Partnership Annual Review 2014/15 · Somerset Partnership provides a comprehensive range of...

Somerset PartnershipNHS Founda on Trust

SomersetPartnership

Annual Review2014/15

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Contents


SomersetPartnership

Welcome 3

Service delivery 5

Quality and safety 11

Innovation 18

Integration 21

Culture and people 23

Viability and growth 28

Working with our local communities 31

Putting our thanks on record 33

Somerset Partnership NHS Foundation Trust2nd Floor, Mallard Court, Express Park, Bristol Road, Bridgwater TA6 4RNTel: 01278 432000 Fax: 01278 432099Email: [email protected]

Somerset Partnership NHS Foundation Trust Annual Review 2014/15

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“I just wanted to thank you on behalf of the

family for the care, kindness and understanding that you showed to my father...in his last few weeks, I would also like to extend my thanks to you for the help, courtesy and compassion that you showed to my mother on her dailyvisits to see my father.Wincanton Community Hospital

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WelcomeWelcome to the 2014/15 Annual Review of Somerset Partnership NHS Foundation Trust, our chance to refl ect on another year of great challenge and high achievement.

We can once again be proud that, over the past twelve months, the Trust has continued to deliver safe, effective and high quality services, achieving all national targets as well as very demanding local performance targets. We have again delivered a fi nancial surplus to re-invest in Trust services against a background of signifi cant fi nancial challenge and the need to make substantial cost improvement savings.

Patient safety and quality remain at the heart of everything we do as a Trust. This year we have launched a number of key initiatives which support our focus on quality and safety. These include:

• our three year Quality Improvement Plan which sets out our aims and commitments to further raising the quality of our services and supports our pledge to the national Sign Up to Safety campaign• our Compassion in Practice campaign which sets out the commitments our staff have made to our patients, their families and their colleagues to treat them with dignity, respect and compassion• our See Something Say Something campaign which we have rolled out across the Trust and which has gained national recognition for empowering staff to speak up when they see good ptactice or to challenge colleagues when they see behaviors that don’t match our values.

We have also launched the next phase of our plans to integrate community health, mental health and learning disability services to make the most of our unique position in the county to be able to support patients, carers and families in all aspects of care in their homes and their local communities.

The Trust has continued to acquire more business, taking on additional services this year, including community dental services in Dorset and on the Isle of Wight and the contract to provide early supported discharge stroke services across Somerset. We have also been part of the successful consortium to be awarded the renewed contract for supporting Ministry of Defence personnel with mental health problems.

We remain proud of our commitment to supporting carers through the national Triangle of Care initiative which promotes their vital role

Patient safety and quality remain at the heart of everything we do as a Trust

Edward Colgan, Trust Chief Executive and Stephen Ladyman, Trust Chairman

in patient care and this report showcases just some of the positive stories we receive from patients, carers and families about the care we provide across the wide range of services we deliver.

In 2013/14, we renewed our corporate strategy and agreed six strategic themes around which we would focus our plans. The review provides a summary of some of our achievements against each of the themes.

All the successes set out in this Annual Review are the result of considerable hard work and commitment from staff at all levels of the Trust: out in the community, in our hospitals and inpatient wards, and in administrative and headquarters services and we would wish to recognise the signifi cant contribution our health and social care partners, govenors and members our Leagues of Friends and our volunteers all make in ensuring we can provide the best possible care to the communities of Somerset and beyond.


Respect and dignity

Improving lives

Commitment to quality of

care

Compassion

Everyone counts

Working together for

patients

Our Mission:Caring for you in the

heart of the communityOur Vision:We will be the

leading provider ofcommunity-based health

and social care

Our Values:

“I thought I had towrite to say a verybig thank you to you andall your staff for running what has to be the nicest and most caring hospital that I have ever visited.Bridgwater Community Hospital4

Service DeliverySomerset Partnership provides a comprehensive range of integrated community health, mental health, learning disabilities and social care services to people of all ages. In keeping with our name, we aim to deliver all of our services in close partnership with the patients and carers we serve, in addition to our partners in primary care, acute care, local authorities and the voluntary sector.


We employ more than 4,000 staff and have an annual turnover of £158 million. We provide services in Somerset from 13 community hospitals, seven minor injury units, and a further four hospital sites from which we provide mental health inpatient services. We see people at home, in our community team bases, in GP surgeries and local clinics and in a range of other community settings. As a successful NHS Foundation Trust we also provide a number of services outside of the county in a range of community settings.

How we are performingThe Monitor Risk Assessment Framework assigns trusts a Continuity of Service rating between 1 (signifi cant risk) and 4 (no evident concerns), and a Governance rating of either red, amber or green.

Throughout 2014/15 the Trust maintained a Governance rating of ‘green’, and a rating of ‘4’ for Continuity of Service. These ratings were consistent with the Trust’s plan.

2014/15 Quarter 1 Quarter 2 Quarter 3 Quarter 4

Annual Plan

Continuity of 4 4 4 4 4

Service rating

Governance rating Green Green Green Green Green

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The Trust met, and in the majority of cases routinely exceeded, all Monitor Risk Assessment Framework targets in 2014/15. The quarterly performance levels achieved against each of the standards relevant to the Trust are outlined below:

Community and Mental Health Targets

Referral to Treatment Waiting Times: percentage of patients treated within 18 weeks: Admitted hospital based (Completed pathways)

Referral to Treatment Waiting Times: percentage of patients treated within 18 weeks: Non Admitted hospital based (Completed pathways)

Referral to Treatment Waiting Times: percentage of patients waiting within

18 weeks: (Incomplete pathways)

Percentage of Minor Injury Unit patients waiting under four hours from arrival to admission, transfer or discharge

Care Programme Approach: percentage of patients receiving follow-up contact within seven days of discharge

Care Programme Approach patients having formal review within 12 months

Emergency Admissions of 18-65 year olds via crisis support services

Meeting the commitment to serve new

psychosis cases by early intervention teams

Delayed discharge rate as a percentage of total bed days available for people over 18 in acute mental health beds

Mental health data completeness: identifi ers

Mental health data completeness: outcomes for patients on Care Programme Approach

Data completeness: community services referral to treatment information

Data completeness: community services referral information

Data completeness: community services activity information

Threshold Performance

Q3 Q4Q1 Q2

90% 100.0% 100.0% 100.0% 100%

95% 99.2% 98.9% 98.5% 98.3%

92% 99.6% 99.5% 99.3% 99.5%

95% 99.8% 99.8% 99.6% 99.7%

95% 98.0% 96.8% 98.0% 97.3%

95% 97.4% 98.2% 96.8% 96.4%

95% 98.8% 98.3% 96.8% 98.8%

174 cases 106.3% 108.8% 107.3% 107.5%

<7.5% 4.2% 4.5% 4.9% 4.7%

97% 99.8% 99.8% 99.8% 99.8%

50% 79.8% 79.9% 79.0% 74.0%

50% 100.0% 100.0% 100.0% 100.0%

50% 90.9% 91.1% 93.9% 97.5%

50% 98.4% 98.5% 98.9% 98.6%

Target


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Service Delivery – some examples of best practiceSomerset Partnership aims to deliver services of the highest quality of service possible, working with patients, families and carers and our colleagues across health and social care to provide services tailored to people’s needs. Here are some examples of what we are achieving.

Supporting the Military Our Ministry of Defence (MoD) Inpatient Service at Rydon Ward, Taunton is part of a unique partnership formed six years ago between the NHS and the MoD. The Joining Forces Network is a network of eight NHS trusts, led by South Staffordshire and Shropshire NHS Foundation Trusts, who offer UK wide mental health inpatient facilities for all MoD serving personnel and, where appropriate, additional support to their families.

Staff at Rydon Ward have developed specialist skills in treating serving military personnel and offer a comprehensive range of therapeutic,

social activities and interventions for MoD patients during their stay on the ward. The Network also offers opportunities for education and the development of skills for both MoD and NHS staff.

The Rydon team works closely with the MoD’s Department of Community Mental Health at Plymouth who care for staff across all military services to ensure MoD patients have a smooth admission into hospital and planned after-care arrangements when they leave.

Providing our services to military personnel has become an immensely rewarding part of the work undertaken by staff at Rydon Ward. The Trust takes great pride in being part of this important partnership and the services we offer military personnel and their families to support them on their journey to recovery.


7Rydon Ward Staff

Caroline Mead Carers’ Service Managerexplains:

CC

e

Our Carers’ Service

My Carers’ Assessment Worker made me realise what an important role carers play in keeping their loved ones well


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“Our Trust is proud of the service we provide to carers of people with mental health problems. We offer a creative, high quality and fl exible service which we have continued to develop for carers across Somerset.

We have been able to provide a range of carers’ information so that carers know where they can fi nd more support and other services when they need it most. We run twelve carers’ support groups, a carers’ breaks scheme and a Carers’ Participation Group which give much needed peer support. We also offer a number of carers’ courses, which include the increasingly popular Managing Diffi cult Situations workshop that we deliver in conjunction with the Trust’s personal trainers.

In 2014/15 the Carers’ Services team completed more than 1,300 formal Carers Assessments, a process which encompasses all aspects of a carer’s health and well-being and gives strategies to deal with the stress that caring brings.

Our Carers’ Conference 2014. L to R: Stephen Ladyman, Trust Chairman; Dick Acworth, Chair of the Carers’ Participation Group; Michael Eavis, Glastonbury Festival Founder and guest speaker; Caroline Mead, Carers’ Service Manager and Edward Colgan, Trust Chief Executive.

National Deaf Child and Adolescent MentalHealth Service South WestDeaf children, parents, families, and those in the Deaf community often experience challenges accessing health services. Evidence suggests deaf children are more likely to experience a mental health problem compared with the hearing population.

Somerset Partnership provides National Deaf Child and Adolescent Mental Health Service, South West, a highly specialist community outreach service offering mental health services to deaf children, their families and hearing children of deaf parents. The South West service, one of four services across the country funded by NHS England, covers Cornwall, Devon, Somerset, North Somerset, Dorset, Wiltshire, and Gloucestershire.

Children are referred to our service because their deafness impacts on their ability to access mainstream child and adolescent mental health services. Their fi rst language (or

that of their parents), might be British Sign language. We work closely with local services and also provide advice and support to professionals working with young people not receiving our service.

Our multi-disciplinary team includes a child psychiatrist, psychologists, mental health nurses, deaf family support workers, an occupational therapist, a speech and language therapist, BSL/English interpreters, managers and administrators, all working together to provide a comprehensive service for our patients.

We are also a deaf bi-lingual and bi-cultural service. This allows us to understand the nature and needs of deaf patients (and their families), and those in the Deaf community, to meet and respect their linguistic and cultural preferences and meet their mental health needs at whatever level.

I have seen a transformation in my son’s emotional wellbeing. He is much happier and has increased confi dence. Thank you


9Trust Deaf CAMHS Team

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Service Delivery –new services and sites Wessex House reopenedDuring 2014/15, the new Bridgwater Community Hospital site was opened offi cially when their Royal Highnesses, The Earl and Countess of Wessex, visited in June 2014.

During their hour long stay, Their Royal Highnesses toured the hospital, met patients, NHS staff and managers, the Hospital League of Friends and civic dignitaries. They were able to see the new courtyard sculpture and meet some of the Bridgwater College students whose artworks adorn the walls.

Trust Chief Executive, Edward Colgan, was pleased to welcome Their Royal Highnesses and said:

“I am honoured and delighted that Their Royal Highnesses, The Earl and Countess of Wessex have offi cially opened the new hospital. Patients, staff, hospital ‘Friends’ and the whole community have eagerly awaited the development of the new hospital and I am pleased so many were able to join us on the day. The new Bridgwater Community Hospital is a state of the art, modern NHS hospital for patients, staff and the local community.”

In November 2014, Wessex House, our Tier 4 Child and Adolescent Mental Health Service (CAMHS) Inpatient ward for young people located in Bridgwater, Somerset, re-opened for patients. A new team of dedicated and experienced specialist CAMHS staff and managers have been recruited to the Trust to provide a caring, compassionate and specialised service for young people and their families. Service Manager Lyn Davis explains:“We built a new team with a range of specialities so we now offer a supportive therapeutic environment the minute our young patients come through the door.” Wessex House was initially opened to four young people from across the South West, then opened a further four beds early in 2015. Plans are in place to open the fi nal four beds when the next round of staff recruitment has been completed successfully.


Her Royal Highness, the Countess of Wessex, meets Stephen Ladyman, Trust Chairman and Edward Colgan, Trust Chief Executive.

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Compassion in Practice

Quality and SafetyPatient safety and quality remain at the heart of everything we do as a Trust. In April 2014, the Government asked all Trusts to review their nursing and health care assistant staffi ng levels on each of their wards in order to make sure that every ward has the right number of staff to care for patients at all times of the day.

Research demonstrates that staffi ng levels are linked to the safety of care and staff shortfalls increase the risks of patient harm and poor quality care.

Each of our wards is different so we have worked closely with ward staff to develop bespoke staffi ng levels for each ward taking into account national guidance and staff feedback. In May 2014, the Trust Board approved the ward staffi ng levels for each community hospital and mental health ward and agreed £1.3m extra funding to recruitment more registered nurses and health care assistants.

Because staffi ng levels are important, we monitor and publish staffi ng levels each month, including recommended staffi ng levels and actual levels. By April 2015, 19 out of our 24 wards were regularly meeting the recommended staffi ng levels and we have plans in place to help improve the performance of the remaining wards.

Having the right number of staff with the right skills on duty has been welcomed by our staff. However, like many trusts, recruiting to nursing posts is not always easy.

We have developed an exciting recruitment programme which includes opportunities for career development, excellent practical and clinical support for newly qualifi ed and experienced staff and an active bank of nursing staff. When we meet the recommended staffi ng levels, staff and patient feedback is very positive with great value placed on ward staff having the time to talk, to care and to listen to their patients and carers.

Compassion in Practice has been developed for nursing and other health care professionals as a reminder of the “6 Cs”. We promote the Trust’s 10 Commitments to Care and encourage the development of a Somerset Partnership “Culture of Care” that staff can identify with and take pride in.

To celebrate our Compassion in Practice, the Trust hosted a conference on 12 May 2015 – International Nurses’ Day. The conference was attended by a wide range of professional staff, including Trust Chairman Stephen Ladyman, Trust Directors and Governors. The conference was a showcase of how staff were participating in the development of a culture of care based on our Commitments to Care, the commitments we make to our patients and their families.

The keynote address was given by Professor Keith Brown, National Director for Post Graduate Social Work at Bournemouth University, focussing on Compassion in Practice and the effect of making professional judgements. Other staff attended to demonstrate initiatives across the Trust intended to improve patient care.


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SomersetPartnership

Our Commitments to CareA strategy for nurses and allied health professionals

We will...● always put our patients fi rst

● treat our patients with dignity and respect

● recognise that every patient is an individual and will ensure care is tailored to the needs of that individual

● always care with kindness, compassion and professionalism

● do all we can to keep patients safe

● work collaboratively to provide care for the whole person

● support patients to make choices about their care

● listen to patients, carers and families and act if they are not happy with the care provided to try and remedy the situation

● provide a consistently high standard of care

● speak up if we are concerned.


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Quality ImprovementPlans

Friends and Family Test

During 2014, we consulted with staff, governors and patient representative groups on our proposals for priorities for quality improvement for 2015/16, based on the key areas from our Sign Up to Safety campaign and the Trust’s own review of its quality performance and the identifi cation of areas for improvement.

Following the consultation exercise, feedback was supportive of the approach to focus on harm-free care initiatives and on the following identifi ed priorities:

• reducing harm from pressure ulcers in hospital and community settings• reducing harm from falls in hospital• reducing harm from medication administration errors• reducing the use of restraint in mental health wards• implementing screening tools to improve the coordination of care for frail or older patients• implementing the Duty of Candour requirements.

Each team across the Trust is using these priorities to develop local improvement plans to support the Trust plan and drive up improvements in patient care and safety at every level, in every service, in every ward.

In April 2013, the Prime Minister announced the Friends and Family Test (FFT) for all NHS Trusts as a method of capturing and improving patients’ experience of care. The FFT offers an opportunity to gain important and regular feedback on services, positive or negative, and enable the Trust to respond to any concerns.

“The NHS Friends and Family Test (FFT) has been fully implemented across all services to help capture patients’ and carers’ experiences of care and their levels of satisfaction with the level of service provided. The Test asks patients and carers how likely they would be to recommend our service to their friends and family if they needed similar treatment. They can choose from six options, ranging from, ‘extremely likely’ to ‘extremely unlikely’, meaning every respondent can give quick feedback on the care they receive, giving the Trust more understanding of their needs and helping to make informed improvements.

The FFT has allowed the Trust to gain real-time feedback on its services down to individual wards and teams and helped us to drive up improvements in choice and quality. The Test has been used in our community hospitals and minor injuries units since 2013 and we have achieved the Friends and Family response targets agreed with our commissioners for these services. FFT was successfully introduced into our mental health inpatient wards in October 2014 and has now been successfully rolled out across all Trust children’s services, district nursing, community health and mental health services. On 1 April 2015, the FFT was introduced to our Dental Access Centres and is now available in all areas of the Trust, offering all our patients and carers the opportunity to shape our services and care.

Andrew Sinclair, Head of Corporate Business and lead for the Friends and Family Test explains how the Trust has been using it:

The physiotherapist was extremely thorough and professional in her examination; she was reassuring and gave excellent explanations of all aspects.


The Trust receives more than 2,000 responses each month and these give a wide range of views and comments about our services. Since January 2015 we have received more than 15,000 responses and over 90% of respondents would be likely or extremely likely to recommend Trust services to their friends and family members.

The real strength of the FFT is its follow up questions. These provide a rich source of qualitative views which can highlight and help us to address concerns much more quickly than more traditional survey methods. The

overwhelming majority of comments were positive, covering a range of topics including staff, facilities, food, waiting times and cleanliness.

The Trust listens to those who would not recommend its services and managers provide individual responses to this feedback which are then published by the Trust. A number of issues have been addressed to improve the patient experience, for example, changes to home visiting times and care planning.

Professional and personal kindness given to all patients by all staff members at South Petherton Hospital

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This word cloud contains the words most used in responses to the Friends and Family Test.


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0

6000

4000

2000

5000

3000

1000

80 139 113 147

9881219 1329 1310

2954

5263

4833

4833

Complaints

PALS

Compliments

C

P

C

Complaints Learning from complaints about communicationSomerset Partnership strives to put the voices

of patients, carers and families at the heart of the care it provides. The Trust values all comments, compliments and complaints about its services and welcomes feedback to address any shortfalls, learn from our mistakes and continually improve the quality of the care we provide.

The table below summarises the activity for the past four years for complaints, compliments and to our Patient Advice and Liaison Service (PALS) enquiries.

We recognise that things do not always go as expected and when this happens, it is important the Trust listens and responds openly and honestly to patients and their relatives and carers.

“Somerset Partnership welcomes complaints as a means of enabling us to learn from mistakes and improve our services. The two main themes that have arisen from complaints this year have been communication and involving carers.”

Complaints have shown us that one of the most important aspects of patient care is open and honest communication with patients: about their diagnosis, their medication and treatment and where their ongoing support will come from. This theme arises from complaints across many services.

As well as sharing our complaints with teams across the Trust, this year we joined 70 other NHS organisations in the #hellomynameis national launch of the campaign. The campaign was created by Dr Kate Granger, a hospital consultant from Yorkshire, to improve patient experience. Dr Granger became frustrated with the number of staff who failed to introduce themselves to her when she was in hospital. Her campaign, started on social media platform Twitter, has inspired nurses, doctors, therapists, receptionists, porters, domestics and staff in all roles. The campaign is simple – reminding staff of the importance of good communication to patients and their families.

Lucy Nicholls, Patient Experience Manager, explains:


Launch of #hellomynameis campaign at Somerset Partnership

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Learning from complaints from carersComplaints from families or carers was a theme arising this year; we are keen to learn from the experiences of carers and we hope this shows carers are becoming more aware of their importance to us as a Trust. These complaints have reiterated the need to involve carers in all aspects of care planning as a matter of routine; this is particularly important when planning discharge care, where family and loved ones are often an essential part of looking after the patient.

This year we have continued our commitment to the Triangle of Care initiative – considering carers as an essential part of the way we look after them, as well as the patient and the staff member. We have launched a Trust ‘Carers’ Charter’, explaining to carers and staff the importance of listening and looking after carers as well patients. We have rolled out our Triangle of Care project to our community services from our mental health wards where family liaison meetings and involving families is now a routine part of inpatient care.

Patient surveysThe Trust undertakes a number of national and local surveys each year to test patient experience, and identify areas which may need improvement.

Community Mental Health SurveyPatients of our community mental health services were surveyed on their experiences of our services

Our Trust was in the top ten of Trusts in the country that scored ‘better than expected’ for survey responses

Overall, the results were positive with 66% of respondents rating their overall experience of mental health services as 7 or above out of 10. Responses were generally positive about staff: 73% said that staff defi nitely listened carefully to them, 75% said that staff always treated them with dignity and respect and 66% said that staff defi nitely gave them the time they needed to discuss their care and treatment.

Areas for improvement were identifi ed and plans to improve are monitored through our Patient and Public Involvement Group.

Mental health inpatient survey This survey focused on the ward, staff, care and treatment, patients’ rights and leaving hospital. While some results were positive, there were also a number of areas for improvement, including staff making patients feel welcome on the wards and patients receiving the help and support they needed to organise their home situation during their stay. Improvements have been identifi ed as a result of the fi ndings.

Refurbishment projects continued to improve the ward environment through the year, particularly on Rowan and Magnolia Wards in Yeovil, providing single bedrooms for all patients.


St. Andrews Inpatients surveyPatients were asked for their views about the therapeutic activities and groups offered on St Andrews ward, a 20-bed mixed age acute mental health assessment ward that serves the Mendip area. As a result, improvements were made to the range of activities on offer.

Musculoskeletal Physiotherapy SurveyPatients were asked about their physiotherapy, in particular the degree to which they felt involved in decisions regarding their care. A total of 315 completed questionnaires were collected. The survey clearly demonstrated that patients were helped to understand their health condition. Respondents were generally less confi dent that they had chosen the right treatment option for them; the feedback from the survey was used to improve service communication.

Patient Experience AuditNearly 500 patients gave their views for an audit of patient experience across Trust services. Overall, responses were very positive but there were some areas for improvement around patients knowing that they can ask for a second opinion and understanding their right to accept or refuse treatment. Actions have been put in place to improve these areas.

Child and Adolescent Mental Health Services (CAMHS) surveyCAMHS patients were surveyed about what helps young people to access the service. Six young people were interviewed and a number of recommendations were identifi ed including making information about CAMHS more easily accessible to young people and parents and carers and ensuring that processes and options are explained clearly throughout.

I’d just like to say again that the service has been invaluable to us and we are so grateful that we were able to access it.Child and Adolescent MentalHealth Service West


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InnovationSomerset Partnership has an established reputation for innovation and best practice. Over the last year, we have been building on this in key service developments.

We are pleased that our commissioner, Somerset Clinical Commissioning Group, has recognised this by awarding the contract to deliver a county-wide service. We will be collaborating with Taunton’s Musgrove Park Hospital and Yeovil District Hospital to make sure we identify patients who can benefi t from the Early Supported Discharge Service.”

The new service starts on 1 September 2015.

Trust Medical Director, Dr Andrew Dayani explains further:

Just a note to say ‘thank you’ for all your support, encouragement and good advice following my recent little stroke. I am pleased to saythat I am almostback to normal

Building on innovation and excellence – Somerset’s new Early Supported Discharge Service for StrokePatients say they have a better experience when care is delivered out of hospital and closer to home. We also know that patients recover more quickly when rehabilitation takes place in their own home. The Early Supported Discharge Service has been piloted in Mendip over the past two years and now will be rolled out to all eligible patients across Somerset.

“The Early Supported Discharge pilot, based out of Shepton Mallet’s Community Hospital, has been helping stroke patients to leave hospital more quickly by providing them with their essential rehabilitation at home. The pilot has shown how well we can tailor services to support stroke patients in an earlier return home, and how we can help them to regain their independence much faster. The clinical evaluation showed a marked improvement in patients’ mobility and independence and we are pleased that the pilot has been received so positively by patients.

Success lies in the way that therapists, such as occupational therapists, physiotherapists, speech and language therapists, nurses, rehabilitation assistants and psychologists, all worked in a co-ordinated way, supporting the patient in their own home.


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Using technology to improve our serviceThrough investment in information technology, Somerset Partnership enables staff to undertake their work more effi ciently, eliminating paperwork and duplication of recording information which frees up more time for direct patient care.

“2014/15 has been a very exciting year for our Information Management and Technology team with £2.8 million investment in developments to make services more effi cient.

Over 1300 mobile computer devices have been issued across the Trust. District nurses, health visitors, school nurses, crisis resolution and home treatment teams, older people’s mental health and home treatment teams and staff working with people who have learning disabilities can all access these devices when they are out on the road, giving them access to RiO, our electronic patient record.

These changes are transforming the way clinicians are able to use and input patient data into the RiO record. Staff will be able to access RiO both off and on-line - essential for working across rural Somerset - and will have the capability to work from any location. Having access to a patient’s record through modern devices will have substantial benefi ts for staff and patients by improving patient safety, avoiding duplication of recording and reducing staff travel to free up more time for patient care. This initiative was jointly funded by the Trust and the NHS Technology Fund.

All community hospitals are now using RiO which has introduced a single patient record for the majority of Trust services, avoiding duplication when patients access more than one service.

Self-check-in kiosks have been piloted at the new Bridgwater Community Hospital to reduce queues for appointments at reception. Next year will bring digital “end of bed” care to our wards with patient notes at the end of the bed being replaced by electronic records.

We have also improved Wi-Fi across the Trust and will be installing new fi rewalls during 2015/16 which will also allow the public access to Wi-Fi in our hospitals.”

Sue Flynn, the Trust’s Head of Information, explains:


Trust Information and Technology Team

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See Something Say Something Campaign The See Something Say Something campaign is a great example of an innovative staff-led campaign. It involves a training package developed by staff which has been delivered across the Trust to develop awareness of good practice and encourage staff to speak out when behaviours are less than ideal. This initiative has won local and national attention.

In November 2014, the See Something Say Something team received the fi rst ever Compassion in Practice award at the Trust Recognition Awards. In April 2015, some of the team travelled to London as the project had been shortlisted as a fi nalist for the Advancing Health Awards for allied health professionals and clinical scientists. The Trust was delighted to hear the project was a runner up from over 300 entrants from across the country.

In June 2015, the project won the national Innovation and Best Practice Award from the Community Hospital Association.

Over the last year more than 1500 Trust staff have undertaken the See Something Say Something training. These staff will now initiate conversations with their peers to congratulate each other on good practice and gently remind each other about practice that might not be of such a high standard.

The Trust Board participated in the full training, led by the group of frontline staff who developed See Something Say Something. The See Something Say Something team has worked tirelessly to make the campaign a reality and each of them deserves recognition.

South West Mental Health Summit In July 2014, Somerset Partnership hosted a countywide mental health summit to identify the key challenges to working more seamlessly with patients and their carers in Somerset. Geraldine Strathdee, NHS England’s National Clinical Director for Mental Health, gave the key note address and spoke about the need to structure services that meet the needs of the whole person, instead of a fragmented approach that treats health needs in isolation.

Chief Operating Offi cer Andy Heron addressed the conference and shared the latest in the integration project at Somerset Partnership. Somerset Clinical Commissioning Group spoke about the new Somerset Mental Health Strategy. Other speakers represented the full range of our partners in delivering mental health services from police, ambulance and fi re services to GPs, acute trusts, council housing services and head teachers.

It was a good opportunity to share the challenges each sector experienced and to hear more about the full range of services available to Somerset patients. The strong theme of the conference was the need for a more holistic approach to support better mental wellbeing, to care for the whole person when treating mental health problems, and how much poor mental health can lead to a much more complex series of problems in housing, social care, education and employment.


See Something Say Something Team receives the Compassion in Practice Award from Stephen Ladyman, Trust Chairman

Edward Colgan, Trust Chief Executive and Geraldine Strathdee, National Clinical Director for Mental Health, at the Mental Health Summit

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IntegrationAs part of ambitions to integrate community and mental health services more closely, this year the Trust embarked on our Integration Phase Two programme.

Subject to further consultation and refi nement of these proposals, new service models will be introduced from the autumn of 2015.

Working with partners to integrate care across organisationsThe Trust prides itself on working closely with our commissioners, and our health and social care partners to better integrate patient care.

During 2013/14, Somerset Partnership played a prominent role in leading the design work of the Symphony Project. This project focused on the development of new and improved approaches for caring for people with multiple long-term conditions in the community.

During 2014, our commissioners, Somerset Clinical Commissioning Group, decided to take forward this design work through the launch of a series of multi-agency test and learn pilots across the county. Since then, the Trust has been working closely with colleagues in primary care, social care and the voluntary sector to design and deliver new Symphony-based models of care in the Taunton and Mendip areas. Further innovative work is being undertaken in Bridgwater, Sedgemoor and West Somerset on falls prevention. The Trust is also engaged with the national Vanguard integrated care initiative in South Somerset.

Winter PressuresWinter and Easter are periods of high demand which can put pressure on local services. During these times our Trust works across the health and social care community to make sure patients are able to get a hospital bed, whether in an acute hospital or a community one, when they need it.

In 2015, the Trust took part in a “Breaking the Cycle” week, an initative used successfully by other trusts around the country to help manage the fl ow of patients though hospitals during extremely busy times. Staff in our mental health wards and community hospitals and those delivering services in people’s homes, participated in the week-long initiative in the lead up to Easter.

“During 2014/15 the Trust launched a major transformation project, Integration Phase Two (IP2), to shape the way we will deliver services in the future. The aim of the project is to bring closer together mental health and physical health community services, with patients at the centre of this. The Trust has drawn heavily on the ideas and advice of staff at all levels to develop a set of plans which maintain the Trust’s reputation for innovation through integration. Key proposals include:

• create new career opportunities for non- registered staff delivering face-to-face care with the introduction of assistant practitioners and key workers• increase the proportion of time that staff spend in direct contact with patients through using the principles of mobile working, improved caseload management and reduced bureaucracy• integrate assessment and recovery functions to create community mental health teams with consultants offering medical clinical leadership• create a new 24/7 countywide crisis and home treatment service• create eight new integrated community teams bringing together district nursing, therapy staff and older people’s mental health teams• create a new young people’s 0-25 year mental health pathway• strengthen medical clinical leadership in mental health and other services where consultants work• spend less on offi ce accommodation through mobile working technology and mobile working principles

Andy Heron, Chief Operating Offi cer, explains:


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Our staff worked with acute hospital and social care staff to identify patients who were ready to be discharged, what their health and social care needs were and how they were going to be met quickly. It encouraged staff to identify blockages in the system and better ways of working. Senior staff were freed up to attend rounds every morning, regular, daily conference calls took place between organisations, and staff were empowered to make decisions that would normally go through a long checking process. This focused everyone getting patients moving through the system quickly with the care and support they needed.

The impact for patients was clear: there were 45% more discharges from community hospitals in that week than there were in the weeks before, the average length of stay dropped, and the number of available beds doubled in the following week. On our mental health wards, patient beds were also freed up and additional support was put in place to help patients remain at home through a crisis period. Support teams came onto the wards to help patients with more complex needs make plans for the next steps towards independence.

Night-sitting service – helping patients return home Another initiative employed during winter was the Trust’s temporary night-sitting service. This initiative employed health care assistants to support older and frail patients who lived alone or whose carers were ill, in their own homes by visiting them overnight to help with health or personal care or by staying overnight if the patient needed this level of support. By providing personal care and helping with basic health needs, these healthcare assistants were able to keep patients out of hospital or speed up their discharge when they no longer needed care in hospital.”

We were delighted with the care we received at hospital. The staff were courteous and kind and the service was prompt.Thank you !West Mendip Hospital.

W


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Culture and PeopleOur commitment to creating and continuously improving a positive working culture for our more than 4000 staff has involved many different pieces of work. The Annual Staff Survey remains an important piece of work and enables us to work in partnership with Trade Union colleagues to develop and implement action plans to address areas where staff engagement can be improved.

See page 20 for more information about the See Something Say Something campaign.

Recognising excellence in our staffWith a commitment to excellent patient care and a positive working culture at the heart of what we do, each year Somerset Partnership holds its Recognition Awards ceremony. It is an important opportunity to recognise the outstanding contribution of individuals and teams across the Trust as well as volunteers and community members who have made a real difference to patients, carers and communities during the year.

Staff from a wide range of services were celebrated and, for the fi rst time, the Trust invited members of the public to nominate staff for the Patients’ Choice Award and the Carers’ Choice Award.

Congratulations go to those who were awarded in 2014/15:

Outstanding LeaderAward Winner Clare Woodhead, Team Manager, Older Persons Mental Health Services, Somerset Coast, Glanville House, Bridgwater

Commendations Carol Agnew, Hotel Services Supervisor;Jayne Haynes, Team Manager, Assessment Service Taunton and Crisis Home Treatment Teams West; Abbie Comer, Diabetes Podiatrist

The Staff Friends and Family Test complements this work and has enabled us to start taking a regular “temperature-check” of whether staff feel they would recommend the Trust as a good place to work or to receive care and treatment.

In recognising the value of a regular, systematic approach to asking staff how they feel about their work, we have also developed a ‘Pulse’ survey. The Pulse survey uses the six values of the NHS Constitution and asks staff how they feel about how close (or far away) we are from working together in a way that refl ects our values and creates a positive working culture.

Ensuring an open, honest and transparent culture As part of our commitment to openness and honesty, Somerset Partnership involves and engages with staff at every opportunity.

Formal engagement with staff takes place at the Workforce Governance Group, the Joint Management and Staff Side Committee (JMSSC), and through individual supervision and appraisal. The JMSSC plays a key role in discussing issues which affect staff, and in formal consultation and negotiation with the Trust. This group has been involved in the development and delivery of our plans to further integrate community and mental health services.

The Francis Operational Group, formed in 2013 in response to the Robert Francis Inquiry into the tragic events at Mid Staffordshire NHS Foundation Trust, has now become the Voicebox group. This group provides a valuable channel for raising staff concerns and for developing staff ideas such as the See Something Say Something campaign which was introduced to empower staff to speak out about good practice or practice which they feel is not of an appropriate standard.


Commitment to Quality Award WinnerMary Martin, District Nursing, Bracken House, Chard

Commendation Su Down, Diabetes Service; Staff NurseJackie Treleaven and Heathcare Assistant Dawn Turnball, Magnolia Ward; Andy Sprod, Dental Service; RiO Community Hospital Project Group

Compassion in Care Award WinnersSee Something Say Something Team:Vanda Squire, Adult Safeguarding, Bridgwater; Karen Coffi n, Heathcare Assistant, Ilminster; Pamela Hutchinson, Porter, Wincanton Community Hospital; Sandra Beech, Matron, West Mendip Community Hospital; Julie Fussell, Community Matron; South Petherton Community Hospital; Fiona Grant, Chard Community Hospital.

Commendation Staff Nurse Sally Woods, Burnham-on-Sea Community Hospital; Mandy Gadd and June Troutt Support Time and Recovery; Carrie Butcher Bridgwater; Community Mental Health Team; Sarah Appleton, Speech and Language Therapist.

Patient Safety Award WinnerSister Emily Davies, West Mendip Hospital

Commendation Staff Nurse Vicky Baker, Williton Community Hospital; Heathcare Assistant Gabriella Dyment, Bridgwater District Nursing Team; Staff Nurse Amanda Hoskins, Burnham-On-Sea Community Hospital

Dignity in Care Award WinnerJason Weetch, Memory Assessment Service Nurse and Carey Workman, Community Psychiatric Nurse, Barnfi eld Unit Older Persons’ Mental Health Team, Minehead and Magnolia House Older Persons Community Mental Health Team, Yeovil

Innovation Award WinnerThe Emerging Personality Disorder Service: Ruth Habberfi eld, Clinical Lead; Marcia James, Support Worker; Jon Knight, Support Worker, Personality Disorder Service, Summerlands,Yeovil

Commendation Dr Joy MacRae, Clinical Psychologist, South Somerset Day Services Team; Karen Dockings, Clininical head, Speech and Language Therapist, Oncology


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Chief Executive’s AwardAward WinnerTracy Evans, Head of Mendip and South Divisions and Hollie Camm, Clinical Lead for Somerset Primary Link, Wells

Patients Choice Award Award WinnerFern Busuttil, CAMHS Participation Worker, Ash Ward, Bridgwater

‘Everyone Counts’ Award winnerMichael Munt, Employment Support Specialist, Foundation House, Taunton

Commendation David Knight, Mendip Assessment Team

Unsung Hero Award WinnerJez Eagle, Deputy Ward Manager, Rydon Wards, Taunton

CommendationSylvia Parsons, Community Psychiatric Nurse; Debbie Hartstone, Business Development Manager; Belinda Bennett, Developmentmental Team Leader

Team of the Year Award WinnerNursing Team - Bridgwater Minor Injuries Unit

CommendationTaunton Wellbeing ClinicBridgwater Bay Administration Hub

Volunteers’ Award Award WinnerFreewheelers Emergency Voluntary Service Work across Somerset and Bath and Bristol

Chairman’s Award Jill Meikle, Governor for Carers

Our congratulations and thanks goes tothem all.


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Mary Martin receives her award for Commitment to Quality

Micheal Munt receives his Everyone counts award

Trust Chairman presents the Emerging Personality Disorder Team with their award for Innovation

Jill Meikle with her Chairmans Award

The NHS South West Leadership Awards were celebrated again, this year in a ceremony at Brunel’s Old Station, Bristol, in November 2014.

The Trust was shortlisted for three nominations under the following categories:

• Trust Board for NHS Board/Governing Body of the Year• Emma Norton, Ward Manager, MagnoliaWard for NHS Development Champion of the Year• Mary Martin, Professional Lead for District Nursing, NHS Emerging Leader of the Year.

Trust Chief Executive Edward Colgan was also presented with a Special Award for Contribution to Leadership Development by Sir Ranulph Fiennes OBE, on behalf of the South West Leadership Academy.

Edward Colgan receives Special

Award for Contribution to

Leadership Development from

Sir Ranulph Fiennes OBE


27

NHS South West Leadership Recognition Awards

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Viability & GrowthSomerset Partnership had a total operating income of £158 million in 2014/15 and has been rated by Monitor as four (out of four) for its fi nancial sustainability. The Trust has a strong track record of delivering challenging fi nancial targets. In 2014/15 we delivered a cost improvement programme (our contribution to the Government’s effi ciency savings) of £7.6 million and ended the fi nancial year with an operational surplus of £508,000 - £7,000 more than planned. This is a signifi cant achievement given that many of England’s Trusts have declared defi cits and that we are in the tenth year of increasingly diffi cult cost savings.

Alongside the delivery of challenging fi nancial targets, our performance has continued to improve. We have maintained a strong performance against all key health targets – in some cases ranking the Trust amongst the best in the country.

In providing an extensive range of community and mental health services, the Trust spent £158 million. This chart shows where that money was spent.”

“In 2015/16, this surplus means we can continue to invest in information technology – giving front line staff the IT tools they need. We can also replace old diagnostic imaging equipment and deal with the backlog of estate maintenance to ensure our buildings are maintained properly to support staff to deliver great patient care.

Next year’s fi nancial challenges will be even greater for the Trust. We will continue to generate additional income and bring new business into the Trust. In the past year we attracted £3 million of new business to the Trust.

Pippa Moger,Director of Financeexplains:

Pi M

Where does the money go?

Pay (73%)

Establishment costs (4%)

Premises costs (7%)

Depreciation and fi nance (5%)

Supplies and services (7%)

Other (2%)

Purchased health (2%)

2%2%

5%4%

7%

7%

73%

Cost improvements programme 2014/15: £7.6 million. Achieved.


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Looking forwardAttracting new services is a vital part of our viability and growth. In competing for new services we look to where our strengths lie and where we can demonstrate a history of high performance and quality services for patients.

One of Somerset Partnership’s new services is providing dental services in the County of Dorset and on the Isle of Wight.

“In the summer of 2014, the West and East Dorset Special Care and Paediatric Dental Services and the Isle of Wight Community Dental Services went out to tender for community dental services in the Dorset and on the Isle of Wight. Somerset Partnership’s Primary Care Dental Services had previously been successful in two previous tenders for dental services outside of Somerset (the Dorset Prison Dental Services in 2010 and the Bristol Prison Dental Services in 2014) and after evaluation and assessment, the Trust decided to bid for both of these contracts.

The successful bid was due to a huge team effort from across the Trust and the contracts went live on 1 April 2015, following an intensive six-month mobilisation project. The services and staff we have acquired are very high quality with highly respected senior clinicians supported by excellent teams of dental nurses. The focus in Dorset initially is to integrate the West and East Dorset services as one service with common procedures and pathways for Paediatric Dental Services and Special Care Adult Dental Services.

On the Isle of Wight we are focussing on ensuring that the strengths of the full team are used to continue to provide high quality services more effi ciently. The Isle of Wight service is smaller but is fairly complex including not only special care dentistry and paediatric dentistry, but also out of hours urgent dental care services, some general dental services, and orthodontic services.

As we deliver these services we expect that both patients and clinicians across the whole area from Somerset to Dorset to the Isle of Wight will benefi t from a more integrated service, with shared knowledge, expertise and skills, common pathways and standards.”

Domiciliary PhlebotomyThe Domiciliary Phlebotomy Service is a new service which provides a professional and caring service for housebound adult patients who need to have a blood sample taken within their home. The service collects blood samples every morning from Monday to Friday for these patients who are registered with a Somerset GP. It means a faster service for these patients who would not otherwise fi nd it easy to access mainstream services.

Andy Sprod Clinical Director of the Trust’s Dental Access Services explains:


30

School-based national fl u vaccinationFrom 2015/16, Somerset Partnership will be providing the school-based National Flu Vaccination Programme to school children in years one and two across Somerset and North Somerset.

Our Trust has been successful in a bid to deliver the National Flu Vaccine programme for the next three years to 5 – 7 year olds in primary schools - both within the Trust area of Somerset and across the border into North Somerset.

The Flu vaccine for this age group is administered nasally and will be delivered by the Trust School Nurse team across both counties. This is an exciting time for the Trust as it is the fi rst schools-based national programme outside of Somerset.

Immunising is due to start in October 2015 and our service is be delivered as a nursing-led school-based programme. This is a mark of success for the School Nurse team as most areas of the country have opted for a GP or pharmacy-based delivery teams.

The Flu vaccine programme will be delivered in the autumn school term, extending each year to incorporate older children each time. In 2016, it will be extended to Year Three children (7 and 8 year olds). This new service has enabled new staff to be recruited to the team including community staff nurses and an administrator, who will support the existing staff.”

Staff were clear, friendly and effi cient. Would recommend.


Trust School Nursing Team based in Taunton

Working with our local communitiesA word from one of our Governors

We continue to actively involve ourselves in public meetings, patient participation groups and Health Forums to better understand the needs of the population of Somerset and to ensure these are refl ected in the service provided by the Trust.

The role of the Council of Governors continues to evolve and change. We welcome our new governors this year and are sure they will play an active part in the years to come.

A fi nal mention must go to Sheila Harvey, our Lead Governor, who skilfully and expertly directs the Council of Governors, encourages us to give of our best and forges such good relationships with the Trust as a whole.”

League of Friends demonstrate the support of our local communities Our Leagues of Friends at our 13 community hospitals have a long history of supporting the Trust with major fund-raisers within their communities for signifi cant works in our hospitals. Here are some examples of works completed last year.

CrewkerneCrewkerne residents, members of the hospital League of Friends and hospital staff were joined by Lady Gass DCVO JP, Her Majesty’s Lord-Lieutenant of Somerset, who opened Crewkerne Community Hospital’s rehabilitation department. The modernised unit, opened to patients in 2014, was made possible thanks to Crewkerne League

“Life is never dull in the NHS and this extends to the work of governors too. In such times of uncertainty and change, our principal role is to ensure that the Trust continues to focus on putting patients fi rst. We represent all the patients, their carers and their families served by the Trust. We are independent champions of their needs.

So the relationship between the governors and the Board and staff of the Trust is vitally important. Undoubtedly the Board makes great efforts to be open and honest with us: actively involving us in planning for the future and getting our views when major decisions have to be made. When we have had concerns about the level of care, the management team, both as a group and individually, has always been very helpful in listening to us and responding in positive and meaningful ways.

Governors have been made to feel very welcome at Board and other committee meetings where we can observe the Trust in action. We are also able to play an active part in formal assessments of all the Trust’s wards for cleanliness, tidiness, their standard of nutrition and their overall welcoming nature. Furthermore we talk to the staff about their work in the Trust: their problems and their rewards, their highs and their lows.

Another of our responsibilities is to make sure the Non-Executive Directors (NEDs) are playing their part in the Trust by challenging what the Trust is doing and intends to do. A new innovation this year has been to invite a couple of NEDs along to our governor meetings to discuss their roles and experiences within the Trust. This is another way in which the governors seek to engage with and infl uence the Trust.

Our governors play an important role in the life of our Trust. Elected Governor for Sedgemoor, David Allen explains:


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of Friends and their very generous donation of £175,000. The refurbishment created a separate rehabilitation space for inpatients, and outpatients now also have their own entrance to the unit so staff can still access both as easily as before. Chief Executive Edward Colgan spoke at the opening and said: “This is wonderful news for our patients. This project is the latest in a 66 year long history of the League of Friends funding major development schemes to improve the hospital for patients. The Crewkerne League of Friends has shown tremendous support.”

Dene Barton(Cotford St Luke, Taunton)Thanks to the Friends of Dene Barton Community Hospital, the ward now enjoys a quiet room for relatives and carers. The room was previously an unused lobby area close to Lydeard Ward. The League of Friends funded all furnishings and decoration and in September 2014 Paralympic Gold Medallist Debbie Criddle MBE offi cially opened the room. Debbie is a Paralympic dressage rider who won two silver medals and team gold at London 2012. The Chairman of Cotford St Luke Parish Council, Don Stansbury, was also present. The room offers a quiet space for relatives and patients to have time to themselves away from the busy environment of the ward. It is also a place where hospital staff can discuss the needs of individual patients with their relatives and carers in a private and friendly atmosphere. The room has two recliner chairs where relatives can rest or stay over.

Trust Charitable Funds – making a difference for dementia patientsEach year the Trust receives donations from patients, carers and their families. At Magnolia Ward, Yeovil, the Trust was able to use these funds to create a dementia friendly garden for patients on Magnolia Ward.

Gary Johnson, then Manager of Yeovil Town Football Club, joined staff and patients to offi cially open the new garden at Magnolia Ward in July 2014. The garden was paid for through public donations made to the ward and took around fi ve weeks to complete. The landscape architects worked in consultation with Trust staff (including Emma Norton, Ward Manager, and staff occupational therapists) who advised

on the specifi c requirements for patients with dementia and together drew up the plans. Emma Norton was delighted with the result and said:“The development of this dementia-friendly garden has signifi cantly improved the service that Magnolia ward offers its patients. “People with dementia have the same need for outside space as everyone else. Our patients are now able to get out into the fresh air and get some exercise in a safe and secure garden. They are also able to use the garden to relax in and also to sit with their loved ones when they visit. They are able to do things that they would have done at home such as planting, weeding, watering and tending to the garden either individually or as part of a group activity-all of which contributes to their sense of wellbeing.”


Putting our thanks on record

The Trust is also grateful to the contribution our members and particularly governors make to the Trust, through Council meetings, working groups, constituency meetings and assisting in developing the Trusts’ planning priorities for next year and beyond.

Finally, thanks to our staff. All the achievements set out in this Annual Review are the result of considerable hard work and commitment from staff at all levels of the Trust: out in the community, in our hospitals and inpatient wards, and in administrative and headquarters functions.

This year we have launched two Forums to ensure the voice of the community is heard in the Trust. The League of Friends’ Forum has been an opportunity to meet and share learning across our 13 Leagues of Friends, to build relationships and to hear news and developments from the Trust. The Voluntary Sector Forum comprises charities and patient and carer groups from across Somerset and has met to feed back the views of the wider public to the Trust and to keep informed of Trust developments. We would like to thank the members of both of these forums for meeting with us and for providing their unique and insightful views which have helped us develop our services for the community we serve. We have greatly enjoyed working with you and look forward to building on these relationships in the coming year.

“Thank you for being simply great!”. Mulberry Centre


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Somerset Partnership NHS Foundation Trust2nd Floor, Mallard Court, Express Park, Bristol Road, Bridgwater TA6 4RNTel: 01278 432000 Fax: 01278 432099Email: [email protected]


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