SMHPT 2010 Annual Report by Suffolk Mental Health

Suffolk Mental Health Partnership NHS Trust

Annual report and

summary ďŹ nancial statements

2009/10

Helping people make the most of their lives

This is the annual report of Suffolk Mental Health Partnership NHS Trust. We provide services to people with mental health or substance misuse problems, and to people who use learning disability services. If you would like to know more about our work please visit our website at www.smhp.nhs.uk. Contents 1 1.1 1.2

Foreword Foreword by Mark Halladay, chief executive Foreword by Lord Newton of Braintree, chairman

3 5

Overview of our work

3 3.1 3.2 3.3

3.4

Review of the year Month by month - highlights of the year Environmental sustainability Promoting wellbeing 3.3.1 Campaigns 3.3.2 Equality and diversity 3.3.3 Using feedback to improve our services Improving communications

8 14 15 16 18 19 20

4 4.1 4.2 4.3 4.4 4.5 4.6 4.7

How our services are supported Snapshot of our workforce Education and workforce development Human resources - a great place to work Staff survey Employee network groups Employee excellence - Staff Awards 2009 Estates portfolio and projects

22 24 26 27 28 29 32

5 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8

Delivering on our promises Mental health services Learning disability services Children and adolescent mental health services Substance misuse services Suffolk Support Services Human resources Estates portfolio and projects Education and workforce development

35 36 36 37 37 38 39 39

Our performance

We're listening

7.1 7.2 7.3 7.4 7.5

What happens when I make a complaint? Our performance in handling complaints Referrals to ombudsman Some examples of recent improvements we made as a result of complaints Principles for good complaints handling

8 8.1 8.2 8.3

Partnership working Suffolk User Forum Suffolk Family Carers Patient and public involvement group

50 51 52

Your involvement

10 10.1 10.2

Board of directors Non-executive directors Executive team 10.2.1 Board members 10.2.2 Non-board members

43 44 45 46 48

54 57 61

11.1

Helping people make the most of their lives 5 ways we are helping people make the most of their lives

Our finances

1. FOREWORD 1.1 Foreword by Mark Halladay, chief executive Thank you for taking an interest in the work of Suffolk Mental Health Partnership NHS Trust. This report will tell you about our services and the progress we have made in 2009/10. In this foreword I will pause to highlight some of the Trust’s most memorable achievements during the year. It was very encouraging that the Audit Commission rated our quality of finances as ‘good’ for the Care Quality Commission Annual Health Check. We are delighted to match last year’s rating and to continue receiving recognition for our solid financial performance. CQC also rated us ‘fair’ for quality of services. This is a disappointing drop from last year’s rating ‘good’ by the Healthcare Commission, CQC’s predecessor. This follows an in-depth on-site audit of our standards. It was salutary for us and we are taking the rating as an opportunity to redouble our efforts to improve services and provide the best mental health care in the region. Our ethos of continual improvement means we have new services and developments for people with mental health and learning disability problems in Suffolk. Clinicians are now at the forefront of service developments meaning that local people can be better assured of the best possible care for their needs. Our service lines have been working through a programme of reviewing care pathways to continuously improve quality. This will continue in the new financial year. May 2009 was an exciting month seeing the launch of two important developments. Connect, a service for looked after and adopted children, was re-launched. The service has proved to be effective and popular. May also marked the start on site for our £24million modernisation project to improve inpatient services. The low-secure unit at St Clement’s in Ipswich will be opened in September 2010. It is a delight to see these long-awaited and much needed buildings going up in front of our eyes. We have made a lot of progress on the reprovision of learning disability services, part of a national programme aimed at giving greater independence to people living with learning disabilities. By discharging people from inpatient status to tenancy of social care providers, they can live with the same rights and benefits as the rest of society. The transfer of all those people will be complete by June 2010. In addition to these new service developments we have also continued to work on already established areas of work.

Improving access to psychological therapies (IAPT) has now seen its first full year of service. IAPT provides talking therapies to help people manage their symptoms and prevent them getting worse. This year, we have set up two new bases for the teams, one in Ipswich and one in Bury St Edmunds. The service allows staff to support a great many more people at an earlier stage of their ill health. We have also successfully developed our public benefit role by addressing public attitudes to mental health problems. We have developed two new arms to our popular ‘If you only knew…’ anti-stigma campaign: Suffolk Business Minded, which aims to reduce workplace stress and anxiety, and Respect for dementia, which aims to increase awareness of dementia. We have received extremely positive feedback about the work we have done in these areas with other organisations keen to adopt similar approaches. Another highlight of the year is that two of our four acute admission wards have now received Accreditation of Inpatient Mental health Services, a programme provided by the Royal College of Psychiatrists. We welcomed the PCT’s prominence for mental health issues signalled by the publication of a dedicated report by NHS Suffolk’s director of public health Peter Bradley. The importance placed on good mental health by our commissioners, and strategies to support this, will only benefit the population. We wholeheartedly support the emphasis placed on primary care, early intervention and unmet needs and will support the new direction with all the resources of the Trust. We are continuing our plans to become a foundation trust (FT) and aim to achieve that status in autumn 2010. In advance of FT status we have moved to monthly public board meetings. We want to show the public we are dedicated to being open and engaged in their interests. The achievements over the year have shown the determination and dedication of a great many people. I am delighted with the progress we have made and continue to acknowledge areas where we can and are improving. As chief executive I would like to extend my thanks to the board, our staff and all our supporters for another year of great achievements. Mark Halladay Chief executive

1.2 Foreword by Lord Newton of Braintree, chairman The year covered by this report coincides almost exactly with my first year as chairman. I have been pleased to have the opportunity to get round to many – if not yet all! – of the sites from which we operate and to meet so many of our staff. In one key respect it was a year which brought great encouragement – a warm endorsement from NHS East of England for our plan to rebuild acute inpatient facilities on the Ipswich Hospital site, create a new low-secure unit on part of the St Clement’s site in Ipswich and refurbish wards on the Wedgwood Unit on the West Suffolk Hospital site in Bury St Edmunds. The work is proceeding apace, for completion in 2011. While it was disappointing that we were not also able during the year to achieve our objective of Foundation Trust (FT) status, we remain firmly committed to achieving the best possible future for the Trust and the services it provides. We are grateful to the thousands of people, including prospective governors, who also supported us in this. Behind the headlines the Trust has continued to move forward in many ways. Our improving access to psychological therapies (IAPT) service has been widely welcomed. Our child and adolescent mental health service (CAMHS) has been developed and improved, for example with the relaunch of our Connect service to meet the needs of looked-after or adopted children. We have made some real steps forward in promoting awareness of equality and human rights issues across the Trust. Participation in the national programme ‘Releasing time to care: productive mental health wards’ is helping to improve further the working of our wards, allowing staff to spend more time with patients. A new service-user led project, ‘Get out and live’ (GOAL) is supporting recognition of the benefits of fitness and a healthy lifestyle. And a strong partnership we have created with local businesses, called Suffolk Business Minded, is working to reduce the stigma sometimes associated with mental illness in the workplace. I look forward to further developments in the year ahead. Meanwhile, I record my warm thanks to the members of the Board who retired at the end of the year – Tim Webb (medical director since April 2003), and Paula Kerr (nonexecutive director since April 2007). And they, I know, would wish to join me in expressing to all who work in the Trust our appreciation of what they do. Lord Newton of Braintree Chairman

2. OVERVIEW OF OUR WORK Suffolk Mental Health Partnership NHS Trust (‘the Trust’) provides:     

Mental health services for adults and older people living in the county of Suffolk (the NHS Suffolk area) and the Thetford part of Norfolk, a total population of around 580,000 people. Mental health services for children and adolescents in the county of Suffolk (the NHS Suffolk area). Learning disability services for the same population, plus people living in the Waveney part of north Suffolk (the NHS Great Yarmouth and Waveney area), a total population of around 670,000 people. Substance misuse services (SMS) across Suffolk. Suffolk Support Services (SSS), a range of business support, financial, information management, estates and facilities services to the Suffolk and Great Yarmouth health economies.

We provide these services in the community, working from around 60 sites in Suffolk. These include the two general hospital sites in Ipswich and Bury St Edmunds and the main mental health site at St Clement’s Hospital in Ipswich. These directorates are supported by corporate teams including finance, human resources, Centre for Service Excellence (including risk management and complaints), and community engagement (including PALS, equality and diversity, communications and the foundation trust project). Suffolk Mental Health Partnership NHS Trust came into existence as in 2003/04 as a partnership organisation with Suffolk County Council. In the late 1990s, mental health services were provided by three NHS Trusts in Suffolk, and these were combined, along with community health services into Local Health Partnerships in 1999. Our main commissioner is NHS Suffolk although we do also provide service for other PCTs. As an NHS Trust we have a reporting line to the East of England NHS which is the regional Strategic Health Authority based in Cambridge. The work of the Trust is governed by a set of values:     

Valuing service user and family carer experience, recovery, professionalism, supporting and developing staff, and providing effective services.

These are the principles which drive the Trust towards its mission of helping people make the most of their lives.

3. REVIEW OF THE YEAR 3.1

Month by month - highlights of the year

This section highlights some of the Trust’s developments throughout the financial year. They are just a handful of examples of the huge number of accomplishments achieved by staff and those who support our work. April April 2009 saw the launch of Suffolk Business Minded, the Trust’s campaign to reduce stress in the workplace. The initiative gained praise from TV businesswoman Ruth Badger. The successful campaign has since produced a Manager’s desk guide and a quarterly business forum to further promote its work. From April 2009 to March 2010 the Trust ran its second ever series of mental health lectures covering subjects such as dementia, post-natal depression and psychosexual therapy. Around 400 people attended the 2009/10 lecture series which were put on in Bury St Edmunds, Stowmarket and Ipswich. An 80% positive feedback rate ensures that more lectures will be put on during 2010/11. May May signalled the start of a new era for the Trust as building work began on new inpatient facilities in Ipswich. The plans are a culmination of over a decade of hard work. The Trust aims to construct the best mental health wards in the country. The section 136 suite opened at Wedgwood House in May. People thought by police to be suffering from mental health problems in the west of Suffolk are taken to this assessment unit rather than being kept in police custody. It is purpose-built to the highest standards and is one of the best in the country. There was a service relaunch in May which showcased the redesigned Connect service for looked after and adopted children. The exciting occasion was marked by internationally acclaimed guest speaker Dr Margot Sunderland from the Centre for Child Mental Health in London. June Minsmere House, Ipswich celebrated National Falls Awareness Day on 23 June 2009. The team at Minsmere, a mental health unit for older people promoted falls awareness and prevention with a wide selection of leaflets available for patients, public and staff. Technical instructors, who are members of the physiotherapy team, were on hand to speak to people.

At the end of June members of the Trust’s community engagement team promoted the Respect for dementia campaign at the Orwell Walk. Wearing campaign t-shirts to support dementia awareness the team nominated the Alzheimer’s Society as their designated charity (who are partners on the Trust campaign). July The Trust’s Respect for dementia campaign was officially launched during an event at IP-City Centre, Ipswich, in July. The day was attended by around 100 people and was opened by chief executive Mark Halladay. There was a keynote speech by Dr. Robert Butler, consultant psychiatrist for older peoples’ mental health, on the past, present and future of dementia care. The event also marked the unveiling of the campaign pack which includes two diaries based on the experiences of someone diagnosed with dementia and their carer. At the end of 2009/10 over one thousand of these have been requested. July also saw the first Trust-wide user and carer reference group which was attended by local user and carer group representatives, directors and Lord Newton, chairman of the Trust. The reference group advises the Trust on whether we are consulting properly and helps us to make sure that we are involving service users and family carers in the day-to-day running of services. The Trust’s Care Programme Approach department also won an award in July for excellence in partnership working for their ‘Stepping Forward’ events. The Care Programme Approach Association recognised the Trust’s series of informal workshops which engages with over 250 participants. August The August sun shined upon the Trust’s walled garden project in Stowmarket called Living Valued Lives. Twenty service users have been digging, weeding and planting their way to mental wellbeing at the Museum of East Anglian Life (MEAL). Patients help to maintain the acre of land in return for learning horticultural skills in a socially inclusive environment. Black and minority ethnic champions at the Trust in August attended the national ‘Breaking through programme’. The programme enabled the participants to examine personal characteristics which could either enhance or hinder the likelihood of career progress. It looked at the organisation as a whole and how the individuals can work closely with others to tackle this problem. It examined ways to improve identified personal and organisational weaknesses and emphasised the need to focus on both departmental and also wider organisational strategy. September

In September the Trust’s education and workforce development department began a project to introduce a library and knowledge service. The initiative was in response to the Darzi NHS review which emphasised the importance of evidence based practice. The review stated that “all NHS staff will have access to a new NHS evidence service where they will be able to get, through a single web-based portal, authoritative clinical and non-clinical evidence and best practice.” Also in September the Trust helped to organise a football tournament in conjunction with Ipswich Town Football Club Community Trust called ‘Breaking down barriers’. The event saw both service users and care workers battling it out on the football pitch to build confidence and promote mental health. October World Mental Health Day was on 10 October 2009 and was celebrated by community mental health teams across the Trust. The public event was organised by VASP (voluntary and statutory partnership) and promoted mental wellbeing in Suffolk. Among the events were a football tournament, live music and a fruit smoothie bike. The Trust chairman marked the day by visiting Warren Hill prison with the Trust’s child and adolescent mental health prison in-reach team. The idea of the day was to shape the ethos and psychological understanding within the prison. Suffolk Support Services launched its new website in October which highlights its services. The website provides up-to-date information about how its services will benefit potential customers. It also introduced a better feedback system to develop a better quality of service delivery. November Prosecutions of two people who committed assaults on Trust staff members were highlighted in a national report in November. The report on assaults in the NHS also showed figures for Suffolk Mental Health Partnership NHS Trust as below the national average. In the months leading up to the report the Trust also developed plans to improve access to psychological support, time away to recover and other practical help for the victims of assault. November also saw the inaugural meeting of a steering group called GOAL, also known as ‘get out and live’. The group will look at developing partnership working to involve service users and family carers in healthy activities. The group covers all aspects of healthy living and is chaired by a service user.

December A project called ‘Releasing time to care: productive mental health wards’ was launched in December. The project is part of a national programme to give front line staff more time on direct patient care. The project allows ward staff to review their practices and the surrounding environment to become more organised and efficient. A survey in December revealed how customers of St Clement’s Terrace Restaurant, Ipswich rate the food and service they receive. Almost 90% rated the choice of food as good to excellent. In response to the survey the catering team have developed new initiatives including offering one free sachet of sauce with a meal purchase and have started providing a breakfast service. Learning disability staff at Oulton became safeguarding champions by developing training on dignity in care using role-play. In December 95% of the 150 staff at Oulton had received Protection of Vulnerable Adult (POVA) training. January In January 2010 Trust staff were able to view the new and improved management information system, MIS. The system provides data taken from ePex the previous day. It shows where there are gaps in data capturing as well as providing charts and graphs of the information provided. January also boasted improvements to dementia care with the creation of complex care teams at Ipswich Hospital and West Suffolk Hospital. Working alongside existing care teams they will support families and patients and provide earlier recognition of potential mental health problems in the teams were brought together to tackle the growing problems with older people suffering from dementia-like problems being admitted to general hospitals. February Lesbian, gay and bisexual (LGB) people in the Trust drew up new practice guidelines for supporting LGB colleagues and service users in February. The guidelines advise other staff about the journey of ‘coming out’, selfacceptance and being accepted. They also examine issues of being lesbian, gay or bisexual within different faith or race communities, across different age ranges and within other health areas, such as learning disability services. Eating Disorders Awareness Week was celebrated in February by the Suffolk community eating disorders team. During the week, staff from the Trust and from Suffolk Family Carers’ mental health project attended specialist training in a technique called Motivational Enhancement Therapy.

February also saw the provision of flexible workers in the Trust transfer to NHS Professionals, a Special Health Authority. The change was decided upon in line with the Trust’s objective of being cost efficient. The transfer also aims to improve the Trust’s ability to respond to temporary staffing needs. March The Trust’s staff intranet underwent a re-organisation at the beginning of March. The structure was improved to allow staff to access the information they require more quickly. The sort-out was launched with a set of guidelines to improve the quality of existing and future pages. The launch of business management system IRIS, Intelligent Reporting Information System, was also in March. The data collecting system provides service line leaders and managers with financial information to assess costs of running their services. The IRIS dashboard will contain activity data including Trust key performance indicators and finance data allowing users to see operational costs against income and productivity levels.

3.2

Environmental sustainability

The Trust is continuing to review and develop its Environmental Sustainability Strategy. In 2009/10 draft processes and procedures pertaining to sustainable procurement and green travel have been incorporated into the Strategy and an implementation programme will be agreed for the priority actions in 2010/11. One of the first actions from the Green Travel Plan has been the Trust’s commitment to the NHS initiative ‘bikes for the NHS’. The cycle-to-work scheme encourages employees to ride a bicycle to work to aid in the reduction of congestion and environmental pollution. The design and management of the projects for the provision of modernisation of mental health inpatient facilities at St Clement’s Hospital and the Heath Road site include recommendations from the environmental assessment tool know as British Research Establishment Environmental Assessment method (BREEAM) Healthcare 2008 During 2009 a waste management officer was appointed through Suffolk Support Services to provide focus to the many aspects of waste management and its affect on the carbon footprint of the organisation.

3.3

Promoting wellbeing

As an aspirant NHS foundation trust (FT) we are committed to running as if we had already received this status. A key part of that is to help improve the wellbeing of all our communities and fulfil our public benefit role. The Trust's mission of helping people make the most of their lives intends to reach far further than just the people who use our services. We aim to help educate the public about conditions with which they may be uncomfortable by reducing the stigma surrounding mental health. As an FT, a council of governors will work alongside the board of directors in influencing healthcare. Increasingly, we are working with partner organisations to promote measures and attitudes which will help prevent people getting ill. In 2009 the Trust published an equality and human rights strategy and a patient and public involvement strategy. These will continue to be rolled out and implemented across the Trust over the next two years. These strategies will help improve our services and our contribution to local communitiesâ&#x20AC;&#x2122; wellbeing.

3.3.1 If only you knewâ&#x20AC;Ś about our campaigns Following on from the success of the 2008 If you only knew... anti-stigma campaign, 2009 saw the launch and implementation of two new campaigns around dementia and mental health in the workplace. Respect for dementia In devising the Respect for dementia campaign, we teamed up with the Alzheimer's Society, Suffolk Family Carers, Suffolk Age Concern, User Views and more than 50 people diagnosed with dementia or caring for someone with the condition. The experiences of these people were profoundly affecting and greatly influenced the campaignâ&#x20AC;&#x2122;s direction. Many of those interviewed pointed out that although there is no cure for the condition, there is a great deal that can be done to challenge the sometimes hurtful reactions of other people. The stories of these people inspired six messages addressing these issues, which appeared on the sides of buses, on bus-shelters and in the local press in April 2009. As well as producing posters, bookmarks and postcards of the messages, an information pack was also developed which proved to be a great success. The pack contains two diaries detailing the lives someone recently diagnosed with dementia and their carer. The diaries have been compiled from the experiences of real people in and promote understanding around the illness as well as provide details the support available. To reach a wider audience we have worked with Heart FM to commission and produce a short film highlighting the key campaign messages. The film will be soon be available over the internet, on DVD with the packs as well as in local libraries in 2010/11.

Suffolk Business Minded The Suffolk Business Minded campaign was developed as a strategy to reduce stress in the county’s workplaces. The campaign was launched in May 2009 in both Bury St. Edmunds and Ipswich with sponsored one-day paid for training sessions for local businesses. The sessions proved a great success with nearly one hundred businesses attending. Suffolk Chamber of Commerce and Bury St Edmunds Chamber of Commerce are key partners in Suffolk Business Minded, as well as local experts from human resources and recruitment, occupational health, employment law and supported employment. Through partnership working with these local experts, the training sessions gave managers the skills they need to recruit the right person for the job, avoid legal pitfalls and support their staff through stressful times. A business forum was launched in September 2009 to further develop the work of the training days, as well as to build stronger relationships with local businesses and organisations. The forum occurs quarterly and provides a space for local employers to share knowledge around stress, anxiety and mental health in the workplace. Each forum has a guest speaker, focusing on a particular topic chosen by the forum members. Topics so far have included Mindful Employer – an accreditation that shows an organisation’s commitment to the mental wellbeing of its staff - and occupational health. Responding to feedback from the training days and the business forum, a guide to mental well-being in the workplace has been produced for managers. The Manager’s desk guide was launched at the second business forum in February 2010, and has been very well received. In 2010/11 Suffolk Business Minded will continue to work alongside local employers and the business community, supporting them in adopting a positive approach to mental health.

3.3.2 Equality and diversity Suffolk continues to grow as a culturally diverse community with an increasing range of languages being spoken. Many choose the county as a place to retire to or work in. The Trust aims to engage with the community and people it serves to raise awareness of services provided and for staff to understand and respect the needs of the surrounding population. Our involvement at community events continues to strengthen our partnership and engagement within community groups. In 2009/10 events we attended include the Indian Mela, Respect festival, lesbian, gay and bisexual history month, Holocaust Memorial Day, 1st Suffolk PRIDE, black and minority ethnic (BME) LINks, Suffolk Show. Collaboration with the community groups and partner organisations has seen the set up of a BME service user and family carers group. Members feed back their experiences and concerns which support the Trust’s journey to improving services and meeting needs. The trans support group allows another opportunity of sharing experiences and knowledge amongst members and the Trust to create cultural change and learning. April 2009 saw the approval of the Trust’s single equality scheme and human rights strategy which provided the leadership direction in embedding equality, diversity and human rights. The willingness and support of the equality and human rights reference group provides the Trust with the energy and aspiration for cultural change as we move into our 2nd year of the strategy and the upcoming new Equality Bill. All of our service lines have completed equality impact assessments which will be used as bench mark to measure and evaluate change and improvement of services to Suffolk diverse population. The current economic climate has seen funding implications for the equality and diversity and patient and public involvement posts. A joint post ‘head of equality and engagement’ has therefore been created and appointed. The post holder will develop and support the Trust in ensuring that engagement creates an equality of opportunity for the diversity of its staff and the communities which it serves. The Trust wishes to thank all those, including staff for their continual support in our journey towards embedding equality of opportunity, diversity and human rights into our work.

3.3.3 Using feedback to improve our services Suffolk Mental Health Partnership NHS Trust encourages feedback in order to improve its services. Several initiatives in 2009/10 have invited people to share their experiences and comments so we can better meet their needs. The launch of the Suffolk-wide user and carer reference group in July 2009 allows the Trust to consult properly about changes we are thinking of making to our services. The group helps us to make sure that we are asking service users and family carers about the quality of our services and how to make improvements. The Trust’s dedicated patient advice and liaison service (PALS) allows service users, carers and members of the public to find answers to queries they may have about their care or Trust services. The aim is to liaise with staff and external organisations to negotiate speedy solutions and to help bring about changes to the way services are delivered. The PALS annual report was published in 2009 and highlights ways the Trust is learning from the queries and feedback we receive. For example: 

Concern over a patient’s discharge was raised by a family member. As a result two members of staff now check discharge notes on this particular ward.



Confusion from the public about which PALS department to call led to a joint promotional materials between West Suffolk Hospital, The Ipswich Hospital, and SMHPT. There is now a poster in every GP surgery in Suffolk detailing which PALS department to call for which issue.

PALS is coordinated by one part-time member of staff. He has introduced an online feedback form which will gauge ways to improve the service further. As a result of one person’s feedback the PALS voicemail message was reviewed to ensure it provided clear information. The Care Programme Approach also hosts innovative workshops called Stepping Forward. These workshops bring together staff from the Trust, service users and family carers and people from voluntary organisations to shape the Trust’s training and policy. The team behind the workshops gained recognition for their efforts at the 2009 Care Programme Approach Association awards.

3.4

Improving communications

During the year we have improved the way we communicate to staff, to the press and to the public. We use surveys and focus groups to gauge communications needs and to create plans of action. This year has seen much progress in the creation of more effective and useful communications. We have improved links with press contacts by visiting the bases of local media and inviting journalists to the Trust itself. Developing and exploring these positive relationships will be continued in the upcoming year. There have been many improvements to information available to the public in the form of leaflets and team pages on our public website www.smhp.nhs.uk. All teams in the Trust now have a leaflet detailing who they are and what they do, how to access the service and who to contact for more information. We continue to reach out to the local communities with public events such as the foundation trust lecture series, which will see its third year in 2010/11. This yearâ&#x20AC;&#x2122;s series attracted over 400 attendees engaging with topics such as postnatal depression, living with dementia, aspects of forensic psychiatry and mindfulness. Staff surveys have highlighted the need for the Trust to improve internal communications. Staff have indicated that they prefer to receive information via the intranet, briefing cascades and team meetings. In response to this the Trust has introduced standard agenda items for team meetings. This means that all teams in the Trust will be discussing current key issues including finance, data quality, complains and compliments, equality and diversity in their regular meetings. Following a staff workshop the staff intranet was reordered to create an intuitive menu structure. Staff will be able to find the information they need quickly and easily. There are also a set of intranet guidelines for online administrators to understand when to create new pages and what information should be on it. We have begun to roll out the use of an internal communications checklist to all teams in the Trust. The checklist allows staff to assess the effectiveness of communications within their team and then provide a toolkit to help them improve on areas that need more work. This will continue in the new financial year.

4. HOW OUR SERVICES ARE SUPPORTED 4.1

Snapshot of our workforce

As at 31 March 2010 the Trust employed 2,048 people in 1,693 whole time equivalent (WTE) posts: •

Nursing staff (including health care support workers) are the largest single group employed, representing 47% of the workforce.

•

The medical staffing represents 5% of the workforce. This includes consultant, training and other career grades.

•

Scientific, technical and therapeutic staff, including allied health professions (AHPs), clinical psychology and pharmacy staff, make up 10% of the workforce.

•

A total of 37% of staff are employed in non-clinical roles (including estates and facilities roles within Suffolk Support Services).

Just under half of our workforce is currently aged between 40 and 54. Looking at the range of ages within the Trust 7% are aged below 30, while 14% are at upper end of the age scale, aged 60 and above.

Overall the Trust’s workforce is 70% female. Across individual staff groups only medical and management staff groups have a majority male population, 57% of medical staff are male, while 61% of the management staff are male. This follows similar trends nationally.

The majority of the Trustâ&#x20AC;&#x2122;s employed workforce is from a white British background. The remaining 11% of staff are from a diverse ethnic background.

Staff sickness absence data Days lost (long term) Days lost (short term) Total days lost Total staff years Average working days lost Total staff employed in period (headcount)

12,594 7,427 20,021 1,689 11.85

These figures are based on a calendar year.

2,282

Total staff employed in period with no absence (headcount)

776

Percentage staff with no sick leave

34.0%

Over 2009/10, the Trust lost 5.2% of available working days due to sickness absence, with 34% of staff reported no sickness. This rate is similar to other mental health NHS trusts across the East of England.

4.2

Education and workforce development

The theme that continues to run through the achievements and future plans of the education and workforce development department is more training, delivered more locally and to more staff. The take up of statutory and mandatory training is now higher than ever before with an increase of 39% more training episodes undertaken than in the previous year. Course provision is continuing to be reviewed in terms of its content and delivery to ensure that the quality delivered will assist in improving care for the service user. There is a need to develop greater links between management of staff processes and workforce development when assessing training needs. We aim to improve management supervision, appraisals and performance development reviews. In the next financial year we will work towards exploring the areas that we need to improve. This will allow us to increase both the quality and effectiveness of what is being taught. Examples of areas to work on include: • •

Practice educators reaching out to clinical teams to support evidence based practice, and Scenario setting within clinical teams for the use of cardio-pulmonary resuscitation and other emergency procedures as a practice drill.

As in 2008/09 our e-learning menu has continued to expand, and maintains a high level compared with other trusts. E-learning has allowed the department to reduce the impact on the environment by cutting travel costs and has also allowed the staff to access their training in a more flexible way to lessen the impact that attendance at training can have on clinical delivery. A department objective for 2010/11 is for practice educators to write effective generic e-learning programmes to allow greater time to be spent in clinical areas. This years training diary has also allowed staff to book their training as a block, this will have distinct advantages for night staff, part time staff and staff undertaking their induction as it will enable elements of the statutory/mandatory training to be undertaken in a week long period of time. We continue to deliver training at the two main education and training bases at Ipswich and Bury and also in the North of the county, additionally we are delivering some of the training for support services at the cottage hospitals. The trend of bringing education and training to us, rather than sending staff away has continued and we have successfully hosted conferences in ‘Assessment and rehabilitation of memory problems’ and a conference for medical staff ‘No physical health without mental health’ we have been

fortunate that in both these events we have managed to attract well known international speakers and colleagues from around the region. The Trust continues to use LARA (Locally Assessed Risk Analysis), a computer-based electronic management system, which allows managers to set training needs for staff and to monitor statutory and mandatory training on an individual basis. Linked to staff pathways LARA will enable managers and practice educators to match staff membersâ&#x20AC;&#x2122; performance objectives with their training needs. This will allow more effective commissioning of relevant courses. Staff can now book training online which reduces administration costs and the use of paper. In addition the Trustâ&#x20AC;&#x2122;s training areas are fitted with interactive whiteboards and other audiovisual equipment to ensure high quality training and again provide environmentally sustainable alternatives to using paper. We continue to invest in continuing professional/personal development for our staff and have divided this investment into stand alone events where staff can attend specific courses/conferences and by bringing trainers to us, which have included a medico-legal training programme and a soft skills programme these events have increased our transformational learning portfolio. As part of a nationally driven initiative, we have commenced staff on apprenticeship schemes and successfully recruited union learning representatives to provide support and information to staff at a more local level. We were delighted that we were successful in reaching the required standard for education and workforce development for both the Care Quality Commission and National Health Service Litigation Authority.

4.3 Human resources - a great place to work One of the Trust’s principal strategic objectives is to become a great place for great people to work. The challenges ahead make this objective even more important as we improve the way we deliver services and rely ever more on the talent and skill of our workforce. The human resources team works collaboratively with managers so that the Trust does three things:  achieves excellence in everyday people management,  develops the organisation as a whole system, and  develops the skills of individuals. On the ground, managers work with HR to: • • • • • • • • •

Actively manage the performance and development of all employees. Promote the health, wellbeing and engagement of all employees. Resource service lines according to service-user need. Provide clear career, role and succession planning frameworks. Evolve the size, structure and culture of the organisation coherently, openly and in the context of the health system as a whole. Attract, select and induct people with the right skills in the right place at the right time. Provide targeted, succinct, cost-effective statutory and mandatory training. Provide transformational and leadership training. Incorporate higher education into career progression.

4.4

Staff survey

In the last 12 months continued good performance in a range of daily people management practices was noted by the Care Quality Commission following the national annual NHS staff survey of 2009. Altogether, 750 members of staff were selected at random to take part in the survey, 57% of whom responded. The response rate was above average compared with similar trusts. A significant increase in the percentage of staff receiving equality and diversity training in the last 12 months was noted within the survey, while providing staff with opportunities to maintain their health and well-being was also demonstrated; helping the Trust to achieve scores among the top 20% of Trusts within these areas. Strong team values and supportive colleagues and managers has helped the Trust to continue to record above average scores in the following areas: • • • • • • • • • • •

Staff feeling valued by their work colleagues. Staff working in a well-structured team environment. Staff using flexible working options. Staff receiving job-relevant training, learning or development. Staff receiving health and safety training. Staff motivation at work. Low work pressure felt by staff. Low levels of staff suffering work-related injury or stress. Low levels of staff witnessing potentially harmful errors, near misses or incidents. Low levels of staff experiencing physical violence or harassment, bullying or abuse from patients or relatives. Low levels staff experiencing harassment, bullying or abuse from work colleagues.

However, we were ranked in the worst 20% of mental health and learning disability trusts in relation to: • • •

Appraisal and personal development plans. The reporting of errors, near misses and incidents. Staff involvement in improvements to the quality of work/care for patients.

The Trust aims to empower and engage its staff members to create and maintain good work ethics. There is a focus on improving the health and wellbeing of its staff both physically and psychologically. In advance of the next staff survey the Trust aims to improve staff members’ understanding of their place in the organisation to work towards a common set of goals and values.

4.5

Employee network groups

The black and minority ethnic (BME), lesbian, gay and bisexual (LGB) and disability employee network groups have been key partners in creating change and raising awareness of practice and provisions for our staff and community. The employee network groups (ENG) plays an important role in policy and cultural change within the Trust. Three BME staff members have completed the ‘Breaking through programme’ for men and women and one member enabled to attend the national NHS BME employee group. This has created a national link of support and guidance for the Trust. The LGB employee network group has developed guidance for staff which was launched at the LGB History Month. ‘Asking the question’ training has provided an opportunity to raise staff awareness of LGBT and support staff in asking relevant questions of service users and family carers to ensure appropriate care, respect and dignity. The Equality Impact Assessments (EIA) completed by services will take equality and human rights training to individual teams and embedding it into individual team objectives. These achievements have seen the Trust Stonewall equality index scoring to be 14th out of the 43 NHS organisations.

4.6

Employee excellence – Staff Awards 2009

In September 2009 the Trust acknowledged those people, or teams, who make a real difference to our service users, the Trust, the public or their own colleagues. Members of staff were encouraged to nominate their colleagues for a staff recognition award. All winners and nominees were invited to an evening award ceremony which was enjoyed and appreciated by all. The winners and nominees for the 2009 staff awards were: Making a difference award Winners: Mental health and social care services: Marilyn Abbott, community support worker for older people’s mental health Substance misuse services: Kelly Lambert, community drug worker Learning disabilities service: Simon Graves, health care support worker Suffolk Support Services and corporate team: Brian Heath, management accountant in the finance team Runners up:    

Pete Watkins, mental health and social care services Leslie Smith, office manager for community drugs team east Wendy Scottt, learning disability service community nurse Ben Askew, workforce planner, human resources

Shortlisted nominees:        

86 Hospital Road and Keeble’s Yard teams Gill Norman-Palmer and Ruth Goldsmith, community support workers Payroll and pensions team Alison Wragg, personal assistant to head of employee services centre Larry Nicholas, patient and public involvement manager Education and workforce development administration team Derek Jones, care programme approach risk practice educator June Johnson, human resources administrator for specialist services

Team leader award Winners: Mental health and social care services: Simon Leach, Haverhill community mental health team Substance misuse services: Jon Cullum, locality manager for substance misuse services in the east Suffolk Support Services: Kate Walker, informatics programme manager Runners up:  Karen Clements, criminal justice mental health services manager  Jane Lopez, service line manager east community  Lucy Holder, finance team performance manager Shortlisted nominees:  Kevin Moran, Parham ward team leader  Ian Meek, early intervention in psychosis team manager The quality award Winner: Gareth Barnes, senior software developer Runner up:  Finance team Partnership working Winners: Mental health and social care services: Warner Duff and Tom Nicholas from the Ability Counts team at Ipswich Town Community Trust, and Mark Beardmore, technical instructor and Andy Harding, fitness instructor from the forensic team Child and adolescent mental health service: Julia Rock, project manager Corporate services: Sujata Gathani, equality and diversity manager Runners up:  Julia Havers, senior occupational therapist and Jim Kemp, technical instructor



Jeannie Wright, care programme approach practice educator

Shortlisted nominees:  Primary mental health workers for child and adolescent mental health services  St Clement’s Hospital reception team  Hotel services team

4.7

Estates portfolio and projects

Modernisation of mental health inpatient services We are pleased that the projects to produce the following new mental health inpatient services started on site in May 2009. These modern wards will replace those which have become unfit for purpose. They include: • • • •

An 11 bedded low secure forensic rehabilitation ward on our St Clement’s Hospital site, for service users across the county. A 10-bedded psychiatric intensive care unit (PICU) based on the Ipswich Hospital site but for service users across the county. Two 21-bedded wards for mental health service users in east Suffolk on the Ipswich Hospital site. One 21 bedded ward for dementia assessment (11 beds) and for mental health ill service users (10 beds) in east Suffolk on the Ipswich Hospital site.

The projects totalling approximately £22.5 million have progressed swiftly and according to programme in 2009/10. Design arrangements for the 17 bedded dementia assessment at Wedgwood are nearing completion. In August 2010 the Trust will take possession of the new low secure unit from Kier Eastern, the main building contractors. The building has been named Foxhall House and will be a Suffolk-wide inpatient facility for 11 male patients. All of the bedrooms are single rooms with en-suite showers and toilets, the open plan day spaces are light and airy and the main nurse station sits in the middle of the unit. There is a small gym, two interview rooms, general activity rooms, along with laundry and kitchen facilities. The secure garden spaces have been carefully designed with pathways and seating areas overlooking the woodlands on the St Clement’s Hospital site. The staff and patients from the low secure service have been involved throughout the design, planning and furnishing processes and are very excited about the new facility and following an official opening they will be moving in during October 2010. Other estate strategy projects Key achievements in 2009/10: •

We identified and leased a substantial building in the centre of Ipswich which will be the location for community mental health services.

•

We worked through the action plan from the annual patient environment action team (PEAT) inspections.

•

We continued to prioritise and eliminate a range of risk and health and safety issues identified through annual assessment processes.

Plans for the future include: •

Work to start on the new Ipswich community base in April 2010.

•

Work to commence on the new substance misuse base early in the new financial year.

•

The 11 bedded low secure forensic rehabilitation ward to be completed and commissioned during the autumn of 2010.

•

Undertaking the priority schemes pertaining to environmental sustainability.

•

Rationalising our estate portfolio to take account of major strategies pertaining to LD and CAMHS.

•

Continuing to undertake priority projects identified through the annual health and safety risk management processes.

5. DELIVERING ON OUR PROMISES In last yearâ&#x20AC;&#x2122;s annual report our individual services set out their plans for the future. This is a checklist to see our progress made on these objectives during 2009/2010. Good progress made. Less progress made than desired - OR - the programme goes across more than one year and so it is still a work in progress. Target not achieved but carried forward for 2010/11. The plans for the future for 2010/2011 are also set out below. 5.1

Mental health services

Mental health services for adults and older people Redefine the gateway to mental health services to provide one clear entry point to both primary and secondary care. Take opportunity to improve pathway further now improving access to psychological therapies and linkworker services are established Develop a liaison service for Ipswich Hospital and West Suffolk Hospital. Develop a business case for peri-natal psychiatry.

5.2

Learning disability services

Learning disability service Consolidate a care pathway for children and young people. Increase capacity within the Waveney child and adolescent service from April 2009. Launching a strategy for learning disability nurses. Continue the service modernisation programme and help move the remaining â&#x20AC;&#x2DC;inpatientsâ&#x20AC;&#x2122; into their own homes. 5.3

Children and adolescent mental health services

Child and adolescent mental health services (CAMHS) Implement a specialist service to support young offenders in the community. Reduce the attention deficit hyperactivity disorder (ADHD) waiting to within 18 weeks for a first appointment. Use Investors in Children to develop a systematic approach to patient and public involvement across CAMHS in collaboration with partner agencies. Ensure all services are delivered in good quality environments that meet modern standards. Review arrangements for the transition of young people from CAMHS to adult services as they reach a suitable age. Minimise the use of inpatient facilities by extending the intensive outreach team.

5.4

Substance misuse services

Substance misuse services (SMS) Complete the new structure and new ways of working for SMS. Develop psychosocial interventions with support from a consultant clinical psychologist. Further develop mechanisms to ensure users and carers are involved in how we deliver services. Engage more people in treatment, enabling more people to make positive life changes. Offering all clients a healthcare assessment, hepatitis tests and vaccinations. Build to expand our services for people where opportunities arise. 5.5

Suffolk Support Services

Suffolk Support Services (SSS) Tender for additional contracts with other NHS providers. Ensure finance and payroll services are in line with the East of England Procurement Hubs Framework agreement.

5.6

Human resources

Human resources (HR) Improve the management of staff sickness and absence, and the use of bank and agency staff. Install an electronic system for staff rostering to make the best use of staff time. Launch a new Staff Pathways web-based professional and personal development system with direct links of the key skills framework and individual training and sickness records for staff. Work with the advisory board committee to develop leadership and coaching skills for the executive team, service line leaders and service line managers. In partnership with other NHS Trusts in Suffolk, work with the University Campus Suffolk / Suffolk College on a leadership programme for senior and middle managers which will include senior development, coaching and mentoring. Review policies and procedures in line with changes in employment law, to support managers and other members of staff.

5.7

Estates portfolio and projects

Estates portfolio Work to start in May 2009 on the projects at Ipswich Hospital and St Clements in Ipswich. Seek support from NHS East of England for the Wedgwood Unit scheme on the West Suffolk Hospital site in Bury St Edmunds during the summer 2009. Identify and create a new community base for mental health services in Ipswich. Relocate substance misuse services to a 'fit for purpose' base in Ipswich. Undertake the priority schemes identified through a sixfacet survey of the estate portfolio. Undertake the priority schemes pertaining to environmental sustainability. Continue improvements to the information management and technology infrastructure.

5.8

Education and workforce development

Education and workforce development Recruit an infection prevention nurse lead to advise the Trust and deliver infection control training. Increase the e-learning provision. Add new courses in line with the requirements of the NHS litigation Authority and the national Clinical Negligence Scheme for Trusts.

6. OUR PERFORMANCE Robust systems and processes ensure our performance is monitored regularly and that action is taken to improve what we do when required. Our informatics team have improved the Trust’s web-based information systems to allow more effective clinical performance monitoring. The Trust’s management information system MIS has been redeveloped in line with the Data Quality Improvement Plan (DQIP). The revised version of the MIS has improved layout, presentation and information produced that will assist clinical services to identify key performance areas which need addressing. 6.1 Care Quality Commission - Annual Health Check The executive team receives monthly integrated performance reports covering financial, clinical quality, workforce and estates issues. In October 2009, we received confirmation of the independent Care Quality Commission’s performance assessment of us for 2008/09. The rating is broken down into two components: quality of service and quality of financial services: Quality of services Weak

FAIR

Good

Quality of financial management Excellent

This score covers a range of services, including patient safety, cleanliness and waiting times and is made up of the following components: • •

Meeting core standards - Partially met National priorities – Good

Weak

Fair

GOOD Excellent

This score looks at how well the organisation manages its finances. This score was based on information following an Audit Commission's Auditors' Local Evaluation assessment, which covers five areas: • • • • •

financial reporting, financial management, financial standing, internal control, and value for money (economy, efficiency and effectiveness).

2007/08 rating Weak Fair

GOOD Excellent

2006/07 rating Weak Fair

GOOD Excellent

2007/08 rating Weak Fair

GOOD Excellent

2005/06 rating Weak FAIR

Good

2006/07 rating Weak FAIR

Good

Excellent

2005/06 rating Weak FAIR

Good

Excellent

Summary The Care Quality Commission has rated Suffolk Mental Health Partnership NHS Trust’s quality of service performance as ‘fair’ compared to last year’s ‘good’ by the Healthcare Commission. Although the CQC’s standards are applied more rigorously than the previous system it is still disappointing that we have fallen one point in the quality of service ratings. The ‘fair’ rating redoubles the Trust’s determination to achieve excellence for the people of Suffolk. The assessments agreed that we had met all the standards in areas of keeping the public healthy, waiting to be seen, dignity and respect and good management. It also showed that we give our service users a satisfactory experience. The assessments did identify ways in which our inpatient accommodation needs to improve. We are addressing this with our £24million project to build new wards on the Ipswich Hospital and St Clement’s Hospital sites in Ipswich and a renovation plan for our wards at West Suffolk Hospital in Bury St Edmunds.

7. WEâ&#x20AC;&#x2122;RE LISTENING We always welcome feedback. Complaints, comments, and compliments help us to assess how well we are performing and improve services. A full report on all the complaints we received is available on our website at www.smhp.nhs.uk or by writing to us at: Suffolk Mental Health Partnership NHS Trust Suffolk House PO Box 55 Foxhall Road Ipswich, Suffolk IP3 8LS 7.1

What happens when I make a complaint?

All complaints received for formal investigation are handled by appropriately trained and experienced staff working in the service directorates. Each complaint is investigated by a senior manager working under the supervision of the service director. Once the service director is satisfied that the complaint has been fully and appropriately investigated a draft response is produced for the chief executive to review and send to the complainant. Complainants are almost always offered a meeting if they would like to discuss their concerns further. Some people take up this offer, which usually succeeds in resolving any outstanding issues, although the majority of complainants appear to be happy with our response and take their complaints no further. Our complaints policy is available on the Trust website www.smhp.nhs.uk or by requesting one in writing.

7.2

Our performance in handling complaints 2009/10

2008/09 2007/08 2006/07

Number of formal complaints received and investigated in year.

120

116

Number responded to within nationally set target.

105

116

Compliance rate.

87.5%

100%

94.70%

93.90%

There is no longer a nationally-set target for responding to a formal complaint but the Trust, where it does not agree an alternative target, retains the former national target of 25 working days. We invite each complainant to discuss how their complaint will be handled at the start of each investigation. We only respond to complaints when investigations are complete. We never respond without the benefit of a full and robust investigation simply to meet a target. Where responses are outside the Trustâ&#x20AC;&#x2122;s target we contact the complainant in person to discuss the reason for the delay and then stay in regular contact with the complainant to keep them informed of progress. Complainants who are not satisfied by the Trustâ&#x20AC;&#x2122;s attempts to resolve their complaint have the option of asking the ombudsman for an independent review of their complaint.

7.3

Referrals to ombudsman

At the time of writing (April) 4 complaints from those received during 2009/10 had been referred to the ombudsman for independent review. In two cases the ombudsman decided not to investigate further. In one case a meeting had been offered to the complainant but not accepted and the ombudsman asked the complainant to accept the offer. The meeting has been held and we are waiting to see if the complainant decides to re-refer it to the ombudsman. In the fourth case the ombudsman has asked that further information be provided to the complainant before the ombudsman decides whether to investigate. This is being provided. There was one serious untoward incident involving breach of confidentiality during the year.

7.4 Some examples of recent improvements we made as a result of complaints Substance of complaint

Improvement made to service

Client’s mother was told by staff, on two occasions when she rang to enquire about her daughter’s condition, that they had no knowledge of her.

Managers were asked to reinforce the need for staff to answer the telephone with their name and job title. Also to ensure that all staff on duty are familiar with clients’ names.

Mother thinks the member of staff who she spoke to was “agency staff”. Receptionist told client that their service was not a crisis support service and if she was suicidal to go back to her GP.

Although the comment made was true the call centre manager ensured staff understood the need to give such information in an appropriate manner.

Failure to keep family carers informed of client’s appointments.

With this individual there is now a formal arrangement in place to contact the family via text or email regarding appointments.

Therapist asked client in a waiting room in front of others whether she had come for an identified appointment.

More generally, arrangements are in place to ensure that for all clients details of how to contact the individual and/or family members to arrange appointments, and a contingency plan if contact cannot be made are noted in records. Discussed with practitioner and the service has developed a protocol agreed for greeting patients.

The client regarded this as a breach of her confidentiality as the other waiting people did not need to know why she was there. Client’s former husband was concerned that he was treated differently at different times of her admission sometimes regarded as next of kin and as the father of her child, being given extensive detail about her care, and at other times being told he was only the former husband and being denied information.

Record keeping standards reinforced to all team members through team meetings and individual supervision.

His complaint was about the inconsistency in approach, which he said caused considerable tension and stress.

Parent felt that she had been continually fobbed off and promised things that have not materialised, leaving her child disadvantaged.

It was suggested that complainant discussed need for one point of contact in future. As part of service governance, key coordinators have been identified who will then take on this responsibility.

Client complained that there was not a letterbox at the public entrance to a team base.

Letterbox fitted.

Letter sent by service following assessment was incorrectly addressed and not marked ‘private and confidential’.

Administrative staff reminded of the need to be vigilant when inputting data on the record system and to ensure all correspondence is marked ‘private and confidential’.

7.5

Principles of good complaints handling (2008)

The ombudsman introduced the national principles of good complaints handling in 2008. In brief, these principles include: Getting it right:       

Acting in accordance with the law and relevant guidance, and with due regard for the rights of those concerned. Ensuring that those at the top of the public body provide leadership to support good complaint management and develop an organisational culture that values complaints. Having clear governance arrangements, which set out roles and responsibilities, and ensure lessons are learnt from complaints. Including complaint management as an integral part of service design. Ensuring that staff are equipped and empowered to act decisively to resolve complaints. Focusing on the outcomes for the complainant and the public body. Signposting to the next stage of the complaints procedure clearly, in the right way and at the right time.

Being customer focused:     

Having clear and simple procedures. Ensuring that complainants can easily access the service dealing with complaints, and informing them about advice and advocacy services where appropriate. Dealing with complainants promptly and sensitively, bearing in mind their individual circumstances. Listening to complainants to understand the complaint and the outcome they are seeking. Responding flexibly, including co-ordinating responses with any other bodies involved in the same complaint, where appropriate.

Being open and accountable:    

Publishing clear, accurate and complete information about how to complain, and how and when to take complaints further. Publishing service standards for handling complaints. Providing honest, evidence-based explanations and giving reasons for decisions. Keeping full and accurate records.

Acting fairly and proportionately: 

Treating the complainant impartially, and without unlawful discrimination or prejudice.

   

Ensuring that complaints are investigated thoroughly and fairly to establish the facts of the case. Ensuring that decisions are proportionate, appropriate and fair. Ensuring that complaints are reviewed by someone not involved in the events leading to the complaint. Acting fairly towards staff complained about as well as towards complainants.

Putting things right:    

Acknowledging mistakes and apologising where appropriate. Providing prompt, appropriate and proportionate remedies. Considering all the relevant factors of the case when offering remedies. Taking account of any injustice or hardship that results from pursuing the complaint as well as from the original dispute.

Seeking continuous improvement:    

Using all the feedback and the lessons learnt from complaints to improve service design and delivery. Having systems in place to record, analyse and report on the learning from complaints. Regularly reviewing the lessons to be learnt from complaints. Where appropriate, telling the complainant about the lessons learnt and changes made to services, guidance or policy.

Our complaints procedure has been devised to meet these principles as closely as possible.

8. PARTNERSHIP WORKING Suffolk Mental Health Partnership NHS Trust values feedback and input. We work in conjunction with partnership organisations to ensure we have a high level of involvement with service users and family carers, and continue to represent their needs. 8.1

Suffolk User Forum

Once more Suffolk User Forum (SUF) has stood up to the mark and had yet another successful year. We are now a registered charity (No.1133457) and a limited company by guarantee in England and Wales (No.06946785). In addition to these moves SUF has a brand new logo. Our recruitment has seen our numbers grow particularly in the west, at our Bury office. Our new members have immediately asserted themselves well on various committees, had poetry printed in the Trust’s publications, and spoken up at a number of open meetings. SUF also took a leading role in the highly successful launch of the Respect for dementia initiative at the IP-City Centre, Ipswich, in July, providing one of the readers of the popular dementia diaries. We have also worked closely with PALS and the Trust communications team reading and commenting on the production of all SMHP leaflets. Our new working agreement with the pooled fund commissioners of Suffolk County Council will see a wider commitment to the monitoring of various agencies providing services of care. It also will provide opportunities for expression for users of the services provided by both Suffolk County Council and the Suffolk Mental Health NHS Trust. The well established ‘ward walks’ continue to providing information for the maintenance and improvement of standards of patient living quality. We are also working towards a service level agreement contract with SMHP, underlining the Trust’s ongoing commitment to working with service users in conjunction with the Care Quality Commission.

8.2

Suffolk Family Carers

The Suffolk Family Carers mental health project team is pleased to report another successful year of partnership working with the Trust around the county. Family carers are represented at various strategic levels and we would like this to continue in the coming year. It is essential to take into account the experiences of family carers if services are to be planned and delivered in a way that is inclusive of all needs. Feedback from service user and family carer groups tells us that they need more creative and innovative ways of sharing their experiences and being involved. We look forward to developing new methods with our statutory partners. In last year’s annual report we were hoping that the family carers support group on Easton Ward and Chilton Houses in Ipswich would pave the way for closer working relationships. These relationships have indeed developed and culminated in us taking part in the ‘Breaking down barriers’ football tournament at Ipswich Town Football Club in 2009. Many organisations entered a team at this event and Suffolk Family Carers also organised the tombola which contributed to the day. It was an excellent example of partnership work and we look forward to being involved in events such as these in the future. Historically, the Trust and Suffolk Family Carers has enjoyed good partnership working. The mental health family carers assessment team was an example of such partnership work. The Trust funded Suffolk Family Carers to undertake some information gathering for the purposes of Family Carers Assessments within mental health. This was a successful initiative which raised awareness of the needs of family carers. The pilot project report, which includes points for positive practice, will be available May 2010. If you are a family carer who would like to be involved in consultation, or would like a copy of the above report then please contact 01473 835420.

8.3 Patient and public involvement group (PPIG) The patient and public involvement group (PPIG) for Suffolk Mental Health Partnership Trust has developed from the PPI forum. It was originally established under a Department of Health scheme to set up PPI forums for every NHS Trust throughout the country. Although the PPI forums are no longer formally recognised by the Department of Health, the work proved to be so useful that the Trust decided to provide ongoing support for the activities of a patient and public involvement group. The Department of Health now sponsors local involvement networks (LINks) which are organised on a county basis and cover all aspects of health and social care. PPIG is closely coupled to the Suffolk LINk and seeks to feed in mental health issues of concern as appropriate. PPIG sets out to be a ‘critical friend’ of the Trust. Looking from the perspective of patients or carers work focuses on visits to wards and services with an aim to identify issues of concern that may not be visible to those responsible for organising and operating Trust services. Close attention is also paid to issues highlighted by front-line staff. Monthly meetings with the director of community engagement allow the rapid flagging of problems and concerns at a senior level in the Trust. The group includes members with considerable past experience of working in the NHS, the voluntary sector or wider industry. An additional aim is to identify managerial and organisational issues that impact the delivery of customer orientated services in a timely manner. Particular areas of interest in the last period have included: • • • •

short term ward improvements (ahead of the major new build facilities) to meet immediate patient needs. the efficacy of the new electronic locking system for wards. the waiting list problems of child and adolescent mental health services and attention deficit hyperactivity disorder services. problems related to the workings of discharge procedures for dementia patients.

In addition the group has discussed the differences observed in the organisational working of services across the county with senior Trust managers. These discussions are conducted with a view to achieve best practice throughout the Trust. The group continues to seek new members with the aim of broadening the range of its patient and carer experience, and extending the activities and investigations that can be undertaken. Anyone interested in joining should apply to become a volunteer for the Trust mentioning a specific interest in the PPIG.

9. YOUR INVOLVEMENT As an aspiring foundation trust the stronger our membership is, the stronger we will be when we achieve status. On 31st March 2009 the Trust had recruited just shy of 7000 members (excluding staff) to the foundation trust project. Become a member Membership is free and you don’t need to have any special skills, although you must be at least 12 years old. Suffolk Mental Health Partnership NHS Trust believes that the best way to improve services is to listen to what local people say. If you’re not already a member, please consider joining the foundation trust project. Members can:        

Help us improve our services. Be involved as much or as little as they like. Read our newsletters and regular email updates. Take part in surveys. Help spread the word about our campaigns to tackle mental health stigma. Attend the events put on by the foundation trust project office. Vote in governor elections. Stand as a governor (16 years and over).

No matter how little or much time you have, your membership makes a difference. For details about how to join, see www.newmember.info or write to: Foundation Trust project office St Clement’s Hospital Foxhall Road Ipswich Suffolk IP3 8LS Alternatively, you can join straight away by calling the membership hotline on 0870 7071647. To speak to the foundation trust project team, call 01473 329148 or pop in to see them at St Clement’s Hospital, Ipswich in the conservatory building at the front of the hospital grounds.

10.

BOARD OF DIRECTORS

The Trust board is made up from executive and non-executive directors. The executive directors work on a day-to-day basis at the Trust and have managerial responsibility. The non-executive directors often come from a business or health background and bring a wealth of experience and expertise to advise the board. 10.1

Non-executive directors

Lord Newton of Braintree Appointed chair in February 2009 Experience: • Chair, Council on Tribunals/Administrative Justice, 1999-2009 • Chair, North East Essex Mental Health NHS Trust, 1997-2001 • Chair, Royal Brompton and Harefield NHS Trust, 2001-2008 • House of Lords, from 1997 • Member of Parliament for Braintree, 1974-1997 • Parliamentary Under-Secretary of State 1982-1983 • Minister of State 1983-1986 • Minister for Health 1986-1988 • Chancellor of the Duchy of Lancaster 1988-1989 • Secretary of State for Social Security 1989-1992 • Lord President of the Council and Leader of the House of Commons 1992-1997 Qualifications: • BA Hons in philosophy, politics and economics Committee membership: • Nominations committee • Remunerations committee Interests: • Member, Lloyds pharmacy Healthcare Advisory Panel • Council member of the Institute of Directors • Chair, Help the Hospices • Various presidential/honorary positions, including president and former chair of East Anglia’s Children’s Hospices (tenants of Trust at Walker Close) • Wife is a non-executive director of Mid Essex Primary Care Trust and a member of Braintree Council • Trustee, Corda • Trustee, Pharmacy Practice Research Trust • Trustee, National Benevolent Fund for the Aged • Chair, Honours Committee for Community, Voluntary and Local Service Bob Higham Appointed non-executive director in December 2005

Re-appointed for 6 months until end May 2010 Experience: • 34 years in communication and IT engineering and management • Including 10 years’ experience outsourcing (including privately-funded initiatives - PFI) IT solutions to local government, health, defence and banking sectors • School governor including chair of governors • Humanistic and cognitive behavioural counselling, coaching and business mentoring (private practice) • Organisational change, quality management and process consultancy • Quality management and organisational development (including process design and measurement, ISO9000 from the International Organisation for Standardisation, TickIT for IT systems, European Foundation for Quality Management (EFQM), audit.) • Director and company secretary of a small local business Qualifications: • Diploma in management studies (DMS) (1988), • EFQM assessor, ISO auditor • Diploma in counselling (1996) • CITP - Chartered Information Technology Professional • MBCS - Member of the British Computer Society • MBACP - Member of the British Association for Counselling and Psychotherapy • Certificate in mental health studies (Open) • NHS non-executive director development programme, CASS Business School (2009) Committee membership: • Mental Health Act committee • Audit committee Interests: • Spouse provides care assessment consultancy as part of learning disability reprovision programme and untoward incident investigations Peter Collicott Appointed non-executive director in December 2005, reappointed December 2009 Experience: • 31 years in local government in five authorities • Finance, IT, housing, Social Services, economic regeneration • 13 years as director of finance for Suffolk Coastal District Council Qualifications: • BSc (Hons) Mathematical Studies (1974) • CIPFA - Chartered Institute of Public Finance and Accountancy (1979)

•

NHS non-executive director development programme, CASS Business School (2010)

Committee membership: • Chair, charitable funds committee • Audit committee • Finance committee • Chair, Investment committee Interests: Chairman of Ipswich Inflammatory Spinal Group, a voluntary organisation which uses facilities at Ipswich Hospital NHS Trust. Paula Kerr Appointed non-executive director in April 2007 Experience: • Independent consultant in business development and marketing, 20012008 • Marketing and strategic product development in roles in UK and international pharmaceuticals (Glaxo Holdings plc, SmithKline Beecham Pharmaceuticals) 1979 -1998 • Bedfordshire and Hertfordshire Strategic Health Authority, nonexecutive director, 2001-2006 • Trustee, Livability, from 2008 Qualifications: • MSc Health Management (Distinction), City University, London (2006) Research project on the effectiveness of purchasing and its role in improving mental health system performance in Bedfordshire and Hertfordshire was used to inform regional and national policy • BSc Microbiology (2:1), Bristol University (1979) • NHS non-executive director development programme, CASS Business School (2009) Committee membership: • Nominations Committee • Remuneration Committee • Finance Committee • Mental Health Act Hospital Managers’ Committee Interests: • Trustee, Livability from 2008 Laurence Morgan Appointed non-executive director in December 2007 Experience: • Commercial finance Trinity Mirror, York International and Johnson Controls (2001 onward)

• •

Revenue growth, cost management, business process reengineering and change management (2001-2006) Business development, Johnson Controls, (2006 onward)

Qualifications: • Associate member of Chartered Institute of Management Accountants (CIMA) (2000) • Fellow CIMA (2007) • NHS non-executive director programme, CASS Business School (2009) Committee membership: • Chair, audit committee • Chair, finance committee • Remuneration committee Interests: • None declared John Hume Appointed non-executive director in November 2008 Experience: • Senior executive, general management, human resources and communications roles in Johnson and Johnson, SC Johnson, Glaxo, GlaxoWellcome and group human resources director at the Royal London Group 1998-2007 • Chief executive, EAR Ltd1997-1998 • Non-executive director, Firstsite Gallery: chair of audit committee, member of remuneration and nominations committees, from 2003 • Non-executive director, Stevenage CommunityTrust 1992-1997 Qualifications: • HND business studies 1966 -1968 • Postgraduate diploma in industrial administration, University of Bath (1969) • NHS non-executive director development programme, CASS Business School (2009) Committee membership: • Chair, remuneration committee • Nominations committee • Finance committee Interests: • Trustee director with Firstsite (visual arts charity) 10.2

Executive team

10.2.1 Board members Mark Halladay

Appointed chief executive in June 2004 Experience: • 25 years in the NHS as a general manager • 18 years on NHS Boards • Three chief executive positions over 13 years • Primary care NHS management (Chelmsford PCT) • Service modernisation (Essex and Suffolk 1997 to present) • Policy analysis, UCSF Qualifications: • Bachelor of arts (BA Hons) (1982) • Master of arts (MA) (1984) • Master of business administration (MBA) (1997) • Certificate in Health Economics (1990) • Harkness Fellow in International Health Policy Research Committee membership: • Nominations committee Interests: • Trustee of social care charity Adepta • Member Suffolk steering group for learning disabilities reprovision Robert Bolas Appointed deputy chief executive and director of nursing in February 2003 Experience: • 36 years in the NHS in clinical and management posts • Two year secondment to Department of Health (1998-2000) • Director of nursing and deputy chief executive posts since 1989 Qualifications: • Bachelor of arts (Open, 1986) • Diploma in management studies • Registered mental nurse, registered general nurse Committee membership: • Chair, complaints and compliments committee • Chair, research governance committee • Chair, clinical and service governance committee • Audit committee, in attendance Interests: • None declared Nick Gerrard Appointed director of finance in September 2007 Experience: • 26 years’ experience in NHS finance

• • • • • • • •

Board level posts in NHS regional office, acute, mental health and community trusts Roles included financial turnaround, information management and technology, procurement, estates, contracting and privately-financed initiatives (PFIs) Health policy and regional management (Department of Health) Deputy chief executive Private sector consultancy Member of the Healthcare Financial Management Association (HFMA) financial management and research committee Member of the Department of Health mental health costing group Member of Foundation Trust Network

Qualifications: • Bachelor of arts (BA Hons) (1981) • Master of science in fiscal studies (1982) • Chartered Institute of Public Finance and Accountancy (CIPFA) (1988) • Strategic financial leadership programme at Cass Business School, City of London (2008) Committee membership: • Charitable funds committee • Finance committee • Audit committee, in attendance Interests: • Trustee / independent director and chair of audit committee of Firstsite, a visual arts charity in Colchester Dr Tim Webb Appointed medical director in May 2003 Experience: • Consultant in adult psychiatry since 1987 • Invited specialist contributor to National Service Framework adult mental health (1999), steering group for layard report implementation (2006) • Member, faculty executive for general and community psychiatry, Royal College of Psychiatrists (1996-2003) • Chair, NHS Eastern region specialist advisory group (1999-2003) • Member, medical directors’ executive, Royal College of Psychiatrists (from 2006) Qualifications: • Bachelor of medicine, bachelor of surgery (MBChB) (1977) • Member of the Royal College Psychology (1983) • Fellow of Royal College Psychology (2001) Committee membership: • Information management committee

• •

Research governance committee Clinical and service governance committee

Interests: • Managing editor, director and majority shareholder of small publishing company Cogan and Matter Ltd Sandra Cowie Director of mental health and social care, (appointed) July 2003 Experience: • 35 years in the NHS, 28 years in range of mental health services including six years in reprovision of Friern Barnet Hospital • 14 years’ senior manager, five at board level as operational director • Three years as voluntary director on specialist mental health housing boards, including the Dalco rehabilitation scheme and Metropolitan Housing Trust Qualifications: • Registered mental nurse • Registered general nurse • Diploma in management studies – Part 1 Committee membership: • Mental Health Act committee Interests: • None declared Daren Clark Director of specialist services, (appointed) September 2003 Experience: • 29 years working in NHS as clinician and manager • Lead for three institutional reprovision projects • Project lead for modernisation of specialist health services in four counties, integration of operational services with county councils Qualifications: • Registered nurse, learning disability • Registered mental nurse • Postgraduate diploma in art therapy • Postgraduate diploma in management, NVQ • Level 5 in management Committee membership: • Mental Health Act committee Interests: • None declared

10.2.2 Non-board members Robert Nesbitt Director of community engagement, (appointed) June 2006 Experience: • 15 years’ social services experience in various London boroughs, including nine years working in local government at a managerial level • Ten years’ NHS management experience, including seven at board level Qualifications: • Master of Arts in Psychology (Hons) (1982) • Diploma in psychiatric social work (1985) • Certificate of qualification in social work (1985) • Registered social worker (General Social Care Council) • Certificate in management (1990) • PRINCE2 registered practitioner (2007) Interests: • Trustee Ipswich Umbrella Trust, a homelessness charity David Leckie Director of environmental performance, (appointed) August 2002 Experience: • 20 years on NHS boards • Eight years directing shared support services, as well as estates and facilities functions • 24 years developing estate management and facilities management services • 30 years in NHS management of acute, mental health and primary care estate portfolios and projects Qualifications: • Chartered Institute of Building Part 1 • Higher national certificate (HNC) in building Interests: • None declared Kate Coplestone Director of human resources (appointed) September 2009 Experience: • 15 years human resources and organisational development experience in ‘blue chip’ companies • Strategic planning • Leadership development • Employee engagement consultancy • Change management consultancy

Qualifications • Bachelor of Arts in Business studies and French (BA Hons) (1992) • Diploma in personnel management (1993) • NLP (Neuro-linguistic programming) master practitioner (2003) Committee Membership • Finance committee Interests: • None declared

11.

HELPING PEOPLE MAKE THE MOST OF THEIR LIVES

Becoming one of the 10 best mental health trusts in the UK will help us achieve our mission of â&#x20AC;&#x2DC;helping people make the most of their livesâ&#x20AC;&#x2122;. 11.1

5 ways we are helping people make the most of their lives

We are aiming to achieve this aim through five principle objectives: 1. To continuously improve all our services. 2.

Improve the measured quality of services year on year.

To build and maintain strong financial and business management as a Foundation Trust.

To make the Trust a great place for great people to work.

To give the public benefit back to the communities we serve.

There are a number of underpinning strategies which will help us deliver these objectives. These include: Quality and innovation: we are developing an approach to quality that is focused on the three key elements â&#x20AC;&#x201C; patient experience, safety and effectiveness. Information: improving the quality of information across the Trust is essential to good patient care and improved quality of service. Environmental sustainability: we are committed to excellence in our environmental performance and the strategy aims to ensure that all service developments take due account of their environmental impact. Estates: the strategy is focused on the modernisation and rationalisation of our hospital and community sites. Marketing: the market in mental health and related services is maturing and we have to respond to the changing conditions. Human resources: this is critical to making the Trust a great place for great people to work. Equality and human rights / patient and public involvement: help us shape how services work by engaging with service users, family carers and the wider public. Emergency planning: the Trust is prepared to manage unexpected or exceptional incidents to keep service disruptions to a minimum

12. OUR FINANCES These are the summarised annual accounts for the Trust. The Trust was set a control target of a £1.5 million surplus. This target was achieved, although technical adjustments, as recognised by the Department of Health, brought the final surplus down to £1,115 million. The Trust’s performance against key targets for 2009/10 is as follows: Break-even The Trust is required to expend no more than the income it receives. The surplus of £1,115,000 means that the break-even target was achieved. In achieving its control target surplus the Trust successfully managed to meet a cost improvement target of £2.3 million. External Financing Limit This target is designed to ensure the Trust remains within a cash limit. The Trust undershot the target by £7,028,000, mainly due to delays on new build projects over the winter. However, the undershoot meets this statutory duty. Capital Absorption Rate The Trust is required to absorb the cost of capital at a rate of 3.5% of average net relevant assets. The rate is calculated as the percentage that dividends paid on public dividend capital, totalling £1,132,000 bears to the average relevant net assets of £32,367,000, that is 3.5%. Better Payment Practice Code The Code requires the Trust to pay all valid invoices by the due date or within 30 days of receipt of goods or a valid invoice, whichever is the later. Details of compliance with the Better Payment Practice Code are given on page 67. Prompt Payments Code The Trust has applied to sign up to this code and is awaiting confirmation of its status. Management costs Expenditure on management and administration costs during the year was £4,903,000, (£4,264,000 in 08/09) which represents 6.0% (5.4% in 08/09) of income. Capital expenditure Capital expenditure amounted to £13,778,000 which is within the Capital Resource Limit set for the year. Expenditure was incurred on a wide range of schemes, including: New inpatient wards on Ipswich Hospital site (Heath Road) New low secure unit on St Clement’s Hospital Site Information management and technology systems St Mary’s site (G Block, Bury St Edmunds) refurbishment

£’000 10,343 2,319 514 152

Health and safety

104

Other capital schemes under £100,000 Eastgate / Westgate Ward conversion (Bury St Edmunds) Sutton Ward conversion (Ipswich) Mariner House (lease property) conversion

£’000 70 66 60

Asset revaluation The Trust commissioned a qualified valuer (Boshier & Co) to undertake a Modern Equivalent Asset valuation (as stipulated by the Department of Health) of land, buildings and dwellings as at 31 March 2010 which, due to the current economic climate, led to a price impairment of approximately £1.8 million. This has been reflected both on the Income and Expenditure statement (£399,000) and as an adjustment to the Revaluation Reserve (£1,430,000) as at 31 March 2010. Pensions The Trust is an employer member of the NHS Pension Scheme and full details of how this operates are provided in accounting policy note 11 of the Trust’s Accounts. The remuneration report on page 67 of this document relates to the Trust’s senior managers. International Financial Reporting Standards (IFRS) The Trust has prepared its 2009/10 accounts under International Financial Reporting Standards. Comparative figures for 2008/09 are stated using IFRS which were audited during 2009. External auditor The Trust’s external auditor is the Audit Commission. The external auditor is responsible for issuing an opinion and certificate on the financial statements, reviewing and reporting on the financial aspects of the Trust’s corporate governance arrangements and reviewing the Trust’s arrangements to secure economy, efficiency and effectiveness in its use of resources.

STATEMENT OF COMPREHENSIVE INCOME FOR THE YEAR ENDED 31 March 2010 2009/10 2008/09 ÂŁ000 ÂŁ000 Revenue Revenue from patient care activities 79,857 76,397 Other operating revenue 12,770 14,092 Operating expenses (89,835) (86,941) Operating surplus (deficit) 2,792 3,548 Finance costs: Investment revenue 43 602 Other gains and (losses) 33 1 Finance costs (621) (611) Surplus/(deficit) for the financial year 2,247 3,540 Public dividend capital dividends payable (1,132) (2,081) Retained surplus/(deficit) for the year 1,115 1,459 Other comprehensive income Impairments and reversals Gains on revaluations Receipt of donated/government granted assets Net gain/(loss) on other reserves (e.g. defined benefit pension scheme) Net gains/(losses) on available for sale financial assets Reclassification adjustments: - Transfers from donated and government grant reserves - On disposal of available for sale financial assets Total comprehensive income for the year

(1,430) 0 0

(11,642) 2,140 0

0 0 (315)

0 0 (8,043)

STATEMENT OF FINANCIAL POSITION AS AT 31 March 2010 31 March 2010 £000 Non-current assets Property, plant and equipment 54,002 Intangible assets 388 Investment property 0 Other financial assets 0 Trade and other receivables 73 Total non-current assets 54,463 Current assets Inventories 41 Trade and other receivables 2,357 Other financial assets 0 Other current assets 0 Cash and cash equivalents 11,682 14,080 Non-current assets held for sale 430 Total current assets 14,510 Total assets 68,973 Current liabilities Trade and other payables (12,203) Other liabilities (13) DH Working capital loan 0 DH Capital loan 0 Borrowings (131) Other financial liabilities 0 Provisions (1,311) Net current assets/(liabilities) 852 Total assets less current liabilities 55,315 Non-current liabilities Borrowings (4,463) DH Working capital loan 0 DH Capital loan 0 Trade and other payables (126) Other financial liabilities 0 Provisions (3,855) Other liabilities (163) Total assets employed 46,708

31 March 2009 £000

1 April 2008 £000

45,701 129 0 0 209 46,039

55,286 163 0 0 0 55,449

42 2,640 0 0 16,093 18,775 0 18,775 64,814

39 3,151 0 84 16,045 19,319 141 19,460 74,909

(7,387) 0 0 0 (140) 0 (2,061) 9,187 55,226

(7,890) 0 0 0 (132) 0 (2,003) 9,435 64,884

(4,583) 0 0 (117) 0 (4,794) 0 45,732

(4,701) 0 0 (97) 0 (6,311) 0 53,775

Financed by taxpayers' equity: Public dividend capital Retained earnings Revaluation reserve Donated asset reserve Government grant reserve Other reserves Total taxpayers' equity

25,448 5,745 15,515 0 0 0 46,708

24,157 4,166 17,409 0 0 0 45,732

24,157 2,144 27,474 0 0 0 53,775

STATEMENT OF CHANGES IN TAXPAYERS' EQUITY

Changes in taxpayers’ equity for 2009/10 Balance at 1 April 2009 Total Comprehensive Income for the year Retained surplus/(deficit) for the year Transfers between reserves Impairments and reversals Net gain on revaluation of property, plant, equipment Net gain on revaluation of intangible assets Net gain on revaluation of financial assets Net gain on revaluation of non current assets held for sale Receipt of donated/government granted assets Net gain/loss on other reserves (e.g. defined benefit pension scheme) Movements in other reserves Reclassification adjustments: - transfers from donated asset/government grant reserve - on disposal of available for sale financial assets Reserves eliminated on dissolution Originating capital for Trust establishment in year New PDC received PDC repaid in year PDC written off Other movements in PDC in year Balance at 31 March 2010

Public dividend capital (PDC)

Retained earnings

Revaluation reserve

Donated asset reserve

Gov’t grant reserve

Other reserves

Total

£’000

24,157

4,166

17,409

45,732

0 0 0

1,115 464 0

0 (464) (1,430)

0 0 0

1,115 0 (1,430)

0 0

0 1,291 0 0

0 0 0 0

0 1,291 0 0

0 25,448

0 5,745

0 15,515

0 0

0 46,708

STATEMENT OF CASH FLOWS FOR THE YEAR ENDED 31 March 2010 2009/10 £’000 Cash flows from operating activities Operating surplus/(deficit) 2,792 Depreciation and amortisation 2,178 Impairments and reversals 399 Net foreign exchange gains/(losses) 0 Transfer from donated asset reserve 0 Transfer from government grant reserve 0 Interest paid (457) Dividends paid (1,174) (Increase)/decrease in inventories 1 (Increase)/decrease in trade and other receivables 461 (Increase)/decrease in other current assets 0 Increase/(decrease) in trade and other payables 1,836 Increase/(decrease) in other current liabilities 176 Increase/(decrease) in provisions (1,853) Net cash inflow/(outflow) from operating activities 4,359 Cash flows from investing activities Interest received (Payments) for property, plant and equipment Proceeds from disposal of plant, property and equipment (Payments) for intangible assets Proceeds from disposal of intangible assets (Payments) for investments with DH (Payments) for other investments Proceeds from disposal of investments with DH Proceeds from disposal of other financial assets Revenue rental income Net cash inflow/(outflow) from investing activities Net cash inflow/(outflow) before financing Cash flows from financing activities Public dividend capital received Public dividend capital repaid Loans received from the DH Other loans received Loans repaid to the DH Other loans repaid Other capital receipts Capital element of finance leases and PFI Cash transferred to NHS Foundation Trusts Net cash inflow/(outflow) from financing Net increase/(decrease) in cash and cash equivalents Cash (and) cash equivalents (and bank overdrafts) at the beginning of the financial year Effect of exchange rate changes on the balance of cash held in foreign currencies Cash (and) cash equivalents (and bank overdrafts) at the end of the financial year

2008/09 £’000 3,548 2,610 10 0 0 0 (450) (2,081) (3) 386 0 (590) 0 (1,620) 1,810

43 (10,454) 813 (320) 0 0 0 0 0 0 (9,918) (5,559)

602 (2,376) 142 (20) 0 0 0 0 0 0 (1,652) 158

1,291 0 0 0 0 0 0 (143) 0 1,148

0 0 0 26 0 0 0 (136) 0 (110)

(4,411)

16,093

16,045

11,682

16,093

Please note that the summarised financial statements contained in the above Statement of Comprehensive Income and within the Statement of Financial Position, the Statement of Changes in Taxpayers’ Equity and the Statement of Cash Flows (which are also within this report) may not include sufficient information for a full understanding of the Trust’s financial position and performance. For this purpose a full set of accounts, which also include the Statement on Internal Control and the Statement of Chief Executive’s Responsibilities may be obtained by writing to the Director of Finance, Suffolk Mental Health Partnership NHS Trust, Suffolk House, St Clement’s Hospital, Foxhall Road, Ipswich, IP3 8LS. Telephone 01473 329620 or fax 01473 329019. A printed version may be subject to a reasonable copying charge. Alternatively, you may find a copy on our website. www.smhp.nhs.uk Better Payment Practice Code measure of compliance Total non-NHS trade invoices paid in the year Total non NHS trade invoices paid within target Percentage of non-NHS trade invoices paid within target Total NHS trade invoices paid in the year Total NHS trade invoices paid within target Percentage of NHS trade invoices paid within target

2009/10 Number

£000

2008/09 Number

£000

29,399

30,720

29,283

26,931

27,171

29,111

26,650

24,462

92%

95%

91%

714

5,416

685

3,802

621

4,685

530

2,934

87%

77%

The Better Payment Practice Code requires the Trust to aim to pay all undisputed invoices by the due date or within 30 days of receipt of goods or a valid invoice, whichever is later.

Remuneration report Membership of the Trust’s remuneration committee comprises the Trust chairman and at least two non-executive directors. Current levels of remuneration reflect those recommended in the ‘Trust executive and pay report’ of May 2009. All directors have objectives agreed at the beginning of each financial year. Formal assessment against achievement of objectives and general performance, particularly at Board, is made at the end of each financial year. Any issues relating to performance are reported to the remuneration committee. Senior managers hold standard NHS contracts. The Trust made no compensation payments to former senior managers or to third parties for services as a senior manager during 2009/10.

Remuneration

Name and title

Lord Antony Newton, chairman Mr John Hume, nonexecutive director Mr Robert Higham, nonexecutive director Mr Peter Collicott, nonexecutive director Ms Paula Kerr, nonexecutive director Mr Lawrence Morgan, non-executive director Mr Mark Halladay, chief executive Mr Nick Gerrard, finance director Mr Robert Nesbitt, director of community engagement Mr Daren Clark, director of specialist services Dr Timothy Webb, medical director Mr David Leckie, director of environmental performance Mr Robert Bolas, director of nursing and modernisation Mrs Sandra Cowie, director of mental health and social care

Salary

2009-10 Other remuneration

(bands of £5000) £000

2008-09 Other remunerati on

Benefits in kind

Salary

(bands of £5000) £000

Rounded to the nearest £100

(bands of £5000) £’000

Rounded to the nearest £100

20 - 25

0-5

5 - 10

0-5

5 - 10

120 - 125

110 - 115

100 - 105

90 - 95

65 - 70

60 - 65

80 - 85

75 - 80

105 - 110

70 - 75

100 - 105

65 - 70

70 - 75

65 - 70

90 - 95

85 - 90

80 - 85

Benefits in kind

Pension benefits Real increase in pension at age 60 (bands of £2,500)

Real increase in pension lump sum at aged 60 (bands of £2,500)

Total accrued pension at age 60 at 31 March 2010 (bands of £5,000)

Lump sum at age 60 related to accrued pension at 31 March 2010 (bands of £5,000)

Cash Equivalent Transfer Value at 31 March 2010

Cash Equivalent Transfer Value at 31 March 2009

Real increase in Cash Equivalent Transfer Value

Employer's contribution to stakeholder pension

£’000

£’00

Mark Halladay

2.5 - 5

7.5 - 10

40 - 45

130 - 135

859

701

123

Nicholas Gerrard

0 - 2.5

5 - 7.5

25 - 30

85 - 90

585

494

Robert Nesbitt

0 - 2.5

2.5 - 5

20 - 25

60 - 65

399

343

Daren Clark

0 - 2.5

2.5 - 5

25 - 30

80 - 85

408

20 - 22.5

62.5 - 65

80 - 85

245 - 250

1,890

1232

597

David Leckie Robert Bolas

0 - 2.5 0

5 - 10 40 - 45

25 - 30 130 -135

223 0

191 1054

22 0

0 0

Sandra Cowie

0 - 2.5

2.5 - 5

40 - 45

125 - 130

881

779

Name

Timothy Webb

As non-executive members do not receive pensionable remuneration, there will be no entries in respect of pensions for non-executive members. A Cash Equivalent Transfer Value (CETV) is the actuarially assessed capital value of the pension scheme benefits accrued by a member at a particular point in time. The benefits valued are the member's accrued benefits and any contingent spouse's pension payable from the scheme. A CETV is a payment made by a pension scheme or arrangement to secure pension benefits in another pension scheme or arrangement when the member leaves a scheme and chooses to transfer the benefits accrued in their former scheme. The pension figures shown relate to the benefits that the individual has accrued as a consequence of their total membership of the pension scheme, not just their service in a senior capacity to which the disclosure applies. The CETV figures and the other pension details include the value of any pension benefits in another scheme or arrangement which the individual has transferred to the NHS pension scheme. They also include any additional pension benefit accrued to the member as a result of their purchasing additional years of pension service in the scheme at their own cost. CETVs are calculated within the guidelines and framework prescribed by the Institute and Faculty of Actuaries. Real increase in CETV - This reflects the increase in CETV effectively funded by the employer. It takes account of the increase in accrued pension due to inflation, contributions paid by the employee (including the value of any benefits transferred from another pension scheme or arrangement) and uses common market valuation factors for the start and end of the period.

STATEMENT OF THE CHIEF EXECUTIVE'S RESPONSIBILITIES AS THE ACCOUNTABLE OFFICER OF THE TRUST The chief executive of the NHS has designated that the chief executive should be the accountable officer to the Trust. The relevant responsibilities of accountable officers are set out in the Accountable Officers Memorandum issued by the Department of Health. These include ensuring: - that there are effective management systems in place to safeguard public funds and assets, and assist in the implementation of corporate governance. - value for money is achieved from the resources available to the Trust. - the expenditure and income of the Trust has been applied to the purposes intended by Parliament, and conform to the authorities which govern them. - that effective and sound financial management systems are in place. - that the annual statutory accounts are prepared in a format directed by the Secretary of State with the approval of the Treasury to give a true and fair view of the state of affairs at the end of the financial year, and the income and expenditure, recognised gains and losses and cash flows for the year. To the best of my knowledge and belief, I have properly discharged the responsibilities set out in my letter of appointment as an accountable officer. STATEMENT ON INTERNAL CONTROL 2009/10 The Board is accountable for internal control. As accountable officer and chief executive of this board, I have responsibility for maintaining a sound system of internal control that supports the achievement of the organisationâ&#x20AC;&#x2122;s policies, aims and objectives. I also have personal responsibility for safeguarding the public funds and the organisationâ&#x20AC;&#x2122;s assets as set out in the Accountable Officer Memorandum. As accountable officer, I have overall responsibility for ensuring that adequate risk management arrangements are in place within the Trust and I am accountable for the quality of clinical care. Responsibility for various aspects of the risk management system is delegated to key senior staff throughout the organisation. In order to integrate the governance structure the Trust Board has established an Audit Committee. Internal and external audit report to the Audit Committee as does the local counter fraud specialist. In support of the Board there is a comprehensive governance structure with agreed reporting responsibility and accountability in place to ensure that risk

issues are managed and that the Trust Board is kept informed of risks and required associated plans of action. Securing effective partnerships with social care and Primary Care Trusts is a key objective of our organisation, and there is a joint approach to managing risk across the health system. There is a managed process for reporting significant risks and incidents to the East of England Strategic Health Authority and NHS Suffolk. The system of internal control is designed to manage risk to a reasonable level rather than to eliminate all risk of failure to achieve policies, aims and objectives. It can therefore only provide reasonable and not absolute assurance of effectiveness. The system of internal control is based on an ongoing process designed to identify and prioritise the risks to the achievement of the organisation’s policies, aims and objectives, and to evaluate the likelihood of those risks being realised and the impact should they be realised, and to manage them efficiently, effectively and economically. This summary highlights the overall purpose of the internal control statement. The full statement covers the following specific areas of work management and assurance: •

Capacity to handle risk

•

The risk and control framework

•

Review of effectiveness

•

Accountability of the Committees

The full statement also identifies specific significant control issues around the most significant risks to the Trust’s business. Mark Halladay, chief executive. I am happy that this annual report is a true reflection of the work carried out by Suffolk Mental Health Partnership NHS Trust. Mark Halladay, Chief executive

Independent auditor’s report to the board of directors of Suffolk Mental Health Partnership NHS Trust I have examined the summary financial statement for the year ended 31 March 2010 which comprises the Statement of Comprehensive Income, the Statement of Financial Position, the Statement of Changes in Taxpayer’s Equity and the Statement of Cash Flows set out on pages 62 to 66. This report is made solely to the Board of Directors of Suffolk Mental Health Partnership NHS Trust in accordance with Part II of the Audit Commission Act 1998 and for no other purpose, as set out in paragraph 49 of the Statement of Responsibilities of Auditors and of Audited Bodies prepared by the Audit Commission. Respective responsibilities of directors and auditor The directors are responsible for preparing the Annual Report. My responsibility is to report to you my opinion on the consistency of the summary financial statement within the Annual Report with the statutory financial statements. I also read the other information contained in the Annual Report and consider the implications for my report if I become aware of any misstatements or material inconsistencies with the summary financial statement. The other information comprises only the Foreword, Our Finances and How Our Services Are Supported. I conducted my work in accordance with Bulletin 2008/03 “The auditor's statement on the summary financial statement in the United Kingdom” issued by the Auditing Practices Board. My report on the statutory financial statements describes the basis of my opinion on those financial statements. Opinion In my opinion the summary financial statement is consistent with the statutory financial statements of the Suffolk Mental Health Partnership NHS Trust for the year ended 31 March 2010. I have not considered the effects of any events between the date on which I signed my report on the statutory financial statements (10 June 2010) and the date of this statement. Rob Murray Officer of the Audit Commission Date: 9 July 2010 Regus House, 1010 Cambourne Business Park, Cambourne, Cambridge, CB23 6DP