Power to the people

In our current climate it is difficult to avoid politics and the past week has been no exception!

With so many changes happening across the NHS, it is important to keep in touch with the people who represent the people who use our services and the wider public. Recently, I invited Rachel Reeves, who is the MP for Leeds West and Shadow Chief Secretary to the Treasury, to visit the Trust and last Friday Rachel had an opportunity to meet some of our staff and service users from the Learning Disability Service at St Mary’s Hospital in Armley. After the visit, Rachel said, “It was really valuable for me to see first-hand the work you do in the local community, and quite inspiring to meet the user group and see what a difference that makes.”

State of Mind

I have always been a member of the Royal College of Nursing (RCN) and this week the RCN held its Annual Congress in Harrogate. The Congress is interesting in that, as well as having designated delegates who vote on issues, any member can turn up (for free) and speak to any item on the agenda. There is also a huge range of professional development activities that are available during coffee and meal breaks. On Monday evening I had the privilege to be invited to chair a session about the role of sport is playing in promoting positive mental health to young men, specifically targeted at and through rugby league players.

The State of Mind project is something that our Trust has signed up to and uses an education programme targeted at young men who wouldn’t usually access information on mental health and encourages young men to feel comfortable talking about mental health issues. They use language familiar to young men asking them to ‘help a mate’, and encourage them to use social networking websites, such as Twitter, to share the message with their peers. The State of Mind campaign now is going from strength to strength and expanding into other sports. Why is this important? Well, the statistics suggest that young men are more likely to kill themselves than any other age/gender group.

Back to representation..

On Wednesday this week we held our first Council of Governors meeting since the recent elections.

It was great to welcome newly elected Governors representing staff, service users and carers from some of the Leeds constituencies and our new constituencies representing York and North Yorkshire. It was a busy meeting, with a lot to get through, but we shared our plans to update our strategy to reflect our new integrated Trust. We also discussed how we report and manage performance in the Trust. This was a good opportunity for our Governors to have an insight into the complexity of what we do and should help them constructively challenge us about issues they have in the future.

Shining Bright

This week Susan Tyler, Director of Workforce Development, made a surprise visit to Aire Court to present Carolyn Moran, Senior Community Learning Disability Nurse, with the Trust’s first STAR Scheme award. Nominated by her manager, Austin Barnett, Carolyn was chosen for her commitment to quality of care and working well beyond the expectations of her role in supporting service users. Well done Carolyn! If you would like to put someone forward for the scheme, nominations are now open for May and will close on the last day of the month. To find out more or download an application form, please click here.

Thank you for taking the time to read this and please feel free to email me at christopherbutler@nhs.net with any comments, questions or suggestions.

Chris

Create, Challenge, Inspire

In my last blog I reflected on “Small Investment, Big Returns”.  Returning to this theme, last week I met a remarkable group of people involved in the Converge programme run by the York St John University. Converge is supported by our Trust.  It gives people with mental health problems the opportunity to explore and develop their creativity. For people with mental health problems it can be difficult to have the confidence to explore existing strengths or to discover new abilities and talents.  Converge brings service users together with full-time students of York St John where participants are offered top quality creative courses within theatre, dance, literature and music. Converge offers ways in which service users can develop skills as a performer, artist, or writer in a supported and exciting educational environment.

Service users described how this had simply transformed their lives enabling them to achieve goals that at one time seemed impossible to reach.  One service user described how they would sit on the step outside the NHS day service and look wistfully across the road at the University; at that time barely imagining that they would someday cross its threshold.  What a fantastic story.

How was Converge developed?  It was the idea of one of our colleagues, Beverley Hunter who had one of those “why don’t we…” thoughts and then put it into action.  Well done to Beverley, also Nick Rowe and Gemma Alldred, the Converge lead people at York St John.  If you want to find out more about Converge, visit their website or view a short film about the programme here.

Chris

Small investment, big returns

We are facing difficult times across the NHS, and our Trust is not excluded.  NHS and social care services are under pressure.  We provide services to thousands of people every day to help them achieve their goals for improving their health and their lives.  At the same time we are having to change what we do to ensure that, collectively, we provide even better services to people with, over time, less money to do this.  When you are working in your local team it may not seem that management is overly concerned about how you feel about your work and the day to day pressures you are facing.  I certainly had this view when I was working in a clinical team!  However, with my colleagues on the Board of Directors, I am concerned with improving how we all feel about our work and our lives generally.  Why?  Simply because how people feel does have a direct impact on the experience of service users and carers.

The Global Corporate Challenge is an example of how we are making a comparatively small investment for a big return.  I am proud that we can offer an opportunity for staff groups to come together and take on a challenge which will improve their physical health and mental wellbeing.   I’m personally delighted that so many staff have already signed up.  Our new STAR Scheme has a similar intention – a small amount of investment to recognise and reward those individuals and teams who go above and beyond the call of duty.  Despite the tricky times we are living in, not a day goes by without me encountering people in our Trust doing great work.  The other day I dropped by the Mother and Baby Unit at The Mount.  I got a real sense of the huge commitment of the team working there.

I often get invited to get involved in external activities.  I do not like spending too much time out of the office and away from our services, so I always think through if the investment of my time will reap positive returns for our organisation.  For example, for the price of a return train ticket (always discounted!), I attended a Monitor event last week on the topic of quality governance.  Monitor is the independent regulator of NHS Foundation Trusts.  It was an opportunity to share the innovative work we are doing in our organisation as we constantly look for ways to improve what we do, also a chance to learn from the experience of others.  I have already put my reflections down on paper and asked my Director colleagues to consider some specific learning points for implementation in our organisation.  For example, Monitor has developed ways in which organisations can assess if they are providing a quality service.  I am considering if, complementary to the work we do to ensure we always comply with national standards, we should try this out for ourselves.  I would need to be sure that investing time in this would give us a big return in terms of improvement!

Chris

Working together

My working week tends to be full of variety. From focusing on the detail of specific issues in our organisation, to influencing wider policy at a national level, there are some common themes that connect them together. What underpins my work is my small contribution to improving the health and lives of people with mental health problems and learning disabilities. This week, and for the week ahead, I am particularly thinking about our organisational value of working together. How vital it is to work across organisational boundaries, learn from each other and put people first in everything we do.

On Wednesday I took part in the national annual Clinical Leaders Network Congress held in Leeds. This brings together front line clinical champions across the NHS. It was an opportunity for people leading on improving services, across every aspect of work in the NHS, to come together to share their experiences.   is important as we all read about when things go wrong, but it was great to meet people improving things for patients, service users and carers each and every day. This is also true in our Trust and I am looking forward to our third annual Nursing Conference which will be our local opportunity to share our great work with each other.

Closer to home, our Executive Team took stock of our Fit for the Future leadership programme for our first line managers and we were impressed by the many local innovations that have sprung up as a result. Working together means encouraging our staff to use their initiative to make those small improvements that can have a huge impact. The big question for me is to what extent is our investment in our managers directly contributing to improving outcomes for people using our services by developing their managerial and clinical skills. We will be taking a deeper look into how this programme has improved our work in a few months time in order to give the participants some time to put their learning into practice.

Our Board of Directors meets monthly and all are welcome to these public meetings. We are keen to reach out to more people and have been experimenting with live tweeting using the hash tag '#LeedsYorkBOD' for people who would like to follow up on Twitter. I’d be interested to hear views about how we can encourage more interest and engagement with these meetings concerned with the running of our organisation. This week the Board considered our plans for the future of Seacroft Hospital site and ideas to re-locate some of our clinical services there, improving the environment for people and making the most of the money we have available to us. Though we are yet to make a final decision about if we will do this, we have commissioned Shine to explore the feasibility of investing resources for the benefit of the local community alongside a re-located headquarters and I’ll be blogging about this in the future, as proposals take shape.

I enjoy taking the opportunity to get out and about and to meet different groups of people and discuss the work of our Trust. Last Saturday I attended a training session for a group of nurses who will be travelling abroad to undertake voluntary work. It was a great opportunity to discuss our work and do some ‘myth-busting’ about mental health and learning disability. Next Saturday I have been invited to give a talk about mental health and learning disability issues to the Catholic Medical Association at Hinsley Hall in Leeds. One of my key messages will be about the devastating impact of stigma and discrimination experienced by many people who use our services. Our campaigning work aims to challenge that discrimination and make a positive difference. I am really looking forward to a Saturday off sometime!

This week ahead holds a whole variety of different activities. Early in the week I will be in York as part of a strategic review of health services in the North Yorkshire patch. By the end of the week I will be part of a recruitment panel for our new Chief Financial Officer.

So, you can see that I am ‘working together’ with other people each and every day.

Just off to catch up with the Chief Executive of Leeds City Council!

Chris

The challenge of change

On the 1st of February we became a new organisation.  Out went the Leeds Partnerships NHS Foundation Trust; in came Leeds and York. We are now proud to be Leeds and York Partnership NHS Foundation Trust. As we welcome our new colleagues from North Yorkshire and York into our Trust, I have found myself reflecting on recent discussions about the importance of trust in each other and the role of culture in our day-to-day work.

No one can fail to notice that we continue to live and work in changing times.  Change is something that all of us in our Trust are subject to. The 'Transformation' process is still being worked through in our Leeds services; we are providing services to more service users and carers than ever before across an extended geography; we have welcomed into our Trust hundreds of new colleagues and we are forming new partnerships; also there will be changes in our Council of Governors, also the Non-Executive and Executive components of our Board of Directors. Externally, the NHS Bill continues to work its way through the Parliamentary process. Its enactment will change the way the NHS is run nationally, regionally and locally. In this context successful NHS foundation trusts, such as ours, probably seem to be the most stable part of the system, though this may not seem to be the case during times of significant change.

What is the best way for us to respond in such circumstances? A number of things come to mind. 

First is to hold to, and never lose sight of, our common ambition which is to provide excellent mental health and learning disability care that supports people to achieve their goals for improving health and improving lives. I say this, because in stormy seas fixed points of navigation become critically important.
 
For those of us in leadership positions, we constantly need to check if our work meaningfully contributes to delivering our Trust’s ambition. We need to be aware that sometimes, with the best of intentions, our work or behaviours may seem to impede, or even devalue, the work of people who really are doing their best.

Secondly, there is a need to stay engaged with each other.  Under pressure it is easy retreat into an office or to lessen our contact with others, therefore stay engaged; keep listening and responding to others, even when you don’t know the answer to the issue in front of you.

Thirdly, it is critical that we continue to value each other.  It’s all too easy to pigeon-hole people or groups, for example clinical staff are seen as being inherently ‘good’, whilst non clinical people, in particular managers, are ‘bad’. We see this played out in the media. Of course we must always give primacy to those things which directly connect with service users and carers, however in our Trust’s values we say that 'everyone counts'. For me that includes everyone from our colleagues working in our stores department, to the people working in management accounts or human resources. In short, we must do our best to value our colleagues as much as we want to be valued ourselves. If we don’t value ourselves and our colleagues how can value service users and carers?

None of this is easy, particularly when times are tough and people are under pressure but I am up for the challenge – are you?  

Dark days, new resolve

I am writing this on the day of the winter equinox, the shortest day of the year or, to put it in another way, the darkest day of the year.  In some ways this is emblematic of other things happening right now including uncertainty in the national and international economy; rising numbers of people without a job; and people’s incomes shrinking in real terms.

For us in our Trust we are affected by the need to follow through large scale change programmes. This is compounded by other things such as uncertainty over pensions, in the context of some people presenting these as being “gold plated” – whatever that means. None of us are immune from this, including senior managers, and it is not surprising that people’s trust in each other is getting frayed at the edges. This is evidenced for me by a couple of surveys of staff recently conducted in the Trust. These surveys, and the comments submitted with them, show that people are under pressure at work, that the changes being made are at times – albeit unintentionally – having a negative impact on people, and that there is a feeling of disconnection between the top of our Trust and frontline services.  These are serious issues and I am not going to indulge in simplistic answers here, but I will be thinking this through with my colleagues over the next couple of weeks. Expect to see more about this in the New Year.

Anyway, how does this connect to the darkest day of the year?  Well, in contrast to the short days you cannot help but notice that people, regardless of the prevailing circumstances, bring light into the world. You see this all around you. Christmas trees, “fairy lights” (do people still use this term?), and other decorations – some people even decorate their desks. This suggests to me that people always stretch towards a sense of something being “better” even when things are very tough, perhaps especially so.

In the context of working in the NHS, the NHS depends on people going the extra mile no matter what their job. All of us do what we do because we want things not only to be different but better – moving from shadows into light if you will. This is why what can be perceived as attacks on our work can have a negative effect, from the public thinking that people in the NHS are in some way in overpaid easy jobs, through to people seeing internal changes as in some way fundamentally devaluing the work that they already do.

How should we as individuals and as a collective respond to this?  Firstly, we need to hold our heads high and be proud of what we do and why we do it. Every day I see people changing the world for the better in our Trust. I am so proud of you and to be associated with you.  Secondly, we need to steer and influence our future as much as we can and keep faith with one another. Change is unavoidable and we can never be in absolute control of things.  We need to see things coming and steer them as best we can, from becoming a bigger organisation to developing a single point of access and better care pathways for service users and carers.  Thirdly, we need to be honest with each other. Honest about how we are feeling, and honest about mistakes we make along the way with a resolution to learn and improve. We also need to continue to care for each other as best we can, as well as the people for whom we provide services. With you, I want us to be excellent in our work and there is a very small gap between how we are with each other and the experience of service users and carers. What we say and how we say it is of vital importance.

Some of you may think, “here he goes again!” However I am clear that whilst these are indeed warm words they are very hard to put into action. I am up for the challenge and I know enough of you to know that you are too.

Have a great holiday. I hope that all of you will get some down time.

Thank you for taking the time to read this and please do comment below, or email me at christopherbutler@nhs.net

Under pressure

Following my last blog I received an interesting anonymous letter.  This expressed concern about the pressure that people are feeling as a result of all of the changes happening in our Trust.

The background to this is the “Transformation Project” which is our plan to find better ways of providing care, treatment and support for the people who use our services, whilst making financial savings. We are working with people to find out what works best for them. Our aim is to make sure that people have a positive experience of using our services and achieve their goals for improving their health and lives.

Redesigning our services will enable us to focus on what adds most value to service users and take away things that don’t. We must save £8.7 million from within care services over the next three years and we want to do this by being more efficient at the same time as improving quality.

These changes also include systematically working through how people get to access our services and tightening up our appraisal system as I mentioned in a previous blog.

A lot of you, particularly members of the public, may say, “What’s wrong with that, any good organisation does that sort of thing”.  Yes, good organisations do, but it will involve an expectation for people to work differently and it is important that we work with our staff and the Staff side committee to ensure the process is fair for all. The changes will affect a good number of our staff, but this does not mean that people will lose their jobs.  I want to be absolutely clear that I see spending money on such things as redundancy is money that we should be spending on providing services to the public.  In other words, redundancy money is wasted money.  It follows that though some staff will be put  “at risk” while we go through the process of redesigning our services, and some people may have to work differently in the future, I am determined that redundancies will be kept to an absolute minimum.

The letter also touched on a concern that as a Trust we could end up looking good on the outside whilst having problems inside.  One example cited was the positive campaigning work we are doing to tackle the stigma associated with mental health issues, with lots of positive reporting in the media, in the context of the things I have touched on above.  I am grateful to the writer for drawing this to my intention.  The work we do to raise awareness and combat stigma makes it easier for people with mental health problems to be part of their local communities - which helps their recovery and keeps them mentally healthy. What we spend on this campaigning work is only a tiny fraction of our  expenditure and makes an important contribution to our Trust strategy.  Of course we also need to make sure that we are communicating well with staff  internally; so it is vital that we get the balance right.  I would welcome ideas about how we can do this internal communication better.

Finally, my door is always open and I hope that people will all feel free to contact me, even if they have something to say that they think I won't want to hear. It's only by being prepared to listen to the negative as well as positive messages that individuals and organisations learn and improve.

What do you think?

Thank you for taking the time to read this and please do comment below, or email me at christopherbutler@nhs.net

PS: the research on blogs say that you should aim for 200 words – failed again!