Team Brief October 2017

Team Brief October 2017 Slido.com – Event code #TB1017

Business unit updates

Adult mental health (AMH) ‘Right Care, Right Place’ (beds) • Hard-to-place panel supporting top 21 patients • Data gathering begun on all patients and area KPI dashboards: • admission objectives • discharge dates and SMART tasks • DTOC (Delays Transfers of Care), 30, 60 and 100 day stays.

Pathways implementation (AMH & OPMH) • Dissemination: consistency of diagrams and webpages • Rio screen being developed for allocation, outcomes, standards achieved and piloting with cluster algorithm • Care Programme Approach (CPA) and Care planning group Terms of Reference agreed Consistency of practice and resource • ‘Southern parishes’ work begun Crisis and access (with Sustainability and Transformation Plan (STP)) • Delivery unit exploring use of 111 • Acute mental health team: increase home treatment/day care

Learning Disabilities (LD) We are pleased to confirm that Chris Ainsworth Consultant Psychologist in the East LD team has been appointed as Interim Clinical Director Goal Based Outcomes are now available to be completed on Rio. Despite an exceptionally tight turn around we have successfully seconded six staff to complete a two year fast track Msc in Learning Disability Nursing. Two staff from the wider Trust have also been seconded, thank you to everyone who supported this.

The Best Support Register – this ‘At risk register’ is now up and running in Hampshire to support people with a learning disability at risk of hospital admission. Southampton are due to launch their register soon.

East Hampshire LD team are piloting an electronic GP referral form.

Quality – in our quarterly review of audit we were pleased that our compliance with audit is very good and the outcomes of audits have been very positive.

Although there is always room for improvement our results in audits have been excellent and a real credit to our staff.

Specialised services Low secure CAMHS now open and receiving young people Review of safer staffing has been undertaken and now in place across services.

Successful in securing funding to develop stalking services in collaboration with police.

Project plans for CAMHS development and Adult Forensic work underway Team days booked for November onwards for all services – cover will be from within the service.

ISD Business unit 1 South East Hants EMIS Community trial: Includes Petersfield/Bordon ICT, therapists and six GP Practices to effectively provide a single patient record between primary and community care as an enabler to better local care. Due to go-live with our EMIS Community trial at the end Oct/early Nov 17.

Frailty/CHOCs/ePCT Pilot: Has been running for 6 months now. Interim therapy findings/outcomes were very good and indicate a significant reduction in prescribing, GP consultations and improved care for the 83 patients .

LTCs: Plans are underway to develop a hub and Extended Primary Care Team

(EPCT) approach to deliver care closer to home for patients with long term conditions including Diabetes, Heart Failure and Cardio Vascular Disease (CVD).

Health & Social Well-being pilot (Mental health): Due to complete in Dec 17 and report early in 2018. Interim findings for the service at Bosmere Practice were good.

EPCT- Joint Leg Ulcer Clinics: A social enterprise model to provide three hub clinics staffed jointly by Primary and Community Care. Leg ulcer clinics are delivered in Havant & Waterlooville by Community and Practice Nurses

Gosport and Fareham MCP – New Care Model Accelerated Development Extended Primary Care Teams: As part of the ongoing vanguard teams are

coming together to work in a more collaborative way to support patients across primary, secondary and acute settings.

LTC: Based on initial analysis of non-elective admission data the three key areas of focus initially for the LTC hubs will be Diabetes, Respiratory and Frailty. Within the Willow Group work has been ongoing to standardise care across the sites for Diabetes; with clinics across the group being co-located at Forton Medical Centre and staff being brought together to share learning and best practice .

Same Day Access: went live in Fareham 18 September 2017. Tom Bertram (GP

partner, Jubilee) instrumental in leading the Fareham development. Service is located at Fareham Community Hospital and serves three practice populations or just under 40,000 patients. This means that same day access services are available to just under 80,000 patients across Gosport and Fareham and demonstrates the spread of a quality service in our accelerated development.

ISD Business unit 2 South West Hants • •

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Recruitment and Retention is a main priority for us this month – we have set up a workforce group including HR and Communications team support Staff thank you – we recognise there are considerable recruitment challenges for the Business Unit and we want to thank staff for their continued commitment and hard work during this time UHS Transfer – we are now in the final stages of transferring considerable Patient Data (6527 data entries) across all our surgical services into the new University Hospital Southampton NHS FT services Romsey Show- attended and promoted our services at the show, providing health checks for 120 members of the public Staff Conference – we had an overwhelming support and attendance at the Trustwide staff conference which was developed by Rachael Marsh.

There were a number of workshops which feedback has shown had benefited staff to approach the challenges ahead.

ISD Business unit 3: Mid and North Hants From 1 Oct Winchester ISPA will be delivering the out of hours access model for ICTs across the West and South East, significantly improving patient/staff experience. This replaces the current 111 process which took over from Medvivo.

Patients will be automatically diverted from their usual access number.

Working with Hampshire Hospitals Foundation Trust (HHFT) and CCGs to form a joint Quality Forum.

Received STP money/funding in the north to develop geriatrician time and seven day therapy for Anstey Ward.

Working closely with commissioners and HHFT to implement robust Discharge to Assess pathways.

Andover 1 and 2 are now a single team improving efficiency of working across the area.

Anstey Ward at Alton are working in closer partnership with Hampshire County Council and HHFT to improve flow and reduce stranded patients and delayed transfers of care. Red to Green is fully integrated within the ward culture.

ISD Business Unit 4: Children and Families • •

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Commenced service review for Year 2 Quit4Life contract review in partnership with Hampshire County Council commissioners.

Admin review and consultation across 0-5 service on plan to improve service delivery by reducing variation across the service and increasing clinical time through appropriate use of admin support.

Discussions with Local Authority Commissioners has started regarding options for future delivery of 0-19 services.

Launched our new logistics plan for school immunisation programmes

“Yesterday alone it meant that we had to only take one vehicle with equipment carried in line with all policies to our immunisation session 15 miles away. This meant two staff travelled together, and a nurse went straight to the school leading to a shorter journey for her, saving time and money.

I would estimate in total for that session alone we saved approximately £45 in mileage costs, and more importantly the health and well being of the team was supported and there was minimal lifting and carrying” Roanna Ellis SN Team lead

Getting a better understanding of the care we deliver Across our ISD services there is a lot of variation in the work we do. Some of this variation is important and should continue. But some is unwanted and can get in the way of delivering the right care to our patients.

We are now working to build a detailed picture by looking at the information staff record and speaking with staff from different teams to get their perspectives too.

We are also looking at best practice from around the country.

This work is not about reviewing our workforce numbers – it is more about understanding what we are doing.

This will help make sure community services are properly resourced and planned for the future, which is really important as we look ahead to new models of care which are being developed.

Note: This piece of work is focused on community nursing and therapy. OPMH is beyond the scope of this project as these services will be moving to the mental health division in the coming months.

Updates on our strategic priorities

Quality Reducing our organisational risks Our operational risk register identifies risks to our organisation. The following are the highest scoring risks identified. It is important that we all understand these risks, and what we must do to minimise them: •

Financial penalty and fine arising from legal prosecution by the CQC and Health & Safety Executive for cases relating to patient safety. • Not achieving the 17/18 CIP (Cost Improvement Programme) target due to the high level of savings required (5%) and the level of unidentified schemes. • Adult Mental Health - Workforce vacancies - Inability to fill vacancies with suitably qualified and experienced staff.

Quality Reducing our organisational risks: continued •

There is a risk that the Trust will not be able to provide necessary evidence of NICE compliance as there is not an effective system in place • Financial pressure - due to continued use of Mental Health beds over and above available beds within Southern Health.

• OPMH organic wards do not have seclusion facility and do not have timely access to PICU/med secure environments.

• There is a risk the Trust will not be able to provide safe and high quality services due to the inability to maintain safe staffing levels meaning that we have the right numbers of staff, with the right skills available in the right place at the right time.

Performance hotspots National targets have been met but increasing pressure on CPA (Care Programme Approach) 7 day follow up performance.

Across all of our services Delayed Transfers of Care is an increasing pressure – we are looking to put recovery plans in place: AMH - performance is deteriorating (19%) and action is being taken to revise standard operating procedures, work more closely with local authorities on sign off processes and put in place escalation protocols OPMH - delays have been reducing but remain high (18%). The majority of patients are awaiting placement (nursing/residential) and action plans are being reviewed weekly with our staff and commissioners/local authorities Community hospitals - some areas are as high as 30% and we have instigated a review process to set a clear recovery plan.

Community therapies waiting times remain a challenge. Work is ongoing to address variation in referral criteria and service across our contracts and teams.

Use of non-Trust beds for mental health patients continues to be a major operational challenge. External support is in place to further strengthen our action plans to reduce this figure.

Transformation Working with Northumberland, Tyne and Wear NHS FT Northumberland, Tyne and Wear NHS FT (NTW) have offered 200 days of support to assist with our transformation process – this will be co-produced.

This includes developing a comprehensive baseline analysis, mapping patient journeys, shadowing teams, development workshops with service users and staff.

A business case is being sent to NHS Improvement to secure the funds for this support.

A visit to NTW to look at their approach to access is planned for 14/15 November including service users, Solent and commissioners. Focus is on developing a single point of access for the South East system initially.

Our High Cost Placement (HCP) staff spent two days with NTW’s HCP lead looking at opportunities to improve the HCP approach locally which has generated ideas to improve the experience and outcomes for service users and release resources.

Workforce •

Recruitment Authorisation Panel (RAP) process has been updated to improve consistency and to remove some confusion in the approval process

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Revised RAP form is now available on the intranet 4/10/17 – this is the only form to use as part of the RAP process.

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Flow Diagram – A flow diagram has been developed to help managers/staff understand the process – this is attached to the new form.

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MARS update – 20 applications have been received as at 26/9/17 these are now being considered and decisions will be communicated in the near future.

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Retention Plans – NHS Improvement Retention Plan completed and with Exec Team for approval. This provides a focus for our retention activities across the Trust to help reduce turnover and reliance on bank and agency workers.

People – Total Rewards Statement If you were employed in the NHS before 31 March 2017 then a refreshed Total Reward Statement is now available for you. Your statement will be accessible online through the Total Reward Statement portal at: www.totalrewardstatements.nhs.uk via the Government Gateway link.

Your Total Rewards Statement - or TRS - is a personalised summary that shows your employment package (pay and allowance). If you are a member of the NHS Pension Scheme you’ll also be able to view on your statement what benefits you might receive when you retire.

If you want to know more information about other employee benefits for Trust staff go to: http://intranet.southernhealth.nhs.uk/all-about-me/hr/transactional-hr-pay/my-tota l-rewards-nhs-statement /

World Mental Health Day 10 October 2017 Tea and Talk Parties Please encourage teams to host Tea and Talk Parties throughout the w/c 9 October.

The aim is simple, get a group of colleagues together and take some time out to talk over tea and cake! You can talk about anything but we encourage you to talk about improving mental health in the work place!

A step by step guide and a free resource pack available on Mental Health Foundation website. Italk have also produced some conversation starters around discussing mental health in the workplace. Please let the Communications Team know the time and date of your Tea and Talk Party via email What do staff do to help improve mental health and wellbeing in their teams? • We want to know what you already so to improve mental health and wellbeing in the workplace. Whether it is going for a walk every day, eating a healthy lunch or using our workplace options service we would like to use your feedback to share with the Exec team and spread best practice across the Trust! • Please e-mail the Communications Team with your feedback.

People How was your day today?

The annual Staff Survey gives you the opportunity to tell us exactly that. We want to hear all the good and not so good bits about working for Southern Health. The Survey has been emailed or posted to you and will be open throughout October and November. So make sure you take the opportunity and fill yours in!

Where do my answers go?

All the responses go directly back to the Quality Health – an independent company that conduct the survey on our behalf. There is no way that Southern Health can link data back to a particular individual.

How do you know I haven’t filled in my questionnaire?

The Trust doesn’t know. The reminder emails are sent by Quality Health - who conduct the survey on our behalf. Quality Health uses barcodes on the questionnaire so that no personal information has to be printed on the document and to ensure that reminders are sent only to those that do not respond .

For more information please take a look at: http://intranet.southernhealth.nhs.uk/news-and-views/staff-survey/

It’s that time of year again! The flu season is upon us and we all have a responsibility to protect ourselves, our patients, colleagues and families against the flu.

Last year, only 34% of frontline Southern Health staff were vaccinated. Improving the uptake of the flu vaccination to staff is an important way to reduce the risks to patient health, reduce staff absence and therefore reduce additional pressures financially and operationally. If we achieve between 50-70% the Trust will also meet a CQUIN target; achieving the 70% full target means we receive £164,000 - equivalent to employing five Nurses!

All staff that get vaccinated will automatically be entered into a prize draw to win an iPad mini…but you have to be in it to win it! http://intranet.southernhealth.nhs.uk/all-about-me/ support/winter-planning/be-a-flu-fighter/

Money The Financial Recovery Plan was approved by the Trust Board Sub Committee in September The plan acknowledged that progress had been made in delivering savings particularly in ISD, Specialist services, Learning Disabilities and Corporate along with improvements in E-rostering, Bank and Agency and Non-pay. However, increases in Out of Area beds, delayed discharges and non-delivery of CIP targets has increased the pressure on finances meaning, that if allowed to continue, this potentially would mean that the Trust would not deliver its financial target at year end.

As a consequence the Executive team are meeting with Divisions to agree where and how and what additional support services need to be able to deliver more efficient care pathways to reduce delayed discharges and the use of Out of Area beds.

The September financial position will be known w/c 9 October and will be communicated separately.

Estate Services The Estates Services team are looking at how they can help support the Financial Recovery Plan for the Trust.

They have identified a number of schemes which will mean some changes to the services they currently provide. These include changes to frequencies with some services such as: • Window cleaning (now twice a year for high risk and once a year for low risk areas) • PAT testing (checking electronic safety will take place every 3 years in low risk non inpatient areas) • Postage (default to second class) There will also be temporary hold on maintenance vacancies. This may impact on the response times for non urgent work and low risk Planned Preventative Maintenance.

All new minor works requests that require funds will now need to be approved by an Executive Director. Any queries please contact Karl Beanland.

Other Trust updates

Refreshed Intranet What have we done?

We now have a separate website and intranet site. Our website is being fully redesigned and we hope to launch this in 2018. Our intranet has undergone a refresh – the same content remains but it has a different look and feel.

Why did we split the Intranet and the public website?

We received feedback from the public that they were often confused by accessing staff intranet pages and staff found the whole site hard to navigate.

How did we refresh the intranet?

Over the past few months we have been working closely with over 550 staff and members of the public to redesign our website and refresh our staff Intranet to help make both sites more user friendly. We used surveys, focus groups and existing websites that evidence best practice.

Surveillance function The Trust surveillance function is a new virtual team that aims to use existing resource and expertise across corporate services to complete independent reviews of services.

These will be based on a range of data already collected by the Trust.

The surveillance function will aim to: use existing data to support services through informative analysis provide services with an opportunity to understand data better support services to highlight best practice identify team variation and challenges encourage transparency and a positive learning culture.

The surveillance function will NOT: Criticise services through judgement impose or recommend actions resulting from a service review; increase the workload of services through additional data requests; act in isolation without involving clinical leads in reviews. analystteam@southernhealth.nhs.uk

Governor elections We have just begun the process of electing two Governors in the following constituencies: A staff Governor in South East Hampshire A public Governor in South West Hampshire Do you know any colleagues who could represent your views as a staff Governor?

Do you know any patients/service users/carers who might wish to become a public Governor?

For more information contact governors@southernhealth.nhs.uk The deadline for nominations is Wednesday 25 October 5pm

Living our values Thanks and congratulations…

Quit4life 10 year anniversary New logistics plan for school immunisation service The Trust is now Smokefree!

Safewards Success at Ravenswood House – to reduce the levels of conflict and containment within MH inpatient services.

Our Health and Safety champions italk presented at a recent the Fareham and Gosport GP event . Hazel Nicholls, clinical lead for italk and Jonathan Foley, Area Manager for South East talked about the service and the move to the new community hub model. Feedback from GPs was overwhelmingly positive for italk and its new model. They also acknowledged the work done to address waiting times for patients, particularly at Step 3, which was a previous concern for them.”

yourvoice@southernhealth.nhs.uk – a way for you to raise your concerns, ask a question, provide feedback or submit any ideas to the Executive and Senior Manager teams.

All questions will be sent to a senior manager for a prompt response directly to you.

Anonymous queries and concerns can also be raised via the intranet page http://intranet.southernhealth.nhs.uk/news-and-views/your-voice/ Recently queries/changes include: – – – – –

Improvements have been made to our appraisal paperwork following feedback Parking changes and driving on Tatchbury Mount site Using radios/music in the workplace to improve staff morale Our progress towards online payslips When to send out corporate staff communications.