I’d like to start my final blog of 2018 by thanking each and every one of our staff for their hard work and dedication to improving care standards over the past 12 months. Without all their efforts Mersey Care could not have made such good strides towards improving care for our patients, service users and carers and a work environment for all our colleagues in mental health, community health in Sefton and Liverpool and in our Specialist Learning Disability Division.
There will be many of you who have already worked over the Christmas period while your colleagues have enjoyed time off with family and friends. The NHS is a 24/7 operation, but that doesn’t mean we aren’t all grateful for those who did work over the holiday period and maybe working over the New Year celebrations.
In the year the NHS turned 70, 2018 has provided possibly the biggest change to Mersey Care in my six years with the organisation. By acquiring the majority of the Liverpool and South Sefton services provided formerly by Liverpool Community Health (LCH), it’s changed the entire footprint of the organisation from one which focussed primarily on mental health to one that provides healthcare for mind and body – literally from head to toe. We know mental and physical health are often connected and now we have the capability to provide healthcare for all needs under the same roof.
Changing trusts is never easy for anyone and I think the last eight months has been a transitional period for former LCH staff and existing Mersey Care staff to work out the best practices from both organisations to make us stronger together.
That transition has not been made any easier by the publication of the Kirkup Report into the former management of LCH, which understandably unsettled many of our colleagues in physical healthcare services. That said, the whole period was handled with great professionalism and calmness and gives great hope for the future as we move forward and come together as a new integrated team for physical and mental health.
I would hope those colleagues who have joined us from the former LCH now realise Mersey Care sets high standards of care, but we do so within a culture that does not accept bullying and we act in a just and learning culture where the emphasis is on how we improve rather than blaming the individual.
Those of you with long memories will recall that we were introduced to Professor Sidney Dekker a couple of years ago, who is a leading academic on safety culture and author of the definitive book on the subject, ‘Just Culture: Restoring Trust and Accountability in your Organisation.’ We listened to what he had to say and, last January, the Professor visited us over a number of days to see how we were rising to the challenge and made a film of the results which you can see below.
We’ve always been proud of being a learning organisation and this is one of the most important initiatives I have been involved with during my time working in the NHS. It goes hand in hand with some of our other Big, Hairy Audacious Goals like No Force First, Zero Suicide and Zero Pressure Ulcers, all of which have seen distinct improvements in trend this year.
The heart of our Just and Learning Culture is about establishing trust, understanding and developing real partnerships with service users to transform patient experience and, fundamentally, ensuring that staff feel psychologically safe to report incidents, engage in learning and in turn deliver safer services. It’s a particularly good example of how we can work together to forge a better caring and working environment.
Our Zero Suicide approach is still a work in progress, but we’re developing a reputation both nationally and internationally for our work as we see the rates for suicides by people in our care begin to drop. We were also one of the founder members, alongside the MindEd Trust, of the Zero Suicide Alliance (ZSA), a collaborative of NHS trusts, businesses and individuals now numbering over 200, who are all committed to suicide prevention in the UK and beyond.
The ZSA was launched just over a year ago and we now know that over 100,000 people have accessed the free 20-minute online training and we have strengthened our commitment to suicide prevention as an organisation by making a separate training tool mandatory across Mersey Care.
After most of the first year running the organisation primarily on a voluntary basis, we were awarded funding by the Government which should help us spread the word about the ZSA and, more importantly, its training. Mersey Care and the ZSA will also host the fifth Zero Suicide International symposium in 2020, which is a tremendous reflection on how our approach to Perfect Care is now influencing much more widely. I will update you as this important work develops in 2019.
Our estate has also changed over the last year with real progress being made on our new medium secure hospital, Rowan View (see pic below) being built at Maghull Health Park.
Similar progress is being made at Southport with the building of a state-of-the-art mental health hospital, now known as Hartley Hospital, which continues our commitment towards providing an estate that will help aid recovery and foster innovation in healthcare.
Our Life Rooms initiative continues to go from strength to strength and, after establishing centres in Walton and Southport, we look forward to the newest member of the family in association with Hugh Baird College in Bootle (see pic below) becoming operational early in 2019.
Over the years, many of you have asked me why we have to make cost-improvement plans and why we have a surplus. We have to make cost improvement plans as every year national funding doesn’t fully cover inflationary and increment pressures. We try to make cost savings in a way that will make services more effective and at the same time more efficient.
We set our plans at relatively low levels compared with other trusts but at a level that will maintain our financial position and generate a small surplus. We need this surplus to allow us to build up our cash resources to support our capital development plans. Working in this way has allowed us to fund the new Southport development without any loans.
Having a healthy financial position also allows us to borrow capital should we need to in the future. In many ways it isn’t very different to buying a house using a mortgage – you need a means of securing a loan to build or buy. There are many organisations across the NHS that currently cannot build, at least not without a great deal of national support. I think it is a real strength that we are able to build new facilities without passing the pressure of very significant debts onto local commissioners.
We also took over the provision of mental healthcare within HMP Liverpool last April, in partnership with Spectrum Community Health CIC, who provide the physical healthcare within the prison.
All mentions of the prison have been tarnished with negativity in recent years, but I’m delighted to announce that the Care Quality Commission’s (CQC) report into our services were positive overall. I’d like to make a particular mention for all the staff there, whose dedication to provide the best care possible is reflected in the quality feedback within the CQC report.
The Trust as a whole has also been actively involved in our own CQC inspections and we have had well led interviews with directors and senior leaders recently.
Another important part of our forward planning has been the development of our digital strategy, as a Global Digital Exemplar, so it can reflect and support the wide range of services we now deliver. Some of the many items on our agenda include paper free services at the point of care, digital patient engagement and using business intelligence tools, much of which can be supported by our new RiO clinical information system. We’re also planning new therapies using virtual reality in our new builds such as Rowan View medium secure unit.
It’s tremendous to reflect on the great tide of innovation that we are seeing sweep across our services, this despite the leanest times in funding terms. But so often it is getting the basics right that make the most difference. In this important respect we have, today, past 390 days in the Local Services Division without an acute inappropriate out of area placement. This has taken lots of collaborative working across the MDT and daily eyes on from the management leads in order to achieve this. But doing the basics really well, reliably, truly benefits patients.
Similarly, a reduction in pressure ulcers in community services has been accompanied by an increase in reporting and significant periods of zero 3 and 4s. This translates to much better quality of life for patients. Meanwhile in Specialist LD we have seen the development of Specialist Forensic Support teams (supported by high levels of PACE and training) in Lancashire and Greater Manchester ensuring that secure forensic beds for LD clients become places of rehabilitation and not places to live. And in Secure Services we continue to see the level of restraints fall to an all time low while at the same time having very low levels of disciplinary activity, ensuring staff and patient safety.
This year has also been one where Mersey Care has been recognised in a number of awards. This reflects the commitment shown throughout the workforce and the desire for innovation in healthcare and the sharing of best practice. I have tried to put together as exhaustive a list as possible, but if I’ve left anyone out please accept my apology in advance.
Here are some of the awards Mersey Care has been recognised for in 2018:
Set against a year of great achievement, has been many challenges. I want our services to continue to get safer and more effective. I also want them to be more responsive, with shorter access waiting times. To do this, I want us to take the next step forward in working with experts by experience to really listen to understand and co-design the change we want to see.
Finally, I’d just like to thank each and every member of staff for your hard work during 2018. It is their commitment that makes Mersey Care what it is and despite the challenges of what we do, your desire to improve healthcare standards for those we care for is what sets you apart.
Thank you for all your efforts and have a happy new year.