Mental HealthMatters www.wlmht.nhs.uk

September 2011

Quality Award Winners

Involving ServiceUsers

We’re halfway through our consultation period about our proposals to become a Foundation Trust (FT).

We’ve successfully negotiated the first stage in our FT application to NHS London and have received constructive feedback from them. The Trust is currently working to further develop our plans with key stakeholders and commissioners.

The next step is to prepare for an audit of our ability to deliver the plans set out in our application. We expect this to be conducted next year.

We’re also consulting extensively with all our stakeholders including staff, service users and local community groups about what you think about FT status and the make-up of the FT’s Council of Governors.

We’ve held a series of consultation meetings at Board meetings, staff forums and at special events across the three boroughs and at Broadmoor

Hospital attended by hundreds of local people. We’ve also been recruiting members to the Foundation Trust – as well as staff, we’ve recruited over 3100 public members, well on the way to this year’s target of 4000 but we still need your help. If you know someone who’s interested in becoming a member please ask them to get in touch with our membership team at member@wlmht.nhs.uk

If you’ve not yet received a consultation form and would like one, please contact the team at ft@wlmht.nhs.uk. The consultation ends on 27 October.

You’ll have heard the Government talk about doing things in a more “joined-up” way. I’m very confident that our recent and ongoing restructuring, designed to enable us to implement best practice, share learning and drive change across services independent of location more rapidly, will help this Trust work in a more joined-up way, for the good of our patients.

An important new approach is being introduced into the NHS to help us take this to the next level. It’s called “Patient-centred workforce planning”. Specialist and Forensic Services (SFS) are leading the way and have already held two workshops in June, with two more taking place in September.

The SFS faces big challenges. We need to reduce the length of stay and decrease delayed discharges. We must develop care pathways which are clearer to both service users and staff and are more recovery-oriented. And we need to be more efficient and effective without increasing risk to the public or patients. Our commissioners expect nothing less.

Patient-centred workforce planning helps join up these goals. It starts from the questions: “What do patients require and what combination of skills and experience are needed to deliver this?” And “How will it change in different care pathways?”

With patients at the centre of things, it’s clear that not all the services they experience need to be delivered by the same staff roles as now. Some roles may need to be reconfigured.

This joined up thinking also gives new opportunities for staff development. With roles based on the combination of skill and experience required rather than on the traditional structures of the professions, new career paths and different training opportunities can be created.

We’re used to putting the patient at the centre of our clinical practice, but we have yet to design roles that truly reflect this and realise the benefits. As we start to implement recovery at the Trust, our thinking need not be hampered the boundaries in old models of care. Managing the change may tax our ingenuity, but innovations of this kind will help take us to our goal of excellence.

Contact your HR Business Partner to find out more.

Peter chief-executive@wlmht.nhs.uk

Editorial teamMental Health Matters is written by the Commmunications Team for staff and service users of West London Mental Health Trust and for carers. Please get in touch with your news and views.

Paul Wastell: paul.wastell@wlmht.nhs.uk

Ali Nunan: alison.nunan@wlmht.nhs.uk

Telephone: 020 8483 2283

Cubbon’scorner

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Peter Cubbon, Chief Executive

Marien O’Brien, Ealing Loud and Clear service user representative at an FT consultation event.

Staff survey – have your say!

What’s it like working for the Trust? And what do you think about your work?

These are two of the questions we’ll be asking all staff in next month’s confidential staff survey, part of the NHS’ national annual survey, now in its 9th year.

Your answers will help us to improve our services and the way we work.

Last year, for example, we used what you told us to help tackle bullying and harassment – introducing new policies for managers to follow. On p21 you can read what we did in response to what you said in the 2010 survey.

Your comments count – let us know what you think in this year’s survey.

Have you done your PDR?

One area the staff survey focuses on is personal

development reviews (PDRs) – one of the ways we’re trying to ensure all staff have the opportunity to discuss career and personal development with their manager. By now all staff should have begun this year’s PDR process – if you haven’t, you’re missing out. Ask your manager to set a date to meet and discuss it.

Opportunity for staff to have your say

On the cover:Service user Keith Briscombe – getting involved helps recovery. Full story on page 12.

Foundation Trust

application update

Paul Wastell and Ali Nunan

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The Quality Awards 2011

Halima Hachimou, Ward Manager, Hammersmith & Fulham Mental Health Unit

Nael Suleiman, Healthcare Assistant, Tony Hillis Wing

Jimmy Hicks, Activity Coordinator, Hammersmith & Fulham Mental Health Unit

The 2011 Quality Awards – the Awards’ 7th year – have seen a host of Trust staff, carers and service users nominated for their outstanding work.

In all, we received over 150 nominations from staff, service users and carers across the Trust for the special people who have gone the extra mile.

The judging panel – Chief Executive Peter Cubbon, Chairman Nigel McCorkell, Executive Directors, staffside, service user and carer representatives from across all three CSUs and Broadmoor Hospital – considered each nomination carefully and drew up a shortlist of 29 nominations

in the 10 Quality Award categories.

All the shortlisted individuals and teams were invited to a glittering Quality Awards ceremony on 21 September at Ealing Town Hall where the winners and runners-up were announced in an Oscars-style ceremony.

The winners received a Quality Awards trophy. Our special congratulations to them, and to all staff who took part, for making this such a successful event. Here are this year’s winners and runners-up. We’ll publish the night’s best pictures and stories in the next issue of MHM.

Halima Hachimou, Ward Manager, Hammersmith & Fulham Mental Health Unit

Belinda Huse, Estates & Facilities Manager, Broadmoor Hospital

Suzanne McMillan, Inpatient Service Manager, Lakeside

Nael Suleiman, Healthcare Assistant, Tony Hillis Wing

Jeremy Mulcaire, Sector Manager, Avenue House

Parkland Ward, The Orchard

Jimmy Hicks, Activity Coordinator, Hammersmith & Fulham Mental Health Unit Katie Whitewood, Memory Clinic Triage Worker, St Vincent’s, H&F

Natalie Rimington, Accommodation Manager, Lakeside

Halima is the manager of Hammersmith & Fulham’s new admissions ward, Avonmore.

She helped set the ward up earlier this year – working hard to achieve a successful launch and create a welcoming environment for its 22 adult service users and staff.

She listens to colleagues and to service users carefully and treats them with respect.

She’s a hands on manager, unflappable in a crisis, always ready to help and ready to lead when things get tough.

She’s received several nominations from her team. One wrote: “I have never worked with such a happy, fair and amazing manager.”

Service users on Ealing’s Tony Hillis Wing describe Nael as “enthusiastic, helpful and willing”. He demonstrates respect for staff and patients alike and is always willing to go the extra mile to ensure patients are well cared for.

Nael has been known to book himself onto shifts so he can help make special events, like the ward barbecue, go with a swing.

He does event shopping, organises games afternoons and DVD nights and helps take service users out for town leave.

Unsurprisingly, service users like having him around. He’s caring, understanding, patient and kind.

Jimmy is an Activity Coordinator at Hammersmith & Fulham’s Mental Health Unit who likes to say “yes”.

Whether it’s running weekly gym activities, creating individual fitness programmes for service users or organising gardening clubs and parties, he’s a man who likes to take on a challenge.

He’s cheerful, takes the time to chat to service-users and treats them with respect and compassion.

He’s calm and collected in a crisis.

All in all, he’s a great person to have around who cares deeply about his work and the welfare of service users.

Excellence in leadership

Caring

Responsibility ClinicalWinner

Winner

Winner

Runners-up

Runners-up

Runners-up

1st

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Togetherness through involvement

Togetherness

Lina, Carer at Hammersmith & Fulham CAFS Carer Representatives, West London Forensic Services

A Broadmoor Hospital Patient

The Safeguarding Children Team The Physical Healthcare Team, Broadmoor Hospital

The CAMHS Learning Disability Team, Ealing

Winner

Winner

Runners-up

Runners-up

Lina, Carer at Hammersmith & Fulham CAFS

The Trust’s Safeguarding Children Team

Lina is the mother of one of the Trust’s service users, a young man who has autism.

As well as managing to look after him and his younger brother she helps train fifth year medical students from Imperial College, working with them 20 days a year to give them an opportunity to find out about her experiences.

Lina has become expert at giving really useful feedback to the students on their interviewing skills and the students have fed back that this is one of the most useful training experiences they receive.

The Trust’s Safeguarding Children Team is small but responsible for an extremely important service.

They work tirelessly to raise the profile of safeguarding children across the Trust. They’ve created a mandatory training programme for staff and carried out audits of our safeguarding systems and processes.

One example is the Trust-wide audit of child visiting rooms. It’s resulted in significant improvements on inpatient sites.

Their work has received extremely positive feedback from the Care Quality Commission during the course of their inspection of safeguarding arrangements in Ealing.

Margaret Rioja and Vushe Hove, West London Forensic Service User and Carer Involvement Leads

Denise Sullivan, Mental Health Service Manager, Feltham Young Offenders Institution

Margaret Rioja and Vushe Hove, West London Forensic Service User and Carer Involvement Leads Nicky Miller, Clinical Nurse Specialist, Broadmoor Hospital

Lakeside Ward Managers

Denise Sullivan, Mental Health Service Manager, Feltham Young Offenders Institution Lakeside Managers

Terry Fegan, Practice Development Nurse, Broadmoor Hospital

Margaret and Vushe co-ordinate service user and carer involvement in the West London Forensic Service which in turn contributes to the improvement of service user and carer experience.

Part of their work is delivering Care Programme Approach training in collaboration with services users and carers.

The training emphasises the experiences that service users and carers have of CPAs and it’s led to more inclusive practices.

Margaret and Vushe also conduct focus groups in clinical areas. These help staff to get a clearer view of how service users perceive their work, helping them to improve the quality of what they do.

Denise is the primary link between The Trust and Central North West London who won the overall bid to provide mental health care for the Feltham Young Offenders Institution.

She has been instrumental in overseeing the mental health contract changes so that staff in both multi-disciplinary teams work together to meet the same goals.

She continually strives towards excellence to ensure the service we provide is a great example of healthcare services in a prison setting.

Denise is a caring individual who understands the needs of adolescents and is always a wise shoulder to lean on.

Excellence through learning

Excellence in change management

Winner

Winner

Runners-up

Runners-up

Responsibility Non-clinical Chairman’s award

Excellence in innovation

Parminder Gill, Domestic Assistant, Lakeside Jacqueline Thomas, Service Manager, Hammersmith & Fulham CAFS

Delore Jones, Personal Assistant, Broadmoor Hospital

Chris McKay, Dual Diagnosis Project Lead Russell Johnson, Security Intelligence Officer, Broadmoor Hospital

The Working Age Memory Clinic, Ealing

Winner

Winner

Runners-up

Runners-up

Parminder Gill, Domestic Assistant, Lakeside

Olive Thompson, Reception Manager, Hammersmith & Fulham MHU

Chris McKay, Dual Diagnosis Project Lead

Parminder is a domestic assistant on Kestrel ward at Lakeside. She’s caring, hard-working and efficient, always smiling and polite.

She’s both conscientious and dedicated, keeps Kestrel clean and tidy and is always willing to help solve a problem when colleagues want something done.

Parminder’s also keen to learn from others. Colleagues on Kestrel ward have nominated her because she “definitely deserves recognition”. In short, they’re proud of her and proud she’s part of their team.

Chris has been responsible for driving the development of Dual Diagnosis provision in local services. He has delivered evidence-based training to all clinical staff including Dual Diagnosis champions training with University of West London. His extensive knowledge and experience and his positive attitude has enabled the Trust’s Dual Diagnosis strategy to be successfully implemented.

Chris audited the care plan documentation of all inpatient ward managers and nurses in Lakeside.

His innovative approach has produced great results. Feedback from our commissioners is that our nursing records now show clear interaction with patients, evidence of regular structured one-to-ones and a significant improvement in the quality of care.

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Graham Slipper, Head Gardener

Graham Slipper Seasoned gardener Graham received a Special Recognition Award for his 50 years of green-fingered service to the Trust.

Graham, Head Gardener, who retires this year, aged 65, joined the Trust at the age of 15 and has worked at St Bernard’s ever since giving tender loving care to our trees, flowerbeds, shrubs and grass.

Presenting him with a special award, Chief Executive Peter Cubbon told him: “You’ve been here man and boy. It’s a truly remarkable achievement.”

Graham cut his teeth as a junior gardener in the 1960s, propagating seeds in the greenhouse at the back of the St Bernard’s site. He eventually became head gardener, going on to win awards for the plants he helped to nurture as a young man.

Through wind, rain and snow, Graham has been part of the landscape of St Bernard’s for as long as anyone can remember. He’s due to retire later this year. In August his colleagues presented him with a golden trowel to mark the occasion.

Graham said: “I wouldn’t have it any other way – I’m not one of those office types who can sit behind a desk. Even though the winters can be hard, you get the reward of being outdoors in the spring and summer, watching everything change.”

Olive Thompson, Reception Manager, Hammersmith & Fulham MHU

Hedy Cracknell, Occupational Therapy Team Secretary

Olive has worked with us for 31 years and is one of the Trust’s longest serving members of staff.

For many service users, carers and visitors to the Hammersmith and Fulham Mental Health Unit, she’s the friendly face of the service, the first person they see on arrival.

Olive began as receptionist at the Charing Cross Hospital in 1980 and has been with us ever since.

She loves her work – and she’s kept going to the wise age of 74.

As well as knowing everyone and everything about the service, she’s a good listener, smart and helpful. If you’ve got a problem she’ll help sort it, no matter how busy she is. In short, she’s great at her job and embraces and promotes the Trust’s values on a daily basis.

Special recognition award

Winner

Winner

Our sponsors The 2011 Quality Awards were generously sponsored this year by two of the Trust’s suppliers, Capsticks and RSM Tenon. We’re very grateful to them for their financial support.

Runner-up

What’s the most important lesson you learned on your last shift?

Just how patient and considerate our staff can be. Due to the high level of new patients who haven’t had time to settle into the ward routine, you would expect this ward to be quite challenging. Yet on this shift, one of the things I noticed immediately was the positive therapeutic atmosphere on the ward. The patients appeared to trust the staff, and the staff were calm and positive in their interaction with patients.

What will you change as a result?

As a senior manager, I’m obviously aware of how hard staff work, but when you actually roll your sleeves up and do it alongside them, it reminds you of the importance of continuing to represent shop- floor nurses at Senior Management Team level, and to value what they do every day.

What do nursing staff think?

Ken Wakatama, Clinical Nurse Manager, who leads Banbury’s nursing team, says:

“When staff see a senior manager like Jimmy working with them, it breaks down the ‘them and us’ culture, replacing it with a sense of togetherness, unity and support.

“It gives us a chance to speak to managers face to face, shows them the issues they’ve only heard about and demonstrates that SMT are prepared to listen.”

“You can’t learn to swim from reading a book”, says Jimmy Noak, Deputy Director of Nursing at Broadmoor Hospital. It’s why the “Back to the Floor” initiative, which sees the Hospital’s senior managers return to the ward floor monthly to carry out a five hour shift, is so essential.

Since September 2010 they’ve undertaken a variety of roles and Back to the Floor has been positively received by staff and patients. We asked Jimmy to tell us more.

How was your last shift?

Very good. It was a twilight shift (7.30pm to 12.30am) on Banbury Ward, a very busy ward dedicated to admitting new patients. The ward needed an extra pair of hands to help with a new admission, and as well as helping settle the new patient in, I was responsible for carrying out general ward observations and duties in caring for all the patients.

What impressed you most?

It has got to be how organised the ward was. This was evident from the comprehensive handover I received when I first arrived, to the fact that timings for meds (giving patients medicine), supper and observations were all sorted out well in advance. This was down to the leadership of Janet Desouza who was the nurse in charge on the shift.

It was obvious staff knew exactly what needed to be done and when.

They showed me an outstanding example of how excellent organisation, teamwork and efficient use of resources results in a good ward atmosphere.

It also helps patients feel safe and this means they are less likely to have a crisis or act out.

Why did you introduce “back to the floor”?

It gives senior managers a better understanding of what’s going on in the wards. We see first hand the quality of care provided, which gives us much better insight than any KPI report or patient survey ever could. It’s also a way of providing visible leadership, continued clinical engagement and improving communications with staff and patients.

Does it work?

It’s going well. I monitor each directorate’s log of activity and produce quarterly reports for the senior management team. These indicate managers are being seen more on wards but we need to do more to improve consistency. It’s always hectic here so instead of going back to the floor some managers carry out two or three hourly ward visits instead. We’ve found these are valuable but they don’t offer the same experience as a “back to the floor” shift as managers aren’t able to become part of the team. So “back to the floor” is an essential part of managers’ role and we need to make it a priority.

Jimmy goes back to the floor

It’s been a busy year for Isis ward staff. As well as hosting a prestigious national conference, in July the team were awarded National Association of Psychiatric Intensive Care Units (NAPICU) accreditation, making the Broadmoor Hospital ward the only high secure accredited psychiatric intensive care unit in the country.

For the team, accreditation means recognition of the quality of their work and allows them to identify gaps in practice and work together to address these. Team Leader, Mphindisi Nqwaku, said: “The accreditation process makes you look at and question your decisions. By closely assessing what we do and what we do well, we’ve developed new processes and ways of working which allow us to respond much more quickly when we come across similar situations.

“As well as all these benefits, this exercise has helped staff learn new things, recognise their unique set of skills and take pride in their work. We understand that a lot more can be done, so we’re working hard to improve things every day. You often hear the phrase ‘caring to make a difference’ and the NAPICU accreditation shows that on Isis Ward this really is happening.”

Isis ward gets

NAPICU accreditation

Ken Wakatama, Clinical Nurse Manager, Broadmoor Hospital

Jimmy Noak, Deputy Director of Nursing, Broadmoor Hospital

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Continued...

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The first thing that goes when you’re unwell is your self-esteem – you lose it all. It’s the hardest thing to get back. Helping to support and give hope to others made the difference in my recovery, because it made me feel worthwhile again.

She got me on this course to manage my anxiety where I learned to shout ‘STOP!’ when things get on top of you. I did it on the bus one day – everyone looked around for a minute but it wasn’t the end of the world!

Service user, Keith, 48, was diagnosed with severe depression in 2006. He’s been admitted as a voluntary inpatient to Lakeside on three separate occasions. Keith lives in Hounslow with his partner and family. He keeps active, plays soccer and is a former left back for the Hounslow Hawks.

Now he’s helping to train Trust staff about the importance of listening to service users to speed their recovery. This is his story;

“I’ve always been on a knife-edge in my life. I had a self-destruct mode, whether in relationships, at work, or in my family.

“About four years ago I had a catastrophic breakdown – ambulances, police, the whole lot. I was drinking a lot, doing illicit drugs. It wasn’t until I was admitted to hospital that I realised that I had a mental health problem, and it wasn’t just my personality traits. I actually had depression and personality disorder.

“First time, I was in for nine or ten weeks. It was all very professional and ‘tick-box’, and they prescribed medication. I kept telling them it didn’t agree with me – I felt terrible on it. I was discharged and of course, three months later, I broke down again.

“This time, it was very different. I had a keyworker who wasn’t just professional, she actually cared about me. Instead of going through the checklist or saying ‘What’s wrong?’ she would say to me: ‘How are you feeling?’

“This opened up such a different conversation – you can glean so much from someone’s answer to ‘How are you feeling?’ It felt like she was there to help me work out how I was feeling and then find ways to help me sort the problems.

“She also involved my partner and my family – she would ring them regularly. My doctor agreed a change in my medication to one that suited me better.

“In time, I wanted to get back into society but I was scared – even to go on buses – in case I lost it. My keyworker told me about Hounslow Hawks (a service users’ football team), so I got involved with them.

“My keyworker took time to talk to me about what was stopping me doing what I want to do and was interested in me as a person. To work in mental health, I think it’s quite simple – however many qualifications you have, or however technically good you are, you have to care.

“It’s not been a completely straightforward journey. At one stage I got the hump and threw it all in. But you can never go back to where you were, you always have to move forward to where you want to be.

“Now I see mental illness for me as a chance to change my life. My old life was making me ill. Now I do a lot of work with the Trust. I share my experiences with new staff in the induction and I help out at a drug rehabilitation centre. It’s great.

“I’ve learned that asking someone ‘What’s wrong?’ adds to the sense of hopelessness. If you’re ill, you’re not sure of your own mind. I’ve learned that helping to support others gives you back your self-esteem. I tell staff I meet: ‘Just take time to talk to people’. That’s how you can help them on the journey towards recovery.”

Mental Health Matters12

Keith’s story: living recovery to the full

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Keith with his partner, Wendy and Yorkshire terrier, Scruffy

Keith, a keen footballer, stays active to keep healthy

A little sharing goes

a long way

In National Liftshare week (3 -7 October), we’re encouraging staff to sign up for a liftshare scheme at www.wlmht.liftshare.com

Oxford-based, Vickie Holcroft, Redevelopment Programme Director and Tony Cloke, Redevelopment Programme Support Manager, have already paired up on their 70 mile a day round trip. They save the environment and £500 a year each on petrol.

The secret is flexibility – if one of you overruns at a meeting the other may have to wait a while. “But it’s well worth the break you’ll get from driving a couple of times a week,“says Tony.

Says Vickie: “Compromise on start and finish times and coordinate your diaries. If you can do something at home, pack up your laptop and leave, so the other person gets out on time. A little consideration is the key.”

Sharing: Vickie Holcroft, Redevelopment Programme Director and Tony Cloke, Redevelopment Programme

Support Manager

13 Mental Health Matters

A leadership training programme for specialist psychiatric registrars has been a huge success – helping clinical staff to gain new skills and insight into project management.

The first cohort of six doctors to undertake the Psychiatric Specialist Trainees’ Leadership Development Programme finished in July. As part of the training, the doctors each managed a project of their choice, helped and supported by local managers and the Trust’s Programme Management Office, which specialises in managing major projects.

The doctors’ skills were assessed at the outset against the Medical Leadership Competency Framework. This helped shape the projects they became involved in.

The training, which began last Autumn, included risk management, presentations skills and developing a business case for the projects. The learning from the experience of leading change was a major benefit. It was facilitated by a monthly learning set run by Dr Elizabeth Fellow-Smith, Consultant Child Psychiatrist at the Trust and Programme Director,

Gemma Stanion. The doctors presented the results of their projects and experience to the Executive Director team in July.

The training was the result of a successful funding bid to the London Deanery. Further funding has been won again for up to 10 doctors in the coming year.

Dr Fellow-Smith said: “It was a pleasure to work with such an enthusiastic group. The projects were really

challenging and the learning abundant!”

Gemma Stanion said: “The Trust is now driving leadership skills training forward for much of its transformational work, and these doctors’ involvement in it was important.

We’re really looking forward to getting the next group involved and eventually we hope to make it a multi-disciplinary programme.”

Mythili Jayasundaram was a Level 4 Psychiatric Speciality trainee in Hammersmith & Fulham’s North Recovery team when the leadership training began. She’s since moved to another Trust.

She said: “The Trust was going through a redesign and there was a lot of anxiety around change. I learned that when multi-disciplinary team members felt they owned a project they were able to overcome this.”

“I learned to become a better negotiator and learned to use my psychotherapist’s skills to help my relationships with staff. I would definitely recommend this training to all the higher trainees. “

Dr Brian Darnley, previously a Specialist Trainee and now a consultant in the Specialist and Forensic CSU said: “It was an amazing opportunity to see how management operated and how complicated a task it is to run such a large organisation, and that one has to think systemically about the implications of any decisions made. It also made me realise how important it is to think about the practicalities of any service development and how it simply isn’t enough to have a good idea.

“It also became clear how good management is essential to the delivery of good quality mental health care, and that without a good organisational structure supporting clinicians, what an individual can do is probably rather limited.”

Mental Health Matters14

The Trust’s Research and Development (R&D) Department has undergone major reorganisation and expansion.

It’s part of the Trust’s five year strategy to become a world-class leader in research into mental health treatment and care.

The Department has reorganised into four separate units, including a new Clinical Trials Facility and a Recruitment and Feasibility Team.

R&D Director Dr Craig Ritchie said: “It’s about excellence – ensuring the Trust can provide the highest quality of care to our patients, giving them the chance to participate in high quality clinical research and it’s about retaining the best, high quality workforce.”

“We are asking staff to think about how they can get involved in R&D either by recommending involvement to their patients or by initiating research projects with our help.”

Here’s how the new R&D Department is structured:

Clinical Trials Facility

Currently based at Brentford Lodge in Hounslow, the trials facility is a UK leader in dementia research.

Over 300 patients with cognitive impairment or dementia and their carers have been involved in drug trials and other research there since 2009.

The facility has all the necessary equipment and trained staff – doctors, nurses and psychologists. It’s currently working on several new psychosis studies. Due to the necessarily tight regulations, all drug trials conducted in the Trust are run through this unit.

The facility is managed by Dr Patricia Ndhlovu RN PhD.

Contact: patricia.ndhlovu@wlmht.nhs.uk

Registries, Communication, Feasibility and Recruitment Unit

A key challenge in clinical research is to link willing patients with good research and researchers. This unit maintains patient registers and works closely with clinical services to ensure this happens.

They also help researchers assess the feasibility of new studies in WLMHT.

All proposed major research projects should be discussed as early as possible with its team manager, Lisa Curry.

Contact: lisa.curry@wlmht. nhs.uk

Business Development Unit

The Business Development Unit ensures WLMHT attracts the best quality and most cutting-edge research. It will be fully operational in early 2012.

Research Management and Governance Office (RM&G)

The RM&G office is a continuation of the R&D team’s traditional role. It provides governance cover for clinical trials and helps researchers negotiate the necessary paperwork.

Contact: research@wlmht.nhs.uk

Watch this space for regular updates and let the team know if you want help or advice on R&D.

Mental Health Matters 15

Our new Research and Development Department

Part of the Trust’s new Research and Development team. From left to right: Dr Patricia Ndhlovu, Research Nurse; Dr Vanessa Raymont, Clinical Research Fellow;

Sarah Gregory, Registries and Recruitment Coordinator; Lisa Curry, Registries and Recruitment Team Manager; Lauren Pae, Registries and Recruitment Coordinator

Dr Brian Darnley, Consultant Psychiatrist, Specialist and Forensic CSU

Mythili Jayasundaram, former Level 4 Trainee Psychiatrist in

Hammersmith & Fulham’s North Recovery team

Docs’ leadershiptraining

Mental Health Matters 17 Mental Health Matters16

Organisations only get better and improve their services if they learn from their mistakes.

In this second of our regular “Learning Lessons” features, we share the key action points following recent reviews of serious incidents.

Our aim is to increase everyone’s awareness of the issues and the role we can all play improving services and making them safer, for example by reporting problems and concerns.

As well as identifying key issues raised in recent reviews, we highlight some of the practical actions we are taking to resolve them:

A serious incident review has recently been conducted in Hammersmith & Fulham following the death of a patient. The main problem identified was the lack of consistency in the patient’s care resulting from the patient being moved 17 times. The inconsistent approach led to a significant breakdown in the formation of relationships. Care planning, risk assessment and engagement became less meaningful.

• TheTrustisreviewingitsbedmanagementprotocol across local services to help ensure consistency of practice across services. It will put checks in place to ensure that patients who are perceived as easy to move aren’t moved repeatedly.

• TheTrustwillensurethathighqualityriskassessments, a Care Programme Approach and engagement with patients and carers are at the heart of our care delivery. Kestrel ward, Lakeside has recently completed an extremely successful programme of work which encapsulated this approach and which will now be cascaded to Hammersmith & Fulham and then across local services.

The Grade 2 review noted above and other reviews across the Trust have identified that clinical teams often do not identify and escalate concerns about safeguarding children or adults. The reviews have recommended that the Trust should develop a competency framework for both safeguarding adults and children. This recommendation should be completed in September 2011 and will then be cascaded to services.

• Ifstaffareconcernedaboutasafeguardingissue, they must escalate it to their managers and safeguarding leads and must follow the processes set out in Trust polices S28 and C18.

• TheTrustisdevelopingaworkshoptoraisestaffawareness of safeguarding issues – service managers will give staff details of these training events in the next few weeks.

Learning Lessons

Grade 2 serious incident in

Hammersmith & Fulham

Action:

Action:

Safeguarding adults

and children

What does your new job entail?

There are three parts to it. First, it’s about making sure our contracts with commissioners are sound, serving the best interests of both the Trust and our partners. Second, it’s about looking at our performance and productivity to make sure we can maintain and improve services within our fixed budgets. Third, it’s about being a connector, making sure our clinicians are at the table in all discussions about the emerging healthcare landscape, which is very complex now. Keeping all the balls in the air is going to be a major challenge!

What are your immediate priorities?

On the productivity side, we’re targeting a number of measures of patient experience. Things like the amount of time clinicians spend face to face with patients obviously make a huge difference to recovery, so we need to agree standards and stick to them. In fact, these are built into CQINs* which are over £1 million of our local services income.

Physical healthcare is very important, as we now need to have much better connections with our patients’ GPs to care for the “whole person”. Better support for carers is another goal we’ll be looking to quantify and improve upon in the local services management team.

So far as partnerships are concerned, I’ll need to be at the coalface of discussions to explore new ways of embedding mental health services, or clinical expertise, or simply education and information, in partner services. A good example is the acute sector,

where our clinicians can have a major impact on patient recovery and well-being and save the NHS money.

What are your thoughts about the changing healthcare landscape?

It’s true that we have to change pretty dramatically, because you can’t just keep trying to cut things without impacting services. So it has to be about doing things differently and tapping into new pockets of funding – a real opportunity for innovation. For example, work rehab is becoming a social enterprise, and the voluntary sector is co-delivering services with service users, supporting recovery in a whole range of new ways.

What support will you be looking for in your new role?

I’ll be urging clinicians across the boroughs to get out there and make their own connections in the wider clinical network – to invest some energy in it!

How do you relax outside work?

I’m a rower, but I’m getting into running. I’m always in some sort of competition. My son’s partner recently talked me into a 10k uphill run in Chamonix which was fun, and I’m planning my next half marathon.

What three words would you use to describe yourself?

Resilient, determined and wanting-to-enjoy-life. Is that a word?

In the Hot Seat

Helen Mangan, Head of Partnerships, and Deputy Director of Local Services (plus Interim Head of Community Services)

* CQIN, Commissioning for Quality and Innovation, the payment scheme and framework used by commissioners in the UK

When the Care Quality Commission published their report in July 2009 into how the Trust had failed to learn lessons from past serious incidents, it led to widespread change across all Trust services.

Among these was a new system for managing serious incident reviews in each CSU – enabling lessons learned to be disseminated and put into practice quickly.

When four serious incidents occurred at Lakeside Mental Health Unit in Hounslow last year, one of the main review recommendations was to improve the quality of the Care Programme Approach (CPA) – a

process through which medical and nursing staff engage with patients and create a written recovery plan.

In August the ward’s nurses presented their progress report to the Trust’s Incident Review Group chair, Steve Trenchard (Executive Director of Nursing and Patient Experience) and to Dr Nick Broughton, Medical Director.

In Mental Health Matters four Lakeside nurses retell how the new CPA approach has helped them to care for four of their patients.

Lakeside – the lessons learned

Mental Health Matters 19 Mental Health Matters18

Nicole Douglas, Healthcare Assistant and Kingfisher ward Safeguarding Children’s Champion.

Nicole worked closely with a woman patient in her 30s, desperate to maintain her relationship with her 14-year-old daughter while in hospital.

They developed a strong therapeutic relationship.

“In spending time with my patient and understanding her needs it became apparent that, despite her serious mental health problems, her

relationship with her daughter played a significant role in her life,” said Nicole.

“She told me ‘I am her mum and I am her role model’. As a result I was able to help her daughter visit her in hospital and she confirmed how important their relationship is to them both.”

“I have learnt how important it is to think of my patient as part of their family. I have developed the confidence to proactively engage with families as soon the patient is admitted.”

Suzanne Hughes, Band 5 Registered Nurse, Finch ward. Suzanne’s patient, a young man with social and substance misuse problems, had difficulty engaging with any medical or nursing staff. He was reluctant to spend one-to-one time with Suzanne and appeared unwilling to open up about his feelings and the important recent events in his life.

Suzanne persisted, offering reassurance that support was available and he eventually took her into his confidence, revealing his feelings of hopelessness.

Suzanne said: “I have realised that no matter how pressured I am, my priority is to make time for my patient to build a therapeutic relationship that gets to the heart of their problem.”

Joseph Quansah, Band 5 Registered Nurse, Kestrel ward.

Joseph’s patient, a young man in his 20s, posed significant risk of physical harm to members of his family. He found it hard to communicate his needs.

As well as managing these risks, the care plan was dedicated to reinforcing his positive strengths and Joseph kept these in view by talking about them regularly.

He said: “It’s easy to focus on the risks. But this young man needs to build a life beyond his illness and by helping him focus on the things he likes and that he likes about himself we can empower him to make positive relationships.”

Thandiwe Phuti, Band 5 Registered Nurse, Grosvenor ward.

Thandiwe worked with an elderly woman suffering from a psychotic illness and significant physical problems including epilepsy and diabetes. She had difficulties expressing her needs. Thandiwe overcame this through regular 1:1 work and often involved her family. By degrees they were able to work through a recovery plan booklet together and develop a personal plan.

Said Thandiwe: “Completing the booklet with my patient and involving her family made me realise the importance of thinking about her recovery from the time of admission. She was able to tell me about the things she likes – her hobbies and strengths – and that gave her back a sense of self-worth and confidence. It helped me to see her not just as a patient but as an individual. It’s made me more confident in my skills.”

‘‘

Back row, left to right: Simba Kaseke, Thandiwe Phuti, Suzanne Hughes, Nicole Douglas, Archie Chaurura. Front row, left to right: Joseph Quansah,

Rajiv Beechook, Lungi Moyo

Suzanne McMillan, Lakeside’s Senior Nurse Manager, worked closely with Chris McKay, Dual Diagnosis Lead, to provide training and leadership to the nursing team following the reviews.

She said: “It affects staff deeply when a patient dies. It’s the toughest part of the job. Our staff have continued to support the patients’ families whilst coming to terms with their own loss and, at the same time, embracing the CPA learning. They’ve all worked really hard and made huge strides forward. I’m incredibly proud of them. This has been a humbling experience and our team has risen to the challenge.”

Steve Trenchard and Nick Broughton have both reported to the Board on Lakeside’s progress. Said Steve: “We were both very impressed with the nurses’ presentations and the support shown by their clinical lead, Dr Murray Morrison. It was a real team effort and I look forward to the great work continuing.”

We are aiming to reorganise our services in Ealing – the largest of the three boroughs we serve – to bring them more in line with a model agreed in Local Services, following discussions with service users, carers, GPs and our staff.

We want the future shape of services to reflect the borough’s size and ethnic diversity: 316,000 people live in Ealing, Southall and Acton and it is the fourth most ethnically diverse local authority in England.

We are looking to put in place a single assessment team for the borough and two recovery teams. These

would replace the four adult Community Mental Health Teams. We are moving from two older people’s CMHTs to create a single Dementia Team. This will move away from traditional outpatient services to a more flexible service with rapid access for both users and GPs, which we know they want. We are planning to keep the Early Intervention and Home Treatment teams.

We are working in partnership with primary care and local people to develop our plans. We will keep you posted as soon as our ideas develop.

Sixty people including the Trust’s dual diagnosis “champions” attended a one-day conference to promote understanding of dual diagnosis and the hope for recovery.

Consultant Psychiatrist Dr Tim Bullock, Trust lead for Adult Dual Diagnosis Services, chaired the event organised in collaboration with the University of West London in May.

The conference, “Recovery in dual diagnosis – mission impossible or achievable goal?”, heard from Trust clinicians, academics, service users and carers. Chris McKay, Dual Diagnosis Project Lead, said: “The key idea is one of hope – how it’s possible to restore meaningful quality of life following illness. It was a great opportunity to explore ways of working with this very deserving client group.”

The group will meet again on the 28 October. Contact Chris for more details: chris.mckay@wlmht.nhs.uk.

These are the key areas from last year’s staff survey that you told us should be prioritised for action, and here’s what we’ve done as a result:

Mental Health Matters20

Ealing Local Services update

The Trust has published its first Quality Strategy, a five-year plan to improve the quality of all clinical services.

The strategy focuses on clinical effectiveness, patient safety and patient experience. It also highlights the central role of education, innovation and research in our quality improvement plans. An annual Quality Action Plan will be monitored by the Board. The strategy forms part of the Trust’s Integrated Business Plan which has now been submitted to NHS London as part our application to become a Foundation Trust.

The strategy was written by Steve Trenchard, Director of Nursing and Patient Experience and Nick Broughton, Medical Director. They are jointly responsible for clinical governance across the Trust. The strategy can be found on the Exchange or contact: mandy.bassi@wlmht.nhs.uk

Quality Strategy for clinical services

We have :

We have :

We have :

Dual diagnosis champions – “hope for recovery”.

Ealing – a large, diverse borough

2010 Staff Survey – you said, we did

You said that in some areas of the Trust, staff were still experiencing bullying and harassment from staff and there was a perception that no effective action is taken towards dealing with it

You said that many people felt they’re not valued by colleagues

You said you didn’t believe the Trust provides equal opportunities for career progression or promotion

• Developed a Dignity at Work policy (currently out for consultation) with guidance for staff and managers on dealing with bullying and harassment

• Published our Staff and Management Values Charter which spells out what’s important in caring for patients and how to treat one another

• Given managers the skills to deal with issues as they arise as part of the QUASIC programme and through workshops on “difficult conversations”. More training opportunities will include creating good working environments and dealing with bullying and harassment.

• Created open consultation processes to encourage dialogue across the Trust

• Emphasised manager and staff responsibilities through the Staff and Management Values Charter. The value of Caring specifies care and respect as expected behaviours for all. Here are the responsibilities of staff and managers set out in the Charter:

• Strengthened the PDR process so that every staff member has the opportunity to discuss career and personal development with their manager

• Relaunched Recruitment and Selection training to ensure managers adopt a fair and equitable approach when recruiting and selecting staff

• Committed to the Talent Management process promoted by the Department of Health and NHS London, which promotes honest conversations about an individual’s aspirations, open feedback and developmental support where needed.

Please make sure you complete this year’s annual staff survey – coming in October - so that we know what you think and how we can improve.

Manager Responsibility

• TreatothersasIwouldwishto be treated

• Celebratesuccesswithin the team

• Modelandpromotecan-doattitude

• Treatcolleaguesasfellow professionals, regardless of grade or role

• Engagestaffin,andshare rationale for, change process

Staff Responsibility

• TreatothersasIwouldwish to be treated

• Executedutyofcarefor patients / colleagues

• Takeactionwhenseeingorhearings

something wrong - do not walk by

Championing

dual diagnosis

Mental Health Matters 21

Mental Health Matters22

Trust staff – getting qualified

Lynne Palmer, Administration Manager for the Orchard

Usha Sharma, Post Room Supervisor

Elfi Flanagan, Domestic Assistant

The Broadmoor Learning and Development Team held their third Annual Awards Certificate Presentation in July at the Hospital’s Learning and Development Centre. Around 95 staff attended the event to receive certificates for qualifications gained over the last year through training – mainly those from Bands one to four.

Administration Manager for the Women’s Service, Lynne Palmer has retired after 14 years at the Trust. Starting as a Medical Secretary in 1997, Lynne moved to the complaints department for a year before moving to the women’s service. Lynne was also runner-up for a Quality Award in 2008.

She is now working towards a Diploma in Drug Awareness and Counselling for Young Adults. “I’m looking forward to spending more time as a granny to my four grandsons,” she said.

Usha Sharma started working at the Trust as a domestic assistant in 1967 after moving here from India. She went on to work in the Laundry Department, washing and ironing staff uniforms which were then still worn. Usha saw the construction and opening of the John Conolly Wing and moved to its new Post Room. After 34 years of working for the Trust, she’s retiring to spend more time with her three children and eight grandchildren.

Her manager, Amilcar Simoes, said: “Usha is very popular with the staff and did an excellent job distributing letters across all Trust sites. Everyone knows her and she will be greatly missed.”

After 32 years at the Trust, Elfi Flanagan has retired from her work in the Domestic Department at Broadmoor Hospital. Described as “an absolute pleasure to work with”, nothing

was ever too much trouble for Elfi. Her manager, Belinda Huse said: “Elfi was always ready to help with a smile and a cheery word. The domestic department won’t be the same without her.”

Moving On Up Congratulations

Training success

Leavers

Mental Health Matters 23

Lucy McGee, Director of Communications and Involvement, reflects on recent media coverage of mental health.

There seems to be a head of steam gathering around de-stigmatising mental health in the media of late. In May and June MIND ran a major PR campaigns on the secret suffering that many employees with mental health issues endure. The MIND survey, called “The Elephant in the Room”, revealed that the one in six working people who suffer in this way keep quiet about their health problems for fear of being first in line when redundancies are planned. Employees and employers are still afraid to talk about mental illness openly – it’s one of the last taboos in the workplace.

This story obtained massive coverage, not least I suspect in striking a chord with so many people carrying their own domestic and personal stresses at work, exacerbating the pressure of increasingly frenetic working lives.

Then in July, SANE began their 25th anniversary “Black Dog” campaign, a bold and inventive way of setting mental health centre stage in our public life and shared experience. They’re extending this metaphor for depression by placing statues of black dogs with different coloured coats around our communities. Artists – the first of whom is a service user - will design the coats and the black dogs, in time, will become a common sight and a talking point for mental health in all sorts of contexts.

Marjorie Wallace, founder and CEO of SANE said: “The shadow of the Black Dog touches us all, but you can master and live with your mental illness so that it no longer dominates your life.”

I think this positive, recovery-focused campaign is a really inspiring idea and hope it takes off across the country – the BBC certainly gave it prominence.

We have had our own, smaller scale successes with local press coverage for our Open Minds campaign. You may have seen stories about the schoolgirl who won our CD design competition* in the Ealing Gazette, among others. This anti-stigma campaign is one of the ways in which we are promoting Trust membership to the public as part of our FT application. In the last four months we have attended more than 40 events to promote Open Minds and it’s pleasing to see that it’s this, rather than NHS discounts, that does the trick in getting people to sign on the dotted line! *You can see Alina’s artwork for the cover of “Wander Free”, indie band Storey’s song about recovering from mental health, on our website at www.wlmht.nhs.uk and hear the single at www.youtube.com

Ealing Gazette’s coverage of the band, Storey

Outside In

Mental Health Matters24 Mental Health Matters is printed on recycled paper

Pictures ofSuccess

Restaurant’s lick of paint

Four members of staff at West London Forensic Services are celebrating after gaining higher education qualifications.

Lilian Hove, acting Senior Nurse in the Women’s Directorate, and Margaret Rioga, Service User and Involvement Lead, achieved MAs in Education. Appiah Oyinka, Senior Nurse in the Men’s Directorate, gained a Post Graduate Diploma in Education. All three gained their qualifications from Buckinghamshire New University.

Vushe Hove, Clinical Team Leader on Tom Main Ward in the Three Bridges Unit, achieved a BSc in Public Health and Health Promotion at the University of West London.

All four are using their hard won success, including many hours working in their own time, to help spread new ideas about improving services.

Lilian conducted a review of literature on the recovery approach for long-term in-patients for her dissertation. She’s passing on her new-found expertise to colleagues.

Margaret’s dissertation looked at the positive effects of involving service users in training student doctors and nurses about mental health.

She has since been appointed as Senior Lecturer and Recovery Facilitator in a joint post between West London Forensic Services and Buckinghamshire New University.

Appiah’s final project involved completing a portfolio demonstrating

how he had completed his further education.

Having already achieved an MSc in 2008, he now hopes to use his additional teaching qualification to help students, staff and service users.

Vushe’s dissertation was on the subject of service user involvement in the planning and development of mental health services.

He’s looking forward to putting his new knowledge and skills into practice.

Dr Anne Aiyegbusi, Deputy Director of Nursing for Specialist and Forensic Services said: “I am extremely proud of my colleagues’ achievements and especially of the fact we can so clearly make the link between the education they have completed and the way we want to develop our services. I very much look forward to hearing more about their learning through forums and seminars.”

John Conolly Wing’s service user restaurant has had a make-over.

The restaurant, on the Ealing site, has a new skylight, new paintwork, furnishings and plants.

Sue Godsell, Assistant Director of Estates and

Facilities, said: “It’s transformed it from a dull, unappealing place to a bright, vibrant and welcoming place to dine and relax.”

The work was carried out jointly with ISS Catering, and was officially reopened by their Divisional Director, Steve Ellis, in the presence of service users.

Celebrating academic success

John Conolly restaurant official reopening. Left to right: Giuseppe Dispinzeri, ISS Catering Manager; Eric Munro, Interim Director of

Capital, Estates and Facilities; Sue Godsell, Assistant Director of Estates and Facilities.