Mental HealthMatters www.wlmht.nhs.uk

March 2011

He’s a member

- are you?

‘Real-time’ communications in Hounslow

I thought it would be timely to look back at the Care Quality Commission’s investigation of the Trust and reflect on the learnings from this which have led to significant and lasting improvements. I believe that we must never forget what we’ve learned as it will help us in the next stage of our journey - towards excellence and FT. I’d like to thank the staff who worked with me to compile this feature.

Those of you who worked here in 2008 may remember the day in March when it was announced that the Trust was to be investigated by the Heathcare Commission (HC) (which as of April 2009 became the Care Quality Commission, (CQC)). Andy Wells, Associate Director of L&D says: “I remember hearing about the investigation and talking about it with colleagues. It sounded serious, but we could never have anticipated the extent and pace of change which would result. I guess it confirmed what many of us had suspected - that change had to happen.”

The HC / CQC had received numerous expressions of concern about the standard of care we had been delivering. The impact of this was heightened by a cluster of patient suicides and a high profile external enquiry into a homicide of a patient in Broadmoor Hospital.

With this in mind, the HC / CQC were convinced that they had sufficient evidence to launch a full, extended investigation, focussing their efforts specifically on services in Hounslow and at Broadmoor Hospital. During 2008 they also visited the Trust’s other main sites, and interviewed

staff at all levels, culminating with the Board. The investigation team was comprised of specialist HC / CQC staff, and a group of external mental health professionals.

Gemma Stanion who was appointed as the Trust’s investigation lead, says: “By June 2008 the investigation was in full swing. We were receiving information requests from the investigation team thick and fast. They wanted to find out about our policies and procedures, what they looked like, how effective they were and how we made sure our people and those with whom we worked in partnership knew about them and adhered to them. They wanted to know how good our services really were, and about the safety of practice and the quality of our patients’ experience.”

The next phase gave the HC / CQC team an opportunity to talk to our staff, patients and carers as they visited services in Hounslow, Broadmoor Hospital, St Bernard’s and the Hammersmith & Fulham Mental Health Unit. The final stage involved interviews with senior managers, including consultants, directors, and commissioners.

Gemma adds: “The HC / CQC were very clear that it was an investigation, not a review of our services. We had to treat this as an opportunity to learn from the things we weren’t doing well, and to develop and change accordingly. Obviously, we had to put the many difficult emotions that the situation triggered aside, and do everything to co-operate with and support the investigation. Many of our staff, patients and carers shared their experience and insights with the investigating team, helping them to reach their conclusions.”

In the early part of 2009, the HC / CQC reverted with their preliminary findings. We were described as an organisation which accepted ‘mediocrity’ and did not learn from things that had gone wrong.

Simon Crawford, who had been Chief Executive for 4 years, left the Trust, and I was appointed in August 2009, following publication of the CQC’s report in July.

The report’s publication was greeted with a degree of shock and disappointment by staff. Angela Dolan, Service Director at Broadmoor Hospital says: “I remember colleagues talking about how they felt hurt by the report and saddened that we’d let patients down. However, I quickly picked up on a real sense of optimism that things had to, and could, change for the better. The investigators talked about ‘Broadmoor time.’ We knew we had work to do to quicken the pace at which we responded to issues and challenges at Broadmoor Hospital - and in the rest of the Trust.”

The report was critical of the Trust’s leadership and management; since publication

of the report in July 2009, we’ve seen an almost complete change in our Board composition. The CQC continued to pay visits to our services for the next year, probing for insight by talking to staff and patients, and looking for re-assurance that we’d understood the issues, and their seriousness, and were taking action.

We continue to go through a process of significant change in our drive to become a leading trust by pushing for improvements to the patient experience. Although we have much, much more to do, here’s a summary of some of the fundamental changes we’ve seen recently.

Leadership and cultureThe executive leadership team has stepped up and now works consistently to make sure we’re adequately informed to lead our diverse organisation. We’ve gone through a programme of Board development to help us become more familiar with key issues, techniques and processes needed in the new healthcare economy. We’re also spending more time out talking to patients, carers and staff, to deepen our understanding of the ups and downs of providing care at ‘the front line’.

The non-executive directors are more aware of the importance of challenging the Trust’s directors and senior managers, which is part of their governance role.

The ‘culture of mediocrity’ had to change and we’ve embarked on a project to launch and embed common values across the Trust, from top to bottom. This still has a way to go as we incorporate the values in our HR systems and processes, but most staff have participated in workshops in the last nine months to learn about what’s expected of them in terms of behaviour at this Trust.

Dr Sujoy Mukherjee, Consultant Psychiatrist and Medical Lead for Older People’s Service in Ealing says: “I have seen many improvements in recent months, but the most notable change for me is improved communication between senior management, senior clinicians and consulting bodies. Everyone is taking a more active interest and I find the new Medical Director responsive to any queries. He has introduced a regular newsletter which is very informative and the Trust Board members are definitely making more of an effort to get out and talk to staff.”

Cubbon’s

corner

Editorial team

Mental Health Matters2

Mental Health Matters is written by the Communications Team, for staff and patients of West London Mental Health Trust. We’d love to hear from you with your news or views. Do get in touch with us!

Tara Ferguson Jones: tara.ferguson-jones@wlmht.nhs.uk

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

Telephone: 020 8483 2283

Mental Health Matters 3

Peter Cubbon

Ali interviews Archibold Chaurura about the supervision toolkit.

On the cover:Vushe Hove, who works as Service User and Carer Co-ordinator in West London Forensic Services.

Steve Trenchard, Director of Nursing and Patient Experience, meets with carers.

Learning from incidentsWe’re developing as a learning organisation where staff are more educated about and open to sharing the learning from incidents. Andy Jacques, Service Manager, Ealing SDU says: “If a serious untoward incident occurs, we investigate it, document it and share information on the learning throughout the organisation to ensure we avoid a re-occurrence. We have new polices and processes in place so that incidents are reviewed consistently in all areas. As managers we’re accountable for cascading lessons learned to our staff, and this is supported with our ‘Risky Business’ newsletter and regular ‘Learning Lessons’ conferences.”

Physical healthcareJimmy Noak, Deputy Director of Nursing says: “We’ve made noticeable improvements to physical healthcare provision for our inpatients in Broadmoor Hospital and West London Forensic Services. Patients now have regular physical health-checks and good access to primary care doctors when they need it.”

Service user involvement Jules Tennick, an Ealing service user says: “The extent of service user involvement has expanded. For example, this year for the first time a number of service users and carers were involved with producing the nursing strategy. Also, a service user group, Loud and Clear, were commissioned by Ealing PCT to do user focused monitoring in the John Conolly Wing over a 15 month period as a direct result of the poor CQC report. This seemed to be taken seriously by managers and some real improvements were made as a result. The team will be re-visiting the wards this year to see if the improvements

have been sustained since the monitoring project.”

CommissionersThe CQC told us that commissioners’ relationships with us were sub-standard. We’ve worked with commissioners to rectify this and have built mutually beneficial relationships with them. For example, commissioners now attend our Trust-wide Incident Review Group, they’re invited to our ‘Learning Lessons’ conferences, we’ve been engaging them in our pathways re-design work and they worked with us on our values project.

CleanlinessDonna Marie Nolan, Ward Manager in West London Forensic Services says: “We’ve really noticed a difference in standards of cleanliness on our wards, BZ and Brunel. It’s clear that the domestic staff have really stepped up and are working with us to make sure we’re providing the very best environments for patients. Now it’s all about keeping up the very good work.”

In January 2011 we were told that we no longer needed to report to NHS London and the CQC on the action plan, as it’s now closed. It’s important to remind ourselves that this is confirmation that

we’ve now achieved the baseline of what’s expected of us as a provider of mental health services. It’s not a guarantee of excellence and we have a way to go.

We’ve shared with NHS London and the CQC our plans to re-design care pathways and change our management structures to enable us to deliver financial and organisational efficiencies in order to become a Foundation Trust. They’re also aware of the work we’ve been doing to move forwards in our plans to redevelop Broadmoor Hospital and our St Bernard’s site.

The challenge for all of us is to keep in mind the journey we’ve been on, be heartened by what we’ve achieved, and keep up the momentum for change.

Over 100 multi-disciplinary teams have now attended a values workshop, as part of our drive to improve staff attitude by embedding shared values across the Trust.

Kuda Chiweda, Manager of the Hounslow Home Treatment Team says: “The team found the values workshop beneficial because it gave us an opportunity to focus on our strengths and tease out some of our weaknesses and agree steps for improvement. The exercise has strengthened our ability to work collectively as a team and with our patients to ensure we meet our goals.”

Mental Health Matters4 Mental Health Matters 5

As a follow-up to the values workshops, we’re re-issuing our staff and management charter.

Historically we’ve heard about ‘staff attitude’ being poor. The charter spells out, the everyday behaviours, we should expect to see from each other and from our leaders. Our over-arching aim is to support the development of a culture where feedback is given and received more openly, frequently and constructively. If people see excellence in others, they can praise and reinforce it. If they don’t see this, they can refer the person back to the charter.

The charters will be given out to every single Trust employee by the summer through a management cascade.

Signing up

Line managers

Trust news

A reminder to everyone with line management responsibilities that it’s the time of the year to hold PDR follow up meetings. Encourage your staff to prepare for the meeting by thinking about their performance and achievements during the year, as well as examples of living the values.

We’ve developed a half day training course on PDRs which we will be rolling out towards the end of the month. The programme will explain how to manage the discussion productively and how to appraise against the Trust values which is an important change this year. There will be information about this on the Exchange.

Staff and

management charter

Manpreet Grewal, Staff Nurse, with Yin Yap, Ward Manager, on Mary Seacole ward in Ealing.

• Beingkeptinformedbytheteam.

• Takedecisionsinbestinterestsofteam.

• Usestraighttalkinginahumaneandrespectfulmanner.

• Determinethebestallocationofresources.

• Giveconstructivefeedbacktoensurecontinuousimprovement.

• Delegatebasedonothers’skillsandtheirdevelopmentneeds.

• Receivetraining(andsupportfrommymanager)tomanageothers.

• Tobeconsultedandgivenanexplanationoftherationalebehindthechangeprocess.

• Contributetoandsupporttheteamanditsdecisions.• Participateinteamprocessesandgivefeedbacktotheteamandmanager.• Promotepositiveaspectsoftheorganisation.• Worktomyfullpotential.

• Viewtheservicesweprovidefromthestandpointofthepatient/internalcustomer.• Takeownershipofdelegatedtasks.• Raiseissues&concernswithmymanagerastheyarise.• Understandpoliciesand

procedures.• Respectconfidentiality.

• Stayuptodatewithmymandatorytraining.

• Contributeideasforimprovementandinnovationstotheworkoftheteam.

• Understandpoliciesformanagingriskandpatientsafety.• Supporttheteam.

• TreatothersasIwouldwishtobetreated.• Executedutyofcarefor

patients/colleagues.• Takeactionwhenseeingorhearingsomethingwrong-donotwalkby.

• Tobevaluedformycontributions.

• Tobelistenedto.• Toberespected,

regardlessofindividualdifferences.

• Haveasetofpersonalobjectives,andadevelopmentplan.

• Understandrationalefordecisions.

• Workinanenvironmentwhererisksarewell-managed.

• Tobesupportedwithmydevelopmentneeds.

• Haveregularsupervisiondiscussions,andatleast2teamreviewmeetingsperyear.

• Workina‘noblame’culture.

• Takedecisionswiththepatient/internalcustomerinmind.

• Putinplaceprocessesforgoodcommunicationwithinteam.• Modelbeingpositive.• Facilitateresolutionofdifferenceswithintheteam.• Seeksolutionsbetweenteamswheretherearedifferences.

• Setclearobjectivesforteamandindividuals.• Coachotherstofindsolutionstoproblems.• Sharerationalefordecisions.• Modelacan-doattitude.• Respectconfidentiality.

• Manageperformanceinatimelyandconstructivemanner.• Praisegoodperformance.• Preserveconfidentiality.• Promotebothlearningonthejobandformaldevelopment.• Establishsystemswhichhighlightstrengthsnotweaknesses.

• TreatothersasIwouldwishtobetreated.• Celebratesuccesswithintheteam.• Modelandpromotecan-doattitude.• Treatcolleaguesasfellowprofessionals,regardlessofgradeorrole.• Engagestaffin,andsharerationalefor,changeprocess.

• Pursuethecommongoalofpositivepatientoutcomes.

• OneteamacrosstheTrust.• Partneringwithinand

betweenteamsandwithourstakeholders.

• Everyoneisaccountablefortheirownactions.

• IwilldowhatIsayandnotleaveittosomeoneelse.

• Safetyisournumberonepriority.

• Aspiretoexcellence,notmediocrity.

• Seizeopportunitiestodomypersonalbest.

• Can-doattitude.• Steppingupwhenneeded.• Praisewhenit’sdue.• Careandrespect.

Togetherness

Excellence

Manager responsibility Staff responsibilityManager right

Staff right

Value

Responsibility

Caring

Staff &

Management

Charter

Standards of cleanliness have improved.

Togetherness Responsibility Excellence Caring

Now that the CQC action plan is closed, we need to put all of our efforts into driving further improvements and to do this we need to innovate - not because we’re being scrutinised, but because it’s what our patients, their families and the communities we serve have a right to expect.

Mental Health Matters6

Two years ago, the management team at Broadmoor Hospital decided to take a fresh look at how to embed safety into the culture and management ethos of the hospital.

The work used research originally developed within the nuclear power industry following an accident in one of the plants. This revealed that unless organisations find ways of making safety the positive focus of their culture, the explicit purpose of their leadership, and an issue understood from multiple perspectives by everyone, then it’s impossible to control ‘never events’.

Everyone in mental health understands that security is not just physical, but also about procedures and, critically, relationships. The workshops run at Broadmoor helped take this to a new level by linking safety to daily operational practices and behaviours which also tie in with the Trust values.

Eight principles were agreed and action plans developed to realise them;• Everyone is personally responsible for safety, security

and excellent care, irrespective of role.• Leaders are visible and demonstrate commitment to

safety, security and excellent care by their example.• Everyone reports concerns and challenges poor

practice.• Communication and feedback is open, honest and

timely. • High Secure Forensic Services are recognised as

special and unique.

• We’re committed to learning and changing as individuals and as an organisation to improve our service.

• We respect and support each other, and work as a team.

• Safety and security undergoes constant examination.

Work has now started on implementing the actions agreed by the senior management team to make each of these real. Each member has accountability for driving specific actions and reporting progress back monthly.

A booklet will soon be distributed to staff at the Hospital to reinforce the eight principles and give some real life examples of how they can be put into practice. It’s something that staff can keep with them as a daily reminder of the behaviours that maintain a safe and secure hospital.

We’re also rolling out a new awareness campaign, called ‘Don’t Walk By’, which reminds us to take responsibility when we see things that are out of place or that pose a risk to patients, staff or visitors, or when we notice that someone may be in need of help. This includes things like damaged equipment, ensuring confidential records are maintained, clearing untidy work areas and being polite and helpful to visitors, patients and colleagues.

In line with the ‘back to the floor’ initiative, we hope that all staff can contribute to this work and make the hospital a safer, more reliable part of the organisation.

The introduction of ‘real-time’ typing is significantly improving communications between our teams in Hounslow with their patients and with GPs.

Rather than doctors dictating outpatient clinic letters to tape for typing and checking later, the clinic reviews and patient care plans are now typed up immediately following an appointment, by the team’s secretary working with the doctor ‘real-time’. Patients are given the option to wait for their letter to be typed and printed and take it away with them there and then, or they can leave safe in the knowledge that the letter will be sent out that day to both them and their GP.

Dr Pradip Ghosh, Consultant Psychiatrist at the Cardinal Centre where the new process was piloted, says: “Not only are the speedier communications improving our relationships with GPs, but patients are also able to get rapid written confirmation of their care plans. The quality of the letters is significantly improved because they’re being typed up straight after the consultation when the information is fresh in our minds. The new process means that we’re making much better use of our time.”

Dr Ghosh worked with Olu Odukale, Business Manager for Hounslow, to come up with the solution and worked with Lois Warobi and Samuel Annor from the CMHT to introduce it there. He says: “We’d had concerns about the length of time it was taking to get the letters out to patients and GPs; so we worked together creatively to come up with a solution. We developed a new letter template to structure our clinic reviews, which ensures that the patients have a thorough assessment of their needs and that all of our letters are of a consistently high standard. Our secretary, Sandra Pinz, types information onto the new template working closely with the doctors immediately following appointments.”

Dr Ghosh adds: “Our most recent audit tells us that 100% of our outpatient review clinic letters are now completed on the same day of the patient’s appointment, which is a fantastic improvement. The ‘real-time’ typing pilot is now being introduced into the other two CMHTs in Hounslow where it’s anticipated more of our patients will see the improvements.”

‘Real-time’

communications

in HounslowDr Sajida Matloob with ‘real-time’ typist, Sandra Pinz.

Mental Health Matters 7

Making Broadmoor

Hospital a

high reliability

organisation

For most new staff, the first taste of life at WLMHT comes during induction. Starting a new job can be daunting enough, so the Learning & Development (L&D) team have been working hard behind the scenes to improve the experience and put a friendlier, more welcoming face on the Trust.

Induction represents the beginning of many good practices and is the ideal time for new starters to understand how the Trust values can be incorporated into their daily working lives. A well planned induction means that staff integrate effectively into the organisation, which is beneficial to both sides.

Taking the view that recruitment is not fully complete until someone can start effectively in their individual role, Ali Webster, Head of Staff Development, undertook a ‘belts and braces’ review of the whole induction programme, stripping it back to better reflect the training new staff need to do their job.

Ali says: “We’ve gone right back to basics to look at what’s really important for people when they first join the organisation. There’s a lot of vital information to get across, but it needs to be delivered in a way that engages people and gets them excited about the prospect of starting in their new job.

“We’ve streamlined the process so there are fewer sessions with an emphasis on interactive presentations that are tied to our core values.”

The induction now follows the needs of a particular job, so, for example, people who have no direct patient contact will only attend the first two days of induction, instead of an entire week of training.

Judith Joyce, Induction Co-ordinator, adds: “This makes induction meaningful – it’s in-depth but only covers what’s required for particular roles. We’ve also introduced RiO training where appropriate, so that new starters can be effective as soon as they start in their particular area.

“In line with our value of excellence, the team asks inductees to rate their experience which is used in a monthly report to constantly evaluate and review the process.

“For example, we found that a lot of new starters who arrived early got a little lost, as the reception desk wasn’t yet open. This may sound like a minor issue, but for a new starter it can be unsettling. We solved the problem by producing a simple welcome banner to display on the first day of induction. Sometimes these little things can make a big difference to people’s overall experience.”

One of the changes to induction is that service users and carers now play a more central role. Their first-hand experience often conveys more about the things that matter to patients than any number of talks from Trust staff. When we decided to make these changes we took the lead from service users and carers themselves.

Carer Paulette Ranaraja says: “It was really good to be involved in the discussions about the changes in the format of the session. It gives me more confidence to be a facilitator and gives us all a sense of ownership and peer support as it’s something that we have created together.

“I’ve always enjoyed being involved in the session. Although at first it was daunting to talk about myself and my personal experience, I found that

the attendees were always attentive and responsive to my talk. It is very rewarding to find that what I said found an echo in people’s mind. I feel that if I manage to touch one or two people in the room, my time is well spent.

“I met someone once who came up to me and said that she recognised me as the carer who spoke at her induction. She told me that what I said then made her feel that she had made the right choice in working for the Trust.

“My hope is that my contribution helps to raise awareness of the human side of mental illness and that partnership working between professionals, service users and carers is the key to a good outcome.”

Welcome to

the Trust

Learning from service users

and carers on induction

From the left: Paulette, Jane, Remo, Anna and Joshua, service user and carer facilitators on our induction programme.

Mental Health Matters 9 Mental Health Matters8

Overall winning team: Dove ward

Dove and Kingfisher ward staff celebrated their achievements in January, when Dr Sarah Ghani presented ‘Oscars’ and certificates to nursing staff who had dramatically changed the way they manage patient documentation and engage with patients.

Dove Ward were the overall winners with the highest scores in a peer audit of RiO notes, developed as part of a learning lessons action plan. Chris McKay, Project Lead, and Suzanne McMillan, Service Manager, tasked Ward Managers Hilda Muranda and Simba Kaseke with taking responsibility for managing an audit of one another’s teams, selecting random care plans, risk assessments and progress notes from RiO.

When Hilda and Simba found notes that were unclear, they mentored the member of staff who had written them on how to improve these; they encouraged staff to ask patients to say how they’re feeling by giving concrete examples of how they could engage the patient.

Chris McKay says: “Poor documentation in WLMHT was identified by the Care Quality Commission as a major concern. It was clear from the very beginning of the project that there was not enough real engagement with patients. Now, staff are listening to how the patients really feel and actually quoting their words in the care plan. This helps strengthen the team’s understanding of the patient and what they’re going through.

“The openness and commitment to change and improvement from Hilda, Simba and the ward staff has shown that they can run a mental health service that is second to none.”

Hilda adds: “Nursing staff are now better able to recognise signs of distress and avoid potential incidents, and patients feel more engaged.”

“This is a truly amazing piece of work, which really fits well into the Trust’s learning lessons strategy,” says Suzanne McMillan.

Lakeside teams

focus on care planning

Best progress note by a mental health nurse: Lynsey Turnbull, Dove Ward.

Best care plan: Martin Obideyi, Dove Ward.

Best progress note by a health care assistant: Soodarsun Ramjeeawon, Kingfisher Ward.

Why not try this?

Mental Health Matters10 Mental Health Matters 11

The word “audit” frightens many people and is often presented as a dry subject, enjoyed only by academics and those with a love of beige. But used correctly, auditing can reinvigorate poorly performing services and turn good practice into something truly outstanding.

In a nutshell, the aim of clinical audit is to improve patient outcomes by making sure that the way we work and the quality of our services meet the standards that have been set.

Without some form of clinical audit, it’s very difficult to know for sure whether you’re working effectively and even more difficult to demonstrate this to others. Audit gives us a way to systematically review clinical practice and provide strong evidence to the people who commission, use and monitor our services.

But – and here’s the important bit – if audit remains a purely paper exercise, it loses its bite. Sarina Martin, Head of Clinical Effectiveness and Audit, says, “Audit is only useful if we do something with the results. It doesn’t matter how much time and energy you invest, if you don’t tell anyone about the outcomes, nothing will improve.”

Here’s how the audit cycle should look:

1. You create or adopt a practice or standard (often from NICE guidelines).

2. You put it in place in a clinical setting.

3. You check – or audit - whether what you set out to do is actually working.

4. You tell people what you found out and if anything needs to be done differently to improve patient outcomes.

5. You start the cycle again with your refined practices and continue to monitor your progress with regular audits.

As Sarina says, “It really is a very simple process - the key is to make sure that we follow it every time we do an audit. If we do, I think we’ll be well on our way to becoming a really high performing organisation.”

And it’s not all about finding faults – one of the great things about audit is that it tells you very clearly if you’re doing something well. It’s a great opportunity to celebrate and share our successes. For example, a recent audit showed that patients with schizophrenia receive a comprehensive multidisciplinary assessment, including a psychiatric, psychological and physical health assessment. We also met the NICE standards fully in a number of other areas, including promoting alternative ways of coping with symptoms and crisis planning.

As we move forward in our Foundation Trust application we’ll increasingly need to show that we can compete with other providers. To do that we need evidence, which we can get by auditing what we do and putting the results into practice.

The ‘A’Why we shouldn’t be

afraid of clinical auditword:Clinical Effectiveness & Audit Co-ordinators, Clare Harris, (left) and

Aparna Linton (right) meet with Lynne Read, Programme Manager.

Look out for our new ‘Green Stamp’ – a symbol of our commitment to promoting sustainability initiatives across the Trust, with the ultimate goal of reducing our carbon footprint.

1 in 20 road journeys in England are on NHS business. The Trust drove 650,000 miles on business in 2010 alone (excluding the dreaded commute).

We’re developing site travel plans as part of the planning applications for the St Bernard’s and Broadmoor Hospital redevelopments. A travel plan is a strategy for improving access to a site, focusing on promoting sustainable modes and minimising single occupancy car trips. It will help us reduce our carbon footprint, meet planners’ expectations and improve alternatives to single occupancy car trips.

As part of the redevelopment programme at St Bernard’s and hot on the heels of the recent green travel plan survey work at Broadmoor Hospital, we’ll soon be re-surveying staff who work at or visit the St Bernard’s site regularly. Look out for more on that in our internal communications.

We’ll be introducing a Trust-wide car sharing scheme later this year. Cycling is a good way to stay fit and healthy and to that end we’ll be rolling out the employee discounted bicycle scheme, next month, using Cyclescheme. This allows staff to buy a bicycle at a significantly reduced price from over 1,600 independent bicycle shops.

HELPING TO C

RE

ATE A SUSTAINABLE

FU

TU

RE

Green stamp

Focus on transport

Tip of the issueTryandavoidharshaccelerationandbraking

whichcanuseupto30%morefuelandcauseincreasedwearandtearonyourcar.

Ben Green, cycles to work at Broadmoor Hospital.

Mental Health Matters12 Mental Health Matters 13

Last December, the Managed Clinical Network (MCN) brought thirty people together to exchange ideas over two days about how the Trust can improve its services for PD patients. Many of the participants had never met before.

Thanks to input from the Cassel Hospital and Emergence (the national service user organisation based in Hammersmith), service users and professionals sat down as equals to discuss how to improve services – for the first time for some participants. “I found it challenging, but by and large a positive experience,” said Kath Lovell, Director of Emergence. “There was a sense of coming together as a team, instead of just individuals struggling to achieve change against the odds. Several people across the Trust have since contacted Emergence for help to think about how to involve service users in partnership.”

Kingsley Norton, Clinical Lead for Personality Disorder at the Trust, says: “These achievements are a remarkable tribute to

staff who are already hard-pressed in difficult financial times. There was an intangible feel good factor, a sense of optimism, and an enthusiasm for doing things differently. Some of our old habits of ‘us and them’ began to dissolve – between service users and professionals, and between different professional groups.”

The energy has not been lost since last December’s event. The MCN Steering Group and Emergence have developed a proposal for a specialist ‘hub and spoke’ personality disorder service together with service user-led groups, and Emergence have put in a bid for local resources to the Evening Standard Dispossessed Fund for London’s excluded children and families.

For more information, contact Lucinda Shoolbred on

Tel: 020 8354 8173 or Monica Doran on 020 8354 8013.

Improving services

for PD patients

From the left: Kath Lovell, Managing Director of Emergence, Denise Ferrett, OT Feltham CMHT, Tim Wright, Head of Arts Therapy in Ealing, Kati Turner, Consultant at Emergence, Lucinda Shoolbred, Network Developer, MCN, Dr James

Lee, Consultant Forensic Psychiatrist, Jo Campling, Senior Nurse and Monica Doran, Network Developer, MCN.

Climate change

The NHS is responsible for 3.2% of CO2 emissions in England, the main gas involved in climate change which is causing catastrophic impacts throughout the world through extreme weather events such as floods, storms and heat waves.

The NHS has a carbon footprint of 21million tonnes, with 23% from energy use (heating, cooling, lighting, power), 17% from travel and 60% from the goods we buy. There’s also the financial cost of all of this. The NHS has a target to reduce carbon emissions by 10% by 2015 (on 2007 levels) and 80% by 2050. That’s a tall order and we need your help….

Sustainable matters

Support is available to staff who need help managing working relationships with colleagues.

Our Staff Counselling team provides mediation if there is a problem between two individuals at work, or group work sessions for teams where there are high levels of stress or other difficulties.

Donna Pereira, Head of Staff Welfare and Support, says: “We encourage people to try to resolve issues locally or to use mediation in the first instance. Often people who

use our services tell us that they’re surprised that we’ve been able to help them sort something out which has been bothering them for some time, without their having to go down a formal complaint route.

“In the first instance we advise people who contact us to talk to the manager, if that’s appropriate. If not then we’re happy to work with your or your team to resolve issues.”

Contact Staff Counselling on 020 8354 8177

Mark Gullidge, Staff Counsellor, runs a mediation session

Pictured from the left is: Laura Hudson, Nicole Rice, John Viner, Vushe Hove, Margaret Rioga, Marian O’Brien

Working together

to resolve issues

To help make sure service user and carer involvement remains a high priority at the Trust we have a range of ‘involvement leads’ who work with users and carers, supporting them to make sure their voices are heard.

The leads’ work is varied, from organising service user clinics on acute wards and attending ward community meetings, to co-ordinating service users and carers in taking part in Trust interview panels.

If you’re a service user or carer and want to get involved, or know anyone who does, please get in contact!

Ealing Marian O’Brien - 020 8733 0473 marian.obrien@loudandclear.org

Hounslow John Viner - 020 8483 1580 john.viner@wlmht.nhs.uk

Hammersmith Laura Hudson - 020 7471 0589 and Fulham Nicole Rice - 020 7471 0589 enquiries@hfmind.org.uk

West London Margaret Rioga - 0208 483 2114 Forensic margaret.rioga@wlmht.nhs.uk

Vushe Hove - 0208 354 8106 vushe.hove@wlmht.nhs.uk

Broadmoor Jimmy Noak - 01344 75 4066 jimmy.noak@wlmht.nhs.uk

Service user

involvement leads

‘Morning has broken, like the first morning. Blackbird has spoken, like the first bird.’ These words from a well known hymn, were sung by staff and patients on Ravenscourt Ward at a memorial service led by Chaplain, Charlotte Collins, to remember Staff Nurse, Anna Cardow, who died a year ago.

Sandra Bailey, Head Nurse for H&F says: “Although Anna has gone, we all hold very precious memories of her. Anna’s smile, her warmth and her caring nature are just some of her qualities that we fondly remember. We’re thankful for the indelible imprint that she has left on our lives – her memory will always live on.”

From the left: Olanike Tonade, Staff Nurse, Charlotte Collins, Chaplain, Chloe Bates and Peter Chingwaro, Staff

Nurses, Sandra Bailey, Head of Nursing, Sharon Mahmoud, Ward Administrator and Joyce Owusu, Staff Nurse.

Staff and users in West London Forensic Services (WLFS) used their conference in January to celebrate recovery. The event was organised by the WLFS recovery steering group and chaired by Andy Weir, Director, together with the chair of the women’s user forum.

Anne Aiyegbusi, Head of Nursing says: “Over sixty people attended and a definite highlight was presentations by two former service users who spoke with passion about what had helped them to recover. They spoke about the value of spiritual care, the healing quality of caring relationships, the critical importance of creative expression and active involvement in negotiating and planning their treatment. When on the road to recovery, the service users spoke about how they found a rewarding pathway for themselves through involvement work of various kinds, including teaching and training others.

“It was also fascinating to hear from Paul Meechan, Assistant Director of the specialist commissioning group, who explained that commissioners want to see evidence of recovery oriented services being delivered in partnership between commissioners, providers, service users and carers.

“The day ended in celebration as the WLFS service user band shared their musical talents through an upbeat performance. Healthcare assistant Emmuel Ofori (pictured) was applauded for the support he has given the band over the years.

Anna’s memory

lives on in H&F

Healthcare Assistant and leader of the band, Emmanuel Ofori

On the road

to recovery

Mental Health Matters14 Mental Health Matters 15

In a drive to improve staff supervision, managers are asked to record all supervision sessions on our new on-line tool.

The tool generates a monthly report giving a very clear picture of where supervision happens and where it needs to improve.

If your supervision is managed by an external supervisor, please ask the supervisor to record all sessions and send details of the sessions via e-mail to the System Administrator, sirina.kathiara@wlmht.nhs.uk, to confirm that the session has taken place.

You can find the toolkit on the left hand menu of the homepage under Corporate Services/Organisational Development/Staff Supervision.

Archibold Chaurura, Ward Manager at Lakeside, says: “This new tool is really easy to use and my supervision sessions have reduced by half, which allows me to spend more time on clinical work. At a glance I can easily track the work of the clinical team. I’ve had feedback from one of my supervisees who says that it’s so much simpler than the paper

method, now they can instantly retrieve any information we’ve discussed, review any changes and approve it. I also feel I’m helping towards the Trust’s sustainability goals by reducing the amount of paperwork.”

If you need further information, please speak to Margaret Morgan-Valentine on 020 8354 8638 or e-mail margaret.morgan-valentine@wlmht.nhs.uk

It’s your responsibility!

Mental Health Matters 17 Mental Health Matters16

Trust staff and peers from other mental health providers gathered in the Learning and Development Centre for the annual Research and Development Conference hosted by Broadmoor Psychological Services. This was the fifth such conference and it was again well attended and many supportive comments were offered throughout the day.

The keynote speaker, Professor Vincent Egan of the University of Leicester, presented on ‘Personality, personality disorder, psychopathy and antisocial outcomes: the perennial continuum.’ The role of the keynote speaker is an important one as it is an opportunity to raise new ideas in the context of a series of presentations of research work carried out within the Trust. Prof Egan said that the conference was highly topical and he found the presentations gave an excellent insight into the role of research in tailoring the treatment we provide for our patients.

Some of the other interesting presentations in the conference included ‘Interpersonal trajectories for psychopathic patients in treatment’ and ‘Assessing risks, mental health and personality disorder: issues in mentally disordered sexual offenders.’

The conference was concluded by Professor Derek Perkins who set the direction for the next conference, which will be held on the 25 November 2011.

Studies show that 15-20% of the population have a reading disability and, of these, 85% have dyslexia.

Head of Diversity, Maggie Morgan-Valentine says: “Research has shown that dyslexia occurs in people of all backgrounds and can run in families. It causes difficulties in learning to read, write and spell. Short-term memory, numeracy, concentration, personal organisation and co-ordination may be affected. It is not due to the individual’s ability to learn and develop these skills, but it’s about the way people process information and how that affects their ability to learn.”

The dyslexia support group is open for all. For more information contact Camilla.Peter@wlmht.nhs.uk or Margaret.Morgan-Valentine@wlmht.nhs.uk

Diversity spotlight

Professor Derek Perkins.

Participants at the lunch-time poster session.

Archibald Chaurura and Kiara Smith put the toolkit into action.

Sandown ward is an assertive rehabilitation, personality disorder ward which opened last January in Broadmoor Hospital. Since opening, the ward has had full occupancy of twelve patients and team members have worked together to support the integration of patients from different wards within the hospital.

Sheerifa Saidi, the ward’s OT, says: “Sandown is part of the Trust’s productive ward programme. As a result we’ve been working as a team to develop new initiatives to improve patient care, and we’ve done this by working in collaboration with patients as we strive to uphold our values of togetherness, responsibility, excellence and caring.”

“A highlight of the year has been the arts and crafts exhibition which was led by patients and held at the end of 2010. Over 80 guests from around the hospital community attended. As a ward team we were eager to support patients in this endeavour because projects like this help them to develop their confidence and independence by being able to put their talents to good use. We believe that since the event, our patients are more motivated and keen to participate in events on the ward.”

Sandown ward -

one year on

Team members from the left: Nicky Miller, CNS, Victoria Burt, Visiting Consultant, Phil Elliot, Social Worker, Siam Gungulu, Staff Nurse, Judith Edwards, Ward Consultant, Lesley Dudek,

Ward PA, Sheerifa Saidi, OT and Elizabeth Zachariah, SpR.

Broadmoor

Hospital team shares

research findings

We’ve been recruiting members in our quest to become a Foundation Trust. With the current count of 4,200 signed-up members, we’re well on the way to achieving our target.

To get involved, contact us at member@wlmht.nhs.uk, or 020 8354 8325, or become a member at www.wlmht.nhs.uk.

…John Conolly Carers’ Support GroupIt’s important that our membership base includes plenty of carers and service users, so where better to recruit members than at a carers’ support meeting? If you attend a carer or service user support group, please get in touch – we’d love to come and talk to your group about membership, and how it can help you and the services you or your family member or friend use.

…schools across the Boroughs, with the Storey CD design competitionPop/rock band Storey have written and produced a single for us about mental health recovery, and we’ve launched a competition for local secondary school students to design the front cover of the CD.

The competition is open to students in Year 10 and above who live or go to school in Ealing, Hounslow or Hammersmith & Fulham, our three local membership constituencies. The winner will be presented with a framed, signed CD by the band themselves. Their artwork will be used on the CD cover and it will appear on iTunes, for all to download. Lead singer of Storey, Lee Enstone said: “We’re looking for a person with creative talent, whose artwork reflects the song and our band. Whether it’s graphic design, a painting, drawing or photography, get in and give it a go!”

We’ll be displaying a shortlist of artworks on our website.

If you know a school, or any students, that might be interested, please get in touch. The competition closes on 30 April 2011. More information is available at www.wlmht.nhs.uk/get-involved/schools.

Opening minds at…

…home and at work. Recruit members to win M&S vouchers!We’re calling all staff, service users and carers to help us recruit members! Each month we’re running a competition where for every 10 members you recruit, your name will go into the draw to win one of 10, £25 M&S vouchers. The person who recruits the most members for the month wins a £100 voucher!

Contact member@wlmht.nhs.uk with your name and tell us how many membership forms you need. Once these are completed, simply return them to the Communications Team in an envelope, making sure you include your name and contact details!

Members can only sign up once, and keep in mind that staff are already members. This regular monthly competition closes on the last day of each month, so make sure you get your forms to Communications before then. So start recruiting today and win!

If you have any further questions please contact Megan at member@wlmht.nhs.uk or 020 8354 8325.

…where ever they go. NEDs and EDs race for the topOur Non-Executive Directors and Directors have all been given a target to recruit at least 50 members by June, and we’ll be keeping tabs on their progress via the Exchange. You can follow the competition on the Exchange and we’ll be posting regular news articles to see who’s doing well, and who needs to work on their member recruiting skills – make sure you encourage them!

…online. Facebook us today!Open Minds has gone social by jumping on the famous Facebook social media site. We want to help dispel myths and fight the stigma surrounding mental health and with 175 million people using Facebook every day, we figured there’s no better platform to use.

Please visit Open Minds and simply hit the ‘like’ button to become a fan of our Facebook site. Your profile information will remain private to all, unless you choose otherwise. We have some great pictures on there already from our recent recruitment efforts at a Brentford Football match, and of Storey filming their promotional video for the single.

On the cover of this edition of MHM: Vushe Hove, Service User and Carer Co-ordinator.

Liam (left) from Storey working with us to sign up members

Megan Singleton, from the Communications Team, signs up a member

Band members, from the left, Arron Storey, Liam Storey, Lee Enstone and Joe Macklin.

Mental Health Matters 19 Mental Health Matters18

Congratulations

Mental Health Matters 21 Mental Health Matters20

Local Counter-Fraud Specialist John Micklewright talks about fraud in the NHS.

What’s your role?As your Local Counter-Fraud Specialist (LCFS) I work with the Trust to raise fraud awareness, help to prevent and detect fraud in areas believed to be at a high risk and, where necessary, investigate any suspicions.

If someone has suspicions what should they do?They should contact my colleague Sital or me. Fraud is a hidden crime, and I really do rely on people reporting anything that they think is suspicious. Even if you are not certain about what you have seen, I’m happy to discuss it with you in confidence, and if it’s decided that there is no evidence of fraud then the matter won’t be taken further.

Examples of fraud?Common cases are where someone claims for shifts not worked or falsifies their travel expenses. There have been instances where staff have falsified qualifications, references or right to work permits.

Since working at the Trust we’ve received a significant number of referrals where staff are claiming sick leave but are also working elsewhere at the same time. Falsely claiming to be unfit to work and working for another employer is an offence under the Fraud Act (2006) and it’s against Trust policy.

We’ve also been told about staff getting booked into training courses and not attending. Instead of informing their manager or going back to work they simply disappear – which may be fraudulent.

What about salary overpayment?Receiving a salary overpayment usually occurs when an error is made in the completion of change of salary details or leavers’ forms. These overpayments may appear as a gift and be timely, but they are not a free gift from the Trust. If you retain an overpayment and do not inform the Trust, when you know you are not entitled to them, then you may be committing a criminal offence. You should always check your payslip and let your manager, HR or payroll know as soon as possible so that arrangements can be made to recover the overpayment.

Budget holders must also scrutinise their monthly budget reports and question any payments that appear unusual, e.g. staff who have left, or staff who have gone from full to part-time but are still being paid at the full time rate. Budget holders are responsible for completing leavers’ change of circumstances forms.

To back all of this up, we carry out proactive exercises with payroll to identify where overpayments have occurred and whether these have been paid back.

Fraud in the

NHS

Please contact the Counter-Fraud Team:

Meet your LCFS John Micklewright

07970 425275

jmicklewright@nhs.net

Sital Galani

07881 501704

slgalani@deloitte.co.uk

Sital Galani has joined the Local Counter-Fraud Team to focus on fraud awareness, fraud prevention and investigations in the Trust. Sital has taken over from fraud specialist Baljeet Kalsi and can be contacted on 07919 398979 or via e-mail sgalani@deloitte.co.uk.

Welcome to Emma Brookes who has been appointed as Facilities Manager for London in the E&F department, with responsibility for the management of housekeeping and hotel services. She says: “Having worked at Ashford and St. Peter’s Foundation Trust for the past 10 years and leaving the Trust in excellent standing, I look forward to a change and a new challenge. I intend to build up our profile on the wards,

develop pride in our team and make sure that patients come first in everything we do.” Emma can be contacted on 020 8354 8980 or via e-mail: emma.brookes@wlmht.nhs.uk

Moving on upComings and goings

Tony Gonzalez, Healthcare Assistant, retired after 43 years of service in which time he has never been on sick leave. He’s worked in various roles over the years, spending the last 20 years on Blair Ward. Tony says: “The highlight of the job has been seeing patients getting better and I will miss working with the dedicated staff on the ward.” The staff on Blair Ward held a fantastic farewell party for him, where Rajoo Soocheta, Ward Manager of the PICU, said: “It has been an absolute pleasure to manage Tony. He’s caring and has always been there when we needed him.”

Congratulations to Michael Harbour, Estates Manager, for completing his MSc in Facility and Environment Management with a distinction. University College London examiners were so impressed with Michael that he was awarded first prize by the university for his dissertation. This was based on leadership styles, and in particular the value of transformational leadership in the NHS, which greatly echoes the work surrounding the Trust values.

University College London also put Michael forward for a Royal Institute of Chartered Surveyors London Student Award, which he won!

Barbara Wood, Director of Estates and Facilities says: “We’re all extremely proud of Michael’s outstanding achievements. He has done this while holding down an extremely demanding operational job. Now it’s up to us to support Michael so he can use his learning in the workplace which will help us to continue to develop services provided by our maintenance dept.”

John Agbonkpolor, Capital Projects Manager, has been awarded a new professional status as a Registered Chartered Engineer, a qualification awarded by the Engineering Council UK. John became an affiliate member of the Chartered Institute of Building Services Engineers in 2003. They

encourage members to apply for registration, which involves writing a full work experience report and answering a set of questions from an interview panel. John says: “I’ll be able to take on major capital projects, both mechanical and electrical, and approve design work which will result in savings for the Trust. I’ll be able to represent the Trust professionally, if there’s an enquiry on a major incident.

“I can also help mentor other aspiring engineers towards Chartership. I’d like to thank Steven Wilson and John Corlett for their support and valuable advice during my registration process.”

Standards of food hygiene at the Cassel Hospital are excellent, according to Richmond Council’s Environmental Health Officer. Jennifer Holmyard, Support Service Manager said: “The inspectors had nothing but praise for the work done by staff and patients at the Cassel Hospital, to improve the way

food is managed and the processes that are now in place with regards to kitchen cleaning.”

Rebecca Neeld, Lead Nurse added: “The inspection was extremely thorough. The inspectors were particularly impressed that we provide training for staff and patients together.

“Richmond Council participates in the London Food Hygiene Information Publishing Scheme, also known as ‘scores on the doors.’ We were delighted to be awarded five stars for excellence which are now on display on site. I’d like to thank everyone involved for helping us to achieve this excellent accolade!”

Congratulations

Some of the more seasoned communicators we see on TV make talking to the media look easy; but if can be a minefield.

That’s why, in January, we took forward two more initiatives to make sure the Trust’s growing reputation is protected. First, a new media policy was drafted for consultation; the gist is, don’t talk to the press without talking to the communications team first. Second, we ran media training for a group of senior staff from a range of professions.

What struck me most watching this session, led by two ex-ITN journalists, was how little time you have to get your messages across – just 30 seconds on radio or TV, whilst preferably looking calm and being persuasive at the same time. The trainers were impressed by the expertise and poise of our spokespeople, who now feel ready for (almost) anything.

We were very fortunate in February to be invited back by the Science Media Centre to field two spokespeople for a press briefing on personality disorder (PD). Prof Derek Perkins and Dr Kingsley Norton took questions from 11 health and science journalists, who grappled with understanding the differences between

PD and mental illness, and learned about the social consequences of its going untreated, or worse, undiagnosed. Subsequent news coverage on the BBC’s website included extensive comments from both our clinicians, helping put our expertise in this area on the map.

Some people just can’t admit when they’re in the wrong. Fortunately, if you’re the editor of a national newspaper (Mr Mail on Sunday, you know who you are!) the Press Complaints Commission (PCC) are here to help remind you. After more than two months of batting lengthy challenges back and forth around the paper’s bigoted and insulting comments about a Broadmoor Hospital patient, we were rewarded with a full apology and a letter published in the printed version of the paper – a first from the Mail.

Please do keep sending me your ideas for working with the media – all are appreciated!

Lucy McGee lucy.mcgee@wlmht.nhs.uk

Outside In Director of Communications

Lucy McGee

Mental Health Matters 23 Mental Health Matters22

A word of thanks

“I am on my last day working in the Ealing Early Intervention Service, after a three month placement. I would like to commend the team on the great work that they do, and from a student perspective it really has been an enlightening and supportive experience. All of the team members bring something of themselves to the day to day running of the

service. I really cannot express how much I have enjoyed and learnt in this placement and I really will miss the amazing practitioners I have had the honour to learn from. It really is refreshing to work with a team of people who all love what they do and really want to be a part of an innovative service.“

Best regards, Beki Lopez-Pelaez (seconded student, TVU)

Dr David Reiss, Consultant Forensic Psychiatrist in West London Forensic Services and honorary clinical senior lecturer at Imperial College London, has recently published his first book. The book is aimed at practitioners working in healthcare and criminal justice community settings with people who display antisocial, offending, and challenging behaviours, often complicated by severe mental health disorders. The book draws on experience gained across a wide spectrum from within the NHS, the

National Offender Management Services (NOMS) and the wider criminal justice services, as well as various services for children, young people and their families. You can purchase the book on-line at www.amazon.co.uk. David would like to thank colleagues who helped with the content of the book, including, Dr Andrew Hadler, SpR, Dr Alex Lord, Principal Forensic Psychologist, Dr Simon Draycott, Clinical Psychologist and Brian Darnley, Locum Consultant Forensic Psychologist.

We’re improving our communications with Ealing carers, through noticeboards and carer champions on each ward. Annie, who is a carer says: “The carer champion put me in touch with someone who has helped me arrange a carers’ assessment. It’s re-assuring to know that if I have any worries or concerns there’s someone I can turn to. The information boards are another welcome addition to the unit.”

On board with

help for carers

Mental Health Matters24MHM is produced by the Trust’s Communications Team. Call us on 020 8483 2283.

Every picture

tells a story

What a day!

Ruth gets out

and about

Nine staff volunteers went to last month’s Brentford football match to help recruit local residents as members of the Trust. Our efforts paid off as we welcomed 170 new members, and cheered Brentford to victory against Plymouth. The name of every member we signed that day went into a draw to win a signed, framed Bees shirt. We’d like to congratulate Michael Whelan who was presented with the shirt by man of the match, Myles Weston. They’re pictured with Megan Singleton from the Communications Team .

Patients and staff in Mott House were served a cream tea by Ruth Lewis, Director of Organisation Development and Workforce, when she came to visit.

Ruth says: “I was impressed by the environment and ambiance created by the Mott House team and the evidence of the many creative activities. I was also heartened by the optimism of the patients in Butler House as they progress to independent living outside St Bernard’s. The positivity that the staff generate encourages visits from service users who are now happily settled in the community. ”

Both teams felt the visit gave a huge boost to staff and patient morale as well as giving them a good opportunity to talk about current issues with one of our Board members, in a relaxed environment.

Some members of Broadmoor Hospital’s security team grew, trimmed and dyed their facial hair for the most ‘outrageous look’. In doing so, they raised £800 for Help for Heroes.

Very hairy

Pho

to c

ou

rtes

y o

f M

ark

Fulle

r

Participants included, from the left, Eric Stewart, Steve Yarnold, Dave Finch, Steve

Pitt, Jason Spicer and Roger Webb.

Bola Aderogba, Ward Manager, Mott House, Ruth Lewis, and Mary Elsabahy, Activity Co ordinator.

Pictured from the left: Clinical Team Leaders, Owen Nyakwawa, Laureen Dalrymple and Memory Gwash, Ward Manager, Darmen

Ramana, Clinical Team Leader, Harry Ramsay, Interim Director of Ealing Inpatient Services, Bernadette Hennigen, Clinical Team

Leader, Christopher Mafuva, and Carer Lead, Mahbub Khan.