a result of their work in the Memory Service in 2011/12, Occupational Therapist Christopher Denney and Support Worker Lucy Harvey both won C&I Staff Awards.

The Margarete Centre has also been refurbished, creating a drug recovery centre for South Camden. It now houses support groups which are led by ex-service users.

The AOT received national demonstration status by the National Assertive Outreach Forum for a novel service, which involved the creation of a magazine group led by former service user, Andrew Fallon. Andrew says: “I was part of the editorial team from the beginning and my involvement in the magazine has been part of a personal journey for me and others whose development I have seen the magazine contribute to. When I first started on the magazine I was a service user of the Assertive Outreach Team - I am now discharged from the AOT. Whilst being part of the editorial team, I have completed an access course and a degree. Coming to the group every week gave me a break from my studies which, at times, were very intensive, especially when I was revising for exams and when completing my dissertation. I am very proud of the magazine and helping other service users has empowered me - and hopefully them.�


14_Camden and Islington NHS Foundation Trust

People

In this challenging year, we have achieved virtually all of our targets thanks to the phenomenal efforts of our dedicated and professional team of staff. We are especially proud of our clinicians who have an international reputation for research and development, and the frontline staff who continue to deliver excellent care in these uncertain times. Here we celebrate just a few members of the C&I team whose work has made an impact in 2011/12.

“We are especially proud of our clinicians who have an international reputation for research and development”

Kate O’Brien

Dr Helen Killaspy

Kate is a Blood Borne Virus Lead Nurse who provides new service users with the opportunity to be tested for hepatitis and HIV. She runs a number of satellite clinics at local hostels.

Dr Killaspy was the Chief Investigator for a pan–European study that developed the Quality Indicator for Rehabilitation Care.

Kate is the Blood Borne Virus Lead Nurse at Camden Drug Services, working from the Margarete Centre. This is a new service for C&I and Kate has been in post since November 2011. The programme has been a success as testing services are now offered to 80% of new service users. Kate also offers the hepatitis B vaccination, and the completion rates for this are very high. In addition, the engagement at satellite clinics is almost at 100%.

Sally Jacobs Sally has been shortlisted for the RCPsych service user contributor(s) of the year 2012. Sally was the service user researcher on the Closing the Gap project at the Huntley Centre and has been shortlisted for the RCPsych Service User Contributor(s) of the Year 2012 as a result of her work. As a former patient of the St Pancras Huntley Centre, Sally helped to make the research questionnaire more user-friendly and also interviewed patients to find out how the ward was functioning. During the course of a year, she found that patient satisfaction improved and staff were trained more effectively.

From 2007-2010 Dr Helen Killaspy was the Chief Investigator for a pan-European study that developed the QuIRC assessment tool that is completed by managers of longer term mental health units. The tool is available online at www.quirc. eu and reports results on seven domains of care in an easy to understand report that the unit manager can print off. The QuIRC has been incorporated into the Royal College of Psychiatrists’ accreditation system for inpatient rehabilitation units (AIMS-Rehab) and the European Commission are interested in using it as a European quality benchmarking tool for these kinds of facilities. It is also being used in the Rehabilitation effectiveness and activities REAL study and the Trust has now gathered comprehensive data assessing the quality of NHS inpatient rehabilitation units across England.


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Professor Steve Pilling Professor Pilling chaired the NICE Depression Quality Standards and Commissioning Outcomes Framework. Professor Steve Pilling is a senior clinical psychologist in the Trust and an academic in UCL. In 2010/11 the group he runs developed NICE guidelines on alcohol and depression. The latter guideline continues to underpin the IAPT programme and has been the major development in psychological therapies in the UK. In addition, his work on competences frameworks has been used to develop the curriculum and training sessions for both adult and child IAPT programmes. He has also chaired the NICE Depression Quality Standards and Commissioning Outcomes Framework, which will set the developmental standards for the NHS in England.

Professor Gill Livingston Professor Livingston led the CHOICE Optimisation for Carers study, which identified the difficult decisions that family carers commonly face. Professor Gill Livingston is a senior academic in Psychiatry of Older People at UCL and an Old Age psychiatrist at the Trust. She led the CHOICE study, Choice Optimisation for Carers, the results of which were incorporated in illustrated factsheets for family carers and published in the British Medical Journal. They are currently being used in the NHS and in memory clinics across the country, as well as being part of an intervention for carers which is being tested in her strategy programme, the START study. Leaflets have also been disseminated to patients and the public thorough organisations including the Alzheimer’s Society members’ magazine, the Communication Workers Union, Intercontinental Hotel Group, BT, TUC and the Design Council. In addition, her work with clinical academics Martin Blanchard and Claudia Cooper on the determinants of elder abuse has been used by the World Health Organisation to inform their recommendations about the scale of elder abuse and management.

Dr Angela Hassiotis Dr Hassiotis has led on several service developments including integrated service for adults with disabilities and mental illness and developed and evaluated a complex behavior service. Dr Angela Hassiotis is a clinical academic and honorary Consultant Psychiatrist in Learning Disabilities at C&I, where she is based within the Camden Learning Disabilities Service. She is a Reader in the Mental Health Sciences Unit at UCL and a NICE Fellow. She has led on several service developments, firstly in the area of mental health where, with colleagues, she developed an integrated inpatient and community service for adults with intellectual disabilities and mental illness and, secondly, in challenging behaviour where she developed and evaluated a complex behaviour service. She is now focusing on issues relevant to the implementation of NICE guidelines within the newly developed service lines in C&I and will investigate how guidelines can be implemented within care pathways in learning disabilities.

Lorraine Lloyd Lorraine won C&I Nurse of the Year, is a RiO champion and is involved in the development of Safeguarding within her service. Lorraine Lloyd, Nurse and Deputy Manager of Camden’s Assessment and Advice Team, won Nurse of the Year at our Nursing Forum. From 1999 to 2004 Lorraine worked on Dunkley Ward as a Staff Nurse and later as a Charge Nurse. She then joined the Regent’s Park Community Mental Health Team as a Community Mental Health Nurse, and in June 2009 she became their Acting Deputy Manager. In March 2011 she took on her current post as Deputy Manager of the Camden Mental Health Assessment and Advice Team. Lorraine was a member of the Assessment and Advice Team working group from the beginning. She is also the RiO champion for the service and is involved in further development of Safeguarding within the service. Lorraine has used the Assessment and Advice team as her live project as part of her Clinical Leadership Programme, which also involves numerous workshops and reflective practice.


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Financial Summaries

2011/12 2010/11 £000 £000

Operating Income from Continuing Operations

137,393

142,640

Operating Expenses of Continuing Operations

(132,652)

(136,453)

OPERATING SURPLUS

4,741 6,187

Finance Costs Interest Receivable

65

31

Interest Payable

(1)

(2)

(12)

(12)

0

0

PDC Dividends Payable

(2,766)

(3,109)

NET FINANCE COSTS

(2,714)

(3,092)

2,027

3,095

Other Finance Costs - Unwinding of Discount Other Finance Costs - Change in Discount Rate on Provisions

SURPLUS FOR THE YEAR

Other Comprehensive Income Impairments (2,957) (1,526) Revaluations

0

1,990

Other Reserves Movement

0

0

(930)

3,559

TOTAL COMPREHENSIVE INCOME FOR THE PERIOD Full accounts available on request from communications@candi.nhs.uk

Note: After accounting for non-recurrent, exceptional items, the Trust made an underlying surplus of £1,554k.


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Income Breakdown 2011/2012 The Trust’s income for the full year amounted to £137m, the majority coming from service agreements with Foundation Trusts, Primary Care Trusts, Strategic Health Authorities and NHS Trusts. £’000 SHAs, PCTs and NHS Trusts

67.9%

93,306

Foundation Trusts

0.6%

803

Local Authorities

6.9%

9,463

14.4%

19,762

Non-NHS Overseas Patients/Private Patient Income

0.0%

0

Profit on Disposal of Land and Buildings

4.4%

6,004

Other operating income

5.9%

8,055

100%

137,393

Education, Training and Research

TOTAL

Expenditure Breakdown 2011/2012 Total operating expenditure for 2011/12 was £133m, the biggest item being spend on staff. The breakdown of the Trust’s full expenditure is as follows: Services from NHS Organisations Staff Costs

£’000

5.6%

7,483

64.9%

86,103

Drugs

1.8% 2,451

Supplies and Services

4.6%

6,542

Establishment and Premises

3.5%

4,595

Depreciation

2.2% 2958

Impairment of Property, Plant and Equipment

2.6%

Other TOTAL

3,388

14.4% 19,132 100.0%

132,652


18_Camden and Islington NHS Foundation Trust

About C&I

Camden & Islington NHS Foundation Trust provides mental health, social care and substance misuse services to adults of working age, adults with learning difficulties and older people in the London area. We have an income of £130 million and employ over 1,300 people including nursing, medical, psychology, occupational therapy, social care, administrative and management staff. We deliver services to a combined population of 420,000 in our two main boroughs Camden and Islington, as well as additional services in the surrounding boroughs. Our service users come from diverse ethnic and social backgrounds encompassing the extremes of wealthy areas, such as Hampstead, and deprived areas, such as Somers Town. We also serve challenging groups including a large immigrant population speaking over 290 different languages and a transient population of young adults. In terms of quality we have improved services throughout the organisation and delivered, or exceeded, all our targets. The Trust is currently rated as performing ‘as expected’ or ‘above expected’ in the five core measures of the Care Quality Commission, which regulates the quality of our services. We also achieved all our financial targets for 2011/12 and ended the year with a healthy surplus of £2million. Our staff work in multi-disciplinary teams to provide a holistic approach to recovery, frequently this approach extends outside of the Trust to partner agencies and the voluntary sector.


Annual Review 2011/2012_Caring for the capital_19

“I found the crisis team very helpful and think that I would not have survived this terrible time in my life without being helped by them. I am sure I would have ended my own life as I could not cope at all. I very much hope that if I feel this bad ever again I could get the crisis team support again as it saved my life.�


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www.candi.nhs.uk Camden and Islington NHS Foundation Trust, 2nd Floor, East Wing, St Pancras Hospital, 4, St. Pancras Way, LONDON NW1 0PE

Switchboard and General Enquiries Tel: 020 3317 3500

Press Office Tel: 020 3317 3088/89 Fax: 020 3317 3130 communications@candi.nhs.uk


C&I Annual Review 2011_2012