Annual report summary 2012-13

Spotlight on our year

A summary of our annual report 2012/13

About annual reports and quality accounts This is a summary version of both these documents - you can read the full versions on our website or request a copy by calling 0800 587 2108.

We are legally required to produce both documents and we are happy to share them as widely as possible. Our full annual report and accounts provides an overview of the period 1 April 2012 to 31 March 2013 as well as statutory information such as the Trust‘s financial activities, management costs, performance targets and strategic direction.

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Quality accounts are annual reports to the public from providers of NHS healthcare services about the quality of the services we provide.

This report provides an overview of our quality achievements and challenges throughout 2012/2013, showing how we are meeting our regulatory requirements as well as trying to meet the expectations of all our stakeholders.

It also outlines our quality priorities for the next year.

Contents Your comments are welcome We hope you find this document interesting and easy to read. We’d love to hear what you think about it and anything else you’d like to see, so please let us have your comments via enquiries@swyt.nhs.uk or by calling 0800 587 2108.

And stay in touch!

Would you like to stay in touch with the Trust by becoming a member and receiving our Trust magazine? Around 16,000 local people are already members, so why not join them? Find out more on our website (the address is below) or by emailing membership@swyt.nhs.uk or calling 01924 327457.

Introduction Message from our chairman

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About us

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Message from our chief executive

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Looking back to 2012/13 Our values

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Transformation

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A year in our services

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Excellence

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NHS Heroes

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Creative Minds

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Altogether Better

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Our website has lots of information about our organisation and our services. This is where you can also find the full versions of our annual report, quality account and other documents about our performance. If you have problems accessing the internet and would like to receive information in the post, please just call us on 0800 587 2108. Otherwise, log on to:

Our quality account

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Our response to the Francis report

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Summary of financial accounts

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www.southwestyorkshire.nhs.uk

2013/2014 corporate objectives

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Transforming our services

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Our website

Looking forward throughout 2013/14

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Introduction Welcome to this summary version of the Trust’s annual report for the year 1 April 2012 to 31 March 2013.

Our dedicated staff, as always, have continued to work hard to deliver care of the highest quality. It is through their loyalty and commitment, and because of the high standards they set themselves, that our service users and carers receive the best possible care and support.

This year has seen some of the greatest challenges for the NHS due to the new Health and Social Care Act, changes to how services are commissioned and delivered and the required £20 billion national efficiency savings, alongside the pressure of a changing demographic and reduced local authority budgets.

On a personal level, I was appointed as Chairman on 1 May 2012. Since then I have reviewed our Board, our Members’ Council and our relationship with our regulator, Monitor, and have introduced a number of changes, which increase and enhance the effectiveness of the Board.

The Trust is no exception to the challenges but we start from a strong position, both in terms of service performance and governance and from a financial perspective. This means that, despite significant pressure, this year has been one of continued growth and success.

Our Members’ Council continues to develop and goes from strength to strength. Their support has been constructive and effective, providing an excellent basis for their enhanced role in holding the Board to account.

The coming year will be one of great challenge, requiring significant service transformation to make sure we offer best care and use our resources to maximum effect. I look forward to leading the Trust through this challenge.

Ian Black Chairman

About our Trust We are an NHS Foundation Trust providing a range of community, mental health and learning disability services to over a million people in Barnsley, Calderdale, Kirklees and Wakefield. The Trust also provides some medium secure (forensic) services to the whole of Yorkshire and the Humber. We employ over 4700 staff.

To provide the flexible, individually tailored care that local people have told us they want, we work from a variety of sites as well as with people in their own homes. Our community based services are well supported by inpatient services for when people need care or assessment in a hospital setting.

Our Trust Board The Trust Board is our governing body and is responsible for setting the strategic direction of our organisation. It is made up of executive and non-executive directors. Executive directors are employed full-time by the Trust. Non-executive directors are local people whose wide range of experience and skills contribute to the effective management and accountability of the Trust. They work closely with executive directors to ensure the Trust runs in an open and transparent way, providing high quality services that meet the needs of local people.

Our business is conducted through quarterly public meetings. Full information about our Board, meeting dates and minutes are available on our website, www.southwestyorkshire.nhs.uk.

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The past year was challenging for the NHS and for social care, and our annual members’ meeting in October 2012 focused on our journey through this changing landscape.

There are four key themes that have defined our Trust in the past year:

Quality underpins everything we do Improved quality of our services remained our top priority, particularly given the scale of our financial challenge. We continue to work with the Care Quality Commission and have maintained a strong governance rating with our independent regulator, Monitor.

Our emphasis on improved quality and safety is reflected through the number of serious incidents, which has remained stable, though we are continually looking at learning lessons and further reducing the number of incidents. We have introduced practice governance coaches to support front-line services and we also now have a new system for measuring the clinical impact of service change and efficiency savings.

Working in partnership is key to our success and our future The changes as a result of the Health and Social Care Act became more visible during the year. As well as maintaining and developing our existing partnerships, we

forged new relationships with clinical commissioning groups (CCGs) and Health and Wellbeing Boards as they emerged against a climate where resources are scarce.

The past year has called for sound partnership working not only with new commissioning bodies but also with partners in the provision of services. Working in partnership is the only way we, and our health and social care colleagues, can tackle future challenges.

Our partnerships will be further strengthened over the coming year.

We need to transform the way we provide services Over the past year, it has become increasingly apparent that purely improving how efficient services are will not be enough to ensure we remain viable and sustainable.

What is called for is service transformation. This past year has been a year of building the foundation for changing the way we provide services - read more on page 6.

Providing our services through area-based business delivery units (Barnsley, Calderdale, Kirklees and Wakefield), as well as the forensic business delivery unit, has been a key strength in the past year, coupled with the support of our corporate services (collectively known as the Quality Academy) in the support of service change.

2012/13 has also seen work intensifying around our estates strategy, development of IT solutions and re-design of our workforce. In support of this, we continue to enjoy strong partnerships with staff side colleagues.

We must deliver on our values When we took on new community services in 2011 it changed the identity of the Trust; we became a more integrated and partnership-based provider of community and mental health services. This called for a re-evaluation of our core purpose and values. Over the past year, I have worked directly with service users, carers, staff and partners to establish a new mission and set of values that underpin everything we do. Read more on page 6.

I look forward to continuing in the spirit of co-production and partnership as we take the organisation on the next stage of its journey.

Steven Michael Chief Executive

Innovative ways of delivering our services, such as our Creative Minds initiative, go from strength to strength and have been supported by our Innovation Fund to help staff to develop and encourage innovative approaches to supporting service users and their carers. Read more on page 11.

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Looking back to 2012/2013 Re-focusing our values Throughout 2012/13 we talked to service users, carers, staff and partners to re-think our mission and values to ensure they still support our organisation going forward.

We held 23 roadshows where we asked people whether they thought our previous mission ‘Enabling people with health problems and learning disabilities to live life to the full’ - was still relevant and what they thought our values should be. We also gathered views via surveys on the intranet and Trust website and received over 1,000 responses.

Lots of helpful feedback was received and there was broad agreement that: • Our mission should be broadened to focus on reaching potential rather than living life to the full • W e must take account of the need to support people to maintain their link with their lives/their communities.

Steven Michael, chief executive led this work and commented, “I’m delighted that around 2,000 people - over half being service users and carers were involved in this work. Our values help us create the common sense of purpose which unites all our services. They guide us each day to ensure we provide the best possible care for local people and they are statements we can fall back on when times are tough; holding us steady. I am very proud to stand by our new values and our mission.”

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Our mission Enabling people to reach their potential and live well in their community

Our values • • • • •

Honest, open and transparent Respectful Person first and in the centre Improve and be outstanding Relevant today, ready for tomorrow • Families and carers matter

Transforming our services Throughout 2012/13 we continued with a programme to transform the way we deliver our services. This is to make sure we continue to deliver services that meet local need, offer best care and better outcomes and are value for money.

The transformation of our services must be aligned with, and enable the delivery of, our mission and values. It needs to take account of the changes in our communities, widening health inequalities, and make best and effective use of resources – given the significant financial challenge across the health and social care economy.

Throughout 2012/13 we made progress with reviewing all our services under 4 main strands:

Mental health – acute care, community mental health, rehabilitation and recovery and older people General community services – including long term conditions, end of life care, health and wellbeing and children’s services Learning disability services – inpatient services, community assessment and treatment, mental health interface and cross agency links

Forensic services – inpatients, step down and community and links to rehabilitation and recovery.

A year in our services In a typical month we provide care, advice or treatment to 36,000 people across our local communities. We do this in a variety of ways - from advice on wellbeing to prevent ill-health, care in people’s homes and in community settings, to care in hospital. These pages are just a snapshot of some of the work that took place in each of our areas in 2012/13.

Watch our films Over the past year we have made a number of films that shows our staff at work in our services. We have also filmed many service users and carers who share their powerful and inspirational stories. You can find all our films on our website or go direct to www.youtube.com/swypft

Barnsley Active health games 2012 Barnsley integrated learning disability service worked with Newham Barnsley Partnership to bring a fun Olympic theme to Barnsley.

The Active Health Games were a way of introducing the Olympic Games to people with learning disabilities and an opportunity to try different sporting activities that were adjusted to be fully accessible and inclusive for all people with learning disabilities.

272 service users and 149 family members/carers registered at the event. The Mayor opened the games and Olympian Dorothy Hyman brought her Olympic torch.

Barnsley physical activity service Get connected and find out more about our services!

We are proud to highlight and celebrate the work of all our services. We frequently send stories to our local papers as well as include them on Facebook, Twitter and LinkedIn. One of the best ways to stay up to date with our latest news and achievements is to read Like Minds magazine - sent out to all members of our Trust. (Find out how to become a member on page 3).

A Trust service was launched to help people who use mental health services get more active to boost their health and wellbeing.

The new physical activity development team (PADT) - formerly the sports development team - works with acute wards and community teams in Barnsley to provide physical activity sessions for people who use mental health services in order to maintain and improve their mental and physical health.

Boosting bone health To raise awareness of osteoporosis the Trust’s falls and bone health service in Barnsley hosted a special information day. Attended by over 65 people, the event which was run in partnership with the National Osteoporosis Society, was an opportunity for service users, carers and staff to find out more about the condition and what they can do or help others to do, in order to reduce the risk of fractures.

New ward improves patient experience A £1.8m ward opened at Kendray hospital, providing state of the art surroundings for recovery and rehabilitation. The neurological rehabilitation ward was designed to meet the needs of patients with brain tumours, spinal injuries and neurological long term conditions including multiple sclerosis (MS) and progressive supranuclear palsy.

Innovative technology has been used on the ward to offer these patients a level of independence not previously possible.

Four of the bedrooms have been equipped with a special control panel which enables patients to open and close their curtains, work their television, switch on lights and call for assistance using just their eyes. Additional facilities include a kitchen – designed to support the rehabilitation of patients by providing an environment similar to that found in the home – and a gym for physiotherapy. There is also a garden for patients as well as two communal lounge areas.

The £1.8m project also supported the Trust’s sustainability agenda by making use of and extending existing premises.

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Calderdale

Street art project

How simple changes make a big difference

Activity day on Ward 18

Beechdale, a 16 bed older people’s mental health ward in Halifax, implemented new ideas to allow staff to ‘release time to care’ by working through a specially designed toolkit.

The ‘Release time to care: productive ward’ toolkit was developed by the NHS Institute for Innovation and Improvement and aims to help staff improve ward processes and environments so they can spend more time on patient care, improving safety and efficiency.

Elaine Struk, ward manager explained, “The complex needs of older age adults’ experiencing mental health issues requires the knowledge and skills of dedicated specialist practitioners. Our team are determined to reach this standard and to develop and sustain an approach to care that truly keeps the person at the centre. We have been working through the modules in the toolkit as part of this.”

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Kirklees

The substance misuse service in Calderdale used graffiti as an innovative way to explore the journey of a recovering drug user.

Service users produced boards showing a different part of the journey - from the chaos of taking drugs, to an addict asking why, to being arrested and weighing up the options of continuing as a drug user or getting clean.

Donna Kershaw, care co-ordinator, said, “The project has really got people thinking about recovery versus addiction. We were able to use different people’s ideas to make up the boards and we’ve been able to come up with a really collective picture of recovery and the struggles people will face. Now that the art is completed we hope that this will continue to trigger thoughts with our current and future service users.”

The Priestley Unit’s Ward 18, at Dewsbury and District Hospital, held a mammoth 12 hour event for service users, supported by the Trust’s Charitable Funds to celebrate World Mental Health Day 2012.

In the morning, activities included creative writing and dance therapy sessions; in the afternoon, people could try their hand at circus skills and enjoy a range of complementary therapies and henna painting. A friendly Pets as Therapy dog (pictured) joined the fun later on, before the ward was treated to music in the evening to end a packed day.

Royal launch for Safe Anchor boat The Princess Royal visited Shepley Bridge Marina in Mirfield to launch a special canal boat refurbished with the help of Trust funds.

The boat is part of Wellbeing through Waterways, which is a Creative Minds project developed in

partnership with the charity Safe Anchor Trust to provide canal boat trips for people who use local health services.

As part of her visit the Princess Royal officially launched the ‘Austen Johnson’ at the marina. The Princess Royal is Patron of the national Wooden Spoon charity, the Yorkshire branch of which made a significant donation towards the refitting of Austen Johnson.

Good practice received national recognition Staff working in day opportunities services in Kirklees were recognised by the national charity Mencap for their efforts in improving care, treatment and opportunities for people with learning disabilities by being featured in a national good practice guide and film.

The integrated team, which includes staff from the Trust and Kirklees Council provide care for people with complex needs. The team identified that in order to continue providing high quality care to services users who were presenting with increasingly complex needs, they would need to develop the skills of staff to take on new roles and responsibilities.

Wakefield Partnership work in the local community The Trust’s adult ADHD service, which is based in Wakefield, has formed a partnership with social enterprise The ABLE project to provide supported placements for young adults with attention deficit hyper activity disorder (ADHD).

ABLE is based on a former landfill site in Wakefield and combines the production of fish and horticultural produce with a unique outdoor learning facility, training young people in horticulture, aquaculture and environmental skills. The placements are weekly half-day sessions, where young people work with an ABLE project worker to undertake activities such as fish farming, woodwork, horticulture and healthy cooking with onsite produce.

Many of the people accessing the placements have had previous negative experiences of employment and learning environments, and have had limited support. The ABLE project offers a supportive and understanding environment, which enables people to try activities to build new skills and confidence.

Health checks for sports fans The Trust teamed up with the rugby league community this autumn to promote better mental health amongst men.

Staff from the Wakefield health and wellbeing development team offered match-goers health checks and advice on Trust and voluntary sector mental health support services. Service user groups from Rethink were also present along with Rightsteps support services to raise awareness of mental health support for men.

David Cowan, health and wellbeing development worker, said, “Men are less likely to visit a doctor than women, so we have found bringing health checks and health information to men at sporting events a successful way of engaging with men in a place which is convenient for them and at a time when they don’t have work or other responsibilities to think about.

“We checked for high blood pressure in 58 people.

Some, particularly but not exclusively the older adults, had high blood pressure readings that they were not aware of. Fans were referred to our services as appropriate following a high reading and we were really pleased with how many people took the opportunity to be screened at the game.”

One Tigers fan commented, “It’s definitely worth having your blood pressure done in places like this; I probably wouldn’t have it done otherwise.”

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Forensic Activity centre opened at Newton Lodge The first phase of our multi-million pound redevelopment of Newton Lodge in Wakefield was completed with the opening of a £4.8 million activity centre.

The new activity centre is part of the £12million redevelopment of Newton Lodge, a 90 bed medium secure mental health unit based at Fieldhead, in Wakefield.

Sue Threadgold, clinical lead and project manager said, “We are delighted with the new activity centre; it is a fantastic space that will really improve the quality of life for people who receive care here, many of whom are with us for a number of years.

We are committed to involving people in a range of activities that interest them and promote their recovery – from art to aerobics, circuit training to cycle maintenance – we have something to interest everyone.”

Lodgefest During the 2012 summer of washout festivals, the Trust’s own Lodgefest didn’t see a drop of rain all day! Held in Newton Lodge’s brand-new 10

£4.8m activity hall, Lodgefest 2012 brought together staff and service users from the forensic service for a day of games, activities and delicious food.

Tigers training for Fieldhead residents Castleford Tigers Rugby League Club helped boost health and wellbeing of service users at two of the Trust’s low secure inpatient units; Newhaven and the Bretton Centre.

As part of their recovery pathway activities are planned such as art, football and music sessions.

Staff are always looking for new and exciting activities to add to the regular weekly program that will motivate and improve the quality of life for those on the unit. After one service user expressed a passion for rugby staff sought out a way to provide sessions at the unit and contacted Castleford Tigers to facilitate a group. The Trust teamed up with professional community development coaches from the Tigers Trust, the registered charity of Castleford Tigers, to provide a series of six sessions, to teach and develop rugby skills to service users on the units.

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E cellence 2012

Every day, staff who work in both our clinical and non-clinical support services are striving for quality and continued excellence. To recognise and celebrate the enormous contribution staff make to the running of the Trust and to the lives of local people, we hold our annual Excellence awards.

The awards were first introduced in 2009 as an opportunity to highlight the excellent work of our staff and to give them some special recognition. In 2012 we had over 100 entries into the awards that highlighted the diverse and innovative services that staff provide.

Ian Black, the Trust’s Chairman, hosted the awards and said “Excellence is an opportunity to celebrate the work that our staff do every day and to say thank you for their effort, dedication and skill.”

Creative Minds Creative Minds is about the use of creative approaches and activities in healthcare; increasing self-esteem, providing a sense of purpose, developing social skills, helping community integration and improving quality of life.

We formally launched our Creative Minds initiative in late 2011 to show our commitment, as an organisation, to a creative approach to delivering our services. Creative Minds has provided a framework to not only build on existing good practice in our services but also to work more closely with a wide range of community and voluntary sector organisations.

The breadth of projects we have seen developed has been incredible. Central to our Creative Minds strategy is working with internal and external partners and we’re proud to have an ever-growing list of over 50 projects

and partnerships. Creative Minds has challenged the traditional way that health services are provided as well as allowed us to develop a fantastic community and infrastructure of people who are committed to developing creative approaches.

As a Trust, we are always exploring how we can work in partnership to help people reach their full potential in a way that best suits them. Creative Minds not only allows us to tailor opportunities for individuals but also to do this in their local communities.

Find out more

www.creativemindsuk.com inclusion@swyt.nhs.uk 01924 328656

NHS heroes

Altogether Better

In November 2012, we also recognised 56 individuals and teams who had been nominated as NHS Heroes.

The national NHS Heroes initiative was introduced to recognise NHS staff who go the extra mile. Members of the public, people who use NHS services and staff working in the NHS were encouraged to nominate those who they felt deserved recognition for the work they do and the effort that they put in.

The Trust is delighted to be hosting a successful and ambitious approach to improving health outcomes regionally and nationally.

Altogether Better was founded on the firm belief that ‘community health champions’ have the potential to make a significant impact on health inequalities.

Started in 2008 with funding from the Big Lottery, Altogether Better supports community health champions to make a positive difference to the lives of their families, friends and communities. This normally involves a huge change in their own lives as well.

Creative Minds is about the use of creative approaches and activities in healthcare; increasing self-esteem, providing a sense of purpose, developing social skills, helping community integration and improving quality of life.

our service users and their carers.

When the Trust was approached by NHS Yorkshire and the Humber (now part of NHS England) to host Altogether Better it was clear that its principles are closely aligned with the Trust’s own vision and values and so we were delighted to welcome them to our Trust on 1 July 2012.

Find out more about their work at www.altogetherbetter.org.uk

Altogether Better is just one example of the Trust’s innovative approach to delivering services and providing support for 11

Quality counts - a summary of our Quality Account 2012/13 We are committed to making information about the quality of our services easily available so that anyone who is interested in our work can take a closer look. This encourages debate and reflection; something we very much welcome.

information, counselling and bereavement services; as well as free car parking vouchers, to help reduce the distress of hospital visiting at a very difficult time.

• Kirklees Council and the Trust introduced a pilot in Community Mental Health Teams (CMHTs) to see how personal budgets could help people experiencing mental health problems. Over 80 people have taken part and now have a personal budget in place.

This has been very well received; encouraging staff and service users to think creatively about the support that is available and the different services.

• The redevelopment of Newton Lodge, our medium secure services, is continuing on site at Fieldhead in Wakefield (read more on page 10). We also secured further funding to improve the main entrance to Newton Lodge.

• The use of Lean methodology within the organisation has seen 280 people undergo Lean Awareness training and a number of people trained to support Lean facilitation.

Rapid improvement events have taken place in three specific areas of the Trust and the impact is currently being evaluated.

Towards the end of 2011-12 we worked with service users, carers, partners and colleagues across the Trust to define our priorities for the year 2012-13; together we identified seven key quality priorities.

Throughout 2012-13 we measured how we were doing on each of these priorities and reported them to our board of directors. On the following pages we take a look at just a couple of examples of improvements under each of these priorities during 2012-13. These are just a small glimpse into the continuous improvements we aim to make and a snapshot of the quality of our services- you can read more in the full report or in any of our other Trust publications.

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• Families in the Barnsley district have been benefiting from a pioneering comfort care pack from the End of Life team. The information pack includes information sheets for relatives and patients about the signs and symptoms of dying, general hospital

What is a Quality Account?

Quality accounts are annual reports to the public from providers of NHS healthcare services about the quality of the services we provide. The full account provides an overview of our quality achievements and challenges throughout 2012/2013, showing how we are meeting our regulatory requirements as well as trying to meet the expectations of all our stakeholders. The full account is available on our website www.southwestyorkshire.nhs.uk or you can request a copy by calling 0800 587 2108.

Priority 1: Service users are central to what we do • We have introduced a quarterly report to Trust Board - presented as a magazine called ‘What Matters’ - which provides a connection from clinical services to directors and takes a ‘you said, we did’ format. Pick up a copy in one of our services or visit swyt.co/whatmatters • The Trust’s Research Involvement Group (RIG) meet on a monthly basis and all members are service users or carers. The RIG advise on many Trust research projects from the perspective of a service user or carer which helps to guide researchers.

• W e want to ensure information is widely available on common conditions, treatments available and self-help. To deliver this commitment a dedicated project began in early 2013.

Priority 2: Timely access to services

Priority 3: Improve care planning

• S ervice line reports have been developed to help each team monitor progress against Trust goals. This means frontline staff receive relevant and timely information which helps them take ownership of improvements.

• I n our mental health services we have trained teams to use the “Recovery Star”; a tool that helps an individual identify their personal strengths, develop goals for the future and develop action plans to achieve these goals.

• O ur clinical teams are trying to improve access to services at a local level, for example, in response to feedback our Child and Adolescent Mental Health Services (CAMHS) in Barnsley and Wakefield have extended working hours to further meet local needs.

• O ur Barnsley End of Life team enable people to receive care in their preferred place and focus on the individual, and who they are as a person, so that in their last days of life care meets their needs. The team have also worked on a “creative communication at end of life” project with people who have profound and multiple learning disabilities and dementia.

• I n our Barnsley community services we have been monitoring the available (local) choose and book appointment slots. During 2012-13 we achieved 100% against this goal.

• O ur own monthly monitoring consistently records over 80% of people on Care Programme Approach (CPA) being offered a copy of their care plan.

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Priority 4: Improve recording and evaluation of care

Priority 5: Improve transfers of care by working in partnership across the care pathway

• I n Barnsley there have been developments to roll out electronic clinical record keeping systems (which we already have across other parts of our organisation).

• W e monitor the number of Delayed Transfers of Care (DToC) in our bed based services and throughout 2012-13 we consistently achieved the national goal.

• D uring 2012-13, 361 staff attended record keeping training and in our annual clinical audit programme we have a total of 15 record keeping audits across the organisation.

• I n 2012 a data quality steering group was established to focus on the quality of our clinical data.

• C ommunication across the care pathway is vital in ensure a person received safe care. A goal has been agreed with our Barnsley commissioners to improve the quality and timeliness of clinical communications between us and other agencies.

Priority 6: Ensure that our staff are professionally, physically and mentally fit to undertake their duties • O ur occupational health service has introduced a staff occupational therapist and a physiotherapist, allowing staff to access these services in a timely manner and helping to reduce absence from work.

• W e have reviewed the system we have in place to appraise our staff. This will not only review performance but also help staff plan for professional development, ensuring our workforce has up to date knowledge and skills.

Do you want to read our full Quality Account?

A full version of our 65 page Quality Account is available on our website: www.southwestyorkshire.nhs.uk. You can also request a copy by calling us on 0800 587 2108.

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• A number of health promotion activities, such as fitness sessions are being offered to staff across the organisation - we also surveyed all staff about their wellbeing.

Priority 7: Improve the safety of our service users, carers, staff and visitors • A n incident management system (known as Datixweb) has been rolled out across the organisation so that all incidents are recorded in a single place, supporting the organisation to understand trends and develop learning. • I n 2012-13 we have focused our energy on ensuring we learn lessons from incidents and we have developed a framework to strengthen our governance structures. Governance is the formal framework that governs the way in which we operate. • W e are continuing to upgrade our estate to ensure it provides a safe environment for staff and service users.

2013/2014 Priorities for improvement We needed to set our priorities for the coming year and so, in February and March 2013 we once again consulted with our partners, staff and people who use our services on quality priorities for 2013-14. We asked them to review our 2012-13 quality priorities and comment on their relevance for 2013-14. We also asked what actions people thought we should focus on. We are grateful for the feedback we received and we used it to plan for 2013-14.

Our priorities have been identified as:

Priority 1: Listen to our service users and carers and act on their feedback

Listen and act on service user feedback, with the aim of making demonstrable improvements to our services.

Priority 2: Timely access to services

Improve the access times for people who are referred into our services to ensure the right support from the right service at the right time.

Priority 3:

Improve care and care planning

Ensure that each service user has appropriate assessment, care plans and treatment options to enable them to achieve their goals.

Priority 4: Improve the recording and evaluation of care

Ensure each intervention is accurately recorded in a timely manner so that there is appropriate communication across the care team.

Priority 5: Improve transfers of care by working in partnership across the care pathway

Ensure service users who are ready to move along the care pathway are supported across service boundaries in a timely way or those services that are seeing the same person communicate effectively to prevent duplication or gaps in service provision.

Priority 6: Ensure staff are professionally, physically and mentally fit to undertake duties

To ensure we have appropriately qualified, skilled, competent and professional staff to undertake the role that they are required to do and to support their health and wellbeing.

Priority 7: Improve the safety of our service users, carers, staff and visitors To ensure that the people who work with us and visit us are safe from harm.

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The Francis Report At the beginning of February 2013 the 2nd Francis report was published. This was Sir Robert Francis QC’s findings following the public inquiry into the role of the commissioning, supervisory and regulatory bodies in the monitoring of Mid Staffordshire NHS Foundation Trust.

The 2nd Francis report again focused on Mid Staffs – but all NHS organisations, including ourselves, have been scrutinising the findings to determine how the report’s recommendations can be addressed.

The Trust has taken action in response to the Francis Report, this is shown in the box opposite.

1. Our executive management team conducted a high level review of the strategic themes to provide an initial indication of where greater assurance may be required.

2. A summary briefing was circulated to all Trust staff.

3. A presentation was made to Trust Board in March 2013 where the report was considered in detail and approval of the high level response agreed.

4. Each department/directorate is completing a self-assessment against the appropriate recommendations in the report.

5. Professional leaders are discussing the report within their networks.

6. A gap analysis has been completed by a crosssection of staff at all levels at a Trust-wide workshop.

A detailed action plan has been developed, which will be monitored throughout 2013/14 by the clinical governance and clinical safety committee and Trust Board.

Steven Michael, Trust chief executive said, “Quality underpins everything we do in our Trust and we do all we can to ensure that people who come into contact with our services have the best experience of care. Our Trust strives to create a culture of respect, compassion, quality and safety and our Board continually seeks assurance that this is happening.”

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Contact customer services Our customer services team handle any general enquiries or information requests as well as comments, complaints, concerns and compliments about Trust services.

Freephone: 0800 587 2108 Fax: 01924 327668 Email: customer.services@swyt.nhs.uk

Summary of our annual accounts On these pages you can read more about our finances throughout 2012/13. We realise this information is complex - if you have any questions or would like further assistance or information, please just get in touch with us and we’ll be happy to help. Contact details are on page 3.

There have been no significant transactions during the financial year 2012/13 - although we did transfer £42 million of estate and buildings from Barnsley Primary Care Trust (PCT) to the Trust. The buildings relate to the provision of community and mental health services in Barnsley which transferred to us in 2011/12. The transaction was reviewed and supported by Monitor, our regulator.

Capital expenditure and our estates In 2012/13 our budget for buildings and assets (which is classified as capital expenditure) was £10.4 million but we actually spent £9.2 million. The under spent £1.2 million was linked to two main areas; investment on the Fieldhead site and investment in

Of the total income, 88% comes from healthcare contracts with local healthcare commissioners and 6% is from local authorities.

Most of the money given to us is a fixed payment; however, 2.5% of our income (so in 2012/13 that was £5.3 million) is only given to us if we achieve certain key quality indicators (targets). In 2012/13, the Trust achieved 87% of these targets and we saw an improvement in the remaining 13%.

You can view where we get our money from (income) and where we spend it (expenditure) in the table, right.

The Trust planned and maintained a healthy cash balance throughout the year with an average balance of £27million overall. These cash funds have been built up over time to fund future investment in estates and technology which are key to providing sustainable services.

Income & expenditure performance for 2011/12

Overview of our financial performance In 2012/13, the Trust had an annual income of £232.4 million and an overall surplus of £6.0 million for the year.

This surplus equates to 2.6% of our income.

the mental health clinical information system. Both these schemes will be undertaken in 2013/14.

Income from activities Other operating income Total income

2011/12

2012/13

Full Year

Full Year

£k

£k

219,361

219,300

11,694

13,146

231,055

232,446

223,465

224,981

273

374

1,522

1,538

21

256

6,320

6,045

LESS Operating expenses Interest received Public dividend Asset impairment Surplus

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Our savings We need to ensure we make savings so we can contribute to the overall savings target of the NHS and remain a sustainable organisation. The Trust achieved a recurrent savings target of ÂŁ9.3 million during the year which represents a 5% efficiency target achievement. This is consistent with national guidance and the requirements of the organisations that commission (plan for and buy) our services.

What did Monitor say about us in 2012/13?

Monitor is our regulator and they keep a close eye on our finances and governance (how we run things).

One of the ways they present this information is a traffic light system.

For governance in 2012/13: The Trust was rated amber/green for quarter 1.

Did you know?

The Trust has targets for how quickly we pay invoices - these are known as the Better Payment Practice Code and the CBI Prompt Payment Code. In 2012/13 we met these targets as we paid over 96% of valid invoices within 30 days for non-NHS invoices and paid 95% on NHS invoices within 30 days.

We also made sure that 83% of local suppliers were paid within 10 days.

The Trust was rated green in quarters 2, 3 and 4.

Our financial risk rating Monitor also give us a financial risk rating on a scale of 1 to 5 - with 5 being the best. This considers a number of key financial performance measures to assess our financial viability - such as having sufficient cash to meet outgoings and expenditure in line with what was planned.

In 2012/13 our score was 4.3 which is a good result and shows we manage our financial resources well.

2

3

4

5

Low risk

High risk

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1

Did we need to use our overdraft?

The Trust’s cash balance during the year was sufficient to meet our operational and capital outgoings so we did not use an overdraft facility.

We do have an overdraft arrangement with a commercial bank which would allow us up to £9.2 million should we ever need cash to meet our obligations. Our longterm financial plan shows that the Trust has sufficient cash to fund all our outgoings without using this facility.

Recording investment property Buildings and estate that the Trust no longer needs is recorded as investment property and its value is updated annually to the current market value. As at 31 March 2013 these assets are Aberford Field, Southmoor and Hyde Park. There was an impairment of £256,000 in year; the majority of which related to Hyde Park.

Our financial future The key issues for the Trust which will impact on future financial viability include: • T he continuing impact of reduced levels of funding for public sector services caused by the economic downturn both in health and social care. This means we need to continue to make ongoing efficiency savings of 4% to 5% for the foreseeable future.

• C reating further efficiencies and productivity gains in current service models will not be enough to meet the ongoing challenge. We must undertake transformational change in services to deliver different service models which maintain quality at reduced cost. (read about our transformation programme on page 20).

• W ork with commissioners (Clinical Commissioning Groups) and other providers to create sustainable pathways of care across providers which are patient centred, offer good outcomes and value for money.

• S ustained improvement in clinical record keeping and data quality to ensure clinical IT systems support evidence of good quality care and value for money through the introduction of Payment By Results for mental health services.

If you would like to view our full accounts, please visit our website and you will find them in the full version of our annual report.

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Looking forward throughout 2013/2014 We continue our commitment to provide the best quality services that are safe and effective and focus on improving the experience of the people we support and on delivering maximum value for money. We actively promote a culture of commitment to achieving the best possible service outcomes and improvements for service users – delivering the right services, of the right quality at the right time to support recovery and wellbeing.

Our Board has supported the continuation of our strategic direction in 2013/14: 1. Consolidation and expansion of local pathways remains a priority, with a strong emphasis on consolidation. This includes sub-specialisation.

2. Exploring opportunities for forensic service expansion remains a strategic priority and includes sub-specialisation within forensic services.

3. Thought leadership will continue to have a more strategic and clearer definition with greater emphasis on creative and innovative approaches, such as Creative Minds and teleheath.

4. Geographical expansion will not be a priority for 2013/14, given the emphasis on local consolidation. Expansion within the existing geographical footprint or where the area is discrete and governable will continue to be explored.

In brief – our corporate objectives for 2013/14 Strategy - identify the key strategic priorities required to maintain organisational success

Culture - create and sustain an approach of continuous quality improvement

Structure - ensure the best possible structures for our services

Partnerships - maximise the benefit of both external and internal partnerships

Innovation - drive a commitment to innovation at all levels within the Trust, with a view to the Trust being viewed as a ‘brand leader’

Talent management - harness the talents of our staff to support best care and service transformation

Leadership development - strike an effective balance between clinical, managerial and corporate leadership.

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Transforming our services We are transforming the way we provide our services - this is to make sure we continue to deliver services that meet local need, offer best care and better outcomes and are value for money.

The transformation of our services must be aligned with, and enable the delivery of, our mission and values (read more about these on page 6).

It must take account of the changes in our communities, widening health inequalities, and make best and effective use of resources – given the significant financial challenge across the health and social care economy.

We need to change the way we provide our services in order to: • r espond to what people have told us is important to them – care closer to home and avoiding hospital admission wherever possible • p rovide the best care and outcomes for local people, underpinned by evidence based practice • e nsure that when people need to use our services, they have the best experience they can • t o make the most of the latest treatments and technologies to help people through illness and to recovery • t o help people stay healthy, to take charge of their health and, wherever possible, self manage their care and retain their independence • t o make the best use of taxpayers’ money – improving quality at reduced cost • t o invest in direct service delivery, spending less on buildings • t o develop through real partnerships with mutual accountability.

We have shaped our transformation programme to deliver excellent services in the following areas: • m ental health - acute care, community mental health, rehabilitation and recovery and older people; • g eneral community services including long term conditions, end of life care, health and wellbeing and children’s services; • l earning disability services - inpatient services, community assessment and treatment, mental health interface and cross agency links; • f orensic services - inpatients, step down and community and links to rehabilitation and recovery.

Clinical specialists in each area are leading our reviews and involving clinicians and managers who work in services.

We are also engaging extensively with people who use our services, Trust members, colleagues and commissioners of our services to fully involve them in each stage of the process.

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Involving local people Earlier this year we held a series of events to gather views about our transformation work and to ensure we are on the right track to deliver improved services. Over 450 people have joined the dialogue so far and have shared a range of views which broadly fit into six key themes. We are responding to this feedback by looking at a range of initiatives, examples are included on the right.

We are holding more events in late autumn to check that these plans mirror what people have told us they would like and to continue our dialogue with service users and carers, staff and partners.

Stay updated and involved in our work by visiting swyt.co/transform or call our inclusion team on 01924 328656 to find out about upcoming events.

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Feedback theme

Ideas about how we might respond

I want services which keep me in the centre and which focus on my potential

• Peer support networks • Holistic, service user held care plans • Support while on waiting lists

If I choose to make use of technology, I want it to be available

• O ne assessment, one care plan, held by the service user, including an integrated care plan app • Virtual clinics at GP surgeries (eg Skype, video conferencing) • Online directory with connected, clear networks • Ability to communicate with care team via text or email

I want people to recognise early on that I’m beginning to have problems and to help me

• I ncrease partner skills in recognising and working with mental health issues • Invest in earlier preventative initiatives • Make it easier for men to ask for help

I want you to offer me as much choice as possible and help me understand those choices

• Access to sport and creative activity • More use of group work, co-facilitated by peer support workers, service users and volunteers • Encourage social prescription by GPs

I want all organisations, both big and small, to work together so I don’t see the joins

• • • •

I want you to support my family and carers

• A ssess potential for smaller scale ‘discrete’ opportunities, such as Any Qualified Provider.

• Maintain horizon scanning approach for longer term opportunities beyond 2012/13.

Use community resources and networks Community activity that is not illness focused Better use of health and wellbeing services Use voluntary sector organisations to deliver support

Job no 5527 Sept 2013