Trust Board Public Meeting 12 March 2024

All meetings will now take place virtually.
This recording is from our Trust Board meeting, Tuesday 12 December 2023.

Full details about our meetings, including copies of papers, can be found on our website
https://www.berkshirehealthcare.nhs.uk/about-us/key-documents/board-meetings/

No public questions and we’ve got apologies from Aileen. OK, Aileen. OK. Thank you. That tractions of any other business, but creations of interest. Minutes of the meeting. Any corrections? 5.1. No, the action log and matters arising all seemed to be in handle completed. So unless someone’s got something else, the roads OK, in

Which case I hand over to you, Debbie, and to introduce Jade Hens. Is that right? Welcome, Jade. It is right. I’d like to. I just texted her to say feel free to join because I was thinking I was gonna be doing the presentation, which wouldn’t have gone down well.

So, so glad to see you. Jade and Jade is here to talk about the mental health support In. team and getting help in our young people’s services. Today, it’s a relatively new initiative, so hopefully you’ll find it then an interesting presentation. OK. That’s it. Over to you, Jade. Thank you, Debbie.

Thank you, Martin. Morning everyone. I do have some slides that I’ll share with everyone and then I can I can distribute it round afterwards if if people were happy to let me just see if it’s gonna give me permission to share. And everyone see that perfect. We can say, yeah. Good.

Hopefully it’s all working perfect. So my name is Jade Hens. I am the CAMS team lead for the getting help and mental health support teams for Slough and so make up part of East Berkshire. So E Berkshire CAMS team is (Slough), Bracknell and then

Royal Borough of Windsor and Maidenhead, which Ascot also sit within. So although we call them RBWM, you may also see them as (WAM), WAM. So just going to be talking about a patient journey that we had within our MHST or mental health support team.

And there are obviously quite a lot of acronyms in the NHS, so if I say any that you are unfamiliar with, please do. But in and I can clarify that for you. So if you’re not familiar with the thrive model and this details the 5 needs based groupings for & children,

Young people and families. So our service as you can see by the lovely big green arrow sits within the getting help quadrant and this is sort of early intervention, mild to moderate presentations. And our aim really is to get the sort of the children young

Personal family into that yellow thriving section and the getting more help is our cams specialist team. So if they’re not appropriate for our getting help service and the early intervention services, then it would be stepped up to getting more help and that’s where you’ll find the anxiety

Disorder treatment team rapid response and also like specialist community teams as well. So I have three teams that sit within my remit. I have two mental health support teams, or MHST as as I call them, and then 1 getting help team. So the threshold and interventions for all of my

Teams are the same, but the mental health support teams are school based, so they deliver their interventions predominantly in the school. And unless that sort of child or or family request otherwise, and then my getting help team is community based. So they work out of our base at Fir Tree House, Upton Hospital

And they would see people that would be referred from say like GP places of worship, the local authority, etcetera. Whereas MHST and it would be School referrals. So this is just a little bit of a structure of our team and as you can see, we do have a little bit of vacancy.

So that’s why there are stars next to them. They’re either waiting for Recruitment to sort of recruit them and but this is what we would look like if we’re fully staffed. So we have an education, mental health practitioners who are our clinicians or we call them emps for sure.

We obviously have Team administrators, senior mental health practitioners, senior clinicians and supervisors, and then also senior. And then just about our getting help team. So we have children. Well, being practitioners. So again, the the qualification is the same as the Emms, it’s

Just that the Emms would do an extra module about working in schools, and that whole school approach and. But the interventions and and the thresholds are exactly the same. Essentially, we do have some trainees in service at the moment and then we have a very new role which would just

Recruiting for haven’t yet started and that’s the senior mental health practitioner for GOP primary care. So essentially there’ll be working 50% in our getting help team and then 50% in the actual GP practices and within Slough it’s currently being piloted by WAM or RBWM.

And it’s it’s sort of quite successful at the moment. So just a little bit on our service background and there is a link at the bottom for further information about our MHST as it’s a government initiative. So there’s, as you can imagine, there’s quite a lot of

Information on there, but it’s it’s based on the green paper of transforming children and young people’s mental health provision. And the aim is that every school and college to have a designated Mental Health lead by 2025. So as I mentioned before, we do make up 3 localities and Slough

Is just one of those. Like helicities, we have had the MHST support Team 1 since about 2019, but really sort of fully operational by 2020. And then our second Team MHST 2 just to keep it nice and simple and joined the team sort of in 21 slash 22.

So we tend to do the Recruitment, then they do their years worth of training. So then we’re fully operational by the year after. So across the 2 MHST, we’re in 24 schools, which is about 47% coverage. And then the remaining schools fall within our getting help

Team, which we call the non MHST schools just for simplicity. So our offer, so we offer both direct and indirect intervention. So as I mentioned earlier, we are early intervention and from multi moderate mental health interventions we offer one to one support for the actual sort of child or young person if

They’re sort of 12 years and over or primary school and sorry secondary school over about 6 to 8 sessions depending on what the intervention is that we offered and then we do parent lead interventions for anyone sort of 11 years or under.

To that primary school age and the reason why we do that is sometimes, you know, they’re not going to necessarily have that emotional maturity. So working with a 5 year old could be very, very difficult with the interventions that we offer. So we tend to work with the parent because the parent knows

The child best would know their triggers, would know their behaviours, would know how that they would react, which is why we do the parent LED interventions as well. If the child is saying yes 6 and has that emotional capacity, then we would work directly with that young person.

But it’s really done on Earth, so of individual case depending on the child. And then we we can do small group sessions where we feel it’s appropriate. We then do the indirect intervention, so that’s things like multi agency triaging. So we work very closely with the MASH team with the local authority.

When it’s our getting help team and we do school staff consultations and reflective practice. So we have what we call a School surgery every 6 to 8 weeks and they meet with the school and just talk through open referrals, talk through potential referrals and and then

If if there’s any advice or any guidance, we need to give, then we will we do a lot of joined up working with professionals. So local authority like I mentioned in schools and places of worship, etcetera, anywhere really out in the community or school based, we will work with them.

We also do training workshops, coffee mornings, open days, open evenings and really anywhere that we can kind of get in and be helpful for everyone. We will. We will do that. And then we’re also trained in pet care. So that’s Psychologicial perspectives in education and

Primary care, which is kind of an add-on free training available for everyone. I have put the website link just down below in case people haven’t heard of that. So as we’re in early intervention, mild to moderate presentation service, these are some of the presenting problems we can offer interventions for.

I won’t read them out, but it is sort of very sort of quite low level, so it’s low level sort of CBT that we offer almost like self help guided and type skills and so things like simple phobias. So singular phobia as we call it.

So if it’s just dogs or its heights, or it’s separation anxiety, if there’s, you know, more complicated phobias that would then be and specialist cans and it would need to be escalated up. And then what we don’t support with, so anything that kind of falls within this remit, we would recommend that the

Referrer would go to the common point of entry or CPE for referral into specialist Cam. So anxieties, orders, treatment team, as I mentioned earlier, all the specialist community team, now if a referrals not accepted and then we can support the referrer to explore where

Maybe better or more appropriate for that child young personal family to go to. So we never just flat out say no, we say they’re not, you know maybe appropriate for our team because of XY&Z. But actually what we would recommend is and then with our recommendations.

So moving on to a patient journey case study, which I guess is why I’m why I’m here. And so this is a case that we had in our MHST 2 Team. The clinician was Evie Brooke. So if you see the name Evie, then it is my clinician.

It is not the patients name and I’ve just called them Patient X for the sake of this case study and she did a really fantastic job with this family as our go over the feedback a little bit later on. So just a little bit of background information.

So the child was eight years old. Uh, Mayo and then attended a SCN school. A special education needs school as he had a diagnosis of ASD and awaiting an ADHD assessment. And so we did parent LED work for this one because of his age.

So the reason for referral was concerns around sort of food avoidance. Fears of sitting down or being dirty? Social worries about appearance, particularly whilst eating and then other information that we were given at the time, was that the parent was quite apprehensive about the child

Attending the initial assessment and then any further sessions just because he’d never engaged with the service before that sort of lack of trust in professionals and was was really quite high and quite anxiety provoking for him. So because the child had a diagnosis of ASD and pending

ADHD assessment, and with mums concerns that he may not engage, it was necessary to put in sort of reasonable adjustments to try and make the assessment as successful and as engaging as possible. Otherwise, we may not have been able to offer that support,

Because if we, if we can’t do the assessment, then we can’t then sort of then follow through on what would be the most appropriate intervention for for the family. So we had a Pokémon style Assessment to try and increase that engagement. So he was very, very into Pokémon and and Evie actually

Has some Pokémon converses that she wore. So just as a way of just trying to be a bit more relatable to to that little boy and he did, he did really enjoy the shoes and Pokémon cards were provided by Mum secretly exchanged to Evie.

So then he thought that Evie was, you know, handing him over the cards and just a way of just building that trust and building that relationship. And because it meant that he then went away thinking ohh God. Look, I’ve got someone. Who who loves Pokémon just as much as me and Evie does.

You know, if she does actually really like Pokémon, so this was all completely true, all completely relatable for him. So the first Assessment did go ahead and the clinical Room unfortunately was too hot and too small for him to be able to cope.

So they did have to reschedule, but then she made sure that for the rescheduled assessment and that she saw the different room and just made sure that it accommodated sort of more space and and had, you know, less temperature concerns, shall we say?

I don’t know if you’ve ever been to their tree house, but it can be quite warm there in the clinical rooms. So after the assessment, the intervention identified would be a parent LED intervention because of his age and which is called helping your child with fears and worries or hate YC, as

We call it, and this provides the parents with sort of an understanding of their child’s anxiety and how maybe sometimes the parents anxiety can also be influenced in this. And so they were sort of focusing on those anxious behaviours around eating and drinking, particularly in front

Of other people and and with attending school, not eating or drinking is obviously quite a difficult thing. So the help in your child looks at increasing independence, allowing children to build that confidence and just through learning how to cope with everything. Those strategies and being able to sort of sit with that anxiety

And actually work, work through it. And so parents are taught to be curious, gather anxious expectations from their children as opposed to sort of providing closed off reassurance or sort of, you know, accidentally sort of almost squashing it, as it were. So at each step, parents are encouraged to reflect on their

Child’s learning, and they’re taught to encourage and problem solve against any barriers with their child. So this is very sort of collaborative. So although Evie was doing the parental intervention with the parent, the parent would then go away and take what they’ve learned from Evie to then apply and work with the child.

So the outcome so in total EV did actually manage to complete a psychoeducation session with with X, which is a real surprise to us and and and it just goes to show the impact of that Assessment had that he was actually willing to have a session with her.

So the psychoeducation session was around food around eating and drinking, and just that sort of that appearance to other people. And then Evie completed for one hour. Sessions 230 minute phone calls and one one hour review with the parent themselves. So as a result, the positive impact was really, really significant.

Family are now confident in going out together, doing things, and they’ve even planned a holiday because he now will eat and drink in front of other people. School obviously reported huge improvements and good behaviour in school will now sit in some situation and has been able to

Go on school trips, which is really really amazing because he was really missing out on a lot of things and from from having this anxiety intendants at school has improved and he’s attending on time and limited sort of anxiety most days so

He’s able to kind of cope in school now which is which is just amazing, has snacks in lessons during the school day and he no longer shares a bed with Mum which I’m sure Mum. Is also very pleased about as well. Though I’ve just highlighted some of the quotes that I sort

Of pulled out from the feedback and but Deborah Debbie did ask if I could read out to you, so I will read it out to you and and then I’ve also attached it to the slide. So if you do want the slides, you can read it in full as well,

So the the feedback mentions. Obviously, feedback for Evie, of course, but it also does mention feedback for our admin team and also the staff at First Tree House, which is really, really love place. Sorry, I’m just going to read out and I’m don’t think I’m

Gonna be able to share it because the way that I’m sharing the PowerPoint, so if you want to call out or anything, please just because I won’t be able to see you. And so it says. Sorry it’s taking me so long to get this to you.

I just want to say a huge thank you for everything you and the cams getting help E team for the help you have given me. You are the first team of people to make my son and myself not feel like a tick box. The first time I called your team, I was desperate.

As you know, the person that answered my first call spoke to me like a human being and reassured me that someone from the team would be in contact as soon as possible. I felt validated and that first call made such a difference. I wasn’t on my own anymore.

I wasn’t going to have to fight to be listened to. My stress levels were lowering already. I was blown away a few days later with a phone call as promised from yourself. Once again, I was validated, so I’d like my problems have been

Listened to your calm voice and how you explained you and your team would come up with a plan from that phone call. I just knew that I could talk to you on a level I didn’t feel intimidated or interrogated as I have in the past, we have had

Many phone calls like that and many emails I didn’t feel alone anymore. There’s trust. There’s nothing worse than not knowing as a parent how to make things better for your child. I began to trust you and realize that you weren’t going to fob me

Off with the usual spew things I’ve already tried or learned. This gave me hope. At some point, you brought up bringing Exec in for an assessment. There is no PC way of putting it for myself an X that is hell on Earth. Ohh, my God. Panic.

He’s never, ever gone along with anything like that. He fights for his life in situations like that. As I’ve explained to you in many a time, I took a few days to Stew on it, and then I thought to myself, you can trust this woman.

Give her a call and see if you can give her some direction as to how best to approach this assessment. So I did, and the Pokémon style assessment was created. You listened to me and let me take the lead in telling you

What I needed from you in order for the assessment to be successful. You went the extra mile wearing your Pokémon shoes, too. I won’t go into everything we did together, but promise me you will shout about how it shout about it to your colleagues. It worked amazingly.

I feel like you should be listening. Save me so much anxiety and upset for both myself and X. You should be champion. What you did, can I also just say that you’re waiting room is one of the easiest. We frequented having two rooms and the film playing really helps.

The reception staff is smiling. The car park is a nightmare, but the receptionist put me at ease that I could park in the disabled zones and she would look out for anyone that needed the space more than X and I did

The first Room that X and I saw you in was too small and hot ex got claustrophobic and we had to abandon the appointment. However, you were so calm with him and validated how he was feeling. He got a sly look at some Pokémon cards that you were

Holding on, to which you snuck to me and I gave to him later from you. Obviously I was able to say to ex that he that you thought he would deserve them. That planted a little seed in his head, and by that evening he

Was talking about coming back to see you and trying again. He came back to see you. You made sure you had a much bigger room and the assessment was able to take place. The little bit of time and listening to me. Really. Really paid off.

This has also changed access perception of going to see Adults he doesn’t know at all and being expected to bear his soul. To them, this has been proven. Since when he had to visit the Community dentist, then on to the parent LED therapy. The way you delivered the information to me didn’t blame

Me away in petrify me. You’ve never asked me to read the whole fears and worries book, although I have you gave me just enough homework. I’ve never felt overwhelmed. Small steps making X realise he can do things, therefore giving him confidence. Once again, you talk to me on my level.

I felt I could open up to you about my life experience. You taught me the that these experiences could have a bearing on X the way you did it though, you never once made me feel like a bad mother. You’ve actually made me feel pretty amazing about everything

This journey has thrown my way. Anxiety breeds anxiety and encouragement and independence breeds confidence. Please make the powers that be listen the way you work in your approach. Things should be how all professionals do. You’ve made such a positive difference and completely changed my perception on the professionals.

I will actually miss our sessions, but you’ve made me realize that I can do this and I’m good at it. Thank you. And that concludes everything. Jerry, could you just unshare your screen and then we can? Yes, absolutely. There we go. Jade, that’s absolutely fantastic presentation and wonderful work. So reassuring. I’m.

That’s lately. I don’t know. I’ll open it for questions. I’ve got some, but I’m I must hold them back until my colleagues have had a chance to speak to you, Alex. JPEG one of the CD. In fact, the teams having, I’m just gonna particular question around schools and their expectations of the mental

Health support in schools and what’s the feedback from schools to you and the team. Are there any gaps as far as they’re concerned, where they get support? They understand the thresholds they there’s ever been any issues around by managing expectations. Yeah, I think there was a imagine there was a quite a few

Teething problems in the beginning suggest for information I’ve been in post since April last year, so coming up to a year and I think that generally our feedback is amazing from schools. They really appreciate the work that we do, and I mean it doesn’t cost them anything.

So that’s that’s always handy for a school. What? But yes, our feedback generally is really, really good and there’s we have a lot of demand for the schools that aren’t in the provision. We get asked almost monthly when we’re gonna be taking on more schools.

When we’re able tea, but because it’s a government initiative, we are capped at the number on row and so unless a school drops out, we can’t really pick up another school until we’re giving another mental health support team and they come in waves as they call them.

So when the next Wave comes in, if it’s offered to East Berkshire, then obviously and we may be able to take on more schools, but generally, yes, they they’re aware of our thresholds and we talk over things in those School surgeries that I mentioned.

So if they’re kind of not sure whether it’s for us or maybe whether it’s the specialist Cam and that they can have that open conversation and and they don’t necessarily have to wait the six to 8 weeks for the next one, they can contact their sort of the Emms.

So we have emps assigned, kind of designated to the school, so they have a designated person that they can reach out to. And I think sometimes there can be a little bit of a gap and I think you’re, I mean everyone’s probably aware that there is a

Slight gap between our service and specialist cams that sometimes they’re a little bit too high soft threshold, but they’re not high enough for specialist and that’s where our sort of my band 7 senior clinicians sort of come into play that if we can, maybe if they’re maybe a little bit too

High for my band 5 clinicians, then they may be able to be seen by a band sort of 6 or 7. And so there is a slight gap, I would say, but that’s a that’s a Cam S thing rather than anything to do with the schools. OK. Jane.

And so you’re just just just a quick question, Martin, on the behavior aspects that schools are often challenged with that made that may not meet the threshold for your team. It not not translation this work but below that or it may be excluded. And do you?

Do you see any issues or frustrations and schools around where they can get support and behavior? Yeah. So I’m behaviour we don’t necessarily see unless there’s a mental health presentation. So in the work that we do, there has to be some form of mental health need.

And what we do find, though, is that one of our parental interventions called incredible years is a good intervention for behaviour, putting those structures and those boundaries in place in order for sort of parents to be able to manage. So if they have a mental health presentation but also

Behavioural difficulties, we can do that. But that’s where our training and our workshops also can help that if maybe they don’t meet that mental health need but have behaviour issues, we may be able to do some work with the school in helping that.

So I know that one of the pet care modules is around behaviour. We’ve also created our own resources and training and workshops around that coffee mornings and for the parents. Quite often the schools asked the parents for a theme, and so it could be around anxiety.

It could be around behaviour, so although we may not be able to offer an intervention, there’s there’s other things around that whole school approach that we can do instead of. Jade. Thank you. Right, good. Thank you. Thanks. Thanks Sally and Julian. You’re. A very interesting presentation, Jade cannot. Can I ask you?

Have you looked at your referrals from a ethnicity point of view? Do do do the referrals, reflect the ethnicity of the no and I was going to ask you whether you ever have this sort of. The cultural sensitivity around different parenting styles, whether you know that gets sort of factored in. Yeah, absolutely.

Sally, this is a big piece of work that we’re currently and going through. So just for context and Slough Democrat, main demographic is Pakistani and I think they I think from the cams away day last week or maybe a week on the 28th, I think it was 48.32 I

Wanna say percent and was Asian population and a majority of our referrals are white British and so there is definitely and a need there. So there’s a couple different projects that I’ve tasked my getting help team on, and there’s also a Qi project going

On and someone’s yellow belt has decided to take on a huge task of looking at the lack of diversity and and this is slow as a whole, so this is not just my service, this is is. This is all services in Slough and also through the early help

Hub where we get our community referrals from. So there are pieces of work being done and a couple things my team have done is they’ve taken the top three languages spoken in Slough, which is Punjabi, Urdu and Polish, and have translated some leaflets and School leaflets.

And we’re just waiting on whether we’ve got the budget to to expand that into secondary schools. And so there’s a couple of things that we’re doing already. My getting help team. I have tasked them with almost like an awareness project where they’re going around to all GPS, all non NHSFT schools, places of

Worship, mental health charities, mental health organizations and basically just screaming about our service. Now a lot of people do know about us, but it’s just that refresher and and we’re hoping especially the places of worship. We’re hoping that maybe we might get some more referrals.

There’s a couple of ideas within the early help Hub or the local authority of maybe getting sort of a designated kind of community based person who we would work alongside with &, Yeah. but obviously I’m I’m waiting to see whether they actually do materialize that role.

So it’s it’s a big piece of work and we are already sort of working working on it. Yeah. Thank you very much. Welcome. Thank you very Julian. Thank you, Sally. Yeah. Good morning, Jay. Thank you for that. That presentation I’m it might feel like a tricky question, but

It’s not meant to be in the fry of model. It’s predicated obviously on sufficient support and obviously the idea is is you get as much early on as possible. Now, if you think about our child and less Mental Health Yeah. Services, we often come in for some criticism because of the

Length of weights, which is understandable because of time. We’ve got long waits and that would come from schools and the GPS refer as politicians and thing else in your view. Now saying the landscape do think there’s anything more schools can do other than having a specialist service provided by

You which they don’t financially contribute because we often interface with education professionals and it would just be helpful just to think about it is something that schools could do that they’re not doing that would be really helpful for our young people. Yeah, there’s a couple of things.

Education Psychologicial in Slough seem to be second to none, and a lot of schools have to sort of privately pay for an EP. And so I think that that’s really, really lacking and and we’ve seen the difference. And so just for context, my sister is an education

Psychologist in Surrey and the the difference of what, you know, the support that they can offer is very, very different to what Slough, I guess, is lacking from not having. I think there’s only a couple & and when I’ve asked their names to make contact, no one ever seems to know what their

Names are or what their contact details are. So there’s some Unicorn EP’s flying around Slough, but no one seems to know who they are. So I think education psychologists definitely need more of those in Slough, because not all schools can afford to pay for private. And provide that EP.

And I think also not, not all schools have almost like a dedicated Mental Health person, so we are. Emms tend to liaise with sometimes the assistant head teacher or deputy head teacher. They might liaise with the head of schools. They might liaise with a senko or a safeguarding lead, but only

A handful of schools actually have a dedicated Mental Health lead, and I think that as Mental Health, the awareness has been growing over the last by 10 years, maybe a little bit more that actually having a dedicated Mental Health lead almost, I think should be mandatory.

Now I’m a counselor by background and I worked in a secondary school for 3 1/2 years as the counselor and and my direct manager was the Cinco that knew nothing about counselling. So I was having to to guide her and to sort of educate her.

And that school didn’t have a dedicated Mental Health Lee. They had safeguarding people, of course, but none of them were actually. They were trained in safeguarding issues rather than mental health issues, so I think those are two main things that I would say are lacking within schools. Now, that’s not all schools.

There are some schools that have so much support, they have internal therapists as well as utilizing our service. But if we’re sort of thinking it quite general, I would say EPS and mental health leads. Thank you very much. I I think I’m doing a visit to to your service sometime in the

Near future least I hope. I hope Maan ipam yet that’s that’s lucky for you, wasn’t it? Uh, yeah. OK. I’m but just just one question. Then we must move on Jade. But this is you’re talking about. Slough and the Sparks. Where I’m not sure whether I should ask you all the Tehmeena

Or Julian, but is this also across West Berks? It’s there equivalent service across West parks, so it’s a Yes. common service across Berkshire. It’s not, not just funded in the East. Yeah. So because of the way that the West and the East are funded and

The West only have an MHST in reading and they don’t have the funding elsewhere within West, I believe Wokingham have a equivalent service which is an acronym I can never remember and it’s like PM for why something and I would have to come back to

You, Martin, on the actual acronym because I I’m not as That’s right. No, no, that’s fine. familiar with the West as I am the East. And so Reading have an NHSFT, which I believe Amanda Mavunga heads up and then we’ve got the Wokingham kind of equivalent of getting help.

But apart from that, no, I think that will just be due to Bob funding I imagine because it is a government initiative. OK. OK, that’s fine. Anyway, thank you for that. Look, this is fantastic presentation and I can I can OK. just.

I really see how the parents and the children benefit from this service so fantastic. Thank you very much. Please pass on our. Thanks your your team too, will you and? Well Day. Thank you so much for your time and thank you for letting me gate crash. That’s all right. Now. It’s fine.

It’s a pleasure. Thanks so much indeed that we missed. Thank you. Move on, I’m afraid, but thank you. Take care. Bye bye. Well, it’s fantastic presentation. Thank you, Debbie for bringing that to the board and clearly some issues about funding generally about the, the the

Breadth of the service but and not for now, OK, we must move on. 6.1 is Patient Experience. Quarterly report. We’ve got the papers, Debbie. So I think perhaps you can just pick out the key things you want to bring to our attention and.

Yeah, there’s just three things that I wanted to flag really. Thanks Martin. I’m in. The report is pretty similar to previous and small fluctuations, but nothing if we looked at statistically over time would really, really show anything. The three things I just wanted to flag is I did mention from

The quarter two report when I presented it that we had seen quite a decrease in patients feeling listened to in East Mental Health Services, although we were not able to triangulate that with anything. It didn’t correspond with and any narrative feedback or increased complaints or any other and informal concerns, and

That has gone back up to much more positive levels this quarter, which we’ve kept an eye on. So I will continue to keep an eye on it, but it looks like for whatever reason that was, it has reverted to to its previous positivity, which was good to see.

We are doing a rapid improvement event with the support of the quality improvement team to see how we might improve our. I want great caretake up and and that is happening in April because despite having an in. This we would need in order to get to our our 10% target from our strap.

From a strategy perspective, so I’m that’s the 16th of April, I think & 15 steps is on hold at the moment because it’s being revamped. It will be recommencing from April, so you will start to see that reporting again, but it’s moving over to the patient experience team.

We’re having a look and A refresh and then we will be taking that forward again. That was really the three things I wanted to flag. Thanks so much to me. Any questions, Debbie? No, it’s already. Can we look forward to hearing more about it and and you know,

Normal routine reporting feeding the speak up, self reflection tool Debbie, I think this is sort of just for approval isn’t it cause we’ve? It is. It’s it came to the discursive. It’s been Marchesini T and and others have seen it, so it is really here. Normally this would be 2 yearly.

We took a we we did this last year last July, but it is a newer tool and following the letter around the Lucy Letby case, we decided we would refresh sooner than the two years. So that that is what we’ve done. We’ve got some actions in towards the back for sort of 6

To six months to two years and I will bring updates on those actions 6 monthly too. So formal board so it can be logged to the actions and progress we’re taking. Thanks so much, Naomi. Yeah. I just wanted to inquire about how you rate the tool.

It wasn’t was in the easiest tool to use and it was quite lengthy. And it’s what I would say. It’s a it’s quite a different format mark smiling because he like to look at it with me. I’m it’s a different format to the other one, but the substance

Isn’t actually much different when we pull it out, so it could probably be more succinct is what I would say if I was to write it myself. Naomi. Yeah. No, I’m. I’m. I mean, I think my sister to agree with that I it I think the

The it’s purpose would be to you know to to move the dial wouldn’t it to to & and enable some kind of form of Yeah, yeah, yeah, yeah. continuous improvement and do you feel that it has the IT has

The has what it takes to do that and it be slow Ben I’m sure you I I when I think so. know. I think two things. I mean, if you look at our staff results compared to many, our focus actually needs to be on targeting those areas within the

Staff sovey they are not feeling so safe to speak up. We are pretty near to the best in terms of the four questions that are asked and the offense speak up. So you are trying to make relatively small changes target with targeted effort. Yeah.

So I would say we are in a different place maybe to someone who is scoring below the average and has got some, some blanket Yeah. if you like improvement work to do that would make a difference across the whole organization and the actions we’ve come up Yeah. with will absolutely be coupled.

I couldn’t put it in here at the time because obviously the results were embargoed, but we will be one of the actions we’ve got is looking at those those specific services and teams that are not scoring so well, not feeling so confident to speak up

Or that we will actually address their concerns and look at what we can do within those teams. So for us, I would say it’s more targeted, Naomi. Yeah, that makes complete sense, Debbie, because I I know that the tool it endeavors to encourage best practice to be shared.

But what you’ve just described, which is kind of a incisive, you know, very targeted intervention, that it doesn’t feel like the two kind of addresses that tool. Umm. So cause where I was headed with this was, is there any opportunity to give feedback on the tool that might be helpful?

And I’m not advocating you goes you you create an odd continuously at that. And if the answer is absolutely not, then it’s absolutely not. You know, just just go with the flow type thing. From, yeah. So what we are doing is is, is, is Mike is the regional chair for frame speak up.

So he does share a lot of what we do and in turn gets some ideas from others. And we also have recently. And I would say it’s a stuttering start to get off the ground, but the Frimley ICB are really keen to work. We there are organisations that haven’t even started using this

Tool yet and this is our third iteration of it, and there are also services that have got relatively new frame, speak up, guardians or. More improvement to do, and I’m sure it is more beneficial for them. OK. Thank you for that, dude. Cheers. Thank you, Naomi Sally.

Well, I’m pleased to have met him. He made the point. I was going to say it seems a bit repetitive this tool, but that’s it’s just me and Debbie. I wonder if you could say a little bit about what good would look like in terms of depth detriment and and because and

Whether my class came to the board, it seemed that he there was a great focus on detriment and he spent a bit of time talking about it, didn’t he? And when I looked at our school, you know, we scored ourselves about 3 on that.

But in terms of you know where we are now and then what good would what good would look like in around that issue? Well, firstly, I think there’s an there’s a. It’s about understanding what detriment is when somebody is and that that’s relevant to the teams and the services where the

Individual is as well as to the wider organization. And then there’s definitely something about us looking at and actions that are taken when someone does raise concerns. So at the moment. And some staff would say if they remain in, in a team that’s

Really tricky for them or if they are asked to move and it’s somewhere they don’t wanna work, that’s also tricky for them. So it’s about what does it, does it look like for individuals? I think Sally, and making sure we’re doing everything we can

And making sure that the investigations are as quick and as smooth as they can be as well because obviously when things take longer than people are left hanging and and they often feel a sense of of increased detriment because of that. Now, that’s really helpful, Debbie, because it seemed to me

This concept of detriment ad really come into the focus over the last year or so. And I it was helpful for me to have that sort of clarification. So thank you. Thanks, Debbie, mark. Yeah. Thank you, Martin. I just wanted to Bungo back to Naomi’s question in terms of the

Usefulness of that, because we’ve obviously come out with a fairly positive response from the self assessment. And I know I mentioned at our discursive meeting that I did go back to Mike when I first saw those results to say is this

Truly realistic or are do we have a Halo effect in terms of ourselves as the organization? And but I feel very reassured by those conversations with my kids role. But Debbie already mentioned regionally and anecdotally by attended a guardians training session Ned session last week

With around three dozen Ned drawn from other trusts in the UK and the tone coming through from those other Ned representatives was far more in terms of how do we get more of our exact 2 engage with this, how do we increase transparency, how do we increase openness which isn’t the kind of

Discussion we ever find ourselves having to take within our own trust. And so I do feel it’s a good reflection and an honest reflection on ourselves. Thank you very much, Mark. Debbie some I think some interesting stuff and and and the Bureau bureaucracies often produce more and more paperwork

When they have a problem thinking it’s gonna solve the problem, but I think it’s a cultural one and I think cause the trust we’re taking the right line and I very much support, I think you see our colleagues do about focusing on those areas

Where we know there’s more to do rather than blanket everything. You know, we gotta target now for this dress. So thank you very much for that. Well, that’s a good discussion. Thank you. It’s a really important topic, of course. OK, I think now if I’m gonna hand over, I may to Sally and

And menu and just take us through item 6.3. Right. But thank you, Martin, and I’ll be brief and you can see from the minutes we had a presentation on reducing restrictive umm practies, which is clearly there’s a national focus on that and it was from the team at Prospect Park and

They’ve done some very good work around there. We’ve had a threshold of 15% and that actually since August 23, we’ve been below that threshold. So that now there’s a particular focus on long term seclusions and physical risk restrains and and and and I think one of the

Important things actually offer me around that presentation is it’s very much a that data driven. I won’t say too much about the quality concerns because we’ll talk about that in the in committee session, but you can see there that Perry naval health has come on to the

Quality concerns register and that’s around the the the sort of mismatch between staff vacancies and and high demand and also in early intervention in psychosis. And I’m sure to mean and might want to say something about this in in committee, but that’s really as a result of benchmarking ourselves against the National Audit.

And there’s a feeling that it’s a quite a bit of a fragmented. Service and level problems with low stopping. So that’s going to be brought into the one team approach, and Campion has come off. But it’s clearly because of the nature of the sort of closed

Environment and the high vulnerability of the patients with learning disabilities. It’s always in a sort of line of line of sight the the other presentation or the other item that I should bring to the board’s attention was the discussion on the sexual safety of (NHS staff and and and and and patience.

And when we get to the staff survey, we can see for the first time that there are two questions in there around as staff perception of of sexual safety and NHSE issued in June at Charter, which with the the trust is beginning to benchmark

Its celf against and and doing some work around on that. And because of the the concerns around this and and and the national focus on it, we’re going to have an an update on the at the next committee and the Serious Incident quarterly

Report, you could see there that from the beginning of January we transitioned to the new new framework. So there’s going to be a more, and perhaps in Debbie might want to say a bit more about this. Let me know, we might say that, but because of that and the

Issues around the date, datex has been implemented tation issues around that quite challenging implementation issues in terms of staff navigating around the data system that we’re beginning to see perhaps more small small incidents or less serious incidents reported. But there there’s a focus on quality improvement and and supporting families.

I won’t say anything around the the, the, the, the, the, the the mortality review or that the. Safe staffing report because I think. I’m I’m not meaning like what to say is something around that, but other than that I’m quite happy to take questions on the minutes. Any any questions, comments for Sally?

They’re very clear. Sorry. Thank you. OK, I’m going to hand over to minute. Thank you. Thanks, Sally for the summary and and regarding the learning from deaths report, it’s a fairly standard report. No, that’s which are cause for concern from Governance point of view.

This format of the report is probably the last one where we have the sort of a broader mortality process reported separately and they are size reported separately because from January we now have combined system under piece of whereby we review all debts under the same process.

So, so so the next quarter report would probably looks slightly different and and try to bring everything together and and and more data and charts there which are representative. So happy to take any questions on the learning from that report from the board. Any questions? You know, it’s very clear. Thanks a million.

Thank you. Regarding the Guardian report, we can see that there has been what we would see as an unusual increase in number of. Reported the extra time that the juniors has spent working beyond their designated shifts, and we’ve explored that further.

There are a number of factors we need to consider, one of which is of course, umm the the the juniors feeding generally under pressure, broadly about work and and of course the impact of industrial action. The 10th round, which is just completed, but when we explore

The individual areas, there’s a mix of 1 particular Ward where the juniors stayed over ten 1520 minutes extra to complete some Patient work which they were involved in but preferred not to hand over to the next. Junior was coming on, but in a sense, because reporting a under

The Guardian reporting mechanisms is a neutral act, sort of agreed that they should report it. So we don’t see this as working pattern of juniors having changed or anything but but the juniors being more willing to report any additional time that they spend even time traveling

Back from their education session in Oxford, which is almost certainly going to breach the time because education session covers the full elevated shift that so, so, so those are the values factors we’ve discussed these with the juniors, they’re going to be carrying on with more prompt

Reporting and discussion with the consultants of supervisors. Thank you very much. Any comments. Right, in which case. Thank you. Minute. Thank you, Sally. That’s very clear. Umm, executive report think, Julian, we just have questions for Julian. Any questions? Item 7. Umm. OK. In which case, let’s get on to something.

I’m sure we want to hear about the Staff survey, revolt the results? But it so we’ve got Jane and Steph Moakes with us. Big thank you to 7 point together reports the Staff survey results in 2023 were published last Thursday. They walk in Bargo really pleasing to see another strong

Set of results for us and particularly supported by an increase in our response rate and increasing the diversity comfort we can take. This as a really representative group of view of specters of our staff, and we can benchmark against others, but I think there are some facts here.

Some of my lights in terms of top of our class in terms of starting the gagement Burford, you’re running no stop saying this is a great place to work. Again, talk about sector and the first time that few years now we organisational reporting that it sees care of our patients as a

Top priority. And I think those two areas are directly linked to the prior admission around the vision to be great place to get carried, great place to give care. So very encouraging, more like my points Awards, the vision rather batch like against others tools where we need to be

Thinking about obviously within those top results there’s a a number of staff that don’t feel that you know you can see that Jane will take us through their areas of focus. That remain for us and spectives. So I will stop that and I’ll change just to take 3 minute context and detail. OK.

Thank you very much. Thank you. Welcome, Jane. Thank you. And I think staff is going to show the slides and for those of you who don’t know, staff staff is our engagement lead in the trust and looks after all of the collation of the staff survey results for us.

And she has prepared in the presentation today. So any sort of detailed questions, stuff that was able to answer all the details for you, just to pop you into some context of this and on the national call last week and it

Was became clear that we have got a data quality issue on a couple of questions for us. It’s a minor data quality issue, but it does mean that some of our data and is being held back until they can finalize the actual results.

It affects only as tiny number of people in our survey and it relates specifically to won’t set of questions. Question 13 would you, you know, you couldn’t make a better number to be affected, could you question 13, which are the questions around physical violence?

So overall, we still think we’ve got pretty robust set of of of schools for everything else and there’s a slight, you know, question on question 13. So we just put an asterisk by that again to put this into context, in terms of the national picture.

So the national team team really pleased with the Staff survey results last year to put again this into context in 2022, so not last year, but the year before they had the nationally but then the NHS suffered some of its worst schools that’s ever seen in five years.

And this year, the schools are much better. So they’re much, they’re improving again. So they’re very pleased to see that that dip is reversing nationally. Umm, the and I see ICS level. Again, very pleased and most of all, my colleagues seem to be very pleased their results are going up.

The exception seems to be in the ICB’s, which as you may expect are going to are going through difficult time at the moment with restructuring, so not unexpected that they did see dips in their scores. But that’s just a set some context before we go into into our slides.

So yeah, if we could go to the first slide then please. UM, which where we talk about response rate. Really excited to get a 67% sponse rate. Umm, you know, a lot of people taking the time to say what it’s like to work here and well above average and, you know,

Continuing a trend that we’re seeing of of more people responding, you know, a really big thanks to operational colleagues. I think we’ve done a lot to try and encourage people and to complete the survey and create it time for people to complete the survey.

If we go to the next slide, please, our overall engagement score was 7.45. So and yeah, we’re we’re sort of, you know, slightly up and it will round up this year to 7.5. And so definitely you know, looking at best in class schools

For us again, which we’re really pleased to see, as I say, against the national average, that’s increasing as well. So good to see that we’re following that trend. If we go to the next one and this again talks about how our engagement score is calculated, I will also remind people that

As soon as you start moving into engagement schools through around 7.5, you know that’s a world class school for engagement. It’s really quite hard for organizations to get much above, you know, 7.5 school. So you know, we’ve done really well. You know, uh, when you take into account all of those factors

That will create that overall engagement score, there’s a lot of people having to say quite a lot of really good things about the organization. So the self motivation, the advocacy and involvement is really good. And I know Debbie will want me to say this and we’ll talk about it as well later on.

But we are top of class in terms of recommending the organization as a place to work. She’s good to know. So if we go to the next steps, next slide, I’ll start survey results. We always compare against the people promise and that’s the

NHS people promise and that’s in line with how national and like to present the schools. And again it gives a nice way of showing some of the themes of what we are dealing with on a day to day basis. So if we look at all of our different themes here and again

We’re and a top of class has to say for staff engagement and a number of our schools are statistically improved and we’ve got statistically significant improvements in the scores, I won’t take you through all the detail of I’m sure you can ask questions at the end. Next one please.

And then, umm, top scoring questions and again we’ve got a couple of the questions there just to show you what our top schools are and actually and. We’ve actually got some of the top scores in in, in the class as well. So recommending the organization as a place to work, as we said

And the team feeling, it has a set of shared objectives and that’s shared objectives I’m sure is coming back from the plan on a page approach where we cascade all of our of objectives through the organization. Good to see a really big increase in work life balance

Because we’ve done quite a bit of work trying to focus on work, on work life balance, particularly because we know one of the main reasons that people leave the organization is often because they’re inability to balance home and work life. I hope that that actually the one of the things that we’ve

Done differently this year is we do have it a email address now. So if people want flexible working and they want some support in trying to help, I’m organized that there is an Central email and our people partners will work with line managers and staff to try and make flexible working

Arrangements for them either within their service or in another service. If it can’t be done at their local level, can we go to the next one please? We have a huge amount of significant improvements and this year again, I’m not going to go through each and every one

Of them, but 28 of our questions showed a statistically significant improvement compared to last year and in the year before, we only had three. So again, what we’re seeing here is a much more positive response from the organization. And again, you know it’s mirroring what’s going on and

Nationally, but you know 28 significantly. And, you know, increased schools is really important to see. So yeah, we’re pleased that if we can go to the next one, I’m again won’t go through every single one of those. And but you know it gives you a feel for where we’re moving in

The right direction with a number of things, and particularly some of the ones which, you know, worry as such. As you know, people coming to work when they don’t feel well enough and having resources to do the job properly, that type

Of thing, OK, if we move to next one, we did have some declines and sadly you know in, in, in generally a sea of good information. There are a couple of things that we’ve got to look at. Time always passes quickly when I’m working as gone down. It’s a strange question.

I’m never quite convinced that we really know what we get from that question, but yeah, just to be aware of that and stronger attachment to the team has gone down slightly and that’s that’s an interesting one because we do know that team support continues

To be a driver of high engagement and the more that people feel supported by a team, part of a team strongly attached to a team that that will drive high engagement. So that is something that and we need to keep an eye on and we

Need to to, to work on in that space. And then again one that we and we and we’re going Debbie and I have been you know talking about as part of the safety culture work is that and people feel confident that we would address concerns about unsafe clinical practice.

I don’t know whether that is a reflection of what happened with the Lucy Letby, or whether that is something deeper within our own organization. But again, that’s something we need to really take seriously this year. If we go to the next slide though, these are our our workforce, race equality standard slides.

So they show where we are and we are seeing more positive trends still not where we want to be, but we are seeing improvements for our ethnically diverse colleagues across all indicators. And our schools remain better than average. I think the phrase is are we measuring the mediocre against

The even more mediocre sometimes? But if the the work that we’re doing around and anti racism is really to look at uh at tackling some of these and these areas here and the underlying issues here. So that’s the that still remains a critically important piece of

Work if we’re going to be able to shift any of these schools significantly over time for our ethnically diverse colleagues. Because yeah, there are results here that whilst they’re improving, are still nowhere near where we would want them to be.

If we go to the next one and this is the same on the workforce Disability Equality standard again, national and standard, that we report against again, we’re seeing some, you know, mainly positive trends, one that has declined, one that’s not really changed, still screwing better than average in seven of the nine.

But you know, as with ethnici, inequalities do remain and and again it means that we continue to have to, you know, focus in this area. And so yeah, there’s some, some, some things that we’ve got to and continue to look at in in here.

So if we go to the next one sexual orientation. And so the report indicates that colleagues who identify as gay, lesbian or bisexual have a poorer experience compared to those who are heterosexual or straight. Again, not acceptable, not something we want to see that differentiation. Umm, so again has to.

You know, we keep looking at this keep, you know, keep monitoring on this, keep reminding this, you know, the organization of our support. And, you know still. Yeah. The investment that we put behind our pride network, for example, so we move to the next one.

And for the first time, we’ve actually reported on sexual safety and this year, as some of you might be aware, that there’s been an article came out this morning in one of our local newspapers reporting on the results, sexual safety, having seen the staff survey, we remain.

This is the first time we’ve had this sort of report. Sexual safety is a real area of focus for the (NHS at the moment. As you know, we’re working on our sexual safety charter. Yeah, we wanted zero tolerance approach to any inappropriate or, you know, harmful sexual behaviours.

We aren’t best of class in this area. We are below average, but we’re not at best a class, but even best of class is still not appropriate. Umm. So yeah, again, sexual safety is is an area we’re going. We we’re we’re starting to put lot more focus around and as you

Can see there is we measure both from patients and from staff and colleagues. But every incident from a colleague is, you know, we need to investigate patients, service users, some of that may be related to capacity, may not be patients with capacity. But again, it’s understanding you know the what’s happening

And following through with actions. And when we’re made aware of that, if we go to the next one, so I’ll focus areas to talk to loss about, you know focus areas continuing with the anti racism work stream and this is going to be really important.

This is where we’ve really got to significantly make some inroads into the structural inequalities that we have within the organization. The big conversations that have just ended and and the the ideas that will come out of that and I think will help us to ensure

That we focus on things that going to make the biggest difference for staff and we’ve got meeting and this afternoon where we will start talking about and what’s coming out of those conversations and where we want to take that work forward, the violence prevention and reduction work has really

Started starting to really and I have a level of focus in the organization and with the follow through from. Uh. Inappropriate behaviours from patients and violence to get from patients with capacity and and idolatry. You know, we were talking the other day with Prospect Park and

They are beginning to see actions taking place. So it’s about following through and continuing with that work. And as I say, the sexual Safety Charter work stream is now up and running to really focus on sexual safety. When we did a deep dive and just as an example in our area and in

The in the People Directorate, when we looked at sexual safety and most of the issues in our Directorate, I cannot talk about others seem to be about inappropriate comments rather than actual physical and. And you know, anything physical, but that still does not mean that that’s acceptable and should be tolerated.

So we’ve got to really work on that and then we recognise really with such high schools that actually we need to really focus in on those areas where we’re getting we’re reports of poor staff experience. So working with divisions to target those teams, those

Service areas that need the most support and help to try and increase staffing engagement. So discussions starting to take place with support from people, partners with divisional management teams looking at their results and discussing you know where they really want to focus their efforts discussing you know the next steps and

Creating the action plans for them. Nothing. One more slide wasn’t there. And and that’s so next steps in terms of what’s happening? The results being shared from Julian and there’s an all staff briefing on the 21st of March and we shared the information

With our staff networks and our unions and we will be supporting them with next steps and actions where we will also be taking this presentation out to Trust leaders and managers for a discussion at trust leaders and managers forum. And yeah, thank you to Steph who’s going to be presenting

That because I’m away on leave and the most important action really is for leaders and managers to review results with their teams and to look at what actions they can take to improve experiences locally. But top level results were all live on Nexus. Along with this presentation and there are other slides and

Prompts that we can use and to create for individual conversations within teams. I’ll pause there and then leave it for questions. Thank you very much. Can you? Uh, that’s right. Thank you. Well, obviously some very, very pleasing results. And I know a lot of hard work’s gone in across the trust.

So to get there and also clarity about where we need to focus to address some of those ones where we’re not quite where we want to be. Alright. Any questions for colleagues? Comments mark. Yeah. First of all, it goes almost goes without saying,

Congratulations to all of the executive team and I think it’s very easy to almost to gloss over what a fantastic set of results this is because it continues along trend. But well done, Julian and all the executive and the leadership, you have to be commended.

Just picking up the piece, Jane, where you talked about focusing actions on the areas where the biggest difference can be made. I would certainly endorse that, but the thought crossed my mind. Could some thought be given to what we as non executive members

Could do to support that, whether it’s in terms of our board to the floor meetings, whether it’s visit 15 steps, whatever, if there are things that we could be do doing to support that. And I think that we’d became rather than just simply be

Observed as to what is going on there, to feel that we are part of it rather than just simply sitting on the sidelines with it. Yeah. Thank you. And that’s actually an offer that we could take back because as you say, even sometimes just getting some attention from some

Of the UM the the non exec directors might be helpful or just getting a a different and I have an individual into here. What’s happening? Can can make a big difference to some areas, but Steph will can take that away as an offer for the divisions. Conway. Uh. Thank you.

Thank you, Mark Sally. I’m thank you for that presentation. And I I you know, I’ll echo what Mark said. It’s a it’s a very, very impressive set of outcomes. Can I just ask a couple of questions? One is around the Governance surround. The action plans because obviously you you said that

Local areas are gonna develop action plans and where do you get the oversight of those action plans and how it sort of comes back. And the second one is the sort of it’s more of a a micro question in terms of the sexual safety results.

When I looked at those, they were against sort of the the the the charts were nationally, you know, looking at us against what was best and worse nationally. Does it make a difference if you look at mental health trusts? I know Debbie’s gonna come in and say, actually it happens in Yeah.

All different areas, but my my sense is that you get more incidents in within mental health trusts cause the some of the patients can be very ill at times and disinhibited, does that make a difference or is that a figment of my imagination

And Debbie about to tell me it’s a figment of my imagination. Debbie, did you want to come in? Where you put your hand up to come in there. Yes. So I’m from a patient perspective that may well be true from a staff on staff perspective, that isn’t and some

Are some of the bigger national you know things that have hit Right. national press around staff on staff are actually Acute trust rather than mental health trust. So and so part in part, possibly some some validation to that, Right. but certainly not in total Sally.

And actually it and actually when I’ve looked at our My. responses in detail around sexual safety, it’s not all the Mental Health. It’s not all the Mental Health Services, by any stretch that are reporting patient related sexual harassment, Community Nursing flagged, and another and a number of other. Right.

So people going into patient’s own homes. And so so I don’t I I think it would be wrong to assume that just because it we’re a mental health trust, we are gonna see more. Now that’s really helpful for me, you know, to contextualize those results. Umm. Thank you very much. Yeah.

On the on the just to add to that, on the national call, there were some real concern about behaviours, particularly in theatres, interesting. Yeah, OK, Naomi. Yeah. Just interested to know. Well, firstly congratulations and well done. That goes without saying, almost, that is this, and maybe it’s a question for Julian.

Are these the results you expected? Yes, yes. I mean, we we shouldn’t have any surprises and. Obviously you could point to individual schools, but as a as a global sort of staffing gagement recommend as a place to work. The success really isn’t.

This year, it’s the fact we’re top for four years, five years, that starts to make make the difference. Yeah. It’s consistency that is different. And actually, if you look at a decade, we’ve been in the top three or four for 10 years, which is extraordinary.

And and the moment to get a recommendation of a place to work, you’d have to travel very long way. So the whole of the South of England that Southwest SE, you couldn’t even go to the Midlands to find somewhere. That is a very big geography that we’re starting to cover.

So very pleased around that. And the key issue is homing in such take Sally’s question on those areas where the experience is less so. So you covered off the sort of areas around res and dares we probably let sort of micromanage the action plans on those teams.

So Slough the appraisal process, particularly to me, in a that cascaded down, we’ll have an objective which would be outcome based. The 10:15 twenty teams that are struggling the most where we expect to see improvement will just put an improvement trajectory on that and then the plumbing and wiring teams can

Kind of look after it will be more about the outcomes really Yeah. about where we’re at, because I think that’s where we’re gonna Thanks Julian. get the biggest benefit. Yeah, that, that, that backdrop around the trend, the long term trend is is so significant in terms of the the context.

The other question I had, and it really is a an open question, do you think well, could we and do you think it would be meaningful to get the results from our the trusts that comprise our ICB’s? I I just think these are so you know, there’s such a depth of

Insight that comes from these reports. That is a snowing. It’s a snapshot, but I don’t know what. What do you think? Yes. And Jane, Jane, and AA colleagues will do that. So we we can sort of we’re bringing that back.

So the next board or the one after where you can just see so against obviously what that is against the national sort of benchmark, those trusts that we are currently. You know, working in system where we again we we we all do that very easily.

In fact, there’s already some work done, but obviously we don’t wanna overload you with all of that information. We kind of national benchmark is quite helpful, but yeah, we’re So yeah, and and that, that’s that’s fine, Jane. we can easily do that.

And I’m not in the least bit advocating that you know that this would be a matter for you operationally. If you have the data in front of you, So what you know, not necessarily something for for the boards to pay attention to

You unless you felt it was, it was the right thing to do. Thank you. Thanks so much. Just before I go to Minoo, I just feel that this. Long term high level of performance is driven by cultural issue rather than individual actions as it were.

So I think it’s about the overall culture of the way the trust is run and the way it is, openness and support for task. So I I think it’s that rather than a specific that would be my judgment rather than specific action here, a specific action

There and and whilst it’s always interesting to see what others are doing. Umm yeah. I always worry about losing focus on what we do and what more we need to do, but to let us my narrow minded view to me now. Yes, thank you.

I was quite interested in this year’s results, cause obviously we’ve had a really significant operational restructure and I did wonder whether that would be affected adversely or positively in the results. And just to let the board know where we’ll be doing a more

Thorough evaluation of the of the changes, I think there’s a lot of learning in any case, but I was interested to see whether it would play itself through with the Staff survey results. I think from my perspective with my senior team, I think as we’ve

Discussed, it’s not just looking at the difference in experience with protected characteristics, but also those overarching results will be hiding some really high performing teams in terms of the questions that are being asked in the survey. But other areas where we know there are some significant issues.

So I would like to learn from the teams who are consistently doing well or have made a significant improvement like we observed last year with with some of the children’s teams, but just need to think about some of that variation in what

Might be causing that we have we have a little bit of of information now developing around some of our smaller specialist teams. Sometimes they’re a bit difficult to track through the staff survey because of the number of results, but there is something we start to triangulate around.

The Staff Survey food and speak up and some staff concerns being expressed around those very small teams and how we can make sure we’re looking at the culture within those as well as some of the board to teams as well. So it would be interesting to come back to the board just in

Terms of the reflections from my divisions about their, about their learning and thoughts from the staff survey. Maybe in a few months time when we started to develop the action plans. Thank good. Well, thank you very. But just to say thank you very much again, Jane.

Well, to you and all the colleagues at the trust, so OK. fantastic results and I know we won’t stop. So we’ll keep going, OK? Yeah. Thank you. Take care. Thank you very much indeed. Bye bye bye. Well, that’s really, really interesting and positive stuff.

We must move on how everyone to Performance item 8 financial report, Paul. Thanks Martin. So I guess in in context of a challenging national position and challenging financial position within within our local systems, we continue to perform well financially and still look

Like we’re on track to deliver ahead of our forecast for the financial year. So the numbers for January our year today surplus moved to 2.1 million which is 1.9 million better than planned. Further, 700,000 surplus reported in the month in terms of just some key elements around our income and funding.

Obviously, I think we previously reported we’ve got additional 600 thousands of income coming from NHSE in regard of initial settlement around industrial action costs. We’ve also agreed position with Bob around elective recovery activity and associated funding, which means we’re recognized a further 1.2 million of income in the month.

Umm, the has been some additional funding issued nationally around deficit support and further industrial action funding, but given the position of providers within Bob, we’re not going to take any of those allocations and they’re gonna be focused on the organisations that are in deficit or have incurred significant costs in relation to

Industrial action. So I don’t see any of that coming into us all moving forecast before the end of the year. I’m in terms of areas of risk that we’ve previously reported, certainly in terms of our out of area placements, the numbers have come down over the past two months, which is really encouraging.

So that kind of derricks our forecast position where averaging about 25 beds in January, which was down from the 40 that we were running at kind of October time, Umm probably 40% of those relate to P gig pacity which we know we struggle

With and then we’ve obviously got the six beds that we’ve closed at (PPH) on our kind of transition to moving to right sizing the wards. So taking those two into account, we’ve probably got about another 10 beds outside of that that we’re out of area beds at the moment, which we’re covering off.

I’m probably worth noting just where we’re at with our workforce numbers at the moment. You’ll see that including temporary staffing with our numbers are broadly now where we expect it to be in terms of plan. So we’re gonna have to closely monitor those workforce numbers

For the remainder of the year, especially heading into next financial year. In terms of the assumptions we’ve made around run rates and starting establishments for next year. Increases in substantive numbers this month of about 56, but also we’ve seen temporary staffing still remain quite high, so

We’re doing the tagged piece of work around looking at where the hotspots are in terms of temporary staffing and certainly mental health inpatients is 1 area where we continue to see high usage as well as having high number of vacancies as well.

So piece of work to carry out their agency spends still within the headline numbers that we’re expected to do. So about 3.2% apposed to the target of 3.7 in terms of 4 cast? We’ve revised the forecast to a 3.8 million surplus for the end

Of this year and this is the 3.1 I think we discussed with the board previously, but we’ve also recognized some work that we’re doing at the moment around asset valuations, which we expect to see a benefit from by the end of the year. And that’s what’s moving the forecast to 3.8.

Now if I move on Capital with 1.6 behind where we expect it to be, but expect to catch that up by the end of the year in terms of projects completing and outside of our sadel numbers and the spend on PFI related expenditures gonna be short by

About 2.5 million this year and that’s entirely due to place of safety which is now going to be delivered next year. Decarbonisation at West Box, which will be delivered now in 2526. Uh cash, still healthy and still ahead of plan, 55 million in the bank for now operate token questions.

Well, thanks so much. And any questions? Any comments? It looks to me, forward said. Even your colleagues are doing a great job in managing a difficult situation. And uh, you know, I think we are good as a, be very insightful to realize that money is gonna be very tight irrespective of who’s

In government for the next few years. So I think we all in the NHS need to be looking at how we can deliver, you know more or at least the same for less or more for the same. And that’s gonna be quite tricky judgments, I think on some of

These things, particularly when we know we’re already sort of reasonably and pretty good, right in terms of the way we deliver and we have a discussion, don’t we at our next discussion, we’ll then discursive after next about productivity, which (NHS is very seized with just to to check

That you know we where we are on that quite complicated measure, yeah. So we don’t get complacent. OK. Well, thank you for that. To I I got an outside, just a detailed question, one on the grass, but I do it outside the meeting from April, just I, I I But Board to it.

Did, yeah, yeah, sure. Yeah, I’m here to help you. Let’s move on to 8.1 then performance report. Thanks. If I just, I’ll take those port as read, but just focusing on a couple of the key breakthrough metrics that are currently showing right at the moment.

So bed occupancy in terms of Community, very discharge 888 against target of 500 and those delays relating to 135 patients still seeing packages of care as being the primary reason for delays in getting patients out certainly in this month’s Jubilee ward was one that was flagging with the significant

Number of delays and there’s been some really good engagement with the thus in my area around trying to move some of those patients and packages on. And I think the recent numbers show significant reductions. So we are working well with where we can with Director of

Social Care and in terms of visibility, we’ve now got our delays reporting on Frimley Dashboard and we’re doing a lot of work internally around reporting with a new bed management system or reporting system going live in April, uh Clinical recording for discharge on the mental health wards,

Again higher than planned 371 against 250 target. But this is down from previous month where we were at 542. I’m average delays have come down from 18 days to 13 and the delays covered 28 patients. Longest delays are remaining within Sorrel, where obviously the complexity of the patients is a significant barrier to

Discharge and we’ve certainly got some exceptionally long stay patients in there where the work we do to try and get packages in PERF. Yeah, I’m are falling through repeatedly, which is a a challenge for us. And then final one, just drawing these physical assaults on staff.

Which at 48 remains slightly ahead of target. Still seeing high number of cases obviously at PPH with POS, Campion Soil and Snowdrop accounting for majority of the cases this month and the team are still continuing to work with Townes Valley police in terms of inviting them to states

Exchanges to try and improve reporting. And we’ve put a new role into PPH, help support staff post incidents as well. So happy to leave it there and just take any questions on the report. Thank you very much. I think you’ve covered most of it, but Sally?

And Paul, I was perhaps it’s not for you, but for Alex. But our sickness rate remains sort of persistently high, doesn’t it at 4 point. But I’ll look at it at 4.8 against the target of 3.5. And I wondered if, yeah, perhaps it wouldn’t be for you to

Comment on, you know, the the, the, the, the sort of and activity that’s being taken place around trying to bring that down a bit or to mean it. Yeah. So we we we do the check back over our trend and a broad sense

That we’re not out of line with some seasonal sickness at this time of year. But there is a a new obstructor there to sickness work stream that we’re going to get into to check out around our processes and management also specifically around anxiety, depression and

Mental health related stretches, which is a significant portion of our sickness absence that everything in line and all of our resources aligned to that right. But they say those are two key Berks areas for us. An Alex. Is it around particular areas you know, there’s some areas

Where you get much more sickness and whether they triangulate with other things? Like you know. We are trying but I got. That’s it. My finger tips in terms of just 6 semester me the nose ticular I’ll come in. set. Yes, thank you. So I think it’s a number of things around because it’s

Because it’s a percentage. Actually, if you have a small team, and if one person’s off sick for a significant period of time, that doesn’t massively throw off kilter. What the overall percentage is and we’ve had a rapid improvement event, which was really well attended to look at

Some of the drivers around sickness, but also specifically some of the countermeasures we could take to train, improve the management and the way in which we support staff who are sick and that’s one of three pieces of work. I’m really pleased that HR working stay positively with OPS

On and sickness as some work on caseload and they’ll be work on Recruitment as well. So a really important piece of work Recruitment, rapid improvement event where we bought a lot of data together to truly understand and unpick where some of the issues all

Challenges were, but also looking at some of those areas where they seem to move managing sickness well. So there is a significant amount of triangulation going on also about whether their issues with particular demands and capacity issues, the pressure and the type of work that staff are

Undertaking as well does seem to have a an impact as well. So it’s it’s probably worth be really happy to kind of bring some of that work back. So I, Claire Williams, I think is the OPS lead for this particular bit of work.

Working closely with HR, so it might be that we can come back and share some of the early findings and actions we might want to be taking to the board at some point. Or maybe one of the one of the committees if that’s more appropriate. Thank you. That’s very helpful. Thank you, Sally.

To meet A did you have something else to say or. No, no. I was just gonna comment on that. OK, that’s alright. Thanks so much. Any other comments? Questions. OK. Which is not just on that, Martin. I mean, I think that was a help helpful update. Yeah. Obviously there’s a city.

I mean, you can look at the graph, it it it, there is a seasonality to it. So, yeah, six months ago is a percent lower, which goes to prize in the summer. The best we’ve ever managed as an organization, whether Precode

We’re posting is just around the 4%, but the uh and the 3 1/2%, I think is a a helpful stretch target to see if those specific interventions can sort of make a difference. But Trust like ours, we’re sort of average just below average in

Terms of our sickness rate at the moment about where it’s at. So you’ve been sort of a sense, but obviously the 3 1/2 percent is we don’t want to be average. We wanna yeah, build on the staff engagement and everything else whilst at the same time we of course there’s been this

Horrible cold going around. We don’t want people coming to work, you know, with horrible, No. cold and everything else and back in the day 15 years ago, 10 years ago, that was commonplace. People would come with really stinking colds to work, and we’ve been much clearer post code with those people are to

Stay away and not come to work, which I think is a good thing overall. Umm. So yeah, something to look out to see whether actually there was interventions in maybe the the stress anxiety sort of burn out stuff, we can make some inroads there and see that

Reduced and again perhaps have a look at our the impact of our MSK intervention as well, which again is a reasonable contributor. Right. Thank you. Thank you very much. Thank you for that. Then Paul, Naomi, finance investment formance committee. Any comments you want to make? I can be super brief, Martin.

The the boards very very much in the nose that we’re in terms of Thank you. our financial position and I think the only thing I wanted to mention was that the committee had a brief conversation about productivity. Actually, it was sort of framed in the context of the next financial plans.

So the planning process for 2425, but really recognizing that in the near and longer term, the need for us to thoroughly understand what productivity and efficiency really means. And you know, as appropriate, the committee is keen to support the efforts of the board and the trust more generally to to, you

Know, to thoroughly understand that going forward and start pulling the levers as and when we can. So that was that piece. And as I say, it was in the context of the planning process for this coming financial year, which is only what, three weeks away I think, Paul.

And at that moment, back in January, the national planning guidance course was not readily available and boards where of that I don’t, I don’t know Paul is there an update that we are we gonna be able to see something in the next Fit which I think is 21st of March. You will.

Yes, and national planning guidance is apparently this week. It’s going to be issued now that now, now that we’ve got through How far it is? the budget, we’re expecting it this week. Well, well, that’s great. So I’ll look forward to seeing something in fit.

And again, you know the the the team has been priming the pump on developing our draft plan well ahead of the national planning guidance being delivered. No, I’ve no doubt that we’ll be in extremely good shape. And of course, they also sits within a the the again the the

ICB context and our knowledge and understanding that our two ICB are in significant deficit going into the new planning cycle. Any questions? No, I just just to reiterate. Thank you. Newman, just to reiterate that about productivity, that was at the NHS chairs event with the NHS England board and the final

Extract of anything. This was very, very strong on this issue of productivity and the view that the Treasury has, I think that you know, is a lot more money gone into the NHS and the output is it in the simplistic terms is not gonna proportionally, of course, when

You unpick some of this, it gets very, very complicated as to & anyone who’s done the detailed benchmarking of other organizations knows, it’s not always very easy to know whether you’re more efficient or less efficient. But nevertheless, it’s clearly a major issue and we know that money’s gonna be constrained.

So it does behoove us to look in our cells. And I think, as Julian would say, take the wood out of our own eyes just to make sure that there isn’t more we can do in these difficult circumstances. But thank you for that. OK.

Umm, I think we’re now do Julie fit and proper persons test. I think we probably do quite quickly, Julie, but. Yeah, I know. Absolutely. Just to say that since writing the the the policy NHS England issued its national the national Leadership Competency framework,

So I’ll just need to to make references to that document in this policy. OK. Thank you everyone. Content we have to approve it. Thank you very much and your health and safety report, Paul. Thanks Martin. Again, take it as right. Just pull some of the highlights.

So over the past year, no enforcement notices from health and safety, executive and local authorities in terms of RIDDOR, which are report lingeries, where staff off work for more than seven days or potentially need hospitalization, we have seen an increase in numbers to 11. I’m Rajiv.

Be increases were trips, slips and falls, and we look at this. Each of these cases in non clinical risk Committee that doesn’t appear to be a pattern there just just do look like genuine accidental injuries that staff Wave that staff have had in the course of in the course of our daily work.

I’m from a 5 perspective about four visits from fire service, all of which resulted in lowest level of risk being deemed in terms of the reports we got back from them, which is positive and overall it’s the second year in the row that we’ve seen a reduction in fire related incidents within the

Organization. In terms of funds and aggression, obviously, but will be aware there’s quite a quite a level of work being done around this in terms of violence reduction groups, breakthrough objectives that PPH and work we’re doing to reduce physical restraint. We’ve seen a reduction in physical assaults reported over

The past year, down 13% on non physical assaults reduction of 14%. Within that, we have had a decrease as well in number of hate crimes that have been reported. And majority of those were PPH. Again worth mentioning, we have moved to new reporting the format as well.

So as well of all the work that’s being done, let’s say we are taking into account that we have moved to or made some adaptations to our dating system. So we are continuing to push and make sure that we are reporting all all instances correctly in terms of training, umm, far

Awareness training increased percentage over the course of the year, same with health and safety training. So both or by half percent, 1% respectively, and we’re still hitting our targets around manual handling and conflict resolution training. And I think just following up on Sally’s point, sickness rates overall fell over the past year.

And as mentioned, anxiety sickness, depression by far making up the highest proportion of lost work days. Umm. Up to absolutely there. Answer any questions. Any questions? Alright. Thanks very much, Paul. Very clear Rajiv Audit Committee meeting. Anything you wish to say? I think we’ll take its red.

Nothing special to call out for this month. Page 151 of the pack is where the minutes are. Thank you. Any questions? Yeah. OK, I’ll do a cancel governors update the suppose the main thing is that the governors appointments and REMUNERATION committee and firm invited Mark stand for another year and ready

For another three years and then take Mark to his maximum nine years. So I’m sure we we we welcome their decision and thank you very much guys for continuing to support the trust. The other thing is that I think the government are really interested in the quality data that they’re taking.

There’s a lot of data there, a lot of details. I think they find useful, even if it’s a bit overwhelming, but I think there’s a genuine desire to understand, you know, quality issues, which is a helpful priangan for us cool due to the trust seal. Yes.

So the sales attached to a lease renewal for first floor Thatcham Health Centre on on Bath Road during the month. OK. So we note that. Thank you very much. I think we’re nearly at the end of this session. Any any other business you want to raise. Any other comments?

OK, the next Trust Public Board is the 14th of May.