COG 33/2013
COUNCIL OF GOVERNORS MEETING
20 March 2013
CHIEF EXECUTIVE’S REPORT
1. Potential Relocation of Northwood and Pinner Community Inpatient Unit
As reported at the December 2012 meeting, the Trust has been exploring the feasibility
of relocating the Northwood and Pinner Community Inpatient unit, which is currently
sited on the first floor of the Medical Block at Mount Vernon Hospital to the Woodlands
site adjacent to Hillingdon Hospital. This is a 22-bedded in-patient unit providing
nursing and rehabilitation services for patients who are registered with a Hillingdon GP.
The current layout of the unit is configured in a typically old-style traditional
arrangement with two main large bays; one 10-bedded male bay and one 10-bedded
female bay. This configuration impacts on the degree of privacy and dignity that can be
provided when curtains are all that separate individual bed areas. In 2009, work was
undertaken on the unit to create 2 side rooms to support infection control requirements
providing a total compliment of 22 beds.
The general fabric of the building where the ward is housed is poor and the structural
limitations of the building limits opportunities to remodel the ward sufficiently in order to
provide the required improvements that would deliver an affordable, modern ‘fit for
purpose’ intermediate care facility. The proposal is to provide superior accommodation
and services for the Northwood and Pinner in-patient unit by relocating it to the
Woodlands site adjacent to Hillingdon Hospital. There will be no additional costs to the
overall health economy as a result of this move. There will also not be any planned
reduction in service provision or the number of beds as a result of this move. The new
site has the potential to offer greatly improved accommodation and on-site facilities.
The proposal has been positively received by stakeholders including the CCG, and
London Borough of Hillingdon. A business case has therefore been developed and will
be presented to the Trust’s Business and Finance Committee on 22 March 2013. A
schedule of visits for Governors and other interested stakeholders will be agreed over
the coming weeks to enable interested parties to see first-hand the potential benefits of
the move. Visits for Governors with a specific Hillingdon remit are being arranged if
any other Governors are interested in joining these visits please contact Christine
Baldwinson, Trust Secretary.
2. Acute Services Update
During 2012/13 the service undertook a key redesign programme within the boroughs
of Kensington Chelsea and Westminster, this programme forms a vital part of the
services 3 year efficiency plan to reduce the acute inpatient bedded provision.
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Building Better Mental Health Care consultation ran from the 24 of August to the 16 of
November. During the consultation period the trust undertook various stakeholder
engagement events to ensure all affected parties were able to comment on the
proposed service changes. Following on from an in-depth consultation both
Westminster and Kensington and Chelsea Policy Committee held no objections to the
service changes and have asked the trust to return to present further updates to
services in the summer.
The Board are in favour of the reduction in inpatient bedded provision and have
approved the redesign programme on the premise that some of the released monies
are re-invested back into community services. At this stage negotiations are still
underway with the Clinical Commissioning Group to establish the nature of this reinvestment.
The service line is also looking to improve how Home Treatment Teams are currently
operating, with the emphasis being put on better engagement with inpatient wards to
ensure admissions are prevented and discharges facilitated in a timely manner. A
project group has been set up to look at new ways of working within the Home
Treatment Teams, improving the quality of care seen across the acute services care
pathway and reducing the potential blockages within the system.
Sitting alongside and heavily integrated with the service redesign programme is the
acute services care quality programme, which is looking at maintain and improving
quality through the service. The main components of the programme are as follows:
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Development of Triage Wards
The productive mental health ward framework
The 15th Step Challenge
Multidisciplinary Care Plan
Reflective Practice
Nursing Strategy and Development Programme
i. Nursing Supervision
ii. Nursing Competency Framework
iii. Medicines Competency Framework
iv. Risk Assessment and Risk Management Training
v. Handovers
vi. Communicating and Engaging with Patients
vii. Nurses Handbook
7. Service User Involvement
8. Support for Carers, Families and Friends
9. Acute Service Audit Programme
10. Acute Service Care Quality and Innovation Group
3. Safeguarding
The Board receives regular updates on the safeguarding of both vulnerable adults and
children. The Board asked for specific focus to be given to how we ensure that a
situation similar to the Jimmy Saville affair could not go undetected in the Trust. There
are a small number of ‘celebrities’ who visit our services but they are all treated in the
same way that we treat any other visitors ie by being escorted or having CRB checks.
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We are mindful that these checks alone do not identify all potential abusers therefore
we are mapping the very many opportunities we provide for patients and their carers to
feedback concerns in supportive environments.
4. Equality Act Compliance
We have just published the Trust’s second Equality Act Compliance report. It includes
examples of the data included and actions that have been and are being taken which
demonstrate that the Trust complies with the Public Sector Equality Duty of the Equality
Act 2010 Act.
From the findings of the Report it is clear that there are a wealth of actions and
initiatives taking place within the Trust to meet the public sector equality duty and that
areas that continue to need addressing are largely being addressed via the 4-year
Equality Objectives that the Trust put in place in April 2012:
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Improving staff understanding and sensitivity through training and community
engagement
Improving data collection for service user equality demographics
Improving staff experience of the Trust through targeted staff development
initiatives
Tackling staff experience of violence and abuse
The full CNWL Equality Act Compliance Report 2013 is available from Richard BryantJefferies, Head of Equalities and Diversity.
5. Monitor Licence
From 1 April 2013 the Trust will operate under a new licence from Monitor. The terms
of this licence have just been published and the Trust is confident that it will be able to
comply fully with these. Monitor will continue to demand regular performance and
financial information from the Trust as well as receiving self certifications from the
Board to ensure that it is meeting all the terms of the licence. If Governors would like
more detailed information on the new regulatory framework in place from 1 April we
would be happy to host a Governor seminar.
6. CQC Activity
There was a routine review of the Max Glatt Unit in Jan 2013. The CQC found that we
were not compliant with one standard in respect to staffing. They found that staff
shortages, due to vacancies and absences, were having an impact on the consistency
and continuity of care and the overall operation of the unit. However they found that
there had been only minor impact on service users. We have an action plan in place to
address this issue.
The CQC have also carried out an inspection at HMP Feltham. This was a joint
inspection with HM Inspector of Prisons. We were found to be compliant with all
standards.
A further inspection was held at HMP Rochester but we have yet to receive the final
report
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7. A New Name: Future Proofing the Organisation
The time has come where the name Central and North West London (CNWL) NHS
Foundation Trust no longer reflects who we are and what we do. We now also provide
services across Enfield, Surrey, Hampshire, Kent, and soon Milton Keynes. We are
looking at opportunities beyond these areas and need to take steps now to ensure we
are ready for future growth. Also, the name CNWL is largely associated with being a
provider of only mental health care, whereas community health services now account
for nearly 40% of our revenue.
There are a number of reasons why a growth strategy is the best course of action for
the Trust. We are working in an increasingly competitive market and we need the
economies of scale and efficiencies that only a large organisation can achieve, so we
can invest more in front line care.
However, growth is not just about money. We want this Trust to be a national name
and to be recognised as a symbol of quality healthcare. We want the policy makers to
think of us so we can influence the direction of healthcare, just as large acute Trusts
such as UCLH and Great Ormond Street do at present. We also need to be so good
that we can hold onto our contracts and remain competitive.
We will not allow the name change to cause unnecessary distraction, as a name is a
small part of the overall picture. We intend to come up with a list of potential names
which we will consult with stakeholders. The re-launch will be supported by a
communications campaign to ensure that key stakeholders, service users and carers
are aware of any potential name change and the reasons for doing this.
We will be writing to members with more information about the name change. However,
In the meantime, if you have any comments or suggestions please email
[email protected].
8. Engaging with our Staff – The Conversation
Some of you were at our nursing conference where we launched ‘The Conversation’.
We know that nurses are central to the care we provide across CNWL and we want to
engage them in a conversation about the values that best embody a commitment to
care. We have therefore asked all our nurses to tell us their top values that reflect high
quality compassionate care.
We are already getting lots of feedback and we intend to use this to develop a
charter which will set out a consistent caring and compassionate approach across all of
our services.
Some examples of comments received to date:
On Compassion
- “Compassionate, person-centred, mindful approach towards patients, carers and
other staff members to build, facilitate and maintain a positive and enjoyable
environment for all.”
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“Demonstrating care, compassion & understanding in practice.”
“Instilling hope to those who others have often given up hope on.”
On Communication
- “To be open and honest about our own strengths and weaknesses and that of
our colleagues.”
- “Breaking down barriers.”
- “Short term contracts and fear of losing their job make people less likely to speak
out about problems.”
On Empathy / Respect
- “Treating people as you would expect to be treated yourself.”
- “Being understanding and respectful of patient’s needs and the concerns of
friends, families and carers.”
- “Respectful, non judgmental, unconditional care. Providing care that I would
wish my family and friends to receive.”
- “Providing support and guidance and empathy to people in distress.”
- “Respecting that every patient is an individual with their own history, special
needs and goals which should be treated as such.”
On Professionalism
- “Having a patient centred approach to health care so that patients feel as if they
are in control, having a positive experience to hopefully promote a faster rate of
recovery.”
- “Always remaining up to date with modern clinical practice.”
- “Being educated and competent practitioners delivering care with sensitivity and
respect.”
On Dedication
- “Making a difference by working outside of the box to meet individual needs.”
- “Providing support and supervision to all staff, challenging poor practice and
acknowledging and celebrating good practice.”
- “Passionate belief in the NHS.”
On Empowerment /Knowledge
- “Empowerment of students, to encourage and harness fresh, new ideas directed
towards making improvements to practice, care and procedures.”
- “Empowering patients to be involved in their own care and choices.”
Claire Murdoch
Chief Executive
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