Annual report 2004-2005 - South West Yorkshire Partnership NHS
Transcription
Annual report 2004-2005 - South West Yorkshire Partnership NHS
With all of us in mind r u O ar Ye Positive about mental health 005 2 / 4 0 rt 20 o p e al R Looking through Annu someone else's eyes A novel approach! Why reading can make you feel better Moving forward - How we're improving our services Our cover stars are getting the balance right! Meet John Getting over mental health problems. John says ‘it can be done!’ Art Attack PLUS! The amazing effects of teamwork! n e w s v i e w s One woman describes her creativity and the recovery process f a c t s f i g u r e s Let us Our people (Declared interests are shown in brackets) Chairman Sukhdev Sharma Chair of Remuneration and Terms of Service Committee introduce ourselves… Halifax Dewsbury (Chair and a trustee of the Migration Policy Group Trustee of the Shaw Trust Member of the European Economic and Social Committee Member of Industrial Tribunals) Wakefield Huddersfield Non-Executive Director (and Vice-Chairman) Denis Sunderland Chair of Mental Health Act Committee Lead Complaints Convenor for the Trust Our Trust is one of the largest specialist mental health and learning disability trusts in the country, serving a population of almost one million people. We work from over 100 hospital and community sites, and with people in their own homes, providing services for working age adults and older people. Our main inpatient sites are in Dewsbury, Halifax, Huddersfield, and Wakefield. Non-Executive Director Gary Dimmock Chair of Risk and Governance Committee (Trustee of the National Children’s Centre, Huddersfield) We employ nearly 2000 clinical staff, plus an additional 400 staff providing non-clinical support services. Non-Executive Director Anne Gregory Chair of Audit Committee For a full directory of services, please visit our website at (President of the Institute of Public Relations until Dec 04) Non-Executive Director Thiruvenkatar Krishnapillai Chair of Charitable Funds Sub-Committee Deputy Complaints Convenor for the Trust (Owner – Ivy House Nursing & Residential Home) Non-Executive Director Jan Wilson Chair of Clinical Governance and Clinical Safety Committee Chief Executive Judith Young Deputy Chief Executive Steven Michael www.southwestyorkshire.nhs.uk Contents 4 Deputy Chief Executive Nick Morris Medical Director Dr Nisreen Booya 5 Director of Risk and Governance Sheila Dent 6 (Director of Cognisance Solutions Limited) Director of Performance, Information & Professional Development Hazel O’Hara 8 Associate Director Simon Plummer Associate Director Prasadu until 20 January 2005 Associate Director Roland Self from 20 January 2005 Director of Public Affairs Ruth Unwin (Partner is a shareholder in Tribal Group PLC) Produced by Trust communications department Cover photo by Louise Woodward 2 Our year 9 16 Building a happy workforce Health check How we’re looking after our staff 12 New Horizons 13 Looking through someone else’s eyes Looking back Trust chief executive looks back as we continue to move forward Mapping out care 14 Meet Big John! 17 Happy new homes! Resettlement project comes to a close 18 Art therapy Tracey tells us her story 20 How one man’s involvement is improving services Listening carefully What people told us 21 Follow my leader Valuing our diversity Why it is so important Inside our new Horizon Centre Art attack! How clients have been encouraged to unleash their creativity Director of Finance Malcolm Featherstone 10 We’ve been blowing our own trumpets! Award success Monitoring our performance Director of Human Resources & Facilities Alan Davis (Chairman of Childcare Information Service - Non-paid) The South West Yorkshire Mental Health NHS Trust was established in April 2002, and provides mental health and learning disability services in Calderdale, Kirklees and Wakefield. Digital manipulation Why Gary got into digital art How Trust leadership arrangements have been strengthened 21 Welcome to the annual report of the South West Yorkshire Mental Health NHS Trust, I hope you find it both interesting and informative. This report is a great opportunity to reflect on our achievements over the last year and also to look forward to our future. Over the last year we have met with many challenges yet have continued to improve and change services for people with mental health problems and learning disabilities, responding positively to national and local priorities. We are confident that we are moving forward in the right direction, ensuring that our services provide individual, tailored care for people who need to use them. I must also mention the professionalism and dedication of our staff. I’m very proud of the hard work they do and the enormous support and care they offer to service users and their families. Last year, our annual report received a prestigious national communications award. We were delighted to have been recognised as we wanted to encourage people who may not usually pick up an annual report to read ours and discover how our services are constantly improving. This year, we have kept the same award-winning style to once again encourage people to learn about our achievements. Sukhdev Sharma - Chairman 22 Modernising services Moving forward with all of us in mind 24 I hope you are glad you picked up this report and that you enjoy reading about our aspirations, achievements and future plans. Please tell us what you think, you’ll find details of how to do this on page 35. 34 Reading and you How the Trust is getting the messages out There’s nothing like a good book 25 Why hobbies help Spotlight on groups at Mirfield Day Centre 27 Raising awareness 35 Positive messages How you can look after your own mental health Understanding depression 29 24 Turning of the tide Champion equality Encourage involvement Support and value diverse lives Modernise services and increase choice For people with a learning disability and people with mental health problems and their carers. To make this vision real we translated it into goals against which we must make progress. Our corporate plan details all the actions needed to move us towards achieving our goals, and progress is reviewed by the executive team every three months. The Trust Board reviews progress against the plan twice a year. How the tidal model is transforming care 30 To help us set a positive direction for the work of the Trust, in 2002 we developed a vision of what we hope to achieve. This vision was developed with the involvement of people who use our services, their carers and partner organisations and it takes account of both local needs and national and local policy. Our cover stars Getting fit and getting healthy! for the future In summary, our Vision, Values and Goals set out our commitment to be a sound organisation, with supported workers, working through partnerships to: How it really feels 28 A vision It all adds up Our financial report 2004/2005 34 You can view our Vision, Values and Goals on our website, www.southwestyorkshire.nhs.uk Alternatively, call 01924 327055 for a copy. Our year 3 g n i d r a n Aw o i t i n g o rec PLATT team The PLATT service - which stands for Primary Care Liaison Assessment, Treatment and Training – were runnersup in the Guardian Public Service Awards, in the 'Service Delivery Mental Health' category. PLATT is an innovative service which delivers care for people with mild to moderate mental health problems within a primary care setting in the Wakefield district. Anybody experiencing common problems such as anxiety, depression, bereavement or relationship problems can be referred to the service by their GP, which reduces the need for people to access secondary care services. PLATT have offered assessment and short-term interventions to over 10,000 people since its launch in 2001, reducing referrals to secondary care by 70%. The service is encouraging GPs to place a high importance on common mental health problems, reducing the need for people to enter secondary care. The team also provides training to primary care professionals, educating them around a wide range of issues relating to mental health and the importance of mental health promotion. Speaking about the award, Linda Clarke, PLATT service manager, said, ‘To be a runner up for such a prestigious award is a major achievement for every member of the PLATT team. We cannot underestimate the need to provide rapidly accessible services for people with mild to moderate mental health problems. Maybe by tackling these issues earlier we can reduce the need for prolonged engagement with specialist secondary mental health services in the future.’ Awards are a perfect opportunity for the Trust to highlight areas of good practice and for staff to celebrate achievements! Here’s a quick look at some of the award success we have had over the last year. Nursing Standard Karina Hepworth, learning disability nurse, was highly commended in the Nursing Standard Nurse 2004 Awards. Karina, who works for the Kirklees Youth Offending Team, was recognised for researching and implementing a test that detects previously undiagnosed learning difficulties among young offenders. The project’s effective detection of learning disabilities has far-reaching consequences, affecting the ongoing treatment and support that patients receive. She said, ‘We can hopefully influence a change in practice at all levels and deliver a service to young people that identifies and addresses all of their needs by acknowledging them for who they are as individuals.’ A simple screening process was implemented to identify young offenders who would benefit from being referred to a specialist learning disability support group. The painstaking work involved complex negotiations with the parties involved and persuading the young people to take the ‘test’. Professor David Sines, a specialist judge on the panel praised the project, ‘Karina has undertaken an incredibly innovative project and shown a very well considered approach to her work. She is clearly a very dedicated and focused nurse who believes in making a difference. Karina has invested a great deal of time and effort in undertaking such a careful and groundbreaking project. Her approach has enormous potential and could easily be extended throughout the UK. I hope this commendation will enable her work to reach a wider audience.’ Calderdale children’s team The Calderdale disabled children’s team beat off tough competition from 120 other entries to be announced as runners up in the West Yorkshire NHS Modernisation Awards 2005. Calderdale disabled children’s team is made up of learning disability nurses, social workers and occupational therapists. Collectively, they wanted parents and carers to have a say in service development and convinced parents that agencies providing services for disabled children genuinely sought and welcomed input from them. They helped Calderdale parents set up the Calderdale Parent and Carers Council (CPCC) which now has over 100 members. The CPCC consults its members about their needs and is regularly consulted about services and how they should be developed. ‘Being short listed gives a huge boost to Calderdale’s disabled children, parent carers and the team and everyone in Calderdale who works to ensure that disabled children and their families are at the centre of service provision,’ says disabled children's team manager Dilys Hetherington. ‘The needs of disabled children can be overlooked when mainstream services are planned, this will help raise their profile and demonstrate the importance of including parents in service planning.’ Check out our other award success for the Psychiatric Intensive Care Unit (PICU) on p29 and the Horizon Centre on p12 4 Our year Getting a health The Healthcare Commission reviews each NHS Trust’s clinical governance arrangements every three years and it was our turn for a visit last Autumn. Following their visit, the Commission wrote a report which was, overall, very positive for the Trust, however it also highlighted some areas for improvement. The Commission was impressed with many aspects of the Trust’s work, in particular our approach to involving service users, carers and partners in our work. The main findings are shown in the box above/below. check The Healthcare Commission’s overall impression of the Trust The Trust has made progress on establishing a clinical governance structure. Its clinical governance structure, although complex, appears to be well established. There are good reporting arrangements for clinical governance across the organisation and staff are committed to identifying and reducing risk. Clinical governance is also A workshop was then held in the Spring, supported by a range of What is the Healthcare Commission? involving 200 staff, service users, carers operational groups which work and representatives of partner and The Healthcare Commission is a new organisation, across the organisation. These are voluntary organisations to develop an launched in 2004. It has a wide range of referred to as policy and action action plan following the review. People responsibilities, all aimed at improving the quality groups, for example there is one attending the workshops had the of healthcare. It covers both the NHS and the for risk. opportunity to identify solutions to issues private and voluntary sectors and took over from identified by the Healthcare Commission the Commission for Health Improvement (CHI). These arrangements are part of and this led to a detailed action plan the trust’s matrix organisational being drawn up, which forms part of the structure. This includes other Trust’s three to five year plan. To make structures, such as learning and change networks, that work sure the Trust implements the action plan, it will be monitored by across localities to coordinate and support services. The Trust Board and also the West Yorkshire Strategic Health Authority. trust’s clinical governance strategy and plan are integrated into its strategic plan. Progress has been made on most Speaking about the review Judith Young, chief executive, said, ‘The review was a positive experience for us, and staff showed excellent aspects of clinical governance. support for the process. The report highlights our commitment to working with service users and carers to provide the best possible There is committed, dedicated leadership and staff work services and to continually take account of their views and expertise. hard to deliver a quality service. Much has been achieved We are now fully committed to ensuring our action plan is under often difficult circumstances, for example severe embedded in the organisation so that we can continue to move financial pressures. The trust works hard to ensure that forward and improve our services for people who need to use them.’ service users are at the centre of everything it does. This is one of its key strengths. The full report and action plan can be accessed via the Trust website: www.southwestyorkshire.nhs.uk. term? S H N r e h ot uch ships are m Is it just an our partner just health. ings like: arder than es th This includ bo Twinkle twinkle In the 2004/2005 Healthcare Commission’s ratings the Trust service ce. n a achieved two stars, sustaining ieves that d el rn b e an v st r o u e re G Tr The user, ca ntial to th Clinical last years performance. • Service t hat it ance is esse w en rn w em ve o lv o n g vo k public in anisation Do you rg o e so th ’s r ay u o w why it agement support of Judith Young, chief executive, said, means or • Risk man operates in goals and d an , it t? es d n lu au va , ‘We’re very pleased to have al n ic o si lin vi C importa • e effective ess find out. retained our two stars. This is a effectiven ensuring th modernisation al ic lin Read on to C • d redesign an . The Trust has fabulous achievement in a year d staff een b an g as n h fi es ce ic af • St vernan of our serv ped clinical t rk en o when we’ve worked hard to Clinical go em ew ag elo man u as “A fram a well dev da and yo ning and described ai en introduce new models of service tr ag S , H n ce o N ti h an hic govern • Educa pment y on our through w nal develo ur strateg e and to continue to improve o io ar ss s ew fe n vi ro io n p at ca organis nuously services in line with what people site. formation le for conti f b in eb ta f w n o u se co U ac • e quality o th g said was important to them. We n vi al ro imp is also ise, clinic es and governance To summar rnance is all s have worked hard to offer al d ic ar d lin their servic as C an ove ferred to ing high st (service) g that the is metimes re services that are modern and is re safeguard so su Th an g ’. g in ce n ti ak crea vernan about m work of care by ‘service go effective and I am very proud lth and l it’s staff hich ea al w h d l in t ta an r u en en st o u Tr environm ake sure because m ices care can m rv al to se ic of the continued commitment d in ty ar cl ili h in isab really t they can excellence learning d partnership are the bes ly is and professionalism of our in es ic ed rv d ”. se vi sh flouri are pro ns e, it real d organisatio rity, So, you se staff.’ Judith also thanked an e. er , b d th o ar h rw it it o o t w u th ightf s, but to p the local au and quite a stra t, term! people who use our services Wise word clinical including ry ta an n rt ly, very impo y care, volu by e ar w m and their carers, who have g ri more simp in p h is everyt ups. So, lf-help gro ance’ governance als and as an se rn helped us in planning and ve o g ce idu ervi do as indiv to make sure calling it ‘s ge that moving services forward, as d le w n o io kn at t they organis we can ac well as our partners in are the bes es ic rv se r u o health, local authorities and e. can b the voluntary sector. ?? ? Our year 5 e r a c f o s r a e 20 y for shire Centre rk o Y e th 4 198 mid public On 31st July ned quietly a e p o y tr ia ch ewton Forensic Psy July 2004, N In . st u tr is m d e that suspicion an ars as a servic ye ty n e tw d te gside Lodge celebra volving alon e , ly b ra e d si con nding of this has changed nd understa a s e d u it tt a changing client group. challenging s Making alway said, ‘We have keep up ed as en op to e st dg be r Lo done ou Newton A group of artistic clients from approaches rst forensic with modern one of the fi in at th es ic ve rv lie se be re I Newton Lodge have produced a to care and medium secu ith 40 beds s of psychiatry the standard the country w masterpiece to brighten up the with the best ith are on a par for people w . ing nd nd ou fe ar s of d ce ti an dining area. The painting (pictured possible prac challenging a big day there are has also been e er Th behaviour. To above right) is the group’s second attitudes; care the building shift in staff 80 beds and nd d yo an l be ia ed od st nd is now less cu has also expa project and was inspired by 1970’s e, clients are less restrictiv recognition. m do ee pop artist, Roy Lichtenstein. given more fr it and their ical leader, in un cl e h, th it n Sm hi it n w Ia ected and as a staff views are resp was on duty s nt ie count.’ y cl work. I wanted to It was basic skills taken into ac nurse the da n to ew N to provide the clients teacher Paul Nicholson in ed ov m e g back, he es, ‘The regim re ag with the opportunity who had the idea of n Ia Lodge. Lookin d ore rigi ally strange to be a lot m ed us to discuss things, talk said, ‘It was re working on group art as y w r clients t at Stanle and choice fo to start a shif about art, come up n projects and taking to e ew th N e past d it in limited. In th Royd and en with ideas and make ke inspiration from great ta om ld fr t ou w en whole ward Lodge, we w was ve at si th decisions,’ says Paul. artists. ‘Traditionally art as ty m vi a ti of ac rt in an being part less of feel like pa rd d ga di groups have all been re it e, d ac an pl taking hospital wanted to t isolated at Chris from whether they we were a bi n he w , is th t. te no or the group in in jo first. Despi ened it was a like t no said, 'I’m very ’s It the centre op time. There anymore, at th really exciting proud of the sources we can be a were great re picture I d re su ch en lot more available, whi think it’s d ul co re flexible.’ that the cent d ar great! I've rw fo a develop as ’ e. done art ic e rv yn se ka Dr Has thinking work before d, de lu nc co s, specialist but this is the ‘We are Over the year been oud of first time I've pr services have meet a e way we th developed to had a go at s. of need have diverse range something as d ar is a w adapted to Today there e big as this. th t ee m trends in specifically to ho w It's fantastic en om psychiatry needs of w forensic a I never in re ca e and requir ith mber of w nu d thought it would come about individuallya de g; on in sp tt re se ds of care. are trained in out like this. It was lots based work, but I erent metho ff di nursing staff edict s such as difficult to pr is of fun I'm looking felt there was a lot It specialist area use and ice will how the serv substance mis forward to the next to be gained from d an t en e future, but em th ag in develop anger man ill project.' collaborative group w t e lis w ia s ec ppen a sp whatever ha there is also w ne h it to w t le ap op ad continue to service for pe care and bilities. approaches to learning disa ensuring rehabilitation, e, modern yn a ka that we take Dr Leslie Has , has er on ti ti ac .’ pr approach hospital with the been involved e ic rensic Serv Wakefield Fo 20 years. She st pa over the 6 Our year an impact ‘I've very much enjoyed the group, I'm proud of the end result. It was good for me to work as part of a team, doing something I enjoy, under a good teacher. It's given me respect for other people and their skills and I hope that I can be involved in the next project,' said Diana, another member of the group. Clients on the Heath Unit have also worked with Paul to create the eye-catching superhero collages pictured. ” “ Each project is an opportunity to explore different ways of working and collaborating on projects that can involve anyone regardless of ability. It boosts the confidence of the clients no end. Modern services, modern facilities The Trust is committed to providing modern services, that reflect what people who need to use services have told us they want. The following are examples of things already achieved in the last year: New double glazed windows for Wards 4 and 5, St Luke’s, Huddersfield. Upgrade of the staff call system at The Dales, Calderdale, and improvements in observation. New floor coverings for two learning disability services in North Kirklees. Improved pharmacy facilities at St Luke’s, for both staff and customers. Refurbishment of patients beverage bar on Waterton and Priestley wards, Newton Lodge, Wakefield. Further work in Castle Hill Unit, Huddersfield, to reduce risks and improve the patient’s environment. Works at Enfield House in Halifax to improve disabled access and improve the patient environment. Improvements to the building used by the South Kirklees Assertive Outreach Team, to provide an interview room, better staff facilities and improve safety with access control. Refurbishment of Southmoor Lodge in Wakefield to give office and consulting facilities for the child and adolescent mental health team. Improvements to the ventilation system for Newton Lodge, Wakefield and also extension to the fire road around the perimeter of Newton Lodge to improve access. At St Luke's in Huddersfield and at Hebden Bridge Health Centre, work was carried out to provide interview/counselling rooms to be used by the Staff Counselling Service. This has also been provided at Ravensleigh in North Kirklees. The roof was replaced on the building used by psychology services at the Links Centre, Huddersfield. Paul Nicholson Our year 7 g n i k o o L k c a B T he last year can best be described as a year of transition. Our skilled and committed staff have been working in new ways providing services closer to people’s homes. The introduction of community mental health teams, crisis and home treatment teams have helped people to stay out of hospital whenever this was possible and remain with their families and connected to support networks. At the same time we have been reviewing our services and asking the people who use them and their families what services are important to them and how they would like to see services develop in the future. You will read in this report about the work we have been undertaking to improve services. I want to pay tribute to the service users and carers who have given up their time to work with us and to help develop and refine the proposals for service improvement. Over 400 people have been involved in each of the three major milestones as this work has progressed. Our Open Space events in the summer of 2004 were an opportunity for people to tell us what was important to them. We discussed options for the future use of the buildings we work 8 Our year from in January this year and listened hard to local opinion about what would help people and what support they needed in their local community from health services and from other agencies. By June 2005 we had developed and refined a range of proposals about future services which will help us work in full partnership with people who use our services and their families to offer services that meet individual needs. We are now translating those proposals into firm plans to share with Commissioners and expect to consult with local people in autumn /winter 2005 about some of the more significant changes. Continual engagement Our services are underpinned by the involvement of and engagement with people who use our services. This has been particularly evident over the last year in our service improvement work, but is also a day to day feature of our working practices. Service users participate as full members of Trust committees and groups to make sure there are opportunities to influence and inform the way we work. There has also been active involvement in research and development work and some service user groups have conducted service reviews providing valuable feedback about what it feels like to use trust services. We also involve service users in the recruitment process for new staff whenever possible. We are absolutely committed to this way of working and will continue to look for new and innovative ways to work in partnership with service users and carers. Lots of us, our relatives and friends will need to use services at some point in our lives and it’s important that we work hard to provide the services we would want for ourselves and to do so while treating people with dignity and respect. Sustained performance In a period of such significant change I am delighted that our Trust was again awarded two stars in the Healthcare Commission’s performance ratings. Whilst these ratings only measure certain aspects of our services, it does reflect the enormous amount of progress made in all parts of the organisation. Our performance in the ratings is entirely due to the efforts of our staff. I am very proud of the way they have worked in new ways whilst coping with this period of transition for the Trust as we work through our proposals for further service improvement. Working in new ways can be very challenging and the Trust does not underestimate the impact on staff working in our services. We have put in place strong workforce development practices and are offering training and development opportunities to assist staff in their roles. We will continue to work hard to ensure our staff feel supported and valued. Partnerships As services improve and care pathways are developed to help people receive the care and support they need, the importance of working in partnership becomes increasingly important. For people to feel their care is ‘seamless’ and that there are no gaps in the care they need, we must work closely with our partners in health, in social services and with voluntary agencies. Many of our staff work in teams made up of health and social care colleagues to ensure appropriate care and support is co-ordinated for service users and carers. We very much value this way of working and will continue to involve people in planning their care and ensure that partnership working continues to develop. The different pieces and features in our annual report reflect many aspects, but not all, of our work and achievements over the last year and it is very gratifying to see them here. They do offer an insight into the hard work, skill and dedication of our staff and into the many positive achievements and talents of those who use our services. I hope you enjoy reading about them. With very best wishes, Chief Executive Strengthening leadership Trust staff work in teams that are made up of many different professions. The five main professional groups identified in the Trust are medicine, nursing, psychology, pharmacy, and allied health professionals (such as physiotherapists and dietitians). The professional leadership arrangements for these groups have been significantly strengthened over the last year to ensure service user care continues to be fully tailored to individual needs. Hazel O’Hara, director of performance information and professional development, said, ‘This is all part of the continuing journey of the organisation into phase two of the Trust’s service improvement agenda, with a strong focus on developing more service user centred care.’ Dr Anne Hoyle, professional leader for dietetics, commented, ‘Our Trust has been extremely innovative in its approach to the development of the new leadership roles. By establishing these new arrangements, the Trust has made a clear statement regarding how highly AHPs are valued within our organisation’. In June 2004, the Trust also appointed two heads of nursing development, Ann Hargate and George Smith (pictured). These new posts were established to address and support the development of nursing across the Trust, leading to more visible, robust nurse leadership and helping to raise the profile of nursing throughout the organisation. Since their appointment, Ann and George have had an impact on the Trust, including holding workshops with the Trust’s modern matrons and also the development of a ‘nursing council’. The Nursing Council acts as a forum to assist in, amongst other things, developing a nursing vision, providing a voice for nurses, developing and sharing best practice and providing advice and consultation. Sue Brearley, a healthcare worker with the crisis resolution and home treatment team in Dewsbury is a member of the nursing council and said, ‘Everybody needs a voice, qualified and unqualified staff alike. It’s about feeling valued, about moving the Trust forward Sue in the right direction, it’s about being listened to’. Moira Armitage, a community nurse for children with a learning disability is also a member and added, ‘It’s a much needed idea. It means you are valued as a clinical practitioner in a very open process’. Moira The above is just a snapshot of some of things that have happened in the last year. With the emerging integration agenda (see article to the right) the need for recognised professional leadership and development arrangements for social care staff is also being considered. Seamless care People with a learning disability and/or severe mental health needs, are groups of people who are at risk of being excluded from services, and not having opportunities to fully participate in society. By the very nature of their specialist needs no one organisation can meet their needs comprehensively as they often require a range of services which need to be fully connected and seamless. Meeting the holistic care needs of people cannot be met by one organisation or professional group. It requires a range of professionals, that through integration should compliment each other’s skills in helping to provide a seamless and effective service. Service integration will also mean clear and efficient working for staff in joint services. By developing more integrated approaches to the management, delivery and commissioning of services, it should benefit users and carers in having: A single point of access into services Shared locations for agencies to work together Unified protocols and systems processes, such as assessment of need Sharing information The Trust has been working hard throughout the year with partner agencies to recognise, underpin, and develop the level of integration that already existed. In a nutshell: Service integration is designed to promote and enhance the provision of seamless mental health and learning disability services through ensuring effective working across organisational boundaries and the efficient use of resources based on service users and carers needs. ? g to change What is goin Everything planned and managed together. Services working more closely together. Using the same policies and procedures where possible. Some changes in line management. What isn’t going to change? Staff will still be employed by the same organisation. No services will be withdrawn as a result of integration. Service’s won’t be changed for individual people. Our year 9 Our most Last year, the Trust’s training department processed 4,200 study leave forms for internal courses and 1,772 for external events. e l asset b a u l a v The Trust is built on the dedication and hard work of our staff and we are very proud of our highly-skilled workforce. This is reflected by our Vision, Values and Goals which places as one of its key objectives the need to support workers. The Trust has always recognised the critical importance of good people management practices and how these underpin the safe and effective delivery of services. The Trust has been visited by both the Healthcare Commission and the Health and Safety Executive and HR staff are working with colleagues across the organisation to implement the recommendations from these reviews. The opinions of staff are also vital to the growth of the organisation and in October 2004 the second National NHS Survey was undertaken. The Trust asked a randomised sample of staff to complete the survey and a total of 800 staff received a questionnaire, with 63% returning a completed copy. % staff having well structured appraisal or personal development review within previous 12 months quality of work life balance opportunities for flexible working fairness and effectiveness of incident reporting extent of positive feeling within organisation staff intention to leave jobs It’s good to talk! The Trust offers a staff counselling service to all staff in locations across the Trust. The service is totally confidential and can offer staff someone to talk to and help work through problems – both work-related and/or personal. Rod Walsh, who leads the service said, ‘Changing demands of work and home life sometimes become difficult to manage and all of us will experience stressful situations and crises from time to time. If staff are struggling to cope with issues, then this will have an impact on their performance at work. Talking things over with a professional counsellor can often make all the difference’. 842 Nurses Nursing support 490 411 Admin and mgrs 214 Therapists 165 Ancillary Staff figures (as at 1st April 2005) 106 Doctors Therapy Support 10 Our year Over 10,000 copies of the Trust’s newsletter, The Source, were sent out last year quality of senior management leadership The results of the survey have been used to develop action plans across the Trust and the broad themes identified in the 2004/2005 survey have formed the basis of these action plans. They include: •Workload management •Communications •Supervision and appraisal •Health and Safety •Harassment and Bullying Since the previous survey in 2003, the Trust has made statistically significant improvements in the following areas: 70 Grand total: 2,298 299 people were welcomed to the Trust as new starters -lighted! HR processed 3117 application forms last year AfC Agenda for Change (AfC) is a complete restructuring of pay and other terms and conditions in the NHS. The Trust has taken a proactive approach to the implementation of AfC and has worked from the outset in a joint approach with staff side organisations. The Trust appointed two joint project managers to manage this work, an assistant director of human resources and a Unison branch secretary. The Trust achieved the target of having matched 50% of staff by the end of March and continues to work hard to meet future targets. Thanks goes not only to the panellists but also to staff and managers across the Trust who have worked so hard to do this, particularly as it has inevitably put extra pressure into services. Staff from across the country represented the A-Z of NHS careers and dietitian Annette Cockfield, from Priestley Unit, Dewsbury, was pleased to volunteer. Annette, who posed holding a big ‘D’ at the photo shoot, said, ‘I really enjoyed the day, campaigns like this are very important, especially for professions like dietetics. There’s a shortage of dietitians at the moment so it’s great to receive recognition and promote the career. A Trust dietitian took her place in the limelight as part of a national NHS careers campaign. It’s also interesting to see all the other professions that exist in the NHS from ambulance drivers to zoologists!’ ‘An individual’s mood can affect their food intake’, Annette continued, ‘so if someone is feeling low that can lead to poor appetite and subsequent weight loss and the symptoms of starvation can lower mood even further. It’s a vicious circle, so it’s important to maintain nutrition when somebody is unwell to aid their recovery’. Working with people that have eating disorders is also a big part of Annette’s job, ‘This is an area of my work that I most enjoy. It is extremely challenging, but equally the most rewarding. My role is to help reduce the fear of weight gain, develop a regular pattern of eating and to educate.’ Annette has worked in the NHS for three years after she completed a degree in Dietetics at Leeds Metropolitan University. Improving Working Lives Improving Working Lives (IWL) is a national standard which aims to make improvements to the working environment for all NHS staff. It aims to ensure that the Trust, in line with the Vision, Values and Goals, supports workers to enable them to provide improved services. The Trust was awarded the ‘Practice’ stage of accreditation in January 2004 after an external team of assessors visited the Trust and interviewed staff, managers and staff side representatives. The assessors recognised that the Trust had put in place the key employment policies and practices and identified a number of areas of good practice. Since then, the Trust has been working towards ‘Practice Plus’ level of IWL which is split into 7 standards and we hope to achieve accreditation in the autumn. Here’s how some staff have benefited from IWL: On my return from maternity leave I initially reduced my working hours. This was discussed with my line manager who fully supported me. When my children started school I re-arranged my hours to fit in with school hours. I was always fully supported in doing this. Physiotherapy assistant “ ” Staff used to be able to request their off-duty time, but now they can request their shift patterns. Staff know what the service requires and make sure the needs are met – they contribute a lot to the system working. Ultimately it improves working lives - people can fit their shifts around families and other commitments. Ward manager “ ” When my mother in law was rushed into hospital I worked flexibly to care for her and take her to appointments when she had been discharged from hospital. HR manager “ “ ” I work eight sessions a week and can vary start and stop times within limits. I can also vary my working days and times to suit work-based events for example undertaking training. This is incredibly helpful in promoting a work-life balance. Consultant clinical psychologist ” 5460 application forms were sent out by the Trust last year Our year 11 New horizons The Horizon Centre at Fieldhead, Wakefield opened in 2004 and has been applauded for its design. The centre was highly commended in the ‘best designed mental health project’ category of the Building Better Healthcare Awards. But just why is it so special? ‘Staff had a lot of input into the design of the centre,’ explained Simon Plummer who is the physiotherapy lead at the Trust. ‘The architect worked closely with us and incorporated our ideas, so a lot of the rooms are exactly how staff wanted them. We also involved service users in the process – we held events to see what people liked in terms of colour schemes and things. It was a real joint effort.’ The Horizon Centre has been designed to create a homely feel and a sense of space, both of which are vital to the successful treatment of people with learning disabilities, particularly those with challenging behaviour. The different areas are all colour coded and photographs are displayed on each door displaying what’s inside to help people who can’t read or have low vision. Special features at Horizon Centre include therapy bathrooms with a specially designed spa and height Valuing People A partnership project has been ensuring that people with learning disabilities in Calderdale and Huddersfield get the best possible care when they go into hospital. The project is led by the Trust in collaboration with Calderdale and Huddersfield NHS Trust. Heather Pearson, project worker, talked to patients, their carers and support workers, external service providers and internal hospital staff and this gave a picture of what the issues are. A report was then produced, along with an adjustable bath and basin, and a state of the art sensory room. There is also an assessment kitchen which has height adjustable work surfaces, this serves as a rehabilitation kitchen to help service users learn to cope on their own. In the horticultural unit at the centre, service users grow plants and flowers for the conservatory and sensory garden. The Horizon Centre has been very well received by both service users and staff. ‘The centre gives service users a much more spacious, pleasant environment to what they’ve been used to,’ concluded Simon. ‘All needs can now be met in one place; physical, mental and learning disability. Such an environment is very conducive to rapid recovery.’ accessible summary for patients. These documents outlined the findings and recommendations that would ensure acute services meets the aims and objectives of chapter 6 of the ‘Valuing People’ white paper. The resulting Action Plan will now be implemented. The actions include: Producing accessible information and communication aids Improving internal and external communication systems Offering an extensive package of training to hospital staff Review of admission and discharge procedures 12 Our year Review of specific departmental procedures Heather said, Going into hospital can be a confusing and frightening time for people with learning disabilities. This project is all about finding out how their experiences can be improved. “ ” If you would like a copy of the report, please call Heather Pearson on 01422 222482. Improvement Who are our partners? through partnership The Trust needs to work in partnership with many other local agencies to ensure that we provide the kind of services that local people need, across the large geographical area that the Trust serves. We cannot modernise and improve mental health and learning disability services without working closely with our partners and agreeing shared priorities. We enjoyed excellent working relationships over the last year with our partner organisations in all localities and we firmly believe that working jointly with our partners is the only way to continue to improve services for the benefit of local communities. They include: Service users & carers Patient and Public Involvement Forum Primary Care Trusts Hospital Trusts Local Authorities Voluntary and statutory organisations Strategic Health Authority Looking through A new project in Dewsbury is ensuring that all older people who come into hospital will have their mental health looked after, as well as their physical health. The Older People’s Partnership Project promotes a culture of person centred care, using a process known as ‘dementia care-mapping’. (See box below right) The project is led by our Trust and provided in partnership with Mid Yorkshire Hospitals Trust, North Kirklees PCT and social services. Kath Williams, team leader, explained the basic function of the team, ‘We are working in any clinical area within Dewsbury District Hospital that has older patients, to promote a positive experience for older people, carers and staff. This means looking at the culture of care and placing full emphasis on the needs of the individual.’ 30 members of staff are now trained as dementia care-mappers. Speaking about the training, Kath Williams said, ‘We had an excellent mix of people on the training including ward sisters, unit s e y e s ’ e s l e e n o e m so managers, nursing home staff, catering staff, a porter, and, very importantly, a carer. People who attended the course said they will never look at an older person with mental health problems through the same eyes again.’ ‘The range of staff who attended the course demonstrates why a partnership approach is vital – everyone who has contact with an older person in a hospital environment has a role to play – from the porter, to the ward sister, to the catering assistant’. There are now 12 champions (acute hospital staff) who facilitate person-centred care whilst highlighting work areas for the core team to concentrate on, in each clinical area. Kath concludes, ‘Coming into hospital and the change of environment can be a frightening experience for any older person, who can have complex disease presentation, multiple medical problems and are particularly vulnerable to problems which can arise during a hospital stay. By looking at things through the patient’s eyes, we’re providing the best possible care we can, and ensuring people leave hospital with not only their physical, but also their mental health on track.’ What is dementia care mapping? Dementia care mapping is an increasingly popular way of measuring the care and well-being of people with dementia. It is an approach grounded in person centred care, and uses observation to measure well-being. Mappers ‘put their eyes in’ and look at care through the eyes of the service user. Our year 13 Involving to The experience of those who use our services, and those who care for them, is at the heart of everything we do and has had a huge impact on the way we continue to improve our services. ONE! D E B N A C IT John Girdlestone is a familiar face at Fieldhead, Wakefield, due to his many involvement activities. John created a special collage which was displayed at Baghill House in Pontefract, and it is accompanied by a letter which reads: The exhibition is a collection of archive photographs capturing the history of Featherstone. The images represent hard times yet also the strength of the community to overcome these difficulties. I likened this to my own experiences of tackling mental health problems and the realisation that there is “light at the end of the tunnel.” “ The photographs are displayed at Baghill House as I wanted to thank all the staff from Day Treatment Service and the Community Mental Health Team for all their help and support through my journey of recovery. I was born and bred in Bradford, but have spent the last thirty years of my life living in Featherstone. I first came to Baghill House in the year 2000 following a crisis. My GP recommended that I came here for therapy, but before this I didn’t know that the service existed. During my time here I attended several therapy groups, including anxiety management, panic relief and relaxation training, to learn how to cope with my illness. I also engaged in individual cognitive behavioural therapy. Today, it is a very different story. Now I am well, I am able to help other people with mental health problems. I am currently working with the Trust as a service participant (some people say service user – but to me the label ‘user’ doesn’t quite feel comfortable). This means representing the views of other individuals engaging in services at trust meetings and boards – contributing to influential decisions about the care and services provided and received. I help out at PALS at Fieldhead Hospital – providing advocacy and advice to clients and their families, on a range of different issues. I also became involved in the Inspire project – using photography as a means of selfexpression. At the time, when I was ill, I never thought I would be doing what I am now – helping other people. Yet the work also continues to help me. There’s something therapeutic about giving something back to others – especially when I’ve been there myself. So don’t give up – it can be done. ” (Read more about how John’s involvement is helping shape services on page 29) 14 Our year Service users and carers are experts in mental health and learning disability services both in terms of their own care and in shaping what services exist and how they are delivered. By using this expertise, we can create better, more flexible and more accessible services - this is clear in our public involvement strategy. This has also been reflected in the restructuring of the Trust’s public involvement and PALS function, including the new appointments of a Trust wide PALS manager and a public involvement coordinator. Service users and carers are integral to the Trust’s work to improve services and involved in a number of ways throughout the Trust. These include: • Involvement in scrutiny through Trust committee structures, including taking part in Policy Action Groups. • A number of service users have undertaken training to sit on recruitment panels and further training is planned to enable more service users to help the Trust appoint staff. • Service users and carers are members of Locality Management Teams. • Mental health promotion activities are strengthened by the involvement and experience of people who use our services. • Service users and carers play a very important role in the Trust’s diversity groups and their contribution is vital to the development of the diversity agenda. As Phil Walters, head of involvement and inclusion at the Trust said, ‘The Trust is committed to working in full partnership with those who use our services and their carers. These are real and practical ways that we can translate our vision, values and goals into reality. It continues to move us further away from the ‘us and ‘them’ idea and truly embraces the vision of a mutual organisation.’ The Trust’s Patient and Public Involvement Forum, joins PALS and the Independent Complaints Advocacy Services (ICAS) as ways to help the public have their say about how services are run. You can get in touch with the patient and public involvement forum at: Cora House, 2 Gills Yard, Wakefield, WF1 3BZ Tel: 01924 361555 There are PALS offices in each of our localities, you can get in touch with any of these offices by: FREEPHONE: 0800 587 2108 Minicom: 18001 0800 5872108 Fax: 01924 328658 Email: PALSoffice@swyt.nhs.uk e v o r p im Nice work if you can get it? Experience Counts Service users in South Kirklees took part in a survey that looks at mental health and work. The Trust has a positive commitment towards employing people who have used mental health services. We value the contribution of personal experience and believe that our services can be improved by listening to those who have had mental health difficulties. The Consortium of Employment, Recreation and Training (CERT) proposed the survey, which was carried out by service users and mental health staff, to identify employment experiences, issues and needs of working aged adults with mental health problems in South Kirklees. CERT spoke to people who were in paid employment as well as those who were not, all of whom had experienced mental health problems. Results of the survey included: of those not in paid employment and 50% of 73.3% those currently in paid employment had left a job as a result of mental health problems. of those not in paid employment and 61.1% of 46.7% those currently in paid employment believed an employer would discriminate against job applicants who declare mental health problems. The most prevalent barriers to employment were: • Lack of confidence in the ability to work • Being unable to get benefits back if a job doesn’t work out • No job being offered • Having a job may be stressful and lead to a mental health relapse • Discrimination at work because of mental health problems • Mental health problems may interfere with ability to do a job • Being financially worse off after getting a job Experience Counts is a project that has been set up to encourage and support people who have experienced mental health difficulties to obtain employment. This is achieved by offering employment opportunities within the Trust itself. The Experience Counts scheme can support individuals in a variety of ways, including: • Identifying individual strengths and skills • Advice on preparing a CV • Help with completing job application forms • Interview preparation skills • Work preparation course • Work experience placements • A fair recruitment and selection process which values the skills and experience gained from using mental health services • Signposting to practical and emotional support when in employment People who have experienced mental health problems have a wealth of life experience that can be beneficial in the workplace and service delivery can be enhanced and improved by encouraging people with mental health problems back to work. cts a f y Ke ures g i f & has a ivity t c a in Ruth Unwin, director of public affairs ing: ll be e ealth w lth takes the lead on public involvement tal tal h n n l hea ows e e a t m m n s n e t initiatives in the Trust. Speaking por ct o ch sh mm t sup tal impa g-ter al resear n about the results of n e o l m n loy me with l and loc the survey, Emp detri ults d na a f she said: ro natio ike to be for e t – r t a en nefit 5 qu dl e l m a b u y o o n y l t w 99 p ci tha n em ny more capa d since 1 i Less n i e r g a e ma imin oubl lems le cla lmost d ms prob p o e sa roble fp a p o h h r s t e l n b easo l hea n claim num Employment is a lth r enta The a a m e h t h h l it it major contributory factor to enta le w ty benef p m ce o n e a i p people's mental well being. This w ac e o r p l l a they o a c M in r’s s say fact was reinforced by a Social Exclusion r e y claim ob-seeke j mplo a report produced by the Office of the en e ne with t n i r o Deputy Prime Minister. The Trust will u e o f . som than blem ruit continue to support people who have had ewer ould rec ealth pro F a mental illness to get back into work’. w tal h men “ ” Our year 15 The Trust is committed to supporting and valuing diverse lives both as a service provider and as an employer, and aims to ensure that services are designed and managed, as far as possible, to respect and value difference. Valuing our diversity The Trust’s Diversity Strategy recognises that diversity is core to the way we work and provide services. It aims to ensure that the Trust is organisationally competent to meet the positive challenges associated with equality in the 21st century and to maximise people’s potential through valuing diversity. Eid celebrations The Trust believes that it is important for organisations, and those who work in them, to reach a level of ‘diversity competence’. This means that they can meet the needs of people of diverse backgrounds, recognising what those needs may be and having the skills and resources to provide the necessary services. If an organisation is ‘diversity competent’, then it will not make decisions and mistakes based on stereotypes and ignorance. If members of the community recognise that an organisation What do we mean by ‘Diversity’? and its staff are An awareness of a number of strands or dimensions in which human society may be diversity competent, differentiated – including gender, class, religion, education and language. This approach they will feel arose from the Trust’s recognition of diversity as a positive source of enrichment within society and within the organisation itself and that individuals and groups should not be confident to use its defined solely by one of aspect of themselves. services and provide it with support. During the last year the Trust has developed a number of initiatives around equality and diversity and a Diversity Policy and Action Group (PAG) is responsible for overseeing the implementation of the Diversity agenda. Staff from the Trust’s public affairs directorate got together to celebrate the Muslim festival of Eid. Organiser Aboobaker Bhana, PALS development worker, (pictured left) thought the celebrations were a great success, ‘It was really nice to all get together and celebrate Eid. It’s good that we can share cultural and religious events. Everyone had a wonderful time.’ This wasn’t the first time that Trust staff got together on Eid, in November all the diversity groups from across the Trust met to celebrate Eid ul-Fitr (Muslims have two Eid festivals each year). Count me in! The Trust was one of 211 organisations across the country to take part in ‘Count Me In’, the first national mental health ethnicity census. The census is part of the government’s plan to tackle inequalities in mental health services, described in the recently launched 'Delivering race equality in mental health care'. The census will give a snapshot of all inpatients in the NHS and independent mental health facilities in England and Wales and will provide a benchmark against which future improvements can be measured. Information on ethnicity, language, religion, any periods of seclusion and recorded injury to patients will all be collected as part of the census. The results of the census should be available in the autumn and the Trust is looking forward to receiving the information and using it to help inform our continually developing diversity action plans. Meeting of the Minds 16 Our year In December 2004, over 70 consultants and doctors working in psychiatry in the North East came together with many other health professionals all with an interest in South Asian Psychiatry. The group met for the inaugural conference, ‘Meeting of the Minds’, of the South Asian forum on Mental Health & Psychiatry in Yorkshire. The conference was attended by Trust chief executive, Judith Young, and Chairman, Dev Sharma, who praised the contributions made by South Asian doctors to the NHS. Dr Mansoor Ahmad, the conference convener and consultant psychiatrist at our Trust, closed the conference by re-emphasising the need for the development of culturally and ethnically sensitive services. ‘Asian cultures are group cultures whereas Western European cultures are individual cultures’, he said. ‘Treatments designed for individual cultures when delivered to group cultures have failed with some serious consequences. The time is now ripe to put in national drivers for a change in service delivery to make it more user friendly.’ Celebrating Independence A special “house warming” party was thrown last December for former residents of Fieldhead in Wakefield who are now living in supported housing across the district. The party marked the end of the Fieldhead Resettlement Project which has helped 64 people with learning disabilities move out of an institutional setting into houses adapted to meet their individual needs. The project was coordinated by Wakefield Council in partnership with our Trust, the Wakefield PCTs, the voluntary sector and housing association partners. Cllr Peter Loosemore, the Council’s cabinet member for social services and health, said the resettlement programme had given the former Fieldhead residents the same rights as all other citizens. ‘Everyone has their own tenancy and everyone is enjoying a much improved quality of life, experiencing new opportunities and able to lead the lives they want. They are being welcomed by local communities and are making new friends. The party was a celebration of how well they are doing and how much they are all enjoying independence and having a choice about what they do and how and when they do it just like other people in the community.’ Sukhdev Sharma, Trust chairman added, ‘The party was very significant and marks an important moment in the lives of people who have moved into new houses and their families. We are thrilled to have worked with people living in the villas, their relatives, and the local authority during the time we've been a Trust, to make these exciting changes a reality. We wish the residents every success and happiness in their new homes.’ Yvonne Ward a participant in the Inspire creative arts project, was congratulated after her artwork was featured on the front page of a national publication. Yvonne’s piece of art was selected by the National Institute of Mental Health in England (NIMHE) to be featured on the cover of their Annual Review 2004. The front cover featured artwork from each of the NIMHE development centre areas to make up a map of England. Yvonne’s piece was selected from service user artwork from across the northern region to represent the North East, Yorkshire and Humber area. To download the NIMHE annual review and view Yvonne’s artwork visit www.nimhe.org.uk Inspiring artwork Our year 17 The art of perseverance Tracey Abraham’s pictures have been used for the past few years to publicise World Mental Health Day celebrations. Here, we meet the remarkable woman behind the pictures, and she tells us about her creativity, the recovery process and why she participates in service user involvement. ‘I was always creative as a child and I only ever considered being an artist, from my earliest years. I was aware of the major artists such as Leonardo di Vinci, Michael Angelo and Picasso from about 5 years old. My parents were not creative and did not know very much about art, so my interest was totally self initiated. I used to enjoy illustrating other subjects with pictures and diagrams more than being interested in them for their own merit. I was always drawing and painting and making things more than doing any other activity - I did not need expensive presents and was never bored as a child. 18 Our year I went to an art school in Barnsley when I was 16 and we covered lots of art subjects such as textiles, painting, graphic design, ceramics, printmaking and sculpture as well as doing art history and English literature. I then went on to do an art foundation course to prepare a portfolio for a degree course. Most of my art educational experience was self-directed study - I liked to experiment and be free to discover things for my self. I was accepted into Goldsmiths College in London, to study textiles and embroidery, which, at the time, was a cutting edge course as it did not recognise traditional arts boundaries. During the second year at college I started to feel ill – I didn’t know what was wrong and just put it down to myself. I’d had a crisis some 6 months earlier but did not connect how I was feeling to that episode. Everyone on my course was under a lot of pressure so I just put it down to that - I didn’t know that I had a problem. I became increasingly depressed and this affected my creativity. I can remember feeling remote from everything and visiting various galleries and museums feeling lost and not understanding why. It was, in retrospect, the beginning of psychosis. for help. This happened just 6 months after being discharged as an out-patient at the Maudsley where I had been under observation for a year. I was diagnosed with a psychotic illness within a few days of being back home in Yorkshire and was looked after by my family. I started receiving treatment at home in 1987 and began the long journey to rebuilding my life. No-one realised I was developing a serious mental illness - especially in an environment where angst and eccentricity were the norm, if not art itself. One performance artist wrote his poetry in gold lettering on slices of toast, and did regular recitations standing inside a suitcase with flaming torches at either side of him! The difference was though, that I was not in control of my thoughts but was a victim of them. After about a year, I attended a secretarial course which opened up job possibilities. At work, I met the man who became my husband – meeting him was a high point after a long period of deep unhappiness. I was making steady improvements all the time and I wanted to do something more ambitious so I studied to become an adult education teacher. I undertook voluntary teaching at the art school that I had attended when I was younger and then I progressed to paid work in adult education teaching basic skills, IT and art for about 5 years. I took a break from university and started receiving benefits, with the intention to take up my studies later. I became bogged down and caught in a poverty trap and I found it difficult to cope with the hardships. I felt I was just barely surviving. I tried to see a psychiatrist or therapist but 20 years ago it was unusual for people to seek that kind of help themselves – professionals didn’t think that people could be aware of their own mental illness and there were no early warning systems in place like there are now. I spent seven years living in poverty and I failed to realise that I should give up and go home, as I still thought I could finish my degree I’d been ill for a very long time with no treatment. I gradually became in a permanent state of psychosis and rang my parents In 2000 I found out about service user involvement work at the Trust. Although I’ve accepted my diagnosis and treatment I felt that it was still possible to attempt to change things in my life or improve my condition, even though I had been told I would never recover and have to take medication for the rest of my life. people who were telling me not to attempt to do things, I believe I would have overall poorer mental health and quality of life today. When I became involved in service user activity I hoped I would be able to find some answers about mental health as well as help improve services. One of the themes of my own life has been creativity and so I got involved in the Inspire Project, a creative partnership project, led by the Trust. Service user involvement has helped me understand my own condition and broadened my knowledge about how other people are affected by mental illness, but the experience has also involved going through a few pain barriers. For some people a breakdown can be the start of a creative career, in my case it was the closedown of creativity and then a gradual revival over a long time. Throughout my illness I have tried to face things and extend my experiences. Part of the recovery process is meeting new challenges and one of the most important qualities to develop when suffering mental illness is the art of perseverance.’ I did not believe that having a mental illness meant that I was incapable of learning or somehow making the best of life, but putting myself through the educational process was like putting money in the bank - not benefiting straight away but the rigor of the courses helped build my capacity and started to help me think in a more informed way which lessened the strength of any delusions or paranoia. If I had listened to Our year 19 Listening to you We aim to provide the highest possible standard of care and want everyone who uses our services, or cares for someone who uses our services, to have confidence in them and feel safe. We like to hear what you think about our services, whether good or bad, as it gives us valuable information to help shape services that truly respond to the needs of individuals. When things do go wrong, we try to act quickly to put things right and to answer questions in a responsible way. Throughout the last year, the Trust received 60 formal complaints – which is one more than we received the year before. We acknowledged 100% of these within 2 working days and responded to 73% within 20 working days. Overall, we have responded to 98% of the complaints received. The ones we have not yet been able to respond to relate to complex and ongoing processes that have not yet been completed. Of the 60 complaints we received, 3 have been referred to independent review and one to the Health Service Ombudsman. There are also a small number of complaints from last year that the Ombudsman is still reviewing. Over the year a number of changes have taken place in the Trust’s risk support team with the aim of implementing a stable and sustainable system for ensuring that complainants receive a timely and thorough response to the concerns that they have raised. A new post has also been created with responsibility for patient safety issues, including incidents, complaints and compliments. The role has a particular emphasis on developing a learning culture within the organisation. Here are some examples of improvements made following complaints: • • • • • An administration department have changed the procedure of informing people of cancelled appointments Concerns about healthcare records notes have been addressed directly with individual staff through supervision The processes for agreeing and recording informal leave from inpatient care are being reviewed to implement a more robust system A local standard of care has been developed for the management of violence and aggression A monitoring system for recording restraint details has been introduced 20 Our year ’There’s always room for improvement’ We believe in the importance of hearing the views of people who use our services and the National Service User Survey gave people the chance to tell us what they think. The survey was sent to a sample of 850 service users and respondents were also invited to share their comments on what they thought was particularly good about their care, and if they felt that anything could be improved. Here are some of the things we learnt: • 94% of respondents who had a number to contact in a crisis, were able to get through within an hour or less • 89% of respondents had seen their care co-ordinator in the last 3 months • 88% of respondents had seen a psychiatrist in the last 12 months and 79% stated that the psychiatrist had treated them with dignity and respect • 81% of respondents said that their diagnosis had been discussed with them ‘to some extent’ • 70% of respondents had seen a community psychiatric nurse (CPN) in the last 12 months and 86% said the CPN treated them with dignity and respect. Many of the people who filled in the surveys wrote additional comments that reflect the hard work and dedication of staff and the high standards of care that they provide. Comments are shown to the right. We also received some comments which were not so good, but are just as valuable as they help us identify where improvements need to be made. For example: • 48% of respondents had not received a care review in the last 12 months • 47% of respondents had their appointment with their psychiatrist cancelled, or changed, at least once in the last 12 months • 46% of respondents said that they did not have the number of anyone to contact in mental health services ‘out of hours’ • 44% of respondents had not been given or offered a written copy of their care plan. The results of the survey will help the Trust review services and continue to develop them in line with what service users and carers have told us they want. As one person who completed a survey put it, ‘There is always room for improvement.’ I know someone is at the end of the phone if I need to talk to someone about my illness or how I am feeling. “ ” “ ” “ ” “ ” “ ” “ ” “ ” “ ” “ ” “ ” “ All involved in my case are working tirelessly to get me better. It is nice to know someone cares about me and I can get in touch if I want someone to talk to. I have received excellent support throughout my care…..this support has helped me greatly, I have been working for over 2 years. I have never been so well looked after by so many caring people. Support visits are giving me confidence in myself. I believe over the last few years the service has really developed and the service user has had opportunities never open to him/her before, which really help patients’ confidence. You’re doing a great job. Thank you all. I know that in times of difficulty I can ring either my CPN or psychiatrist and I will be listened to and treated with respect and care. I always feel at ease and relaxed, reception staff were always helpful and friendly. Thank you for helping me in my hours of need. If it wasn’t for you all I would have drowned in the river. But I wanted to see you all again. ” Gary’s An exhibition of abstract art provided a bright and thought provoking focal point at Mirfield Day Centre. The artwork was produced by Gary Wilkinson who attended the centre for around two years. The exhibition gave Gary the opportunity to showcase his talents and demonstrate what can be done with creative flair, a computer and a lot of imagination! story Gary explained how it all began, ‘I’ve been interested in abstract art for a few years and really admire the work of artists such as Jackson Pollock. I began producing my own pieces of art about two years ago when I started having occupational therapy at the garage project at Mirfield Day Centre. I tried out lots of different creative activities before I found something that really allowed me to express myself. ‘Everything that I’ve achieved so far is completely down to the garage project and the people that work there. They have really helped me to develop my skills and worked with me to find methods of expressing myself. Five years ago I was very institutionalised and didn’t leave the house. Coming to Mirfield Day Centre and producing this artwork has been a great stepping-stone in my rehabilitation.’ ‘My artwork is produced by manipulating, distorting and enhancing images in the computer application, Photoshop. I get ideas and inspiration for the images from loads of different places. These include magazines, record covers, books, photos and my imagination. I’m part of the IT Bytes group at the garage project, and have been getting some tuition in different areas of IT but most of the time I’ve been left to my own devices. ‘I’m really excited about my exhibition – I’ve had some really positive feedback from visitors to the centre and many people have expressed an interest in buying my work. In the future I’d like to learn more about graphic design and I might enrol on a college course, which will help me find work within the graphic design industry. I’d also like to have more exhibitions in different locations to ensure that my work gets seen by as many people as possible.’ ‘I find that art allows me to articulate myself in a creative way it’s really therapeutic to create new images that reflect the deeper thoughts and emotions that exist within all of us. I am really interested in the inspirational things that lie beneath the surface of our everyday life experiences and I hope that other people will take something from my exhibition. For me, the arts play a big part of the therapeutic process. I also play the guitar and write songs, which I find very cathartic. Some of my songs have been recorded and appear on CDs that are produced at Mirfield Day Centre and I performed with a drama group called ‘Whole in the head.’ Whole in the head A group of people who use services have formed a theatre group called ‘Whole in the head’ to help raise awareness about mental health problems. The group performed their play ‘Sticks and Stones’ at World Mental Health Day celebrations and at a variety of other venues, including a school. They are also taking this successful play to the Edinburgh festival. The honest and thought provoking play follows the real life experiences of a person’s journey through life; from an abusive childhood to how she is treated by society when she has a nervous breakdown. A member of the audience who saw the play said, ‘It really challenged how you think about mental health problems. It was very profound and moving - being able to see these experiences through someone else’s eyes.’ Narelle Summers from the group said, ‘We want to promote mental health and raise awareness. 1 in 4 people have a mental health problem. The whole group feels we need to get out into the community and educate people about mental health.’ Our year 21 Moving forward Telling it like it really is with all of us in r carers, services, and thei ted and an w had said they ed ish bl ta es en have be t’s us Tr e th l al ss acro localities. Rosie Health Minister, ental m d Winterton an sor es of Pr , ar health Ts ed the sit vi y, eb pl Ap s Loui e se to Trust in 2004 action. modernisation in isterial Rosie, whose min clude in s tie responsibili th al he l ta en adult m ith w et m s, ice rv se newly members of the s isi cr ed establish sertive resolution and as d Gill an s outreach team ult ad ld ie ef ak Green, W Lo . uis services manager Appleby, who sie, is the accompanied Ro for national director England mental health in tal en m e th and chairs t up to se e, rc fo sk ta health Plan. S implement the NH For the last three years the Trust has worked hard to introduce changes and new ways of working in response to what service users and carers said was important to them, and in line with nationally and locally recognised best practice. ned more Gill Green explai ‘They s, about the team unity m m co e work in th t for or pp su e id ov and pr n ow people in their care in homes, offering and ive ict str re t the leas ments on stigmatising envir e er w e W as possible. sie delighted that Ro staff ith w et m n rto te Win a g in who are mak ople’s difference to pe lives.’ met Louis and Rosie line nt fro of rs be mem care l cia health and so ity un m m co staff from ff from sta as l el w as s team to s ice rv other adult se rt of pa ch ea w illustrate ho on nds the system depe e other. th of t or pp su e th ams te ity The commun onse to sp re in up t were se e us what people who r time at Talking about he Winterton the Trust, Rosie said, ‘I really enjoyed rs meeting membe ho of staff w ntial provide such esse l ca lo e th in services to ks an Th . ity un m com tal en m k their hard wor ve ha s ice rv health se erably in improved consid dale and er Wakefield, Cald years. nt ce re Kirklees in “ phasis ‘The shift in em care to nt ie from in-pat peoples’ in re ca g deliverin e homes and in th s to community help r of be m nu e reduce th g used in be ds be l ita hosp ople pe at and means th ent m at tre e can get th to se clo as ed ne they ’ e. home as possibl Our service improvement programme is changing services for working age adults, for older people, for people with learning disabilities, and for people currently receiving care outside the South West Yorkshire area. Changes have taken place in all localities to make sure our services offer greater choice, are provided closer to people’s homes and possess a strong evidence base. The Trust wants to continue modernising services to further improve the quality of life for people with leaning disabilities and mental health problems. Here we take a look at the progress made to date, where we plan to be and how we plan to improve and develop services. What is the Trust trying to achieve? d ‘These modernise increased t or pp su s ice rv se be choice for care to unity m m co in provided le’s op pe in or s ng setti e id ov homes and pr pects of support for all as people’s lives.’ 22 Our year ” The Trust aims to provide high quality, safe and effective services by working with service users and carers to choose care and treatment and to shape the future of services. Key to modernisation is workforce development, improving buildings and making sure we stick within the budget available to us. What is important to the Trust as we undergo service improvement? The Trust will constantly check any actions against our Vision, Values and Goals and ensure any proposals for change result in better services. It important to provide person centred care and make sure that new service models are underpinned with practice change and workforce development. What has already happened? Since the Trust was established in April 2002, we have made a lot of positive changes to services, by responding to what service users and carers told us they wanted. This has led to the development of more community based services – for example crisis and home treatment teams - which provide comprehensive care to people in their own homes. This has resulted in a need for less hospital beds, and although inpatient services are still highly valued, they are a last resort available when community support is not possible. We are now in ’phase 2’ of our service improvement programme, and are working to translate proposals for service change into firm plans for the future. How have service users, carers, staff and partners been involved with this work? Over 400 service users, carers, Client Identification and access A model of comprehensive mental health services – joint working across agencies helps to deliver a Income and Entitlements (employment, benefits, etc) comprehensive care plan. Physical Health and Dental Care Crisis response services mind Service Users and Carers Care Interventions and treatment staff and stakeholders attended ‘Open Space’ events held in July 2004 to give their views about how services should be further developed. More events were held in January 2005 to look at how inpatient services might be organised in the future and what community support there should be. Since then, clinicians, support staff and managers have been developing service improvement proposals. This work has resulted in 31 proposals which were discussed and refined at a series of workshops in June 2005. The Trust has also listened to staff from other Trust’s, learning about their plans and aspirations for service improvement. We are continuing this process of engagement and are working with a reference group, made up of service users and carers who participated in earlier workshops. This group is helping to make sure we translate all the proposals for improved services into firm plans for the future. We are also continuing to offer regular briefings and information exchange sessions for staff, and staff side representatives, so there is opportunity for discussion and for update. What is the Trust proposing? The proposals will help to; Increase the range of services offered. Reduce the amount of unnecessary variation across the Trust Increase the Trust’s ability to offer effective care in the most appropriate environment Introduce more flexible working practices so that services are available around the clock. Family and Community supports Rehabilitation services What needs to happen next? The Trust will continue to provide high quality care and involve people in decisions about their care. All established networks and communication channels will still be used for debate and update on modernisation. The information gathered throughout the last year will help the Trust develop a Service Improvement Plan for the organisation. We also expect to have to formally consult with local people on some of our proposals – for example the best use of estate, including main hospital sites. The Local Authority Overview and Scrutiny Committees will decide if this is necessary and we are keeping them up to date on the process we are following. There will be a document to support any public consultation, which will outline what we hope to achieve and the benefits for local people. This work will be done over the summer 2005. These documents will not sit on a shelf! We will need to work with Primary Care Trusts and other partners to agree timeframes for those Housing/Accommodation full partnership with users and carers. Greater Advocacy emphasis will be and Empowerment placed on preventing crisis and responding Peer quickly when crisis occurs. Support More people will receive treatment within or as close to home as possible. Services in each locality will be enhanced with changes that are new services offered that supported and ensure they are not currently available are implemented. locally. What will the future hold? By implementing the proposals it’s hoped that the Trust will become a more responsive organisation that works in For these improvements to be delivered there will be changes to the way we work, and our service improvements have to be delivered within the monies available to us. MP praises Trust service David Hinchliffe, MP for Wakefield (until May 05), visited the Trust to learn how services for older people have been modernised to provide the most appropriate care in the most appropriate setting. Mr Hinchliffe met with members of the team from the Rapid Access Service, along with Richard Clibbins, nurse consultant, and Professor Curran. Mr Hinchliffe heard how services have been refocused to allow the rapid access team to offer the most appropriate care for older people who have mental health problems. This is regardless of what environment they are in, such as in their own home, hospital or care home. David Hinchliffe said, ‘I found my visit to the Rapid Access Service most interesting and helpful. It is encouraging to see the very positive support which is now available locally for older people with mental health problems. I think we are very fortunate in having a service of this quality within our local community.’ Our year 23 escape into literature We all enjoy relaxing with a good book every now and then, but service users in Calderdale are now finding that reading can help them in their recovery process. ‘Books are very therapeutic, they allow people to escape into literature,’ says Maggie Leighton, a bibliotherapist from the award winning RAYS – Reading and You Scheme. ‘Reading can also be very cathartic; certain stories or themes might ring bells for people and they can relate it to their own experiences.’ Reading can aid relaxation and reduce stress as well as providing entertainment and enjoyment. RAYS helps people with mental health problems or those who feel lonely and isolated to enjoy these benefits. ‘We aim to promote well being, relaxation and friendship through books and reading. Lots of the people I work with haven’t been to the library or haven’t read for ages so I familiarise them with the library and help them to choose books,’ says Maggie who works from Todmordon library. ‘The library is like a springboard to the community,’ Maggie continued. ‘It’s fantastic that through our scheme people who often feel very isolated from the wider community can become involved again.’ And the wonderful benefits of RAYS aren’t confined to the library, the bibliotherapists run reading groups, carry out home visits and help clients pursue other interests via reading. New journal shares research The Trust and the University of Huddersfield have launched of a new journal: ‘Mental Health and Learning Disabilities Research and Practice’. The journal encourages people to share research, service developments, and educational developments, or to write reviews. Importantly, it particularly welcomes contributions from service users and carers. Virginia Minogue, head of research and development explained, ‘This has been a very exciting development and one of the real successes from our 24 Our year partnership with the University of Huddersfield. Publishing research findings in an accessible way allows us share with colleagues both locally and nationally evidence that will improve our services for those who use them. The journal is a testament to both organisations commitment to encouraging research and the development of evidence based practice.’ The Journal is available to view on our website. Fiona Seinfield, a community practice nurse based in Hebden Bridge says that RAYS has brought enormous benefits to the service users she has referred, ‘This is a wonderful scheme and we’re lucky to have it here in Calderdale. It supports the recovery model by encouraging and supporting people to return to what they did before they became ill.’ For more information about RAYS call Maggie on 01706 815600. G a t r e den r c e S A piece of wasteland at Crows Nest Park, Dewsbury was transformed into a beautiful garden with the help of a group of green-fingered service users from the Mirfield Day Centre. The group eagerly volunteered to help and donned their gardening gloves every week. ‘The transformation is amazing. Before, the garden was full of glass, iron, rubble and felled trees. Now there are flower beds and paths and it attracts lots of wildlife,’ says Anne Sharp from the Mirfield day centre. People from all over the community helped with the project including the local Soroptimists and a group from the Mormon Church in Dewsbury. A local artist created a beautiful mosaic with the help of schoolchildren and members of the public have donated plants and seedlings from their own gardens. The ‘Wildflower garden’ was officially opened in June 2005. “ ‘I love coming here, it’s ace! It gets me out of the house and seeing what it was like before and now, gives me a real sense of achievement. (Michael) ‘I learnt how to make concrete paths. It’s something I didn’t think I could do, but I did and I’m really proud of myself.’ (James) ‘We’ve created something for future generations, the garden will be around for years so we’ve made something for people in the community.’ (Terry) ‘I come to work on the garden all the time - I’ve worked 1032 hours here since the project started. It’s peaceful here, and if I just work in my own garden I might never see or speak to anyone. Here I meet lots of people.’ (Brenda) ” The work of a digital photography group at Mirfield Day Centre is brightening up the reception area. The group has visited lots of local beauty spots and places of interest to take the pictures such as Bretton Park, National Coal Mining Museum, Ings Grove and Ponderosa. ‘I’ve enjoyed being creative and going out and taking photographs. It’s been good to connect with nature through the camera,’ says groupmember John. ‘Sometimes it’s been hard because with my condition there can be difficulties with memory and concentration. The staff have really helped me though and the group has kept me focused.’ Photography has now become a regular hobby for Sharon, another member of the group. ‘I often borrow the camera from the centre and take it out with me. I like taking photos when I go out with the walking group here. I liked socialising with the other members of the group and getting to know them. I’m really proud of the exhibition’. Snap-happy Day Centre officer Jo Kay ran the group, and thinks all the members have really benefited from it. ‘Socially the group has bonded, and everyone’s self esteem and confidence has grown. It’s nice that other people can see the work – it’s a brilliant exhibition.’ ‘People often focus on the negative aspects of mental health,’ concludes John. ‘It would be nice for people to see some of the positive things we do for a change.’ d Sharon John an red u are pict e of m o with s y. otograph their ph Our year 25 about e v mental health i t i s Po be good h. It can lt a r e h l a ysic weeks o st like ph st a few fetime. ju ju is st h la lt t li a ea Mental h d to problems th anaging over a mental a m ir le e d , e th d e a h n b it or that ve lives w with physical or ones producti g ry e in months v v ’s li d a o ey d hritis. It ople le Many pe blem, just as th iabetes and art f o t u eo ro , d that com good s health p such as asthma g in th ns the good promote conditio celebrate lem and b to t ro n p a rt h chieved. the impo healt can be a ages and mental it t a a th g s in lth mess h depicts y a a e w hav h l d n ra gene whic ealth a look ealth’, ntaining mental h ividuals ental H alth’, co d M He e how in uted ositive sers at th cond ‘P tements about en distrib for u e e s b e e ic v a rv s h a se e , st g e f se r a o e l a ss h a c up .T y Me person ositive n health and in primar 03, a gro eas for their ow mber 20 r to form a ‘P ctices. id t r e s t e c ra u a e p r ft k T D a P o G In s and as to lo ut the out ic w o b togethe n a h p li t g c u o u n y g ro o io it r th un mat Trust of the g motes and to comm e infor The aim that pro xample to shar with Trust staff r e e , s tt Group’. e e sl ic v e w le with a ne ce th g ser ther, at peop ludes ublished h nd redu ugh t improvin lth with each o p a p s y u g tr ro in th d inc hea thro d to The g positive mental done an y unity an alth problems n e m a v m a m o h c s l e the problem the loca out mental h y living. l health ab t health s. ta u rt n a o a e b m e a m v ig e ti t s a a , nd advic produce n and cre s set up poetry a educatio nding to f mental ce it wa fu n si d e y rl in o ula obta e stigma ject is to met reg cts in particular: up has ucing th up has ro je d The gro p ro re ro is G p t r a th e u f h o T ed fo lth ating on video aim rkplace. The aim tal hea alth Day concentr h men o ental He nning it nd w a M w e d ry th rl a le o ma peop ealth in a-ordin t rted W h y tr a o x b h p e t p d r su n e a group trat ts in Octobe Members s ordinary e to share. The demons in ermarke ve, th p o u b s n ject c d re io e a n t s onsi perie he pro select celebra problem l and ex t and edit t very resp range nds in il a and t sk re s s e e h c c w n u e tio le nchy pie have m , shoo u e p informa ld. Local peop ions, and a wid ealth it , r rt w o diverse n, of sh fie ental h will pla of quest a series ross to a m c g a ts Hudders n n s lo si o e u g m sk a s, e ss to a n com themselv to get their me stopping information o s w n ie e . rv tt d ri te te in of w tribu e. s was dis ther to audienc problem ed toge etter rk o w p B u ro to g ad and of the ‘The Ro embers Members o posters, one an 15 m out th b a re o g tw asts m tandin o rs b e produce d y n tl u n ple’s te rre p cu promo ure peo The grou rk hard to d to make s o w to s continue alth issues an re valued. he illness a Better mental oad to f mental R o s e e h c n ‘T e port. oster experi of this re r roup’s p e g v o e c th k c see inside ba You can h’ on the lt a e H l Menta Did you know that in 2004/2005: • Nobody using our learning disability or older people’s services had to wait longer than 13 weeks for a 1st consultant outpatient appointment. Only 8 people who use our adult services had to wait longer than this time. • 1092 patients have received crisis resolution services. • The percentage of 1st consultant outpatient appointments that were missed are: 22.7% for adult services, 12.5% for older people’s services and 10.7% for learning disability services. • Our hospital facilities were judged as offering clean and pleasant environments by a national team of assessors. • The Trust is fully compliant with the Freedom of Information Act and has produced a publication scheme that is a complete guide to the information routinely published by the Trust. 26 Our year • 83% of patients who required follow-up received face-toface contact within 7 days of discharge. • Our staff turnover rate was 11%. • The Trust is compliant with privacy and dignity standards (mixed sex accommodation), although further improvements will continue to be made. • We have maintained level one status against the Clinical Negligence Scheme for Trusts assessment - a scheme that ensures appropriate arrangements are in place to manage risk. • The Trust is 100% compliant with New Deal targets and junior doctors hours . • Our staff sickness rate was 4.9%, which is a reduction from the previous year when it was 5.9%. Understanding depression Depression is one of the most common medical conditions in Britain today. 1 in 5 people will have depression at some point in their life, with the World Health Organisation predicting that it will be second only to heart disease as the biggest global health burden by 2020. Yet, as many as three in four cases are neither recognised nor treated. In National Depression Week DASH (Depression, Anxiety, Self Help), a drop-in group for people who have been diagnosed with depression, spoke openly and honestly about how it feels and how DASH has helped them. Factfile: Janet Pollard, manager, explained more about DASH. ‘The group provides an enjoyable setting for people to make and meet friends who understands what it feels like to have depression. We provide a range of activities for everyone who attends the group. These include arts and crafts, parties, quizzes, social afternoons such as going out for lunch or a coffee, “I find life in general very day trips and weekends away. We hold a book difficult. Small tasks are like club once a month, we mountains to climb. read stories and poems and there is a selection People don’t understand of books to borrow. ve ey ha depression if th is also very It . ed er ff never su hard to concentrate for any length of time.” ‘There are health mornings once a week to explore ways to deal with stress, sleep problems, anxiety and anger management, there are sessions to build self confidence and we practice relaxation techniques with relaxation tapes. One to one counselling is also available. Tuesday mornings are especially for women, within these sessions we discuss health issues and healthy living, giving advice on diet and fitness. ‘The loneliness and isolation of people who have to live with depression and anxiety is not easily understood by those who have never suffered from it. We aim to provide support, advice and friendship to everybody who attends the group.’ Here is what members of DASH told us about depression and the support that they receive from DASH … alone. I’ve made lots of new friends and learnt new skills. You can talk to Sue and Janet about any problems that you’ve got I’m glad that I got brave and came, I really look forward to coming. Its better than sitting at home dwelling on things.” “It makes me have a permanent tiredness. In moments of deep depression I withdraw and don’t mix with anyone.” • Depression is one of the most common conditions in Britain today, affecting 1 in 5 people at some stage in their life. • More than 2.9 million people in the UK are diagnosed as having depression at any one time. • Depression is still the most misunderstood illness, with as many as 3 in 4 cases being neither recognised nor treated. • People who are depressed experience an intense feeling of persistent sadness, helplessness and hopelessness accompanied by physical effects such as sleeplessness, a loss of energy or physical aches and pains. haven’t “People who experienced it, nd.” don’t understa “Its wonderful here (DASH), it keeps me sane. I’d come every day if I could.” “One comes to a standstill and it’s very “I can’t go out on my own difficult to do anything at all. One feels that one is I can’t even walk into a on a bottomless pit and supermarket on my own, you’re unable to get out I’m afraid of crowds of people. of it.” tacks. I suffer panic at “Its good company for me is The safest place (DASH), you can share my home. I find it very hard your problems; you don’t I’m n feel so isolated and whe ed to get motivat depressed. Can’t face housework and I neglect myself.” Our year 27 Getting ce n a l ba right the Open Day demonstrates benefits “ I’ve really benefited from coming here, it’s given me so much confidence, ng Clients from the Learni e ntr Ce rce sou Disability Re rnt lea ve ha ry bu ws in De of about a wide range as ll we as s, health issue t pu to w ho wn being sho into e vic ad hy alt he s thi life. practice in day-to-day ‘The explained Darren. the nts clie e giv sessions y’ve the s ng thi to ers sw an ow always wanted to kn ver ne ve ha t bu about, rly pe pro d ne lai exp en be ise an org before. We also so s up gro ise the exerc ng rni lea th wi le peop re disabilities get mo .’ en oft active more O’Donovan, Darren the fitness instructor at dy Bo the s unit run red ctu (pi up gro ce lan Ba up above) which was set t tha ar cle e cam when it be ow kn n’t did nts clie e som the basic things about it w ho d an human body to s aim up gro e Th . works take empower clients to and s die bo care of their ll we d an h alt their he are t tha s pic To . ing be ns covered in the sessio ol oh alc d an g include dru diet , ing ok sm ss, ne are aw what exercise, and we en wh happens the w ho d an ill e becom ject body works. The pro ly ek we es also provid t igh we , ng swimmi it cu cir and training training sessions. dy The success of Bo a dy, Bo My Balance led to le sty ers tch wa weight ed. group, being establish en giv is Each member ich wh ok bo log their own d is used to keep a foo ss gre pro diary, chart the and of their weight loss ers ind rem ful use e provid and healthy about ents unhealthy food. Cli to w ho wn sho o are als and d foo hy alt he re pa pre and each week choose ch lun n ow ir the prepare you ‘It’s hard enough for ced lan ba and me to eat a e tak d an t die healthy we d an se, rci exe gh enou ding have the understan So s. thi do of how to is it ult fic dif w ho imagine a th for some one wi ,’ do to y ilit learning disab 28 Our year vital Darren thinks it’s ups gro are that there so ce lan Ba dy Bo as such ng rni lea that people with the disabilities have rt po sup d an y nit opportu up, gro a ‘As se. rci exe to ng people with learni en oft are ies disabilit they , ed lat iso ly ial soc ts or often live with paren get t jus ’t can d carers an up. et me d an s bu a on s up gro The body balance as on asi occ are a social y to well as an opportunit out get fit, they talk ab he !’ ek we the groups all explains. ” says James Chapman (pictured below with his nephew, Zak). Echoing these sentiments, Joanna Cockburn talks excitedly about moving into her own home, ‘I’ve got the confidence now, and the practical skills too’. James and Joanna have both been coming to the Learning Disability Resource Centre in Dewsbury for several years and spoke about how it has helped them during an Open Day held at the centre. It is clear that the multidisciplinary approach of the Centre works. James, together with the occupational therapists, started going to the gym and now has the confidence to go on his own. He has also been going to Dewsbury College to improve his computing skills, has had speech and language therapy and has found employment.James attended the open day with his family, including his nephew, Zak – who he spends a lot of time playing with. Speaking about the service, James said, ‘All the people here are really nice and help you a lot.’ Joanna has also benefited from the many different aspects of the service, and each week is busy and fulfilling. She attends a fitness group, and is studying English, Maths and Sewing at Dewsbury College. “ I’m going to move into my own home as soon as we find one! ” laughed Joanna who has been learning about money management and other practical skills to help her in her move. ‘Cooking sessions are my favourite’ she says, ‘although I’m not very good – yet!’ James summed it up, “ The open day was a really good idea – thank you to everybody who has helped me in so many different ways. They really make a difference. ” The PICU (Psychiatric Intensive Care Unit) team at Fieldhead, Wakefield won an accolade for multidisciplinary working which they achieved after taking part in a prestigious national PICU project. It was a double success for the Trust as service user John Girdlestone received a special acknowledgement for the positive impact he had on the whole project. (Read more about John on page14/15). The team have already started to implement changes as a result of the project. They are currently piloting a scheme with one of the community teams which involves primary nurses from the ward attending meetings with them. ‘It’s hoped that this will increase care coordination and communication between inpatient and community workers –leading to a smoother discharge for service users,’ says ward manager Lisa Archibald. as a daunting place and we have started to get rid of that image. It’s given us a good foundation to develop our services,’ she said. Lisa thinks one of the most important parts of the project was raising the profile of PICUs. ‘We had the chance to dispel myths about PICUs by creating information and talking to people such as carers and members of staff in other units. PICUs are often seen Ward manager Lisa Archibald was also pleased, ‘To have acknowledgement from that level meant a lot to the PICU team and everyone here at the unit. We’re very grateful to John for his dedicated input, service user involvement is so important and he had Service user representative John Girdlestone (pictured holding the certificate), was delighted with the PICU team’s success, ‘It’s absolutely brilliant that we were put forward for this award and got so far. We all put a lot of work in to this project and were so pleased to be rewarded.’ Recovery and optimism People’s mental state can change and shift like the tides of the sea, people can feel they are ‘drowning’ in their problems or that they are ‘all washed up’. Trust services in Calderdale have adopted the Tidal model – a recovery programme that takes this into account and empowers patients to control the way that they are treated. Elmdale ward at the Dales unit was one of the first to benefit from the tidal model. The ward now closes for two hours a day so that ward and occupational therapy staff can engage service users in therapeutic activity. Modern matron Grahame Peace explained, ‘The ward is a lot calmer and less chaotic. There are now many activities such as taking patients out in a minibus, baking, having DVD and popcorn nights as well as structured activities and groups being set up.’ One such group is Solutions, run by ward staff and occupational therapists. ‘The tidal model encourages people to have their own toolkit of treatments and therapies that they know work for them,’ continued Special awards for PICU team What is the PICU? The 10 bed PICU unit provides short term management for people with acute mental illness. something to give to every part of the project.’ The team are continuing their positive work, helping to set up a regional network of governance for PICUs across the Northern & Grahame. ‘The Solutions group allows patients to identify their toolkit, working in collaboration with staff to choose the right treatments and get better.’ North Halifax community mental health team have also adopted the tidal model making them the first community based mental health team in the country to do so. Grahame hopes this will help promote seamless care between inpatient and community services. ‘Community teams and inpatient teams are often seen as separate entities. We want to use the tidal model to break down these barriers. It’s very much about team work between ward, patient and the Yorkshire region. The project findings will be published in a national PICU journal and the team have also agreed to take part in a national research project. community team.’ ‘The most important aspect of the Tidal model is the belief that people can recover their lives. Often people with mental health problems can get written off and lose hope, this recovery model is about hope and optimism,’ Grahame concludes. What is the tidal model? The tidal model gives patients different ways to learn cope with problems, with the fundamental belief that people with mental health problems can get better and recover their lives. Our year 29 Financial Report As an NHS Trust, South West Yorkshire Mental Health NHS Trust has to meet four statutory financial duties as directed by the Government. I am pleased to report that the Trust for the third year in succession has met all of its four statutory financial targets. Statutory Targets External Financing Limit Break-even The NHS and Community Care Act 1990 states that the principal financial duty of a NHS Trust is to achieve a break-even position. The Trust met this target by returning an in year retained surplus of £129,000. Capital Cost Absorption Rate The Trust is required to absorb the cost of capital at a rate of 3.5% of average relevant net assets, and the rate achieved by the Trust was exactly 3.5%. Other Information/Targets The Trust is required to remain within its external financing limit (EFL). For 2004/05 the Trust was set a negative limit of £13,592,000 meaning that the Trust was required to generate additional funds to meet capital payments and other balance sheet movements. The Trust met this target exactly. Capital Resource Limit The Trust is required not to exceed its capital resource limit (CRL). For 2004/05 the Trust was set a limit of £1,219,000. The Trust had a small underspend of £1,000. Better Payment Practice Code measure of compliance Management costs Management costs Income Percentage of Management Costs to Income 2004/05 £000 4,662 £000 96,222 % 4.85 Management costs are as defined in the document 'NHS Management Costs 2002/03' which can be found on the internet at http://www.doh.gov.uk/managementcosts. The Summary Financial Statements These summary financial statements for the year ended 31 March 2005 have been prepared by the South West Yorkshire Mental Health NHS Trust under section 98 (2) of the National Health Service Act 1977 (as amended by section 24 (2), schedule 2 of the National Health Service and Community Care Act 1990) and give a true and fair view of the Trust. Signed Finance Director Date 11th July 2005 Signed Chief Executive Date 11th July 2005 30 Our year Total bills paid in the year Total bills paid within target Percentage of bills paid within target 2004/05 Number £000 17,773 10,960 61.67% 12,583 8,461 67.24% The Better Payment Practice Code requires the Trust to aim to pay all valid invoices by the due date or within 30 days of receipt of goods or a valid invoice, whichever is later. Signed Chairman Date 11th July 2005 Independent Auditor’s Report to the Directors of South West Yorkshire Mental Health NHS Trust on the Summary Financial Statements We have examined the summary financial statements set out below. This report is made solely to the Board of South West Yorkshire Mental Health NHS Trust in accordance with Part II of the Audit Commission Act 1998 and for no other purpose, as set out in paragraph 54 of the Statement of Responsibilities of Auditors and of Audited Bodies, prepared by the Audit Commission. Respective responsibilities of directors and auditors The directors are responsible for preparing the Annual Report. Our responsibility is to report to you our opinion on the consistency of the summary financial statements with the statutory financial statements. We also read the other information contained in the Annual Report and consider the implications for our report if we become aware of any misstatements or material inconsistencies with the summary financial statements. Basis of opinion We conducted our work in accordance with Bulletin 1999/6 ‘The auditor’s statement on the summary financial statements issued by the Auditing Practices Board for use in the United Kingdom. Opinion In our opinion the summary financial statements and the directors’ statement on internal financial control are consistent with the statutory financial statements of the Trust for the year ended 31 March 2005 on which we have issued an unqualified opinion. Date: Name: Address: 22 August 2005 RSM Robson Rhodes LLP St George House, 40 Great George Street, Leeds. LS1 3DQ Income and Expenditure Account for the year ended 31 March 2005 £000 88,715 2003/04 £000 83,291 7,507 6,411 (94,900) (91,251) OPERATING SURPLUS / (DEFICIT) 1,322 (1,549) Profit on disposal of fixed assets 127 3,161 1,449 1,612 404 189 (1) (48) 1,852 1,753 (1,723) (1,732) 129 21 Income from activities Other operating income Operating expenses SURPLUS BEFORE INTEREST Interest receivable Interest payable SURPLUS FOR THE FINANCIAL YEAR Public Dividend Capital dividends payable RETAINED SURPLUS FOR THE YEAR Balance Sheet as at 31 March 2005 31 March 2004 £000 £000 £000 62,186 0 52,504 52,504 6,317 70 11,233 297 11,600 (12,329) (7,751) NET CURRENT ASSETS / (LIABILITIES) (6,012) 3,849 TOTAL ASSETS LESS CURRENT LIABILITIES 56,174 56,356 0 (357) PROVISIONS FOR LIABILITIES AND CHARGES (2,692) (1,472) TOTAL ASSETS EMPLOYED 53,482 54,527 Public dividend capital Revaluation reserve Donated Asset reserve Government Grant Reserve Other reserves Income and expenditure reserve 24,359 22,713 7 204 5,220 979 37,916 11,100 22 212 5,220 57 TOTAL TAXPAYERS’ EQUITY 53,482 54,527 FIXED ASSETS Intangible assets Tangible assets CURRENT ASSETS Stocks and work in progress Debtors Cash at bank and in hand CREDITORS : Amounts falling due within one year CREDITORS: Amounts falling due after more than one year 0 62,186 57 5,406 854 FINANCED BY: TAXPAYERS' EQUITY Our year 31 Cash Flow Statement for the year ended 31 March 2005 £000 NET CASH INFLOW / (OUTFLOW) FROM OPERATING ACTIVITIES RETURNS ON INVESTMENTS AND COST OF SERVICING FINANCE Interest received Interest paid Interest element of finance leases Net cash Inflow/(outflow) from returns on investments and servicing of finance 2003/04 £000 16,046 327 404 (1) 0 189 (1) (47) 403 CAPITAL EXPENDITURE Payments to acquire tangible fixed assets Receipts from sale of tangible fixed assets (1,346) 212 Net cash inflow / (outflow) from capital expenditure DIVIDENDS PAID NET CASH INFLOW / (OUTFLOW) BEFORE MANAGEMENT OF LIQUID RESOURCES AND FINANCING MANAGEMENT OF LIQUID RESOURCES Purchase of investments Sale of investments FINANCING Public dividend capital received Public dividend capital repaid (not previously accrued) Public dividend capital repaid (accrued in prior period) Other capital receipts Capital element of finance lease rental payments NET CASH INFLOW / (OUTFLOW) FROM FINANCING 141 (3,133) 3,478 (1,134) (1,723) 345 (1,732) 13,592 (919) 0 0 Net Cash Inflow / (outflow) movement from Management Of Liquid Resources NET CASH INFLOW / (OUTFLOW) BEFORE FINANCING INCREASE / (DECREASE) IN CASH £000 0 0 0 13,592 0 (919) 0 10,653 (13,557) (7,000) 0 0 0 (2,928) 212 (18) (13,557) 919 35 0 Post Balance Sheet Events Private Finance Initiative From 1 April 2005 HM Treasury changed the discount rate used in calculating provisions from 3.5% to 2.2%. This change will result in an increase in our provisions of £154,706 which will be charged to the Income and Expenditure account in 2005-06. It is anticipated that national funding of NHS commissioners will be increased by the total estimated effect to offset this charge, although this is not guaranteed. The Trust does not have any Private Finance Initiative Schemes. 32 Our year Salary and Pension entitlements of senior managers 2003/04 2004/05 A) Remuneration Salary (bands of £5000) £000 Other Remuneration (bands of 5000) £000 Benefits in kind (Rounded up to nearest £100) Salary (bands of £5000) £000 Other Remuneration (bands of 5000) £000 Name and Title Sukhdev Mulkhraj Sharma, Chairman Gary William Dimmock, Non-Executive Director Anne Gregory, Non-Executive Director Thiruvenkatar Krishnapillai, Non-Executive Director Denis Sunderland, Non- Executive Director Janice Anne Wilson, Non-Executive Director Judith Addison Young, Chief Executive Nisreen Hanna Booya, Medical Director (From 29.1.04) Alan George Davis, Director of Human Resources Sheila Dent, Director of Clinical Risk Hazel O'Hara, Director of Performance & Professional Development Steven Peter Michael, Deputy Chief Executive (East) Nicholas Kevin Morris, Deputy Chief Executive (West) Malcolm Cameron Featherstone, Director of Finance (From 9.7.03) Ruth Unwin, Director of Public Affairs Benefits in kind (Rounded up to nearest £100) £000 15 5 5 5 5 5 115 25 65 55 65 75 75 75 60 - 20 10 10 10 10 10 120 30 70 60 70 80 80 80 65 135 - 140 - 23 36 21 32 79 20 29 15 5 5 5 5 5 125 0 65 55 65 70 70 50 50 - 20 10 10 10 10 10 130 5 70 60 70 75 75 55 55 20 - 25 - 8 1 22 15 21 32 73 5 23 The benefits in kind relate to either staff lease cars or expenses paid in accordance to Trust’s Removal Expenses Policy (which includes provision of accommodation). Salary and Pension entitlements of senior managers B) Pension benefits Name and Title Judith Addison Young, Chief Executive Nisreen Hanna Booya, Medical Director Alan George Davis, Director of Human Resources Sheila Dent, Director of Clinical Risk Hazel O'Hara, Director of Performance & Professional Development Steven Peter Michael, Deputy Chief Executive (East) Nicholas Kevin Morris, Deputy Chief Executive (West) Malcolm Cameron Featherstone, Director of Finance Ruth Unwin, Director of Public Affairs Real increase in pension and related lump sum at age 60 Total accrued pension and related lump sum at age 60 at 31 March 2005 (Bands of £2500) £000 (Bands of £5000) 5.0 32.5 2.5 2.5 5.0 2.5 2.5 2.5 2.5 - 7.5 - 35.0 - 5.0 - 5.0 - 7.5 - 5.0 - 5.0 - 5.0 - 5.0 135 195 75 70 90 75 95 5 35 Cash Equivelant Transfer Value at 31 March 2005 £000 £000 - 140 - 200 - 80 - 75 - 95 - 80 - 100 - 10 - 40 510 834 239 297 345 236 314 21 104 Cash Equivelant Transfer Value at 31 March 2004 Real Increase in Cash Equivalent Transfer Value Employers Contribution to Skakeholder Pension £000 To nearest £100 42 166 9 14 16 18 14 12 13 164 191 94 91 94 107 107 107 81 458 649 223 275 320 212 292 9 88 As Non-Executive members do not recieve pensionable renumeration, there will be no entries in respect of pension for Non-Executives members. A Cash Equivalent Transfer Value (CETV) is the actuarially assessed capital value of the pension scheme benefits accrued by a member at a particular point in time. The benefits valued are the member's accrued benefits and any contingent spouse's pension payable from the scheme. A CETV is a payment made by a pension scheme, or arrangement to secure pension benefits in another pension scheme or arrangement when the member leaves a scheme and chooses to transfer the benefits accrued in their former scheme. The pension figures shown relate to the benefits that the individual has accrued as a consequence of their total membership of the pension scheme, not just their service in a senior capacity to which the disclosure applies. The CETV figures, and from 2004-05 the other pension details, include the value of any pension benefits in another scheme or arrangement which the individual has transferred to the NHS pension scheme. They also include any additional pension benefit accrued to the member as a result of their purchasing additional years of pension service in the scheme at their own cost. CETVs are calculated within the guidelines and framework prescribed by the Institute and Faculty of Actuaries. Real Increase in CETV - This reflects the increase in CETV effectively funded by the employer. It takes account of the increase in accrued pension due to inflation, contributions paid by the employee (including the value of any benefits transferred from another pension scheme or arrangement) and uses common market valuation factors for the start and end of the period. Statement of Internal Control The Trust’s Statement of Internal Control can be found in the full set of the Trust’s Accounts. A full set of accounts, on which these summary financial statements are based, is available free of charge from Ruth Unwin, Director of Public Affairs, South West Yorkshire Mental Health NHS Trust, Fieldhead, Ouchthorpe Lane, Wakefield, WF1 3SP, 01924 327018 Signed Chief Executive Date 11th July 2005 Our year 33 Get Aware The Trust shows its support for many health awareness campaigns throughout the year with a host of activities and events. Health campaigns provide a great opportunity for the Trust to champion mental health and learning disability issues and break down stigma. In the last year, Trust staff have been out into local communities to provide information and advice and raise awareness. Here’s a taste of just some of the things we have supported: World Mental Health Day was celebrated in style with live music, drama, arts and crafts events across the area. Information stalls were held in supermarkets and some visitors were invited to take a quiz to make them think more about their own mental health. A book of poetry written by service users was produced to mark the day and service user art work was displayed. During Mental Health Action Week in March staff also put up stalls and displays at supermarkets and GP’s sugeries across the area. For Carer’s Week, some carers were invited to an afternoon of indulgence at a pampering session. Foot spas, aromatherapy massage and cream teas were among the delights on offer. The Trust will continue to support the following awareness campaigns: er’s Day World Alzheim l Health Day World Menta ay Awareness D ational Stress N 2 Nov 2005 Awareness ng Disorders ti Ea 5-11 Feb 2006 Week ion Week tal Health Act en M 06 20 pr 27 Mar - 2 A ility Week Learning Disab Jun 2006 Alzheimer’s Carer’s Week eek Jun 2006 Awareness W 21 Sept 2005 10 Oct 2005 This is the Trust’s annual report 2004/2005. If you would like help understanding this report please call 0800 5872108 34 Our year w w w. s o u t h w e s t y o r k s h i r e . n h s . u k Get as much information about your illness as possible. Talk to someone. Get some support. Try to understand your illness - get help to do this. Take up a hobby. Do things you enjoy. Find ways to relax. Talk to your Dr. Follow their advice. Keep active, keep fit and eat well. Don’t be isolated. Join social groups. Get out and about. Keep busy through working or learning a new skill. Produced by The Positive Messages Group ort? p e r l a u n n a our g n i d a e r d e joy Have you en e hope you have found it interesting and easy to read. tly to make it better? one differen could have d e w g in h yt an islike? of it. Is there ails below. hat did you d W you thought at e? h lik w u r e contact det yo ea th h id se d to u at e ve h as lo W le d p , We’ ut this report mments abo co r u u would like yo l al e report or if yo is We welcom th in g in h yt ion about an ore informat m get in touch. e e lik as ld le u p o s w ie p u co yo if al , n o kefield WF1 Als additio rpe Lane, Wa W o head, Ouchth ld ie F r, e g a s.uk n nications Ma ms@swyt.nh u m m o c m : o il C a , n m a E Jude Corrig 1924 327689 Telephone: 0 3SP of us will experience a mental health problem* The stigma and discrimination surrounding people with mental health problems has a profound and damaging effect. Stigma makes it harder for people to admit they have a mental health problem and get the support they need and it means that people with mental health problems are often treated with unwarranted distrust and fear. Help tackle the stigma by challenging inappropriate language. *Source: Mental Health Foundation