Insight Spring Summer 2016 by made agency

Insight Spring/Summer 2016 | Issue 91

CELEBRATING EXCELLENCE IN MENTAL HEALTH SEE INSIDE FOR A TRUST AWARDS SPECIAL CELEBRATING STAFF WHO PUT PEOPLE FIRST

NEW WELLBEING SERVICE TO LAUNCH IN SUFFOLK MORE SUPPORT WILL BE ON OFFER

AWARDS SPECIAL

FREE

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Featured in this issue… Spotlight on Wellbeing Trust wins Primary Care Mental Health service for Suffolk

Spotlight on Gender Dysphoria “In the end I learned to be myself. That made me the happiest I have ever been” 8 Insight on Children, Families and Young People Major improvements planned to young people’s mental health services

Work to start on state-of-the-art young person’s mental health unit 14 Innovative partnership boosts young people’s recovery

46 SPOTLIGHT ON AWARDS 2016

Spotlight on Life After Suicide It is important to ask for help

Suicide – facts and figures 23 Supporting the survivors of suicide 24

Additional emotional and wellbeing support for young people in suffolk 16 Standing ovation for unique and inspiring project

Giving people a voice

Extra support for young people

“I don’t want to pretend he never existed”

“People don’t know what to say” 27 “Giving people the chance to talk is essential”

Our Governors: Standing Up For Mental Health Vicki’s drive to make difficult conversations easier

New Governor recruits help to make young people’s voices heard 32 Dementia in perspective

Meet our new Governors

Shining a light on our Governors

Insight on Improving Quality

14 INSIGHT ON CHILDREN, FAMILIES AND YOUNG PEOPLE

New values aim to ‘Put People First’

Additional beds open to improve mental health care

Helping hand for Northgate patients

Five-year strategy launches

Innovative equality project picks up prize

Research work highlighted

Spotlight on Putting People First Awards 2016 Celebrating the staff who ‘Put People First’

Insight on Improving Services Together New strategy to ensure vital voices are heard 56 Special events help care for carers 58 ‘I owe them a debt that I cannot repay…’

A carer’s story: ‘The professionals are not the only experts’

Survey results show improvement in NSFT’s community services 41

Offering vital help to dedicated carers – carer’s leads are making a real difference 63

Mock CQC inspection shows progress being made

Commitment to carers recognised with gold star’ 66

2 Norfolk and Suffolk NHS FT (NSFT)

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Improving services through special roadshows

Insight on Working With Us Academy celebrates its first graduation

Double role for NSFT’s Gary

A WORD FROM THE CHAIR: AGM TURNS THE SPOTLIGHT ON IMPROVEMENT Hello and welcome to the latest edition of Insight magazine.

Newsround Independent experts appointed to lead unexpected deaths inquiry 85 Diary Dates

ABOUT INSIGHT Insight is produced by the NSFT Communications Team, working with service users, carers and mental health professionals to bring you stories about mental health issues that affect people in Norfolk and Suffolk. You can read Insight online at: www.nsft.nhs.uk/insight If you have any feedback, please email ‘Insight Editor’ at: nsft.communications@ nsft.nhs.uk If you are affected by any of the issues covered and are unsure how to access support, contact our Patient Advice and Liaison Service (PALS) - contact details on the back cover of this issue.

SUBSCRIBE FOR FREE If you’ve enjoyed reading Insight you might like to subscribe to our online version for FREE. You can do this by simply filling in our subscription form at www.nsft.nhs.uk/insight. We will then let you know when the next issue is available.

It has been a busy time for NSFT since the last issue was published, working hard to improve our services and to transform our organisation. This edition brings you up-to-date on some of the initiatives, as well as addressing some of the issues and challenges we still face. We also have some powerful insights into the lives of our carers at their most difficult times. Spotlight on Suicide Awareness (pages 21-29) talks to the relatives of those who have died by suicide, and we hear the story of one man who made two serious suicide attempts, but now lives a fulfilled life. Insight hears about the experiences of one of our service users and the effect being sent ‘out of area’ had upon him when no local beds were available. I’d also encourage you to read the humorous and touching account of a mother and her son, and how they live with his lifelong mental health condition (page 61). I was immensely proud to chair the AGM in the autumn, seeing the very real efforts being made by our staff to transform our Trust into a better place to receive services and a better place to work. During the meeting we unveiled our ‘Improving Services Together’ strategy (more on page 56) and launched our Trust’s new values to ensure that service users and carers have the best possible experience when accessing mental health care. (See page 38)

The year ahead for the NHS will not be an easy one. Funding pressures remain, demand for services will continue to be high and, at NSFT, we expect the CQC to re-inspect our Trust in the summer months. We are doing everything we can to be prepared, with clear plans in place to address the challenges we have faced around quality, finances and leadership. To help us achieve this will be our new Finance Director, Julie Cave and three new Non-Executive Directors, who I am confident will help strengthen our organisation further. As will our new Governors. Meet them on pages 34, 35 and 36. Thank you to everyone who has shared their story with us, helping us to raise awareness and overcome stigma around mental health conditions. We hope you all find this issue thought-provoking.

Gary Page Chair of Norfolk and Suffolk NHS Foundation Trust

Insight | Spring/Summer 2016 3

––– SPOTLIGHT ON WELLBEING –––

Trust wins Primary Care Mental Health service for Suffolk People of all ages will get easier access to support for anxiety, stress and depression as well as help to safeguard their wellbeing when a new-look service launches in Suffolk this autumn.

SFT has been awarded a five-year contract to run the Suffolk Primary Care Mental Health Service from September, otherwise known as Wellbeing Suffolk. The decision was made by West Suffolk and Ipswich and East Suffolk Clinical Commissioning Groups (CCGs) and Suffolk County Council following a competitive tendering process. The new service will expand and improve on the existing Suffolk Wellbeing Service, also delivered by the Trust, and will offer help to more people each year while supporting people of all ages. In addition, the service will offer talking therapies to those with more serious mental health problems who would traditionally be referred to specialist mental health services. Its aim is to reach as many patients as early as possible within GP practices or community settings, creating greater access and better responsiveness and focusing on early intervention to help prevent issues in the longer term. Another key component of the new service will be closer working with the third sector and other partners to offer support within communities, while clinicians will also work with service users to develop new interventions.

Nesta Reeve, Consultant Clinical Psychologist and NSFT’s Wellbeing Clinical Lead said: “We are delighted that we have been selected to run this new-look service, which will offer easy access help to people of all ages. “The service will be very innovative and creative. We will work proactively with employers, councils, education providers, public health and other NHS providers to focus on what they can do to help people have a good life, rather than waiting for them to become ill then providing treatment. “We will also be treating people holistically – if someone is depressed

4 Norfolk and Suffolk NHS FT (NSFT)

because of social isolation, for example, we will look at how they increase their connections, such as by starting an evening class or joining a club. “From the start of the service, we will co-produce interventions with our service users so that we know they are what people want and need. By working with our stakeholders, evaluating our data, and reviewing outcomes, we will be best placed to know what works and what doesn’t, which will allow us to put our resources to the best possible use.” To deliver the service, NSFT will subcontract a wide variety of community and third sector organisations to

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provide a range of interventions to boost wellbeing, such as support for carers. As well as allowing the service to reach more people, this will also help build resilience within the community by boosting the funding available to the third sector.

“WE ARE REALLY LOOKING FORWARD TO WORKING CLOSELY AND COLLABORATIVELY WITH OUR SERVICE USERS, PARTNERS AND OTHER LOCAL GROUPS”

Anna Vizor, Acting Service Manager, said: “This new-look service will build on the success of the existing Suffolk Wellbeing Service, which has helped thousands of people return to a productive life since we launched it more than five years ago. “It will focus on communities, working with the third sector and other partners to provide services or support people so that they can become integrated within their community more effectively, in turn reducing isolation and preventing ill health. This will include working more closely with public health to look at what communities need to stop people from getting unhappy in the first place. “We are really looking forward to working closely and collaboratively with our service users, partners and other local groups over the coming months to develop our plans further so that we can make sure our service truly meets the needs of the people of Suffolk.” Dr John Hague, mental health lead for NHS Ipswich and East Suffolk

CCG, said: “Having good mental health is an essential part of living a happy and healthy life. We are confident the new service will build on the good work already delivered by the Suffolk Wellbeing Service by expanding its reach and working more closely with voluntary and community organisations. “A key feature of the service is that it will have a family-based approach and will now provide help for those aged under 16 years, and improved access to services will be achieved by closer working with GP practices. “We will also see the service working closely with people who are living with more serious mental health conditions and who may previously have required treatment in a specialist mental health unit or hospital. Evidence shows that many people have a more effective recovery away from these environments and we want to increase the level of communitybased interventions. “Improving mental health services remains a priority for health commissioners and we expect the new service to have a positive effect on the lives of local people.” Patients will be able to self-refer as well as be referred via their GP.

WELLBEING SERVICE EXTENDS SUPPORT LINE OPENING HOURS Wellbeing Norfolk and Waveney has extended the hours of its helpline to give support to people with mental health needs, who had previously used a telephone service run by MIND in Norfolk. The integrated helpline was launched on 1 April when funding for the MIND helpline ended. It follows an agreement between our Trust and the Norfolk NHS Clinical Commissioning Groups (CCGs), along with Norwich and Central Norfolk MIND. Staff from Norwich MIND will work alongside those from NSFT to answer calls from people who had previously used the MIND support line. Following analysis as to when the Wellbeing service and MIND support lines were at their busiest, the new opening hours for the new integrated helpline are: • Monday to Friday, 4pm-midnight • Weekends, 10am-midnight

FURTHER INFORMATION

The service will provide support to registered Wellbeing service users and for patients who are either in treatment with NSFT or within one year of discharge.

Until the new service is launched people can continue to access Suffolk Wellbeing by visiting www.readytochange.org.uk/ suffolk or calling 0300 123 1781.

In addition to the Wellbeing service helpline, a 24/7 helpline run by NSFT’s Crisis Resolution Home Treatment Team for patients who require urgent help will continue as before.

You can also follow us on @NHSWellbeing or www.facebook.com/ NHSWellbeing

Telephone numbers given to service users will remain unchanged at present.

Insight | Spring/Summer 2016 5

––– SPOTLIGHT ON WELLBEING –––

Improved service helping record numbers An improved Wellbeing Norfolk and Waveney service which offers a range of specialist support for common mental health problems is reaching more people than ever before after recording an increase of 35% in the number accessing treatment in the three months after its launch.

ellbeing Norfolk and Waveney met its access target of 3.8% between its launch on 1 September and the end of November, with 4,270 people receiving treatment – a 35% increase on the 3,166 figure from 2014. The service also processed 7,175 referrals – an increase of 20% compared with the 5,972 recorded the previous year.

“CONDITIONS SUCH AS STRESS, ANXIETY AND DEPRESSION CAN HAVE A MAJOR IMPACT ON INDIVIDUALS AND THEIR FAMILIES, SO OUR FOCUS IS ON HELPING PEOPLE AT AN EARLY STAGE, BEFORE THEIR PROBLEMS BECOME TOO GREAT”

The data shows that the improved service, which is run by NSFT in partnership with three local MIND organisations and Relate, is achieving its goal of helping more

people with conditions such as stress, anxiety and depression.

people at an early stage, before their problems become too great.

Nesta Reeve, Consultant Clinical Psychologist and Clinical Lead, said: “We are delighted with these figures, which show that the improved Wellbeing Norfolk and Waveney service is already helping more people than ever before and making a real difference to their lives.

“We designed the service with the help of service users, and wanted it to be as flexible as possible so that people could access the right support at a time and place which suits them. We are pleased it has been so wellreceived so far and look forward to helping thousands more people in the coming months and years.”

“Conditions such as stress, anxiety and depression can have a major impact on individuals and their families, so our focus is on helping

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Wellbeing Norfolk and Waveney offers a range of help that looks at the whole person, including

talking therapies, one-to-one support, courses, workshops and social events. It also runs Skype consultations and online webinars to make it as simple as possible for people to access help, regardless of where they live. The service held three successful open mornings earlier this year for anyone keen to find out more

about the help on offer and meet staff, service users and peer support workers, who all have lived experience of mental health issues. In addition, a special celebration event for partners and stakeholders took place at the Forum in Norwich, where speakers explained more about how the service was designed and the difference it is making to people.

Paul Farmer, Chief Executive of Mind, and Norman Lamb MP, former Minister of State for Care and Support, both attended the invite-only event, which also included taster sessions giving attendees more information about practicing mindfulness.

FURTHER INFORMATION If you know someone who would like help from the service, they can speak to their GP or self-refer by visiting www.wellbeingnandw.co.uk or by calling 0300 123 1503. You can find out more about by following @WellbeingNandW on Twitter or visiting www.facebook.com/WellbeingNandW

Insight | Spring/Summer 2016 7

In the end I learned to be myself. That made me the happiest I have ever been A transgender writer, activist and occasional stand-up comic who admits to “doing anything she could” to “cure” herself of gender dysphoria says she is now happier than ever before after learning to embrace herself and live the life of her choice. 8 Norfolk and Suffolk NHS FT (NSFT)

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aty Jon Went, from Norfolk, came out as transgender almost a decade ago after spending years trying to make sense of her gender. Now under the care of a gender identity clinic in London, she has been receiving hormone therapy for five years, and hopes to complete her gender reassignment surgery within the next 18 months. Katy has shared her story in the hope it will increase understanding, help change perceptions and bust myths about gender issues. It comes after she joined forces with consultant psychiatrist and former Norfolk and Suffolk NHS Foundation Trust (NSFT) Medical Director Dr Hadrian Ball to host three well-attended gender, sex and mental health lectures in Norwich and Ipswich in 2015.

“I HAD A LOT OF THERAPY AND PSYCHOTHERAPY, AND FEEL THAT REALLY SUPPORTED ME TO FIND MYSELF”

“Looking back, I realise now that I always felt very different,” said the 48-year-old, who lives just outside of

Norwich. “I didn’t feel like a boy or a girl when I compared myself with friends, but would socialise with tomboys as psychologically that’s where I felt most comfortable and where I seemed to fit. “I didn’t really have the right vocabulary as a primary school child to express how I felt, so ended up locking it in. Later on, I came to think of myself as an ‘other’ who was born male but felt more content as female.” Katy was born as Jonathan, and spent years attempting to conform to society’s conventions while burying her own feelings. She was forced to confront her gender dysphoria – a condition which causes discomfort or distress due to a mismatch between someone’s biological sex and gender identity – after her secretive crossdressing was discovered. “I buried gender dysphoria for most of my life and would try and do anything to ‘cure’ myself of it,” she said. “In the end it cost me my software business and my marriage. I would spend hours every morning just thinking about gender and nothing else. I was obsessed. “In the end I learnt to be myself and embrace it, and that made me the happiest I have ever been. It was and is still a long and painful road, but I

was determined to have my slice of life and not let it be stolen from me. “I lost about three quarters of my friends in a matter of weeks after coming out as trans, which was hard. But I had a lot of therapy and psychotherapy, and feel that really supported me to find myself. It got me to a place where I accepted rather than rejected myself and helped me make a more comfortable existence for myself. “About five years ago I decided to go through transition properly and started taking hormones, which made a big difference. Within weeks, it felt like I had put the right fuel in the car. Before that, my mind, body and mood felt separate, but the hormones brought them together so that all three were speaking the same language for the first time in my life. That made me feel happy, content and integrated.” Gender dysphoria was traditionally thought to be a psychiatric condition, originating in the mind. However, more recent studies have suggested its origins are biological, and a result of the way the foetus develops. A range of different treatments are available, depending on people’s individual wishes, feelings and needs. These range from counselling and mental health support to hormone therapy, speech and language therapy, hair removal treatments and gender reassignment surgery. Currently, specialist help is only available at a handful of gender identity clinics across the country, and funding for any treatment or surgery must be approved by the patient’s local clinical commissioning group (CCG). From an initial appointment to surgery can take anything from four to eight years to complete. Continues on next page >>

Insight | Spring/Summer 2016 9

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Continues from previous page >> “There are still funding issues and the service provision across the country is inadequate,” added Katy. “Coupled with this is the fact that the suicide risk among this group is incredibly high, with 34 to 40% having attempted suicide and 80% considering suicide.

“I BURIED GENDER DYSPHORIA FOR MOST OF MY LIFE”

“When you look at government figures which show the cost of suicide, or the impact on the economy when someone remains unemployed all of their life due to their gender dysphoria, then the cost of treatment is negligible by comparison. “Aside from the positive impact it has on an individual, treatment also results in more people going on to live productive lives. Economically, it makes sense to give people the help they need.” A well-established support network for transgender people is in place across Norfolk, while NSFT holds a specialist assessment clinic at the Julian Hospital, in Norwich. It accepts referrals from GPs from across the county (with the exception of the Great Yarmouth area) with appropriate patients then referred on to Nottingham’s gender identity clinic. Patients in Suffolk who feel they could benefit from a referral to a specialist clinic should speak to their GP. “I think perceptions about transgender people have changed over the past decade, in line with the liberalisation of public attitudes we

have seen about a whole range of issues,” said Dr Hadrian Ball. “Conservative estimates suggest that 1 in 10,000 people is a transfemale and 1 in 30,000 a transmale – although the true figures are probably much higher. Despite this, it can still be difficult for people across the country to access help, while the limited availability of specialist centres can make referrals more challenging and waiting times longer. “During our clinics, we ask for any initial questions the patient may have. When appropriate, this allows us to then make a detailed onward referral which includes information about the patient’s medical history. “The assessment process at Nottingham then takes around six months, so it is possible for someone to get from our door to treatment within a year.” For Katy, the support she has received from friends and family has had a big impact. “I have no secrets from the friends I have made since coming out. I wear my life on my sleeve and people can decide whether to accept me or not from the outset. I now feel that every friend I’ve got is really genuine. “My family have been absolutely brilliant, and although they initially didn’t understand, my mother is now one of my greatest supporters and continues to advocate and educate the rest of my family about trans issues. The more exposure that they see in the media also helps them not see me as a one-off but instead a one-of-many. “There is more acceptance of gender dysphoria and transgender issues now than ever before, which is a step in the right direction. But there is still more which needs to be done to change perceptions and stereotypes, both among the public and the wider medical profession.”

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FACTS AND FIGURES • A survey of 10,000 people carried out by the Equality and Human Rights Commission in 2012 found that 1% of the population surveyed was to some extent gender variant • Gender dysphoria was traditionally thought to be a psychiatric condition which originated in the mind. However, more recent studies have suggested that gender dysphoria is biological and caused by the way gender identity develops before birth • There are no physical symptoms of gender dysphoria, but people with the condition may experience a range of feelings and behaviours • Anyone who feels they may have gender dysphoria should speak to their GP and/or a trans support service, who can refer them for further specialist assessment • Treatment for gender dysphoria varies from person to person but has the overall aim of helping people live the way they want to, in their preferred gender identity. It can include: - Mental health support, such as counselling - Hormone therapy - Speech and language therapy - Hair removal treatments - Gender reassignment surgery

There are over 10 trans support groups in Norfolk. For more information visit: www.genderagenda.net/norfolk/

Major improvements planned to young peopleâ&#x20AC;&#x2122;s mental health services Children and young people experiencing mental health difficulties will benefit from better access to targeted help at an earlier stage thanks to a significant investment in services across Norfolk and Suffolk. Continues on next page >>

Insight | Spring/Summer 2016 11

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>> Continues from previous page

HS England recently announced that Norfolk and Waveney will receive an additional £1.9m each year for child and adolescent mental health services (CAMHS), and Suffolk will receive £1.2m. A portion of the money will go to NSFT, which is now working in partnership with other health and children’s services providers to drive through a collective range of improvements to give young people greater access to help and support.

• Recruiting 11 extra whole time equivalent (wte) specialist staff to expand the eating disorders service, (which currently has seven wte staff). This will help meet an increase in demand of 25% while ensuring children and young people can access help at an early stage, before their illness becomes more serious • Increasing the service available to children in care • Recruiting additional staff to work in schools to promote the services which are available and the steps young people can take to safeguard their mental wellbeing. Staff will also work more closely with other services to share good practice and make sure young people can access joined-up care

“THIS NEW FUNDING WILL HELP MAKE SURE EVEN MORE YOUNG PEOPLE CAN ACCESS THE HELP THEY NEED QUICKLY AND EASILY”

Andy Goff, NSFT’s CAMHS Improvement and Development Manager (Norfolk and Waveney) said: “The main thrust of the improvements, are designed to help young people get rapid access to care and treatment, at an earlier stage.

The changes within NSFT’s own services in Norfolk and Waveney will include: • Improving access to the right care at the right time by creating a single point of contact which is managed by partners. This will see all referrals come to one place, and coordinated to meet each individual’s needs. This single point of contact will include NSFT’s services, as well as those provided by other organisations • Making more help available for young people in crisis. Response hours will be extended into the evenings, while clinics will also take place on Saturday and Sunday mornings in Great Yarmouth, Norwich and King’s Lynn. This comes after a successful nine-month pilot in Great Yarmouth which gave young people in crisis the chance to access help at a weekend clinic, in turn reducing the number needing to go into hospital

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“The single point of contact has to be one of the most significant initiatives to help us achieve this aim. We believe it will really help young people and families – and other health and children’s services colleagues working on their behalf – to negotiate the services and support available and get help much faster, be that with NSFT or with other agencies. “By doing this - and by promoting awareness and prevention - we can all work together to prevent problems from becoming too great, and offer young people a much better chance of making a good recovery and living a full life. “The additional funds we receive will also help us to manage the increasing demands upon some of these services, such as in our eating disorders and crisis services.” Although the detail is still being ironed out, the improvements in Suffolk will concentrate on 10 priority

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areas, with the main focus on supporting the whole family when children or young people are referred into the service. A single point of access will be created as a first port of call for children and their families, while additional staff will be recruited to the eating disorder service to make sure young people receive help as quickly as possible. Care for behavioural problems such as autism and ADHD will be reviewed to make sure it is well coordinated and joined-up, while services for children in care will be redesigned to make them more therapeutic. In addition, a scheme will be piloted to make sure that mental health needs are addressed when a young person has been arrested, while crisis care will be further developed and offered within the community, whenever it is safe to do so. Sue Miller, Associate Director of Delivery and Change with NSFT, said: “This new funding will help make sure even more young people can access the help they need quickly and easily, and hopefully before their mental

health problems become too great. “We are now working with our partners to draw up plans in more detail, and will be focusing on a whole-family approach rather than solely on the child or young person who is experiencing the difficulties. “A single point of access will also be introduced, which will help young people and their families to negotiate the services and support available and get help much faster, be that with NSFT or with other agencies. “In addition, we will also be ploughing the extra money into our eating disorder and crisis services so that we can manage an increase in demand and make sure young people receive the right help at the right time.”

“THIS NEW FUNDING WILL HELP MAKE SURE EVEN MORE YOUNG PEOPLE CAN ACCESS THE HELP THEY NEED QUICKLY AND EASILY”

In your words... “…the team have helped so much, without them I dread to think what would have happened to my son, they have guided and supported him through all he goes through; the changes they make happen are invaluable.” Carer

The money has been awarded as part of a national drive to improve young people’s services. NSFT has played a key role in the initiative throughout, with Dr Jon Wilson, its Consultant Psychiatrist and Deputy Medical Director, sitting on the government taskforce which focused on the way children’s services are delivered and recommended the extra money should be made available. For more information about mental health issues for young people and the support which is available locally, visit; www.whatsthedealwith.co.uk

Insight | Spring/Summer 2016 13

––– INSIGHT ON CHILDREN, FAMILIES AND YOUNG PEOPLE –––

Work to start on state-of-the-art young person’s mental health unit Work has begun on creating a state-of-the-art £1m ‘centre of excellence’ which will provide high quality specialist care for young people with complex mental health needs.

he 12-bedded unit is being constructed at Carlton Court, in Lowestoft, and will allow NSFT to care for more young people closer to home, reducing the number who need to travel out of the area for treatment or be admitted into local adult mental health beds.

able to access the specialist help and support they need closer to home, without the need to travel outside the local area which can be stressful for both the patient and their family.

“IT WILL ALLOW US TO EXPAND THE SERVICES WE ALREADY PROVIDE, AND WILL INCLUDE THREE NEW SCHOOL ROOMS AND A GYM”

It will replace the unit currently at Airey Close, in Lothingland, which is dated and can only care for girls. The new unit will include beds for boys for the very first time. The new unit will offer services to young people in crisis who cannot be supported in the community, and will care for patients with any condition, including depression, anxiety, psychosis, eating disorders and self-harm. As well as creating 12 individual en-suite bedrooms, the project will see three schoolrooms added to the building along with a fully equipped therapy suite and gym to boost young people’s recovery. A kitchen will be available so that patients can learn how to cook their own food, along with a separate dining room for use, when necessary, by people with eating disorders. Extra staff will also be recruited to care for the increased number of patients.

Airey Close is currently the only young person’s general admission ward in Norfolk and Suffolk, and has seen increases in demand each year, which has led to some people receiving care outside of the local area. It is hoped this number will be reduced if NHS England, which commissions the service, agrees to fund the additional five beds which are being created.

“The centre of excellence at Carlton Court will be a state-of-the-art facility, fully compliant with the very highest quality standards to ensure safety, privacy and dignity. It will also allow us to expand the services we already provide, and will include three new school rooms and a gym, which will be especially important for helping young people with eating disorders to manage their exercise levels.

Andy Goff, NSFT’s CAMHS Improvement and Development Manager (Norfolk and Waveney), said: “This investment will make a huge difference to young people with complex mental health needs. It will mean that more people than ever – and both boys and girls – will be

“We are absolutely delighted to be carrying through the promises we made during the consultation and investing this significant sum in creating the high quality services which our young people deserve. We look forward to opening the unit in the summer.”

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Innovative partnership boosts young people’s recovery Scores of young people with mental health problems are gaining confidence, learning new skills and getting help to express themselves thanks to an innovative partnership which is boosting their recovery.

SFT has been working with Bury St Edmundsbased Noise Solution to offer service users the chance to make music, write blogs and express themselves via social media as part of their treatment. The initiative has proved especially successful with people who find it hard to engage with traditional services. It gives them the chance to express themselves through music and lyrics while also writing their own blog, which their mental health practitioner, care coordinator, family and friends are able to read so they can keep track of each individual’s progress. “Young people who are losing their way can find it really difficult to

engage with more traditional services, but find this refreshing new approach much easier and more effective,” said Mike Seaman, Acute Service Manager (Suffolk West) with NSFT. “We have seen an incredible turn around in many of these service users. Working with Noise Solution is really positive and recovery-focused, and instils real hope in them while helping channel their emotions.

“THE FEEDBACK WE’VE HAD FROM SCHOOLS, FAMILIES AND THE YOUNG PEOPLE THEMSELVES HAS BEEN GREAT”

“Encouraging service users to engage in this way can stop people from spiralling into crisis, while reading their blogs can also help us understand the way they are feeling, in turn helping inform our care plans. In other cases, attending sessions with Noise Solution has helped people to recover faster. “You really can see a difference in these young people. They can come into the service being quite insular, but by the end of the project have grown in confidence and self-esteem, with some even going on to study for music qualifications. The feedback we’ve had from schools, families and the young people themselves has also been great, as they can’t believe the difference they are seeing.” Continues from previous page >>

Insight | Spring/Summer 2016 15

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ADDITIONAL EMOTIONAL AND WELLBEING SUPPORT FOR YOUNG PEOPLE IN SUFFOLK Our service which provides support to help people look after their own wellbeing has been given additional funding to help it enhance the provision of counselling for young people experiencing mental health difficulties.

“WE ARE WORKING THROUGH THE STRENGTHS THEY ALREADY HAVE, NOT THE ‘PROBLEMS’ THEY HAVE EXPERIENCED”

The programme run by Noise Solution is evidence-based and delivered by professional musicians, who help participants make the type of music of their choice, from hip hop to drum and bass, techno to trance and folk to death metal. Simon Glenister, Director of Noise Solution, said: “Music is a fantastic, non-threatening way of starting a dialogue as it’s something people are passionate about. We are working through the strengths they already have, not the ‘problems’ they have experienced. “Discovering that it is possible to be good at creating music is hugely affirming. This, combined with Noise Solution’s ability to highlight and share that success with family, peers and other professionals through our use of social media, helps to build confidence.” For more information about Noise Solution, visit www.noisesolution.org

The current Suffolk Wellbeing service, which is run by NSFT in partnership with voluntary organisations from across Suffolk, has been given £132k in additional funding over the next few months to help it meet unprecedented demand for counselling for 13 to 15-year-olds.

people which are also available through public health, social care, education and third sector providers across Suffolk.

The money has been given to the service by Ipswich and East Suffolk and West Suffolk Clinical Commissioning Groups.

“We would encourage any young people who feel they need additional support to speak to their school nurse, GP, social worker or youth worker who will be able to direct them to the most appropriate help to meet their needs.”

“THE AIM IS TO PROVIDE SUPPORT EARLY ON WHEN PROBLEMS START”

The additional income will help alleviate pressures created by a rise in demand, allowing young people who are experiencing emotional and mental health problems to work with specialist therapists. Sue Miller, Associate Director of Delivery and Change, at NSFT said: “We are really pleased to have received this additional support from Suffolk’s CCGs, which will help us meet a rise in demand for the counselling service. “This service works with other emotional health and wellbeing services for children and young

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“The aim is to provide support early on when problems start and to help young people to develop skills and learn ways to manage their emotional wellbeing.

Suffolk Wellbeing service offers a range of support to help people of all ages make changes to their lives to improve their wellbeing and help them cope with stress, anxiety and depression. The majority of the services it offers are available by self or professional referral to anyone who lives in Suffolk and is aged 16 and over. The counselling service for young people aged 13-15 years is only available through referral by a health professional such as a school nurse or GP. For more information about Suffolk Wellbeing service, visit www.readytochange.org.uk or call 0300 123 1781 during office hours or turn to page 4.

Standing ovation for unique and inspiring project Members of Suffolk and Norfolk Youth Council created an exciting and unique project through which to share their experiences of mental ill health at an international conference in Canada recently.

he young people worked with Suffolk artist Juliet Lockhart to create puppets of themselves which they then used to deliver a moving narrative, written by them with the support of award-winning poet Luke Wright and TV and radio scriptwriter and author, Molly Naylor. Putting the puppets and their words together the youth council members created ‘As This Is Only Now’ – a film which they showed to delegates from around the world at the International Association for Youth Mental Health Conference in Montreal in the autumn to rousing applause and a standing ovation.

“WE WERE INCREDIBLY IMPRESSED WITH THE WAY THE YOUNG PEOPLE EMBRACED THIS PROJECT”

The film aims to offer an insight into mental ill health from a young person’s perspective, including their experiences of accessing help and the benefits which becoming members of NSFT’s youth council has brought them. Emma Corlett, NSFT’s young people participation lead, said: “We were incredibly impressed with the way

the young people embraced this project, working together as a team. “The conference was a really fantastic opportunity for them – as well as helping them gain confidence, we hope it will continue to inspire them and give them new ideas for further improving young people’s mental health and wellbeing closer to home. “We all felt very proud when they stood on that stage and delivered their film. The audience were just blown away by it, giving them a standing ovation. It was something very special indeed and quite lifechanging for them.”

Insight | Spring/Summer 2016 17

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Luke, who lives in Suffolk, and Molly, from Norwich, held two writing workshops with the youth council members, while Juliet worked with them to complete the puppets.

“IT’S BEEN A DELIGHT WORKING WITH THIS GROUP”

Molly said: “These young people are a wonderful bunch who have made some powerful and inspiring work. It’s been a privilege to be a part of their journey. It has really made me think about giving young people a voice through which to tell their story and about helping more to raise awareness about mental health issues.” Luke added: “It’s been a delight working with this group. They’ve come up with some stunning work and they really did us proud in Canada. I certainly learned a lot from working with them too.”

“IT WAS AMAZING – IT’S GIVEN ME MORE CONFIDENCE AND FAITH IN MYSELF” Two members of the youth council who travelled to Canada have described the trip as an “amazing” experience which has given them a new-found confidence.

“THE WHOLE EXPERIENCE HELPED WITH MY CONFIDENCE AND GAVE ME MORE FAITH IN MYSELF. I NEVER REALLY THINK I AM GOOD AT ANYTHING BUT THIS HELPED PROVE THAT I AM”

Elise Page and Esme Pears, who both live in Suffolk are now hoping to explore some of the mental health initiatives they saw in more detail in Montreal and Quebec – such as mobile phone apps to help track mood – to see if something similar can be introduced in Norfolk and Suffolk. 18 Norfolk and Suffolk NHS FT (NSFT)

“Canada was amazing and quite a surreal experience,” said Elise, who recently joined NSFT’s Council of Governors as a youth representative. “I spoke on stage three times – if someone had told me I’d be doing that two years ago I would have told them they were being ridiculous as I couldn’t even do a presentation in front of a class of 15 people! “We also saw some really good ideas, like apps which you can use to track how you are feeling and will put you in touch with help, such as the crisis team, if you need it. Emse described the whole experience as “brilliant”. The 22-year-old, who was referred to the Trust seven years ago for help to overcome anorexia, depression, anxiety and paranoid thoughts, said: “I felt so blessed to have been given the opportunity. This time last year I never thought I would be completing an apprenticeship and have been to Canada to take part in an international conference. It’s been absolutely brilliant.

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“And I found working with Luke and Molly to be really inspiring. They gave us the freedom to explore for ourselves what we wanted to say, but the structure to say it in a way that would have the most impact. They were non-judgmental, and great fun.”

GIVING PEOPLE A VOICE Juliet Lockhart spent two days working with the young people to create puppet versions to help them tell their stories at the Canada conference.

You can watch ‘As This is Only Now’ by visiting: www.youtube.com/ watch?v=4qHanuCDDqU You can also view a short film describing the making of the project. www.youtube.com/ watch?v=vSvTn7Mwu3c

The Youth Councils’ trip to Canada would not have been possible without commitment, dedication and teamwork which saw them raise the £38,000 needed to fund the visit. The group threw themselves into raising the money at the start of the project, and organised a huge variety of activities and events to help them towards their total. The spent months completing car washes, sponsored walks, quizzes, cake sales and various other activities supported by their families and NSFT staff who all pulled together to come up with innovative ways to fundraise. NSFT Assistant Practitioner Mark Brown even wrote an inspirational single, which went on sale to raise funds for the trip. Called ‘Moving On In My New Life’, the song focused on recovery and is featured on the end credits of the ‘As This Is Only Now’ film.

It is a technique she has honed over the past decade and used to help countless groups express themselves and take back some control of their lives. “I started working with puppets as I was interested in developing an alternative way for people to communicate, especially if they felt they had no voice, or that, for whatever reason, their voice had been taken away from them,” she said. “Making a puppet of themselves, or of an aspect of themselves, also gives them back a bit of control over something. A lot of change happens internally during the process of making the puppets, and often people don’t need to do anything other than simply make them. “It is always fascinating to see the puppets emerge. People invest a lot in their puppets, either by making clothes or going out to buy special items of clothing, and become

very attached to them, animating them to mirror their own traits and personalities. “For young people in particular, this can be really useful as it taps into their ability to work on an aspect of themselves without needing to talk. “I was so impressed with the effort and energy which the youth council members put into this project and delighted that it worked so beautifully in the powerful, finished film.” Juliet is also working in partnership with NSFT, Suffolk County Council and the Association of Suffolk Museums on the Creative Heritage in Mind project. The initiative sees small groups of people who are managing mental ill health, explore heritage by looking at museum collections and making their own creative response to the material.

Insight | Spring/Summer 2016 19

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EXTRA SUPPORT FOR YOUNG PEOPLE Young people with learning disabilities who face difficulties in accessing school or work placements are now benefitting from bespoke education packages alongside targeted mental health support thanks to an exciting new initiative.

Young people with learning disabilities who face difficulties in accessing school or work placements are now benefitting from bespoke education packages alongside targeted mental health support thanks to an exciting new initiative. Our Trust has been invited to work with training provider Lapwing to offer integrated mental health support and education packages to children and young people in east Suffolk who have a significant learning disability and a mental health issue.

“WE HAVE HAD SOME GREAT SUCCESS STORIES SO FAR, AND IT HAS BEEN FANTASTIC TO SEE THE IMPACT WHICH THE PILOT HAS HAD”

The initiative enables Lapwing to provide bespoke packages of education, training or employment to people up to the age of 18 who are not currently in mainstream or special school or have difficulties with accessing it, in turn building their confidence and self-esteem. At the same time, specialists from our Learning Disabilities Child and Adolescent Mental Health Service (LD CAMHS) East and West Suffolk will work with the child or young person to address their mental health needs, offering support and helping them reintegrate with the community.

Sam Gillings-Taylor, LD CAMHS Clinical Lead with NSFT, said: “This exciting project has given us a fantastic opportunity to provide person-centered support to service users who experience barriers to education as a result of their mental illness and learning disability. It is helping to build confidence and selfesteem within these young people while offering them care and support for their mental health needs. “We work hard to develop a relationship with the service users so that we can understand their wishes, desires, fears, likes and dislikes, and can then put together a programme which offers them the right mix of education, support and encouragement to meet their needs. Our aim is to help them gradually reintegrate back into the community and, where possible into education.

“WE WORK HARD TO DEVELOP A RELATIONSHIP WITH THE SERVICE USERS SO THAT WE CAN UNDERSTAND THEIR WISHES, DESIRES, FEARS, LIKES AND DISLIKES”

“We have had some great success stories so far, and it has been fantastic to see the impact which the pilot has had. Service users can go from having an incredibly chronic, complex issue which restricts and isolates them to eventually returning

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to school or the community, which is brilliant for the individual and very rewarding for all of the staff involved in their care.”

“THIS EDUCATION WILL SUPPORT THEM TO GET OUT, BE LISTENED TO, DECIDE WHAT THEY WANT TO DO AND BUILD THE CONFIDENCE TO BE ABLE TO PARTICIPATE AND FEEL VALUED IN THEIR COMMUNITY”

The year-long initiative has been made possible after Lapwing secured funding from the Bailey Thomas Charitable Fund. If the pilot is successful, it is hoped it will continue into future years. Sophy Jones, Chief Executive of Lapwing, said: “We are constantly hearing about young people with severe learning disabilities and mental ill health being excluded from their community and from education due to their high support needs. This partnership is so exciting because, together with NSFT, we will allow some of the most marginalised young people in Suffolk to take their place in society. “This education will support them to get out, be listened to, decide what they want to do and build the confidence to be able to participate and feel valued in their community.”

It is important to ask for help As we focus on Life After Suicide in this edition - speaking to people who have been bereaved by suicide or even attempted to take their own lives - we asked NSFTâ&#x20AC;&#x2122;s Medical Director, Dr Bohdan Solomka for advice for those who may feel or have felt that things have all become too much. Continues on next page >>

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“The other thing to remember is that people who are intent on suicide are often very good at covering their tracks and can smile and say ‘see you next week’ then take their own life later the same day.

Continues from previous page >> eople who are worried that a friend or loved one may be feeling suicidal have been urged to take the time to talk to them and do what they can to persuade them to get help to manage their feelings.

“BY TALKING MORE OPENLY AND THINKING ABOUT WHO IS AT RISK, WE CAN OFFER A HELPING HAND”

Dr Bohdan Solomka said that the right support and therapy could play a vital part in giving meaning back to life when people are feeling at their most desperate. He also encouraged anyone who is feeling vulnerable to not to be afraid to ask for help. “Suicide is rarely something which just happens out of the blue,” said Dr Solomka. “Often there is a long build up and people have had conversations about it in the weeks and maybe months leading up to it, which means there are opportunities to try and persuade them to get help.

“SUICIDE IS RARELY SOMETHING WHICH JUST HAPPENS OUT OF THE BLUE”

“It’s really important for people who feel this way to talk to their family or friends and get their support, then ask their GP for a referral to the Wellbeing service. There, people can get help to manage their depressive feelings and anxiety, which prevents it from snowballing into something much more serious.” People can feel suicidal for a wide variety of reasons, and may be facing a combination of problems which have built up over time. Those particularly at risk are teenagers or

middle aged men, people with a previous history of mental health problems, anyone who has selfharmed or already attempted suicide and those who use drugs or alcohol. When someone does take their own life, it is common for those left behind to feel guilt, said Dr Solomka, but often there is nothing they could have done to change the outcome. “Suicidality is a fluctuating thing, and people can flip between feeling quite desperate one day then brighter the next,” he added. “It’s important for survivors to understand that mood can be triggered by quite seemingly insignificant things. For example, a simple comment could, for all sorts of reasons, lead to a cascade of negative thoughts which are extremely difficult to predict.

“WE CAN ALL DO MORE TO PREVENT PEOPLE FEELING THAT TAKING THEIR OWN LIFE IS THE ONLY ANSWER TO THEIR PROBLEMS”

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“Talking about suicide or suicidal feelings remains a big taboo in our society, which makes it harder to explore alternatives and find ways of increasing hope and other less final solutions. We can all do more to prevent people feeling that taking their own life is the only answer to their problems. “Society has started to provide some wider protection, such as selling paracetamol in smaller packs and putting higher prevention barriers on car parks, but we can still do more as a community. By talking more openly and thinking about who is at risk, we can offer a helping hand and give them that lift which gives meaning back to their lives.”

24 HOUR HELP If you are in crisis, experiencing feelings of despair or actively suicidal, you can contact The Samaritans, 24 hours a day, seven days a week by calling 08457 909090 or visit www.samaritans.org

––– SPOTLIGHT ON LIFE AFTER SUICIDE –––

SUICIDE – FACTS AND FIGURES • More than 800,000 people die due to suicide every year • There are indications that for each adult who dies of suicide there may have been more than 20 others attempting suicide

• Communities play a critical role in suicide prevention. They can provide social support to vulnerable individuals and engage in follow-up care, fight stigma and support those bereaved by suicide

• Men are three times more likely to take their own lives than women, which may be because men are less open about their feelings and less likely to seek help

The kinds of issues that put someone at risk are:

• Men from poorer backgrounds are 10 times more at risk than men from more affluent backgrounds

• Relationship problems with a partner, friends or family

• Suicide rates are highest among men aged between 35 and 54 • Suicides rates for women are at their highest in the age range of 40-59 • Suicide is the single biggest cause of death for young men aged between 18 and 34 • Three-quarters of all people who die by suicide in the UK have not had contact with mental health services

• Difficult life experiences, such as losing a job, financial worries, bereavement or trauma • Experiencing mental health problems, such as depression, anxiety or psychosis • Long-term physical illness • Being socially isolated or experiencing prejudice and discrimination, or physical or sexual abuse • A history of self-harm – although for most people, selfharm is not about trying to take their life, people who self-harm are more likely to take their lives than people who don’t

The World Health Organisation has also issued a series of myth busters about suicide, which include: Myth

Fact

Once someone is suicidal, he or she will always remain suicidal

Heightened suicide risk is often short-term and situation-specific. While suicidal thoughts may return, they are not permanent and an individual with previously suicidal thoughts and attempts can go on to live a long life.

Talking about suicide is a bad idea and can be interpreted as encouragement

Given the widespread stigma around suicide, most people who are contemplating suicide do not know who to speak to. Talking openly can give people other options or the time to rethink his/her decision, thereby preventing suicide.

Only people with mental disorders are suicidal

Suicidal behaviour indicates deep unhappiness but not necessarily mental disorder. Many people living with mental disorders are not affected by suicidal behaviour, and not all people who take their own lives have a mental disorder.

Most suicides happen suddenly without warning

The majority of suicides have been preceded by warning signs, whether verbal or behavioural. Of course there are some suicides that occur without warning. But it is important to understand what the warning signs are and look out for them.

Someone who is suicidal is determined to die

On the contrary, suicidal people are often ambivalent about living or dying. Someone may act impulsively by drinking toxins, for instance, and die a few days later, even though they would have liked to live on. Access to emotional support at the right time can prevent suicide.

People who talk about suicide do not mean to do it

People who talk about suicide may be reaching out for help or support. A significant number of people contemplating suicide are experiencing anxiety, depression and hopelessness and may feel that there is no other option.

Insight | Spring/Summer 2016 23

Supporting the survivors of suicide A vital Suffolk support group is hoping to change the outdated terminology around suicide to help protect victims and vulnerable survivors while honouring their good names.

he Suffolk branch of Survivors of Bereavement by Suicide (SoBS) is campaigning to eradicate use of the phrase “committed suicide”, which originates from the criminal justice system, and replace it with the term “died by suicide”. The group hope that removing a key trigger word will reduce the risk of survivors – many of whom are vulnerable and may be feeling suicidal – from taking their own lives. “We want to break the link with this outdated, negative language, which

can be used to attack both the person who has died and vulnerable survivors,” said Suzy Clifford, who set up the Suffolk branch of SoBS after her husband Len took his own life in 2009.

“THE GOVERNMENT DID HALF A JOB IN 1961 WHEN THEY DECRIMINALISED SUICIDE BUT DIDN’T CHANGE THE LANGUAGE”

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“My own personal experience was that I was just five weeks into my own grief when someone approached me and said ‘I’ve heard your husband committed suicide. He is a coward and should be ashamed of himself’. I just could not believe this was acceptable in the 21st century. If that had been a particularly dark day for me, it could have been a trigger when I was at high risk of suicide myself. “The government did half a job in 1961 when they decriminalised suicide but didn’t change the language. The term has become

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so engrained in our language that people may not think about the implications unless they have experience themselves – I always explain it by saying that you commit murder or a burglary – you don’t commit a heart attack. “Changing this terminology would be amazing – it would help us honour the person who has passed and protect their good name and the good names of survivors. It would also play a key role in breaking the circle of stigma and shame for the next generation.” Suzy’s husband Len developed psychological issues after suffering a brain injury in a car accident. He took his life three years later while Suzy was at the gym.

“THE LONG TERM PSYCHOLOGICAL TRAUMA OF SUICIDE CAN HAVE AN IMPACT ON PEOPLE FOR THE REST OF THEIR LIVES”

She said: “I left the house a married woman and came back a widow. What I found when I returned is an image that will never leave me. “People do not understand the impact when people are profoundly affected by suicide. All grief carries guilt, but the guilt which survivors feel comes from the idea that you should have prevented the preventable – that somehow you are flawed and have done something wrong. It’s when you get into that circle of thought that you become your most vulnerable.” Suzy set up the Suffolk branch of SoBS in 2012 to provide a support

network for others. It offers indefinite support to survivors via telephone, email or face-to-face, as well as regular group meetings to help people develop coping strategies, relieve isolation and bring hope. “The long term psychological trauma of suicide can have an impact on people for the rest of their lives,” said Suzy. “In some cases it could cost the NHS thousands if people need medication or other interventions for many years. “What would be much more costeffective, and would make a real difference, would be if we were able to open a branch of SoBS in each county or have just one person offering support. The help we provide is long-term, unlike the support which GPs can provide.” Suicide rates in the UK have fallen from 6,595 when records began in 1981 to 6,045 in 2011. Despite this, suicide remains the single biggest cause of death for young men aged between 18 and 34, with men three times more likely to take their own lives than women. The World Health Organisation has said that for each adult who dies of suicide, more than 20 others may have attempted it. Where to go for help: Suffolk SoBS has recently launched a new website – available at http://suffolk-sobs. org.uk – which brings together a range of information about the services it provides You can follow the local group on Twitter @suffolksobs The charity’s national helpline is available on 0300 111 5065

FIRST-OF-ITS-KIND GROUP TO GIVE EXTRA SUPPORT Health professionals and emergency service staff who have been affected by suicide while at work will be able to receive confidential support as a first-of-its-kind group launches. Suffolk (SoBS) supported by NSFT, has created a peer support group exclusively for people who have been affected professionally by suicide and are finding the experience difficult. This includes workers from across the NHS, as well as the police and fire service. The group will provide confidential and independent support for as long as it is needed. Alison Thomas, Organisation Development Lead with NSFT said: “We are really pleased to be working with SoBS to promote this valuable new group. “One of our priorities is to improve the support we offer to our staff and make sure it is consistent across the Trust. This group will play an important role in helping us ensure those staff receive the help they need. “Suicide can be traumatic for the professionals involved, and we will be signposting anyone who we feel could benefit to the group as well as offering them support internally.” The group’s first meeting takes place on Thursday 16 June at St John’s Church, Cauldwell Hall Road, Ipswich, IP4 4QE, running between 7pm and 9pm. Anyone who would like more details can contact group leader Suzy Clifford on 07531 087 623 or by email at sobsburysteds@hotmail.co.uk. Insight | Spring/Summer 2016 25

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I DON’T WANT TO PRETEND HE NEVER EXISTED A mother who lost her son to suicide just over three years ago has praised the Suffolk support group which played a key role in helping her come to terms with a “different kind of bereavement”. Anne Maxwell’s son Stuart took his own life aged just 34 after developing psychosis, anxiety disorder, paranoia and depression as a result of smoking cannabis as a teenager. She found out about his death after receiving a knock at the door one Sunday evening, and turned to Suffolk Survivors of Bereavement by Suicide (SoBS) following a recommendation from a friend shortly afterwards. She has since used her experience to help others by warning about the dangers of cannabis and composing an emotional poem, called “A different type of bereavement”, which has appeared on the SoBS website and been read out at an international conference.

“I REMEMBER SAYING TO ONE OF MY CLOSEST FRIENDS THAT I WOULDN’T BE SURPRISED IF I GOT THAT KNOCK AT THE DOOR AND IT CAME ONE SUNDAY EVENING”

“Unbeknown to us, Stuart began smoking cannabis in his teens and became one of its victims after suffering irreversible psychosis,” said Anne, a teacher. “A lot of people who mess around with it don’t have any side effects but if it is going to affect you, you don’t realise until it’s too late. It’s like playing Russian roulette with your life.

month from her home Maldon, Essex to attend the sessions and benefit from the support offered by the charity. “A friend recommended SoBS as there really wasn’t any other support out there which could help with this difficult kind of bereavement,” she added. “The group was – and still is – fantastic. So many survivors have said that without it, they would have turned in on themselves and possibly become the next victims.

“I had huge problems coping with Stuart’s behaviour but I supported him, as that’s what parents do. He suffered three major breakdowns from the age of 21 onwards, when his behaviour would become so bizarre that he would end up being sectioned and put on strong medication. “Stuart was very intelligent and gifted, and wrote poetry as well as editing a magazine. He wasn’t happy that he could never be a productive member of society because of his condition. He was having problems with his girlfriend and had got himself in to huge debts with pay day loan sharks. “It had got to the stage where, for him, enough was enough.” Following Stuart’s death, Anne began attending Suffolk SoBS, initially in Bury St Edmunds but later moving to Ipswich when the group launched in the town. The meetings have proved so valuable that she still completes a 75-mile round trip every

26 Norfolk and Suffolk NHS FT (NSFT)

“SoBS is the only place where I could take the floor and talk about Stuart all evening and nobody would mind. That’s important as I don’t want to stop talking about him and pretend he never existed. Anne is now urging society to do more to help those left behind after suicide by spreading the word about organisations such as SoBS and raising awareness of the support they provide. She said: “Suicide is now the largest cause of death in men under 50 in the country and we should be doing more to help the survivors. Bereavement by suicide is so different and needs to be handled in a completely different way – there is really awful guilt and you have to go through such a range of emotions before you start feeling light at the end of the tunnel. “Nobody knows what it is like and everybody reacts differently. It takes time before you realise it’s ok to yell and be angry, and it’s also ok to get through a day without crying for the person you have lost.”

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“PEOPLE DON’T KNOW WHAT TO SAY” A Suffolk man whose wife took her own life after suffering with depressive episodes has urged society to play a bigger role in helping bereaved families and friends by being more willing to talk about suicide. Chris Lodge lost his wife Ursula in May 2008. In the weeks and months afterwards, not only did he struggle to find the right support to help him begin the healing process, but also battled isolation as people avoided talking about her death.

attending Survivors of Bereavement in Suicide (SoBS) groups, that this trauma is common to all those who discover their loved one, with many survivors feeling unable to remain in their home and others finding out they are suffering PTSD.

Now he is urging the community to help break down the stigma which still exists around suicide by speaking about it more openly.

“I blamed myself and started researching mental health as I was frantic to find out why and couldn’t think of anything else I could do. It was the biggest thing on my mind.

“PEOPLE JUST DON’T KNOW WHAT TO SAY WHEN IT COMES TO SUICIDE. THEY WILL TALK AROUND IT, USE EUPHEMISMS OR JUST NOT TALK AT ALL”

“Even in 2015, there is still a stigma around suicide and society pushes the subject under the carpet,” said Chris, who was married to Ursula for nine years. “It’s treated like cancer was 20 or 30 years ago and almost spoken about in whispers. “People just don’t know what to say when it comes to suicide. They will talk around it, use euphemisms or just not talk at all. That can be very difficult – when you have lost someone who is very dear to you, you don’t want that person to be suddenly removed from your life as if they didn’t exist. It’s almost as if they are judged by their final act and all of the happy memories don’t get talked about any more.

“That is not very helpful in terms of healing and can be very isolating for those left behind. In some cases, that loneliness could even drive people down the path of thinking about the same thing themselves.” Ursula took her own life at the home the couple shared in mid Suffolk. Following her death, Chris – like many other suicide survivors – found himself questioning why and blaming himself for what had happened. He was signed off work indefinitely and his GP recommended counselling, but struggled to find anyone with the necessary skills to be able to help. “There is something very different about losing a loved one by suicide,” he explained. “Afterwards you become a forensic scientist, and want to know why and whether you could have done anything different. The guilt is absolutely huge. “Finding my wife and trying to resuscitate her was traumatic and shocking. I later discovered, while

“I was in a very black place and knew I needed support, but just didn’t know where to go.”

“IT HELPS TO BE AMONG OTHER PEOPLE WHO HAVE BEEN THROUGH THE SAME THING. YOU DON’T FEEL ANY PRESSURE TO EXPLAIN. PEOPLE JUST GET IT”

Chris began attending Suffolk SoBS when it launched in 2012. He said: “I was four years down the line but when I attended the group, I realised I had put my recovery on hold and I still had a lot further to go to come to terms with losing my wife. There was no substitute for sitting with people who empathise and being able to talk to them openly. “Since then, I have been helping out with the Suffolk group, as I know what a huge difference it can make. Continues on next page >>

Insight | Spring/Summer 2016 27

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Continues from previous page >> “Losing Ursula was a complete nightmare – I wouldn’t wish it on anyone. It was the first time I had lost somebody very close to me and nothing could prepare me for it or the way that it happened. “But there is life – and hope – after suicide. I still have bad days – songs will come on the radio and remind me, and grief becomes difficult again when I reach anniversaries and birthdays – but it is incomparable to what it was like in the hours and days straight afterwards.

“GIVING PEOPLE THE CHANCE TO TALK IS ESSENTIAL” A Norfolk father-of-two who attempted to take his own life while in the grip of a deep depression has shared his story in the hope of helping others and breaking down some of the stigma which still exists around mental health issues.

“THERE IS LIFE – AND HOPE – AFTER SUICIDE”

“During those times it’s important to remember that it does get better. One day you will wake up in the morning and it won’t be the first thought that crosses your mind. “I still miss Ursula dearly and feel privileged to have shared those few years with her. She was an intelligent beautiful person, both inside and out – sadly she did not see herself that way and struggled with low self-esteem, but was unwilling to seek medical help. Her friends always saw the outgoing side of her, but inside she struggled with life, and like many others who die by suicide, she hid it well. “After somebody dies by suicide, often people only remember them for that last act and many can be so cruel – branding them cowards or selfish. Nobody would ever use that language if somebody lost a loved one to cancer or old age. That is so sad, but part of the stigma that many suicide survivors have to endure.”

teve Foyster, who lives north of Norwich, made several suicide attempts around 30 years ago after a series of personal losses left his life spiralling out of control. Now, with the help of talking therapies and wellbeing support, his emotional scars have healed and he is enjoying a happy, fulfilled life while working to raise awareness of the importance of safeguarding mental wellbeing. “I had been severely depressed for over a year and couldn’t see anything other than blackness,” said Steve, who remarried in 1991 and has two grown-up sons. “I had faced a huge amount of loss and just wanted to disappear.

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“I FELT THAT I WAS BEING SQUEEZED INTO A PERSON THAT I DIDN’T RECOGNISE AND DIDN’T WANT TO BE AND NO LONGER HAD THE CAPACITY TO LOVE ANYONE, LEAST OF ALL MYSELF”

“At the time I was desperately trying to hold down a temporary job as I’d been dismissed from my previous employment because of my mental, rather than physical illness. I didn’t have the confidence to question the unfairness as I was an incomplete and utter emotional wreck.”

As Steve’s mental health deteriorated, he was prescribed antidepressants, referred to a private psychiatrist and was later sectioned under the Mental Health Act for his own safety and admitted to the Norvic Clinic. But it wasn’t until he make a further attempt on his life by jumping from the top of a multi-storey car park that Steve eventually got the combination of help he needed to change his life. “After the incident, I spent six months in hospital recovering from a punctured lung, multiple fractures of the left ankle, broken pelvis, a ruptured sciatic nerve and compaction of the vertebrae,” added Steve. “The nursing and physiotherapy care I received couldn’t have been better, but in all of that time I was visited by a psychiatric nurse only once. “The GP I saw after my discharge from hospital was very good and incredibly helpful. He really listened to me and referred me back to the Norvic Clinic once a week, where I started having weekly one-to-one sessions with a student community psychiatric nurse which I found very beneficial, as I felt that at last I had found someone who would listen to me.

“I REMAIN PASSIONATE ABOUT MENTAL HEALTH SERVICES AND THINK THAT BOTH PROVIDING EDUCATION AND GIVING PEOPLE THE CHANCE TO TALK ABOUT THEIR FEELINGS IS ESSENTIAL”

“In recent years I have also taken part in wellbeing courses through the pain clinic and received three months of cognitive behavioural therapy via my local surgery. I found both these forms of therapy really useful and gave me a realistic way of dealing with my feelings. For me, that combination of holistic approaches really worked, and helped me to come out the other side.” Since his recovery, Steve has given a talk on his experiences to 60 junior doctors as part of a training seminar, and regularly holds evenings looking at mental health issues at the resource centre he manages.

“IT’S INCREDIBLY IMPORTANT TO RAISE AWARENESS OF MENTAL ILL HEALTH AND BREAK DOWN THE TABOOS WHICH STILL EXIST”

“I remain passionate about mental health services and think that both providing education and giving people the chance to talk about their feelings is essential,” “It’s also incredibly important to raise awareness of mental ill health and break down the taboos which still exist – people are comfortable talking about cancer, for example, but still struggle with mental health, despite the fact one in four people now experiences issues. “It remains exasperating, however, that funding for mental health remains far lower than that earmarked for physical illnesses. If funding was comparative, I’m sure that some young suicides could be prevented and lives could be saved every year.”

In your words... “Around 10 months ago, I had a new doctor and, in this time, my treatment has been second to none. His support, time and care has been outstanding.” Service User, Northgate Hospital, Great Yarmouth “I visited my cousin… who has been a patient on your ward for several weeks. I was so pleased to see such an amazing change in her. Your endless patience and kindness has brought her this far.” Carer, Sandringham Ward, Julian Hospital, Norwich “I would like to express my very grateful affection to the two psychiatric nurses who looked after me during my recent traumatic visits to the hospital. On both occasions, I saw the same two nurses and their actions were absolutely superb…my experience with you has certainly set me on the path for a very positive future.” Service user, Fermoy Unit, King’s Lynn “I am writing to formally thank you and your team for all the care and support you provided, especially to our father, but also to all of the family…We are glad that he was with your team, who provided brilliant care to him. We will always remember your staff and how kind and supportive they were to us all, it is more appreciated than you can ever know.” Carer, The Willows, Woodlands, Ipswich

Insight | Spring/Summer 2016 29

Vikki’s drive to make ‘difficult conversations’ easier A member of NSFT’s Youth Council has highlighted the importance of designing young people’s mental health services around the needs of users after giving a heart-wrenching account of her own experiences at a recent Governors’ event.

30 Norfolk and Suffolk NHS FT (NSFT)

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ikki Versey, 19, spoke of her own 10-year battle with mental ill health at the ‘Difficult Conversations’ conference, which was arranged by NSFT’s Council of Governors, in Ipswich.

“Refusing help can be incredibly dangerous; it can create a spiral in your emotional wellbeing, make you feel physically unwell and it can prevent you living your life. “When you tell people you are suffering they tend to be more mindful towards you. And by getting professional help it can help to iron out the creases in terms of your own understanding of what’s going on.”

Speaking candidly, she told of how the trauma of family breakdown started a spiral of mental decline, culminating in depression, self-harm, eating disorders and anxiety. She suffered a miscarriage at 13 years-old, was bullied at school and made frequent attempts to take her own life – but has since turned her life around and become a dedicated mental health campaigner. Vikki is now urging others experiencing mental ill health not to suffer in silence and ask for the help and support they need – and has been named as a ‘mental health hero’ by the East Anglian Daily Times newspaper in recognition of her efforts. “At school I was ignored, shoved to the back of class and bullied by classmates,” said Vikki, who lives in Ipswich. “I was always the outsider, never thought of as cool enough. “I fell pregnant at 13 but the relationship didn’t work out and I lost my child – a little girl. It was terrible – I sat alone and cried and I didn’t know what to do. I didn’t know who to turn to; I felt I had noone and that no-one was interested. “I kept getting thinner and thinner and I started self-harming – I just could not cope. “I was going to A&E every couple of weeks after trying to overdose. Quite a bit of that time was so dark that I blacked it out. Over the course of one year I overdosed 12 times. I developed psychosis and just shut myself off from the world.”

“I’D ENCOURAGE ANYONE WHO IS EXPERIENCING PROBLEMS TO TRY TO BE OPEN AND HONEST AND DON’T BE AFRAID TO SEEK HELP”

Vikki’s turning point came when she started working with a “wonderful” counsellor and joined NSFT’s Youth Council. As well as recently taking part in the visit to Canada to share experiences of mental ill health at an international conference, she now has a full time job and boyfriend, and is living life to the full. “I now want to do something for young people,” she added. “If I can change one person’s life then that’s enough of a reason for me to live. “I’d encourage anyone who is experiencing problems to try to be open and honest and don’t be afraid to seek help, even if it’s only starting conversations with your friends or family.

As well as listening to Vikki’s story, those attending the conference also heard from NSFT Consultant Psychiatrist Catherine Thomas, and Anne Humphreys and Bec Jasper, who set up ‘Parents and Carers Together’ (PACT) for families with mental health issues. Exciting plans to improve access and make services more responsive to the needs of young people were also outlined. Guenever Pachent said: “We hope that the event gave Trust members, service users and their families, health and social care professionals and anyone with an interest in youth mental health the chance to find out more about initiatives which are taking place both locally and nationally. “During the event, we emphasised the importance of listening, and invited young people and their families to share their stories. We also heard about exciting plans to further improve services with the help of additional funding, which will enable the Trust and its partners to work together more closely to deliver even better care to young people experiencing mental ill health.”

Insight | Spring/Summer 2016 31

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NEW GOVERNOR RECRUITS HELP TO MAKE YOUNG PEOPLE’S VOICES HEARD Two new faces have joined our Council of Governors to ensure young people’s voices are heard and their needs taken into account when planning for the future. Elise Page, who lives near Ipswich, and Katie Davies, from Norwich, will serve as Governors for three years and will be responsible for representing the views of children and young people. Both have lived experience of mental ill health, have used services in the past and are members of the Trust’s Youth Council. Their new roles will see them work with NSFT’s existing public, staff, carer and partner Governors to act as a key link between the Trust and the communities it serves. Photo: Youth council members Katie Davies (left), Vikki Versey, and Elise page (right)

“I’M HOPING THAT BECOMING A GOVERNOR WILL GIVE ME LOTS OF LIFE SKILLS I WOULDN’T OTHERWISE GET... WHILE ALSO HELPING WITH MY CONFIDENCE”

Elise was first referred to NSFT when she was 14 after suffering with an eating disorder, and has since received care for OCD, anxiety and depression. She saw joining the Council of Governors as an opportunity to represent young voices while developing new skills. “I found our first meeting really interesting and a great experience,” said 20-year-old Elise, who currently is hoping to go on to complete

an Open University course in psychology and counselling. “Two service users sit on the Council of Governors to represent adults, and Katie and I will be providing younger voices. “I’m hoping that becoming a Governor will give me lots of life skills I wouldn’t otherwise get the opportunity to learn, while also helping with my confidence.” Katie started experiencing mental health problems aged just 13, and began self-harming before battling anorexia, anxiety and depression. “I was really pleased to become a Governor – NSFT has given me so much that I wanted to give something back,” said Katie, who is 22. “The Trust has helped me through its services, so it’s nice that I am able to do something in return.

32 Norfolk and Suffolk NHS FT (NSFT)

“Elise and I will act as a link between the Youth Council and Governors, and will make sure young people’s voices are heard while taking back any issues for discussion. “I’m already enjoying the role and being given the opportunity to have an input. “It is also really good to get more experience and learn new skills such as holding people to account, which will be useful later in life.” Guenever Pachent, Lead Governor, said: “We are delighted that Elise and Katie have joined us to act as the voices of young people and represent their views. “They both have some really interesting ideas and we are looking forward to working closely with them to help shape NSFT’s future direction.”

Dementia in perspective Carers, service users, the public, and health and social care professionals were given an informative insight into dementia at a special event hosted by NSFT Governors.

lmost 200 people attended the halfday conference called ‘Dementia In Perspective’, at the King’s Centre, in Norwich, in February. There they were able to learn about the latest developments in dementia research, the importance of receiving the right support after diagnosis, as well as the steps that people can take to lower their risk of developing the illness. Opening the conference was Dr Hugo de Waal, Consultant Psychiatrist at NSFT and an internationally respected expert on dementia. He gave an informative overview about the illness, its different types and how it is diagnosed. Professor Michael Hornberger, from the University of East Anglia, explained how the number of people with dementia is increasing and how research is leading to new

ways to treat the illness, which after heart disease and strokes is most common age-related disease. Feedback received following the event revealed that one of highlights for many who attended the conference was the opportunity to hear the personal experiences and challenges of living with dementia faced by service user Clifford Cook and carer Pauline Elliott. Consultant Clinical Psychologist Claire Lussignea explained what steps NSFT is taking to support service users and their carers while Lisa Breame, NSFT dementia trainer, closed the conference with interactive sessions that gave those at the event the opportunity to experience first-hand the pressures and confusion faced by someone with dementia. Andrew Good, one of NSFT’s Governors who hosted the conference, said: “Dementia is an

illness that touches many people’s lives, and whose complexities can mean it is not always clear what help is available or what innovative research is being done every day. “Therefore we organised this event for anyone with an interest in dementia, as well as giving them the chance to quiz our guest speakers during two panel sessions, who were able to provide further information and clarity about the many aspects of living with and caring for people with dementia.” NSFT’s Council of Governors will be hosting a similar dementia event on Thursday 10 November, 12.30-4.30pm, at Jerwood Dance House, Foundry Lane, Ipswich, IP4 1DW. For more information, email governors@nsft.nhs.uk or visit www.nsft.nhs.uk/governors

Insight | Spring/Summer 2016 33

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Meet our new Governors NSFT has welcomed 10 new Governors who bring with them a wealth of knowledge in healthcare, finance and teaching, as well as first-hand experience of accessing mental health services or caring for someone with an illness.

e appealed for people with an interest in mental health to stand for election late last year to fill vacant public, carer, service user and staff seats. Three of the Governors were re-elected, and were joined by six new faces. A tenth Governor – Nigel Boldero – was appointed this February.

“We were really pleased to receive nominations from a wide range of people from a variety of different backgrounds, and are confident that the successful candidates will help us continue to make a difference as we push for further improvements at the Trust.”

The new faces have joined the Trust’s Council of Governors, which is made up of 23 elected seats across six constituencies, and will represent the views of local people and act as a key link between the Trust and the communities it serves. As well as driving through further improvements, they will also hold NSFT’s non-executive directors to account.

NEW NORFOLK GOVERNORS

Robert Nesbitt, Company Secretary, said: “We were delighted to receive so many high calibre nominations, and would like to thank everyone who stood for their interest and ongoing support.

“OUR GOVERNORS PLAY A VITAL ROLE AT NSFT BY REPRESENTING THE VIEWS OF LOCAL PEOPLE, HOSTING IMPORTANT PUBLIC ENGAGEMENT EVENTS AND APPOINTING OUR NON-EXECUTIVE DIRECTORS”

Ginnie Benedettini (Service User Governor) “I have always felt passionately about society working to improve mental health services and enhance emotional wellbeing. “I have extensive experience of working with people with mental health conditions and a lot of insight into the way peoples’ lives are affected. This, together with my own experience of services, prompted me to stand for election as I feel that service users should have a voice, while the way in which services affect them needs to be improved. “I am a peer tutor with NSFT’s Recovery College and am qualified in a variety of holistic therapies, including aromatherapeutic massage, hypnotherapy, reiki and meditation.” Nigel Boldero (Public Governor)

“They come from all walks of life and share an interest in mental wellbeing and a desire to see NSFT develop and thrive. We look forward to working closely with the successful candidates over the coming years to further improve the services we provide across Norfolk and Suffolk.” Guenever Pachent, Lead Governor, said: “We were delighted to welcome our new Governors, who will help make sure the voices of our community are heard and their views represented.

34 Norfolk and Suffolk NHS FT (NSFT)

“I’ve lived in Norfolk for nearly 30 years and have been a volunteer in a variety of fields, most recently providing independent support to public, charitable and voluntary organisations on a range of topics, including social enterprise development.

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“Most of my working life has involved policy planning and I’ve held analytical and management positions in a variety of public bodies, including an NHS community health trust, social services and a housing association. I am committed to effective joint working between agencies and played a part in transforming outdated facilities for older people and those with learning disabilities into less institutional, community-based care. “I want to contribute to the effective governance of the Trust and to connect with the public it serves.”

NEW SUFFOLK GOVERNORS Martin Wright (Public Governor) “I spent 43 years as a chartered accountant and have extensive experience of managing finances in a variety of different organisations. I have also worked with many local community organisations, including the scouts and sports clubs, and currently help with fundraising and supporting the bereaved with Suffolk Cruse Bereavement Care. “I stood for election after three close family members used mental health services with mixed experiences and outcomes. I feel the Trust needs individuals with good judgement, appropriate skills and experience to improve the quality of services it provides and its financial management. “My aim is to work with others to hold NSFT to account, improve services and provide a strong voice for everyone who needs support with their mental health.” Malcolm Blowers (Service User Governor) “I have been a partnership Governor linking Suffolk User Forum to NSFT for several years, and believe I have a good understanding of the way the Trust works. I have also suffered with bi-polar disorder since 1968 so have a strong knowledge of mental health conditions.

Anne Humphrys (Carer Governor) “As the mother of a teenager with complex mental health needs, I have been working with NSFT, Suffolk County Council, our local CCGs and other stakeholders for the past two years to improve services for young people. During this time, I co-founded a support group for parents and carers and have also worked with national organisations, such as NHS England and Young Minds, to make a difference to the services they receive. This work has been informed by both my personal experiences as a carer and my professional life as a teacher. “I am passionate about improving mental health services for all ages. I will bring my experience, understanding and work at both national and local levels to my role as a governor, which I hope will be a natural development of the work I already do.” Continues on next page >>

BECOME A MEMBER OF OUR TRUST The membership of our Trust is drawn from people living in the communities served by us – its service users, their carers, staff and interested members of the public. Our Members bring commitment and enthusiasm for improving mental wellbeing in their local communities. If you would like to become a member of our trust there are various ways to do this. Visit www.nsft.nhs.uk/member and: • Complete our online membership form • Download, print and complete our printable membership form and send by freepost (details on form) • Complete our emailable form, save and email it as an attachment to membership@nsft.nhs.uk • Call our Membership Office on 01603 421468

“Over the past few years, I have set up a group in Great Yarmouth and Lowestoft called Feedback, which gives service users the chance to make their voices heard, and also run a support group in Lowestoft twice a week. I am also a trustee and longest serving member of the Suffolk User Forum.”

Insight | Spring/Summer 2016 35

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>> Continues from previous page

RE-ELECTED NORFOLK GOVERNORS (NORFOLK)

NEW STAFF GOVERNORS Marcus Hayward “I qualified as a registered mental health nurse in 1982 and returned to practice with NSFT in 2002, holding a variety of clinical and management roles. “I want to make a positive difference for those receiving our services and the staff delivering them. During our current period of introspection and improvement, I believe we should be appreciating great staff, identifying examples of best practice and advocating for transformation from the ground up. In my view, no one knows better how to improve services than those delivering them on the frontline. “My aim is to hold the Trust’s senior leadership to account to ensure we really do all work positively and respectfully together to improve mental healthcare.” Dr Zeyar Win “I am an associate specialist in dementia and complexity of later life based in Norwich, and have 32 years’ experience working in medicine. My aim is to ensure the Trust provides compassionate, high quality and safe care as well as services which are designed and delivered with effectiveness and efficiency. “I believe in person-centred care which is based on patient experience and participation, and truly believe that value-based healthcare can be achieved if everyone’s values are aligned. I pride myself on my transparency, honesty and trustworthiness, and hope to engage with staff and use collective leadership as a platform to provide the best care to patients, carers and professionals.”

“WE WERE DELIGHTED TO WELCOME OUR NEW GOVERNORS, WHO WILL HELP MAKE SURE THE VOICES OF OUR COMMUNITY ARE HEARD AND THEIR VIEWS REPRESENTED”

36 Norfolk and Suffolk NHS FT (NSFT)

Public Governors Catherine Wells (left), Stephen Fletcher (middle) Carer Governor Mary Rose Roe (right)

UPCOMING MEETINGS The Governors meet six times-a-year in public and hold two special themed events annually. Everyone is welcome to attend their meetings, with the next one taking place at the King’s Centre, King Street, Norwich, NR1 1PH on 7 July 2016. For more information, email governors@nsft.nhs.uk or visit www.nsft.nhs.uk/governors

MEMBERSHIP INFORMATION Following a comprehensive tendering exercise, the Governors and staff have chosen Membership Engagement Services (MES) as the new provider of Norfolk and Suffolk NHS Foundation Trust’s database services. The Trust’s previous provider, Capita, has securely transferred members’ information to MES, who will store this information and keep it up to date. Trust Members do not need to do anything; however, if you don’t want your information transferred to MES and / or wish to stop being member of the Trust, please email membership@ nsft.nhs.uk , providing your name and address.

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Shining a light on our Governors A former GP who became an NSFT Governor after spending more than 30 years working in the NHS has described the satisfaction he gets from representing local people and acting as a key link between the Trust and the community it serves.

r Paddy Fielder was elected to the Council of Governors for a threeyear term in February 2014. He applied for the role after seeing an advert in his local paper which offered an ideal opportunity to put his professional expertise to good use while also satisfying a personal interest in patient care. “I have always been interested in patient care and feel the NHS is the jewel in the country’s crown,” said Dr Fielder, who began his career as a dentist before qualifying as a doctor in 1975 and moving to general practice five years later. “After I retired I could see things happening the NHS that I was keen to try and influence and decided to apply for the governor’s role after spotting an advert in the local paper. I also have a particular interest in dementia and in trying to support carers as much as possible, and this seemed a good way to try and fulfil that aim. “Furthermore, as someone who has chronic depression I am particularly aware of the need to support those with mental illness and have been especially grateful for the help of those involved in the mindfulness course run by Suffolk Wellbeing at Mariner House. I dispute the artificial distinction between mental and physical problems which serves only to isolate the former.”

appropriate, we raise these issues with the Trust so that action can be taken. “I enjoy the role and feel we are making a difference. The other Governors are a very interesting, highly motivated bunch and have a great deal of professional and life experience. We have in depth discussions and people are able to say what they feel and – of course – there is always room for humour.

NSFT’s Council of Governors is made up of 13 public governors, seven of whom are from Norfolk and six from Suffolk. All volunteers, they sit alongside four service users, carers and four staff governors, as well as several governors appointed from organisations such as the county councils and police. Governors attend sub-groups and committees, as well as spending time visiting services and acting as a key link between the constituents they represent and the Trust.

“WE ARE ALSO THERE TO TALK TO PEOPLE IN OUR CONSTITUENCIES AND LISTEN TO THEIR PROBLEMS”

“It would be nice for us to attract some younger people and those with experience of mental ill health to become Governors, as well as people spread out geographically across both counties.

Dr Fielder added: “The role of the Governor is to act as a critical friend to the Non-Executive Directors. They, in turn, do the same to the executive members of the Board.

“We’d like to hear from people with a range of interests to come forward – the role is ideal for those who are prepared to listen to others and discuss things without prejudice and without being too dogmatic.”

“We are also there to talk to people in our constituencies and listen to their problems – such as difficulties finding carers in rural areas. Where

For more information about the role of Governors at NSFT, visit http://www.nsft.nhs. uk/About-us/ Insight | Spring/Summer 2016 37

New values aim to â&#x20AC;&#x2DC;Put People Firstâ&#x20AC;&#x2122; Our Trust has launched a new set of values and behaviours designed to ensure that service users and carers from across Norfolk and Suffolk have the best possible experience when accessing our mental healthcare. 38 Norfolk and Suffolk NHS FT (NSFT)

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he values were developed by NSFT in partnership with more than 1,300 service users, carers and staff and set out the Trust’s ambition to work “together, respectfully, positively for better mental health”. They include pledges to involve people and share information and knowledge, be professional and effective and be proactive by looking for solutions when faced with problems. They also outline the importance of open, two-way communication and valuing everyone’s unique experience, skills and contributions. As well as driving up quality, the values have also been designed to further improve staff morale, in turn leading to better care for everyone using the Trust’s services. They were developed as part of a project called ‘Putting People First’, which incorporated a series of listening sessions that took place to give staff the chance to talk openly about their working lives, including both the aspects they enjoy and areas which could be improved. Six separate events were held to give service users and carers the opportunity to share their experiences of receiving care.

before the values were refined to make them simple, clear and easy to understand. Leigh Howlett, NSFT’s Director of Strategy and Resources, said: “This exciting initiative is designed to make sure our service users, carers and staff have consistently excellent experiences when accessing the care we provide or while working for NSFT. “These new values have been developed as part of our drive for continuous improvement, and we will expect everyone working for our Trust to demonstrate them.

“THEY WILL BECOME FIRMLY EMBEDDED IN OUR DAY-TO-DAY WORK ACROSS OUR TRUST TO ENSURE EVERYONE RECEIVES THE CARE AND TREATMENT WHICH THEY DESERVE”

The values are now being used to help with recruitment and during appraisals and staff development. Continues on next page >>

People were also given the opportunity to feedback their views via an online survey

Insight | Spring/Summer 2016 39

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Continues from previous page >>

THE VALUES AND BEHAVIOURS ARE: Working POSITIVELY for better mental health

Working RESPECTFULLY for better mental health

• Be proactive; look for solutions, think creatively and focus on what we can do

• Value everyone; acknowledge people’s unique experiences, skills and contribution

• Take pride; always do our best

• Step into other people’s shoes; notice what’s actually happening

• Take responsibility; plan ahead, be realistic and do what we say we will • Support people to set and achieve goals; and be the best they can • Recognise people; their efforts and achievements, and say thank you

• Take time to care; be welcoming, friendly and support others • Be professional; respect people’s time and be aware of our impact • Be effective; focus on the purpose and keep it as simple as possible

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Working TOGETHER for better mental health • Involve people; make connections and learn from each other • Share; knowledge, information and learning • Keep people updated; with timely, open and honest communication • Have two-way conversations; listen and respond • Speak up; seek, welcome and give feedback

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Survey results show improvement in NSFT’s community services A recent survey has shown that people using community mental health services feel involved in decisions about their treatment while their families and carers are also being included in their care.

he survey, carried out by the Care Quality Commission (CQC), asked people who use NSFT’s community services for their views in nine key areas. A total of 256 people responded, with the Trust recording improvements in three categories compared with the 2014 survey.

“OUR AIM IS TO BE ABOVE THE NATIONAL AVERAGE, SO THERE IS STILL MORE WORK TO BE DONE. WE WILL USE THE FEEDBACK FROM THE SURVEY TO CONTINUE TO IMPROVE OUR COMMUNITY SERVICES FOR THE BENEFIT OF OUR PATIENTS”

The feedback also showed the Trust is comparable with the majority of other mental health providers nationwide in all nine categories, and also recorded increased satisfaction ratings among service users for family and carer involvement. Jane Sayer, Director of Nursing, Quality and Patient Safety at NSFT,

CATEGORY

2014 rating out of 10

2015 rating out of 10

Patients feeling more involved in making decisions about their care

7.1

7.7

Services involving a patient’s family and carers more in their care

6.2

7.0

Providing patients with support from people with experience of the same mental health needs

2.6

3.3

said: “These results show that the improvements we are continuing to introduce across our Trust’s community services are having a positive effect on the experience of those who use them. This is the result of lots of hard work and commitment from our community staff and demonstrates our Trust’s commitment to continuing to improve the quality of our services. We will use the feedback from the survey to continue to improve our community services for the benefit of our patients.” “We have made key changes to our Crisis Resolution Home Treatment and community services, and have worked closely with services users and carers to ensure the same standards of

excellence are in place across all of our services and localities. “Our aim is to be above the national average, so there is still more work to be done. We will use the feedback from the survey to continue to improve our community services for the benefit of our patients.” The response rate for NSFT was 31% compared with a national average of 29%. People aged 18 and over were eligible for the survey if they were receiving specialist care or treatment for a mental health condition between 1 September 2014 and 30 November 2014. The full national results for the 2015 survey can be found on the CQC website at www.cqc.org.uk Insight | Spring/Summer 2016 41

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Mock CQC inspection shows progress being made NSFT is using the results of a mock inspection to evaluate the progress being made to improve our services ahead of the Care Quality Commission (CQC) inspectors revisiting the Trust in July.

n November 2015, NSFT commissioned an independent expert to head the mock inspection, based on similar methods to those used by the CQC, to highlight areas that still required improvement. The inspection also enabled NSFT to check its quality improvement plan remained focused on the key priorities required to move out of special measures.

More than 40 clinical areas or services were inspected to similar criteria as those created by CQC – that is, whether services are: Score

Rating Amber

Caring

77% 75% 83% 75% 97%

Overall rating

78%

Amber

Safe Effective Responsive Well-led

Dr Jane Sayer, NSFT’s Director of Nursing, Quality and Patient Safety said: “Once again, we have seen clear evidence of a caring and committed staff throughout our services. “But, although we used similar methodology to the CQC, we decided to raise the threshold for our scoring to give a clearer understanding of areas for action. So this, in effect, was a tougher testing of our services.

“ONCE AGAIN, WE HAVE SEEN CLEAR EVIDENCE OF A CARING AND COMMITTED STAFF THROUGHOUT OUR SERVICES”

“And so we are really pleased to see that we’ve made some significant improvements in areas where our formal CQC Report raised concerns, including reducing the use of restrictive practices, prone restraint and seclusion; safer staffing levels; greater evidence of crisis plans being put in place for our service users; and improvements in the rates of risk assessment.”

The mock inspection was conducted by more than 50 volunteers from NSFT staff, the CCGs, service users, Healthwatch and Trust Governors to ensure that the Trust has the right procedures and practices in place to provide high quality mental health services.

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Amber Amber Amber Green

Dr Sayer added: “Areas of our Trust will now be focusing on improving clinical supervision and mandatory training rates; continue to improve the potential of the Trust’s electronic patient record – Lorenzo – to better support effective clinical practice; further embedding learnings from serious incidents and evidencing this; and to further embed the Trust’s values and vision to help improve the culture and working environment within NSFT.” To read our Mock CQC report in full visit www.nsft.nhs.uk/mockcqc2016

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ADDITIONAL BEDS OPEN TO IMPROVE MENTAL HEALTH CARE A specialist unit which brings all inpatient services for adults with acute mental health problems in Great Yarmouth and Waveney into one place has opened.

HELPING HAND FOR NORTHGATE PATIENTS Mental health patients at Northgate Hospital are now able to receive expert advice on a variety of issues thanks to an innovative partnership with the Citizen’s Advice Bureau (CAB). Full time advisor Alison Warner, from Norfolk CAB, is spending nine months working at the hospital during a pilot project. She will offer advice on everything from debt to housing.

An additional five beds have been added to the existing unit at Northgate Hospital, in Great Yarmouth, taking the total number at the site to 20. It brings all of the area’s acute beds – which were previously split between Northgate and Carlton Court, in Lowestoft – into one place to improve continuity, safety and quality of care.

so that the young people can continue their education during their admission. Read more about the plans for the centre on page 14.

As part of the project, a new section 136 suite has also been created, to offer a safe place to assess people who police feel are vulnerable. In addition to the new beds at Northgate, space previously used at Carlton Court for adult beds is being reconfigured to create a centre of excellence to care for 12 to 18-year-olds with complex mental health needs.

“The next stage of the project will be developing the new centre for youth services at Carlton Court. This will make a huge difference to our patients, as the facilities at Airey Close – where care is currently provided – are outdated and in need of modernisation. Carlton Court offers a much more pleasant environment which we hope will impact positively on our patients’ recovery.”

Once work is complete, services currently based at Airey Close, in Lothingland, will relocate to Carlton Court, with an additional five bedrooms added, taking the total available from seven to 12. New schoolrooms will also be created

Additional support is also being provided in the community by an enhanced Crisis Resolution and Home Treatment (CRHT) and Dementia Intensive Support Teams (DIST), helping avoid unnecessary admissions to hospital.

Gill Morshead, Locality Manager for NSFT, said: “Consolidating these beds in one place means we are able to provide better integrated, more joinedup services which are responsive to the needs of our patients.

“I will work alongside NSFT staff to deliver full advice support to men and women from around Norfolk whose problems may have contributed to their mental health issues,” said Alison. “We hope to deliver the support they need both before and after their release from the mental health unit.” Steve Cheshire, Chief Executive at Norfolk CAB, said: “Our research shows that more than 80% of mental health patients have debt issues and often return to the community without these debts and underlying social issues being resolved. “If patients leave without these practical problems sorted, the pressure can lead to their return to hospital. This comes at a high cost to the patient and their family and, of course, to the taxpayer. These patients may need advice and assistance not available in the inpatient unit. Therefore, we are delighted to be able to provide this assistance by placing a trained advisor within Northgate Hospital.” If the pilot is a success, the CAB will look into securing more funding to pay for a permanent advisor.

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Five-year strategy launches Our Trust has launched its five-year strategy which sets our future direction and outlines the steps we will take to become a champion for positive mental health, by providing safe, effective, trusted services. We will achieve this by concentrating on three core goals:

1. Improving quality and achieving financial sustainability

2. Working as one Trust

• Delivering trusted, effective, quality-driven services

• Embedding our values and behaviours across all our services

• Supporting and empowering our staff to be the best they can

• Giving clear accountability and responsibility to our staff

• Involving service users and carers in development and decisions about their care

• Playing a central role in the wider response to health and social care challenges

• Staffing services safely to make sure we have time to care

3. Focusing on prevention, early intervention and promoting recovery

• Ensuring accountability at the right level so decisions are quick and effective • Becoming financially sustainable; delivering services within our means

• Working together as one organisation

• Increasing our focus on primary care and prevention, while providing good quality inpatient care for those who need it • Promoting Implementing Recovery through Organisational Change

Leigh Howlett, Director of Strategy and Resources said: “Our Strategy 2016 to 2021” responds to the challenges that NSFT faces and will act as the blueprint for the future direction and development of our Trust. These three core goals will inform all our plans and everything we do, down to our individual objectives.

“OUR STRATEGY 2016 TO 2021 RESPONDS TO THE CHALLENGES THAT NSFT FACES AND WILL ACT AS THE BLUEPRINT FOR THE FUTURE DIRECTION AND DEVELOPMENT OF OUR TRUST”

• Reflecting local needs and delivering improved outcomes • Seeking integration with primary care, local authorities and other providers

“THIS IS A REALLY CLEAR DIRECTION AT A TIME WHEN OUR TRUST MUST PLAY A CENTRAL ROLE”

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“This is a really clear direction at a time when our Trust must play a central role in the transformation of health and social care across Norfolk and Suffolk to ensure mental health care is integrated throughout the system.” To read our full strategy, visit: www.nsft.nhs.uk/ five-year-strategy

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INNOVATIVE EQUALITY PROJECT PICKS UP PRIZE An innovative project which aims to improve mental health services for black and minority ethnic (BME) communities received a highly commended accolade at a national awards ceremony recently.

RESEARCH WORK HIGHLIGHTED Work which aims to make sure research brings the greatest possible benefits to people using mental health services was shortlisted for a prestigious national award. NSFT was named as a finalist in the 2015 Health Service Journal’s (HSJ) awards in the ‘clinical research impact’ category. It comes after the Trust submitted evidence about a range of different initiatives taking place across the Norfolk and Suffolk, many of which are already bringing benefits to service users. They include:

The Open Mind initiative was recognised in the ‘equality and diversity in service delivery’ category of the National Positive Practice in Mental Health Awards 2015. NSFT was one of just three trusts to be shortlisted for the award from a field of 14 entries. Open Mind was launched in September 2014 in response to research which showed people from a black and ethnic minority community can have more adverse experiences and negative outcomes within mental healthcare.

NSFT understand the issues which are important to carers and service users. They are now working together with health professionals to look at ways in which services could be adapted to make them more responsive to people’s needs and equitable for BME communities to access. Any recommendations made by the focus group will be introduced over the coming 12 months.

Its aim is to give Norfolk and Suffolk’s diverse communities a chance to make their voices heard so that services can be shaped to meet their specific needs, in turn helping to break down some of the inequalities which can make it more difficult for people to access care.

Ravi Seenan, Equalities and Engagement Manager with NSFT, said: “The Open Mind project has helped us to develop some really strong relationships with members of our BME communities, and has given them a vital opportunity to share their views and use their expertise to help us improve our services in the future by making any necessary changes or cultural adaptations.

As part of the project, community and voluntary organisations and members of the BME community took part in workshops to help

“We were absolutely delighted that this partnership work has been recognised nationally with this highly commended accolade.”

• Embedding research within clinical services by including it in staff inductions and appointing research leads and champions • Launching a five-year development programme to progress research in three priority areas – child and youth, adult recovery and wellbeing and dementia and complexity in later life • Training new investigators to support research studies • Introducing an innovative online research referral and information system to help break down barriers to research • Using research to develop the first specialised youth service of its kind in England Dr Jon Wilson, NSFT’s research lead, said: “We have placed a growing focus on research in recent years by increasing our research capacity by working in partnership with key research organisations, including the University of East Anglia. We have also established our own dedicated department in the Trust, called NSFT Research, to support clinicians to develop, deliver and embed their projects.

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Celebrating the staff who â&#x20AC;&#x2DC;Put People Firstâ&#x20AC;&#x2122; More than 180 nominations were made and 2,361 staff votes were cast, before the finalists of the Putting People First Awards 2016 were invited to a celebratory evening recognising their commitment to excellence in mental health care.

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“THIS ‘THANK-YOU’ IS NOT ONLY FOR THE FINALISTS, BUT IT IS FOR EVERY MEMBER OF STAFF WHO GOES ABOVE AND BEYOND, EVERY DAY, TO SUPPORT OUR SERVICE USERS, THEIR CARERS AND THEIR TEAMS”

ur “Putting People First” awards were presented at Sprowston Manor, near Norwich, on 5 May where we celebrated the work of our exceptional staff while recognising the individuals and teams who go to extraordinary lengths to “Put People First” during a sparkling celebration event. Chief Executive Michael Scott explained that the awards were a chance to thank our staff for their hard work and dedication over the past 12 months, whilst also recognising innovation and best practice across the services we provide to help us further improve. “Saying ‘thank-you’ on behalf of our Trust, on behalf of our service users and on behalf of our Governors is vital in ensuring our staff know just how much they are valued. Investing in the health and wellbeing of both our service users and staff is equally vital, as we know the positive morale of our staff leads to excellent patient care. “And this ‘thank-you’ is not only for the finalists, but it is for every member of staff who goes above and beyond, every day, to support our service users, their carers and their teams,” he said. For the first time ever the Trust also invited service users and carers to nominate their mental health heroes in two Public Choice awards categories - Adults Services and Children, Families and Young People’s services. This gave people the chance to tell us what they believe is excellent care.

Gary Page, Chair said: “It is always important to hear the voice of our service users to get a true picture on how we are doing. The stories we heard were truly inspirational and deeply moving.

“THE AWARDS ARE ABOUT RECOGNISING PEOPLE, TAKING PRIDE, FOCUSING ON WHAT WE CAN DO, AND ACKNOWLEDGING PEOPLE’S EXPERIENCES”

“Each award is based on one of our Trust’s values, and every single nominee has been held up as a living example of those values. Our values, of course, are what our staff and our service users told us they wanted our trust to reflect when we offer care. “And so, the awards are about recognising people, taking pride, focusing on what we can do, and acknowledging people’s experiences.” So, prepare to meet our winners and those colleagues who are highly commended, and if you would like to read more about all our finalists and see some photos from the night, visit our awards website at: www.nsftawards.co.uk Continues on next page >>

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Continues from previous page >>

CLINICAL ACHIEVEMENT AWARD Winner Nesta Reeve, Consultant Clinical Psychologist, Clinical Lead, Wellbeing Services Since the new-look service was launched last year, Wellbeing Norfolk and Waveney has become widely regarded as innovative and exciting – which is down, in no small part, to Nesta. She has played an instrumental role in shaping the service, ensuring a high level of clinical expertise while embracing new ways of working, such as the use of webinars and Skype. A strong leader, she is always on hand to provide expert advice and support while also maintaining her own caseload both energetically and enthusiastically.

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users, he also ensures carers are kept fully involved and informed in their loved one’s treatment, in turn offering reassurance at a difficult time. Clinical Supervision Team, Coastal Integrated Delivery Team (East Suffolk) By arranging group-based supervision for all clinical staff, the Coastal Integrated Delivery Team has promoted reflection while encouraging colleagues to review the impact of interventions. This has helped staff feel supported in their clinical work, in turn allowing them to concentrate on the quality and safety of the care they provide.

EMERGING TALENT AWARD (CLINICAL) Winner Haley Gosling, Peer Support Worker, Thurne Ward, Hellesdon Hospital Empathetic Haley uses her own experience of mental health difficulties to help service users to feel valued on their recovery journey while also offering a useful insight to colleagues. Proactive and positive, she is a firm believer in service user involvement, and goes the extra mile to engage patients so that they can raise any concerns, compliments, or suggestions. “Haley regularly engages in one-to-ones, and service users feel comfortable speaking to her,” said Staff Nurse Owen Spalding, who nominated her. “She can offer another perspective on their care and help them understand there is less of a barrier between staff and service user, making them more willing to engage with other members of staff in the future.”

Ian Young, Associate Director, Specialist Services, said: “I don’t know anyone more passionate about delivering the right sort of service than Nesta. When you add to that passion her immense clinical knowledge and experience, you get a very powerful result.” Highly Commended Howard Muzire, Charge Nurse, Norvic Clinic Howard is a sound and effective leader who contributes to clinical discussions with insight, pragmatism and positivity. Highly regarded by both colleagues and service

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Haley Gosling commented on her nomination by saying: “Being nominated for a staff award when I was once an inpatient myself is so surreal and represents the hope and opportunity for everyone. I’m just doing my job which I enjoy and find really rewarding, so to be nominated came out of the blue and is a complete surprise. “When I come into work it gives me the opportunity to provide a greater insight for my colleagues about the challenges faced by someone who has faced a mental health illness and inspire others on their journey to recovery. “Recovery is paramount in all we do and I feel privileged to have the opportunity to work alongside the fantastic staff at the Trust and provide vital support to patients.”

successfully put an administration system in place to help the project meet high demands for regular reporting, while also offering fantastic support to clinical colleagues. “Shoky has energy, a willingness to take on new responsibilities and develop new skills and an approach which is based on a ‘can do’ attitude where problems exist only to be solved,” said Andrew Goff, Improvement and Development Manager, Children, Families and Young People’s Service, Great Yarmouth and Waveney. “Her level of commitment to promoting the new service is without question, as is her refreshingly innovative thinking.”

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Highly Commended Gemma Gray, Mental Health Nurse, Children, Families and Young People’s Service, Great Yarmouth and Waveney Gemma has worked hard to develop an effective therapeutic programme for young people with complex needs, thinking creatively to arrange different activities so that everyone could take part. The programme helped young inpatients feel engaged and stimulated throughout the summer holidays, at a time when they can often feel more isolated and bored. Rebekah Steadman, Apprentice Support Worker, Children, Families and Young People’s Service, Great Yarmouth & Waveney Rebekah takes pride in her work and does her best to support vulnerable people with complex mental health issues to achieve their goals. Keen to be involved in all projects, she positively enhances the work dynamic of her team and will go the extra mile to help service users fulfil their hopes and aspirations.

EMERGING TALENT AWARD (NON-CLINICAL) Winner Shoky Carter, Senior Management Support Administrator, Children, Families and Young People’s Service, Great Yarmouth & Waveney Shoky has had a big impact on the Compass Outreach Team. She has used her organisational skills and eye for detail to

Highly Commended Sophy Clarke, ICT Senior Service Desk Technician Polite and professional, Sophy is self-motivated and positive, and shows real commitment in her position. She has played a key role in a wide range of initiatives to improve systems at NSFT, and stands out due to her desire to ensure customers receive a good service. Darren Howman, Patient Safety Team Administrator Darren shows compassion and patience, helping service users and carers to feel listened to and valued when they contact the complaints and safety team. Well-organised and committed, he never leaves a task undone and has developed positive working relationships with colleagues from across the Trust.

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INNOVATION AWARD Winner Norfolk Parent Infant Mental Health Attachment Project . Dr Richard Pratt - Clinical Psychologist, Dr Catherine Thomas – Consultant Child Psychiatrist, Dr Danny Taggart - Clinical Psychologist Innovative and effective, the Norfolk Parent Infant Mental Health Attachment Project provides individual packages of care to families with safeguarding concerns, in turn improving relationships so that more babies can remain with their parents. In just one year, it has benefitted more than 50 families by providing intensive support specially tailored to their needs.

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Project leads Dr Richard Pratt, Dr Catherine Thomas and Dr Danny Taggart are sensitive and thorough, and encourage colleagues to work flexibly and explore different ways of engaging with service users who often struggle with trust. They show great enthusiasm, and are always willing to share their expertise and disseminate learning from the project. Highly Commended eMMa (Electronic Medicines Management Administration) eMMa, our electronic medicines management system, is making a big difference since its introduction, helping improve both efficiency and patient safety. The team

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behind the system worked hard on its development, with eMMa now proving so effective that it has been recognised as one of the leading e-prescribing systems in the NHS. Ronnie Simpson, CLiP Clinical Educator, Norfolk A “superb” ambassador for NSFT, Ronnie has developed a range of training sessions which have directly impacted on the quality of care staff can deliver. His proactive approach to problem solving, coupled with the fantastic support he offers to staff, has gone on to help the CLiP initiative flourish and attract interest from across the country.

INSPIRATIONAL LEADER AWARD Winner Dr Sarah Maxwell, Consultant Child & Adolescent Psychiatrist, Children, Families and Young People’s Service, Great Yarmouth & Waveney Sarah has been instrumental in leading the innovative development in child, family and young people’s services both within community and inpatient settings. A positive force for change, she has proactively driven teams to develop service user-centered care, and played a key role in the development of the CAMHS inpatient unit over the past two years.

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Nicky Shaw, Deputy Service Manager, Children, Families and Young People’s Service, Great Yarmouth and Waveney, said: “Dr Maxwell is well respected by staff and peers and represents NSFT in a positive and proactive manner. She (is able) to deliver effective change that enhances the national reputation of the Trust. This is all achieved in a humble and gracious manner that exemplifies her characteristics as an inspirational leader.”

every week. My social skills have progressed and I feel much more comfortable in groups.”

Highly Commended Karen Clements, Locality Services Manager, Secure Services, Norfolk and Suffolk “Inspirational” Karen has led secure services through a challenging year, involving colleagues in the development of new strategies to improve clinical quality and finances. She works hard to promote an open, flexible and dynamic culture which gives everyone the chance to make their voices heard about the future direction of the service. Denise Grimes, Service Operations Manager, Norfolk Recovery Partnership Denise played a key role in making sure anyone who needs help can access Norfolk Recovery Partnership’s services easily and flexibly. Passionate about the quality of the service she provides, she sets high standards and actively encourages people to raise any issues they may have so that action can be taken.

PARTNERSHIP WORKING AWARD Winner Boston Lodge Community Youth Project, Children, Families and Young People’s Service, Great Yarmouth & Waveney The Boston Lodge Community Youth Project has helped around 25 young people develop their skills and confidence by working together to create a bright, vibrant mural depicting some of Lowestoft’s most iconic landmarks. A partnership between NSFT’s Youth Service, Ormiston Families and Great Yarmouth and Waveney Mind, the project received excellent feedback from those who took part. One service user said: “Being a part of the project has given us a sense of pride and achievement. I have found it extremely rewarding – it has helped me to grow in confidence and feel like a part of something. I have something to look forward to

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Highly Commended Veterans Stabilisation Programme, Norfolk. Dr Roger Kingerlee, Clinical Psychologist, Luke Woodley, Founder of the Walnut Tree Project The VSP has made a difference to scores of ex-servicemen and women experiencing mental health difficulties by offering them specially tailored support in a safe environment. The programme encourages them to explore their needs, learn to manage their difficult thoughts and feelings while also identifying any further support they may need. Compass Outreach Team, Children, Families and Young People’s Service, Norfolk The Compass Outreach Service has worked with more than 120 ‘looked after’ children and those on the edge of care, helping some return from out of county placements and others reunite with their families. The team places the child and their family at the heart of everything they do, ensuring their needs are met holistically.

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TEAM OF THE YEAR AWARD Winner Foxhall House, St Clements Hospital, Suffolk Despite being relatively new, the Foxhall House team has performed well over the past year and is setting the standards for other units to follow. The motivated staff work well together and have received some excellent feedback as they have driven through initiatives to improve services still further, such as arranging meetings with carers and service users to make sure everyone is kept fully involved during an admission.

own care while working hard to break down barriers and develop therapeutic relationships which last through each individual’s stay on the ward. Rollesby Ward, Norfolk Staff on the Rollesby Ward place a strong emphasis on collaborative decision making, and will consider everyone’s ideas so that patients receive the best possible care. By working closely with other services, they have also reduced their use of out of area beds to almost zero so that vulnerable patients can continue to receive appropriate care closer to home.

UNSUNG HERO AWARD (CLINICAL) Winner Karon O’Flanagan, Substance Misuse Nurse, Norfolk Recovery Partnership Highly knowledgeable and a consistent and clear communicator, Karon’s expertise is highly valued by her colleagues. Professional and committed in everything she does, she always finds the time to help out her colleagues.

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Nominator Dr Sohail Abrar, Consultant Psychiatrist, said: “Foxhall House is one of the best wards I have worked in. Everybody is so helpful and welcoming that it feels like home and work becomes more of a passion rather than a job. “There is great sense of team working and an “in it together” approach.” Highly Commended Thurne Ward, Norfolk The team at Thurne Ward provide an open and inviting environment as well as positive and person-centered care. Staff encourage patients to take a proactive role in their

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“Karon truly lives the values that should underpin every health and social care professional of being positive, non-judgmental and respectful of everyone she comes across,” said Denise Grimes, Service Operations Manager with Norfolk Recovery Partnership. “She gives hope where there is very little and is an established, knowledgeable, extremely competent practitioner whom I have the greatest of respect for.

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“Her pride in service users that achieve their goals is evident and her detailed and high quality work with those that have severe difficulties is of the highest standard.” Highly Commended Teresa Neil, Assistant Practitioner, Children, Families and Young People’s Service, Great Yarmouth & Waveney A loyal and dedicated member of the team, Teresa has an excellent understanding of the issued faced by young people. She has driven through a range of initiatives to improve the experience service users have at NSFT, including offering support to develop art, craft and social groups and setting up feedback sessions. Dr Andrew Tarbuck, Consultant Psychiatrist, Julian Hospital, Norfolk Andrew has reliably served the needs of older people for many years, and is held in high regard by colleagues. Methodical and inclusive, he works hard to ensure each patient receives the most comprehensive and accurate assessment and interventions. Colleagues say he is an oasis of calm and consistency who promotes positivity within his team.

UNSUNG HERO AWARD (NON-CLINICAL) Winner Paul Johnson, Organisational Development Manager Dedicated Paul Johnson cheerfully listened to the views of almost 1,300 people to fulfil the “game-changing” task of developing our new Trust values. Skillfully leading discussions, he has helped scores of staff to think more about the impact they have on service users and carers, while always embracing the ethos of ‘putting people first’.

“Paul has consistently upheld the values that were eventually chosen – positively, respectfully and together,” said Acting Consultant Psychiatrist Karen O’Sullivan. “His warmth, humour and passion have ensured the project is well received, and he has demonstrated day after day that he is an unsung hero. Everyone has and will benefit from this and it has brought staff closer together with service users and carers.” Highly Commended Emma Corlett, Youth Participation Project Lead Scores of young people have been able to get back to work or education thanks to “inspirational” Emma, who has worked with them on recovery-focused projects to build their confidence and self-esteem. She also offered “outstanding” support to our Youth Council during their Canada trip last October, in turn helping make the visit a success. Isabel Pollock, Business Support Manager, Wellbeing Norfolk and Waveney Wellbeing Norfolk and Waveney would be lost without Isabel, who makes sure electronic recording systems run smoothly so that patients can self-refer to the service more easily while also freeing up clinicians so they can spend more time with patients. She encapsulates the Trust’s behaviours and values with her honesty and integrity.

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PUBLIC CHOICE AWARD (CHILDREN, FAMILIES AND YOUNG PEOPLE’S SERVICES) Nominated by service users and carers Winner Emma Wigley, Assistant Practitioner, Children, Families and Young People’s Service, Central Norfolk Emma was nominated by a service user, whose life she helped rebuild after the teenager was left housebound due to crippling anxiety. A fantastic listener, Emma helped her feel valued while ER building her confidence to start N N I W doing new things and successfully apply for a college place. “Emma is a credit to the service, I admire everything she does and I really believe she is amazing at her job,” read her nomination. “She’s helped me become independent again, and that’s the biggest achievement, considering a year ago I was housebound and had nothing. “Thanks to Emma, I’ve made progress with my anxiety and I am no longer stuck in a hole of worry. I really appreciate everything she’s done for me.” Highly Commended Daisy Corby, Staff Nurse, Adolescent Unit, Airey Close, Lowestoft Kind, patient Daisy offers fantastic reassurance to service users, helping them to express themselves, confide about their feelings and make progress with their treatment. She always keeps carers fully informed of the progress their loved one is making and has a genuine desire to see her patients recover and return home. Jude Applin, Senior Nurse, Child and Adolescent Eating Disorders Service, Central Norfolk Jude always takes steps to put patients at ease, making their referral to the eating disorders service easier. Caring and compassionate, she works hard to make the recovery process less daunting. Her nomination said: “I wouldn’t be making progress if it wasn’t for Jude and her spot on approach to my case.”

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PUBLIC CHOICE AWARD (ADULT) Winner Owen Mutton, Criminal Justice Recovery Worker, Norfolk Recovery Partnership Owen has been described as “remarkably caring and understanding” after he helped a vulnerable and isolated service user to turn their life around after they hit their “lowest point” and were considering suicide. Owen provided unrivalled one-to-one WIN NE support while the service user R adjusted to life outside prison while maintaining his sobriety. The service user said: “Owen is such an asset to NSFT and is someone who I will never forget for the rest of my life. “Due to his support, I am now back with my family and will be eternally grateful to him. He is such a kind and considerate person and always goes the extra mile to help. I believe I owe him my life.” Highly Commended Peter Smith-Howell, Cognitive Behavioural Therapist, Suffolk Wellbeing Service The support which Peter provides has helped scores of grateful service users to a better life, with some managing recurring depression without the use of medication, while others have overcome phobias to go on to fulfilling careers. Polite and friendly, Peter has an infectious enthusiasm and delivers all of his courses with expertise and calmness. Carers’ Support Groups (Norwich and Lowestoft) Howard Tidman, Senior Practitioner. Mandy Halliday, Senior Support Worker. Emma Thomas, Carers Lead. Tiffany Cecchini, Carers Lead Our Carers’ Support Groups in Norwich and Lowestoft received multiple nominations for the invaluable support they provide to help ‘care for carers’. Always on hand to offer a listening ear and practical advice, their meetings are unhurried, respectful and offer everyone an equal opportunity to express their concerns.

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New strategy to ensure vital voices are heard NSFT has underlined its commitment to placing service users and carers at the heart of everything it does with the launch of a new strategy which makes it clearer how their voices will be heard.

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alled “Improving Services Together”, the Trust’s new Service User and Carer Strategy was launched at its AGM in the autumn. Drawn up in partnership with service users and carers, it brings together six commitments designed to ensure people can have a say in the way services are developed. Its aim is to ensure the same standards of excellence are in place across all services and localities “We are committed to placing our service users and carers at the heart of our decision making processes,” said Gary Page, Chair of NSFT. “That is why this new strategy is so important.

“WE ARE COMMITTED TO PLACING OUR SERVICE USERS AND CARERS AT THE HEART OF OUR DECISION MAKING PROCESSES”

“Previously, we had two separate strategies in place – one for engaging with service users and a second for carers. This document combines and updates those strategies while also showing how our pledges will be scrutinised so that we can make sure we are delivering on our promises.

everyone has when accessing the care we provide.” Chris Curry, who has spent the last 15 years caring for her son, helped develop the strategy along with other carers and service users. She said: “This strategy will formalise and strengthen areas of existing good practice while ensuring those same standards of excellence for engaging with service users and carers are replicated across all of the Trust’s services and localities. “It also provides a way of measuring how well NSFT is performing when it comes to service user and carer involvement, which is vitally important.

“It is not something we are just going to leave sitting on a shelf – each of us will be responsible for properly embedding this into our everyday practice.

“What excites me about this strategy is that it feels we are pushing at an open door – everybody has signed up to it, which is really positive.”

“We were delighted to officially launch the strategy and hope it will play a significant role in further improving the experience which

To read the strategy visit www.nsft.nhs.uk/ improving-services-together

THE SIX COMMITMENTS INCLUDED WITHIN THE STRATEGY ARE: 1. Service users and carers will be able to have their say in Trust business 2. There will be opportunities for service users and carers to use their skills and experiences to improve services 3. We are changing the way we provide our services in line with our commitment to organisational change 4. We will strengthen links and create partnerships with other agencies and service user and carer-led organisations 5. We will reach out to diverse and other under-represented groups 6. Service users and carers will ‘judge’ whether this strategy is being delivered

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Special events help care for carers A series of special events bringing together a host of practical advice and expert insight for carers and people experiencing mental ill health have taken place across Norfolk and Suffolk.

he day-long carers’ forums have been held in Lowestoft, Norwich, Bury St Edmunds and Ipswich and explored subjects such as dementia, dual diagnosis, substance misuse, legal highs, self-harm, obsessive compulsive disorder and depression. A range of specialists were on hand to give help and advice on areas such as getting the best from your medication, coping with a diagnosis and what to do when your capacity declines as a result of dementia. Carers and service users also took the opportunity to share their stories at the forums, while different NSFT services and partner organisations held stalls giving more information about their work and how to access support. The importance of looking after carer wellbeing was also high on the agenda at each event, with people offered free holistic therapies to give them a chance to relax and take some time for themselves. The forums were all organised by Howard Tidman, who works for NSFT’s crisis team, working closely with organisations such as the Carers Agency Partnership and Suffolk Family Carers. “These special events gave people the chance to get help, support and practical advice as well as listening

to speakers who provided an expert insight into various aspects of mental illness,” said Howard. “Carers play a valuable, yet challenging role, and I believe it is important to offer them as much help and support as we can. I hope that people were able to take away some ideas, hints and tips to help both them and the person they are caring for.” Visit the events sections of our website, or follow us on Facebook or Twitter, to keep in touch with more events planned in 2016 at http:// www.nsft.nhs.uk/Event/Pages/ CarersForum13Jan2016.aspx

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‘I owe them a debt that I cannot repay…’ Steve Downes is a 42-year-old journalist who works as a news editor on regional newspapers in Norfolk. After receiving support from NSFT recently he wanted to share his personal story to help remove the stigma and fear of mental health issues, and to encourage other people to reach out for help when they need it.

I’m writing this article from a place in my life that I recently believed that I would never reach: a place of happiness, contentment and respite from the demons that taunted and crushed me.

self-fulfilling prophecy, as in May this year I had another bout of anxiety and depression that took hold and refused to let go. Again, there were reasons for its onset. But plenty of people deal with problems without a mental collapse, so why couldn’t I?

In a few months, I have come to this point from utter despair, bewilderment and desperation. And I put much of the credit for my recovery down to staff at the Trust. I should declare now that I am a journalist – a news editor for the Eastern Daily Press and the Norwich Evening News. And I’m all too aware that newspapers and other media do not always accentuate the positives in the NHS. So please accept this article as penance for the occasional sins of my profession. The start of the story is difficult to identify. I guess it began with daily anxiety, and a programmed tendency to worry about everything. Then, in 2008, I had my first, completely terrifying bout of depression – triggered by specific work worries which was thankfully over in a few weeks. Sadly, it was as if the demons had seized the chance to put their feet in the door. And, over the next

I KNOW NOW THAT I WAS ILL, NOT WEAK: I HAVE A TENDENCY TOWARDS ANXIETY AND DEPRESSION THAT IS CHEMICAL AND EXPERIENTIAL, NOT BECAUSE I AM TOO PATHETIC TO PULL MYSELF TOGETHER” few years, they gradually opened it wider, and the periods of depression returned increasingly regularly. Living in fear of depression reduced me as a person. I became risk-averse and even life-averse. I stopped enjoying my life, because I was constantly worried about making myself vulnerable. And my moods became darker, making me far less pleasant to be around. A crisis seemed to be inevitable. Like Private Frazer from Dad’s Army, I was able always to find a cloud on the silver lining. Maybe it was a

Anyway, the crisis with a small ‘c’ became a crisis with a capital C, and I ended up in A&E, before admitting myself to the care of the mental health professionals, and checking in to Glaven Ward at Hellesdon Hospital, in Norwich. I confess that for the first 24 hours or so I was horrified by what I saw, and more than a touch frightened. It was out of my area of experience, and in the heart of my discomfort zone.

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Big Bang Theory (if I could get the remote control), eating too much, and attending therapy sessions.

There were – and are – some very obviously unwell people, including those talking to themselves, and others displaying various unusual patterns of behaviour. And it was so noisy and unsettling. But I settled quickly, and was able to look beneath the headlines and begin to read the real stories of people’s lives. And I soon started to make friends with some of my fellow patients, which was an enriching experience for me, and possibly a crushing bore for them.

“DESPITE BEING UNDER PRESSURE, THEY (THE STAFF) WERE ALWAYS PATIENT – SOMETIMES UNDER THE SEVEREST PROVOCATION”

I have to be honest and say that the ward was a fairly austere environment, and the staffing levels were clearly low. But the care from the staff was exceptional. Despite being under pressure, they (the staff) were always patient – sometimes under the severest provocation (not from me, except perhaps on the occasion when I went on a furious wasp slaughter mission in the lounge). And the compassion they had for the

patients shone through. Some patients were not talkers, but I like to run on. And two staff members in particular showed the patience of saints by listening to me going over and over my issues with them. Men, you know who you are, and I salute you. This, along with the beginning of some counselling, plus the activities laid on – not to mention the fantastic food, which I still haven’t shifted from my waistline – helped me to be discharged within three weeks, feeling stronger, and ready to get back to work and life. But the problems that landed me in hospital had not gone away, and with a month I was back in A&E, then back on Glaven Ward (following a brief but traumatic spell at an out-of-county hospital, which still makes my blood freeze when I think about it). At risk of sounding as though I’d like to rent a room, when I arrived at Glaven again I felt an extraordinary sense of relief. I knew that this was a place of safety – something that, sadly, was essential for me. It was also a place of compassion, care, love and recovery. This time I had really hit rock bottom, so I was destined to be in hospital for almost seven weeks. After an initial period of reorientation, I settled into the former routine of talking, walking, watching

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“I HAVE REGULAR COUNSELLING, AND VISITS FROM A WONDERFUL COMMUNITY NURSE, WHO MAKES SURE I’M NOT RUNNING BEFORE I CAN WALK”

Underpinning my time was the care from the nursing staff and consultants, who tweaked my medication expertly, until I could really notice a difference in my mood and positivity. Because I did not always feel that I could trust myself on my own, on most days a member of staff walked with me around the grounds of the hospital. These walks played a huge part in my recovery. They were a chance to relax, to chat, to laugh and to cry. On October 12, I was released from hospital, and the fantastic follow-up care continues. I have regular counselling, and visits from a wonderful community nurse, who makes sure I’m not running before I can walk. I’m back at work full-time, enjoying my life for the first time for a while, and beginning to see the future as a series of opportunities, not threats. The magnificent men and women on Glaven Ward and in the community team have had a huge part to play in it, and I owe them a debt that I cannot repay.”

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A carer’s story: ‘The professionals are not the only experts’ As NSFT recently launched its new Service User and Carer Strategy: Improving Services Together, Insight asked a parent and a carer of a mental health service user to describe what life is like living with his condition and if she had any advice to share with others.

write this as a proud mother of two adult children, as well as a doting grandmother. However, I have another role, which is as a carer for my son who has the misfortune to suffer from a severe and enduring mental illness. It first became obvious to me that my son was suffering when he was in early adolescence. If you can imagine the worst case of adolescence known to man and then multiply that by 500, you may gain some idea of what our family experienced for a number of years. It is a testament to the love and support of my husband and elder son that the family battled through a period that could so easily have torn us apart. I instinctively knew that something was wrong at a far deeper level as I watched my son suffer and even my GP agreed that his thoughts, beliefs and behaviours needed to be professionally examined. But, as will sound familiar to many I am sure, this was in the days before any kind of early intervention services existed and the only thing my GP could offer was dependent upon my son agreeing to seek help. Of course, he never would, because there was

nothing wrong with him. It was everybody else who had a problem. Eventually, when he was 19 he suffered from his first, full blown psychotic episode and I started on my caring journey, entering the world of mental health provision in different geographical areas as my son experienced numerous periods of hospitalisation under section, stability and relapse.

“I INSTINCTIVELY KNEW THAT SOMETHING WAS WRONG AT A FAR DEEPER LEVEL AS I WATCHED MY SON SUFFER”

It took several years before he was diagnosed as suffering from bi-polar disorder, something I had suspected for a long time, given his varying symptoms. Once he was receiving the correct treatment to keep him stable – a combination of mood stabilisers and an anti-psychotic – we all enjoyed seven years of relative peace and quiet and he was able to return to college and continue his studies.

“I COULD NOT BE MORE PROUD OF HIM AND THE MAN HE HAS BECOME, DESPITE THE STRUGGLES HE HAS HAD TO CONTEND WITH ALONG THE WAY”

Now, at the age of 33, he is well and truly in the recovery period, having gained total insight into his illness, knowing what helps him to remain well and what can hinder that recovery. I could not be more proud of him and the man he has become, despite the struggles he has had to contend with along the way. So, what is it like to be a carer for someone suffering from mental distress? I have always been a great believer in the philosophy “know thine enemy”, the enemy in this case being my son’s illness. I made it my business to learn as much as possible about the condition from which he suffered and how best to help him. In the early days I made so many mistakes. Continues on next page >>

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Continues from previous page >> When faced with his paranoia and deluded thinking it was too easy to try to rationalise with him, thereby contradicting what he believed, which, not surprisingly, did not prompt an acceptable response from him. At that point the emotional mother in me kicked in with the only response I was familiar with – tears – but when I expressed high emotion, it only caused him to escalate still further! I had to learn how best to talk to him without my upset and frustration becoming apparent. This is something that trained mental health professionals can spend years mastering. It’s not so easy when you are so personally involved with the individual who is ranting and raving before you, convinced that their delusions are reality and their paranoid beliefs represent the truth.

“I MADE IT MY BUSINESS TO LEARN AS MUCH AS POSSIBLE ABOUT THE CONDITION FROM WHICH HE SUFFERED AND HOW BEST TO HELP HIM”

Now I think that for the most part I get the balance more right than wrong, but equally that doesn’t stop me dissolving into tears on occasion after a particularly difficult period, as other members of my family can testify. I just try to keep it confined behind closed doors and away from my son. Throughout the years of constant upheaval, my son and I have remained extremely close. If there is one consolation and piece of knowledge that I would pass to

anyone in my situation, it is to take comfort from the fact that individuals in the throes of mental distress will always turn on those to whom they feel the closest. It is important to try and remember that when faced with the most appalling verbal abuse; it is not the individual that is talking, but the illness. When my son suffers from a psychotic break I have to stay well out of his sight until the appropriate medication has kicked in to calm him slightly, because until that happens I am the devil in his eyes. He will make the sign of the cross toward me, on one occasion tearing a crucifix I was wearing off my neck and throwing it out of a hospital window (thank you to the kind member of staff who retrieved it). This is a standard pattern in his behaviour which no longer upsets me – in fact, we frequently laugh about it when he is well. We also laugh about the time that I was waiting in an A&E corridor for that calmer period to arrive when I was faced with my son being escorted out to a secure area to have a cigarette. Having been well-medicated by this time, he immediately approached me, threw his arms around me and told me how much he loved me and had missed me, and proceeded to do the same to the family sitting opposite, telling them what a beautiful place the world was! I’m glad to say they were very understanding. On the last occasion, not only was I the devil, but my poor husband became Hitler. He found this extremely upsetting, until I pointed out that he should take it as an indication of just how much his relationship with my son had improved over recent years – now he was featuring in his psychoses!

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If there is one piece of advice I can give to any carer, it is to learn as much about the condition from which their loved one suffers and to remember that the professional staff are not necessarily the only experts. The carers know the patient better than anyone, and if the professional staff are prepared to work alongside the carer to share expertise, the situation can be improved so much more quickly for the service user.

“IF THERE IS ONE PIECE OF ADVICE I CAN GIVE TO ANY CARER, IT IS TO LEARN AS MUCH ABOUT THE CONDITION FROM WHICH THEIR LOVED ONE SUFFERS”

Over the years, myself and my son have experienced some excellent mental health care and some appalling practice, much of which could have been avoided. I am delighted to say that NSFT is now a signatory to the Triangle of Care and is working very hard to ensure that the carer voice is heard. Inevitably there will be times when the Trust doesn’t always get it right, but at least now good staff know what they should be doing and every step will be taken to address any issues that may arise, all to the benefit of the people we love who may be experiencing mental distress. So finally, I would want to say to anyone in a caring relationship with a mental health service user that there will be good times, bad times and worse times. Hopefully you too will be able to look back with humour eventually, and remember those humorous moments if the situation deteriorates once more.

Offering vital help to dedicated carers – carer’s leads are making a real difference People who look after someone with a mental health problem are now receiving more dedicated support than ever before thanks to an increased focus on carers’ needs at NSFT.

ix fixed-term Carers’ Leads roles are being trialled across Suffolk to promote greater awareness and the support offered to those in caring roles. Funded by Suffolk County Council, they join four counterparts already working in Norfolk.

They can also provide information about particular conditions, and they signpost carers to other agencies which can provide advice and support as well as training or social activities. And they encourage carers to take advantage of the courses offered through NSFT’s Recovery College.

Carers are entitled to an assessment which looks at the impact of their role on areas such as work, money, housing, health, wellbeing and relationships and identifies areas where they may need more help or support, and the Carers’ Leads often support these assessments taking place.

As well as providing vital one-to-one support, our Carers’ Leads are also helping to drive the Triangle of Care programme across the remainder of the Trust, which aims to ensure there is a good therapeutic alliance between carers, service users and mental health professionals, and that carers are identified at the earliest possible opportunity.

“IT’S VERY REWARDING – AND VERY HUMBLING” Catherine Phillips joined NSFT’s Waveney Community Mental Health Team last September, filling one of six new Carers’ Lead posts across the county funded by Suffolk County Council for an initial 10 months. She is one of several staff responsible for carrying out assessments for people who are caring for adults who receive secondary care mental health services and who are the council’s responsibility. In addition to ‘formal’ assessments, Continues on next page >> Insight | Spring/Summer 2016 63

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Continues from previous page >> Catherine offers carers somewhere safe, confidential and nonjudgmental where they can express their feelings and ask for advice on further support. “I find the role very rewarding and very humbling at the same time,” said Catherine, who has spent the last decade specialising in mental health in roles with Homegroup, the Shaw Trust and Norfolk Link, and also has experience of being both cared for and a carer. “It really does make you reflect.

“THEY ALSO REALLY VALUE BEING ABLE TO TALK TO SOMEONE WHO UNDERSTANDS”

“Carers do an awful lot that often goes unnoticed. They give vast amounts of their time supporting, motivating, encouraging and empowering the person they are caring for, not only by listening but also by helping them to manage symptoms, supervising medication and trying to understand how someone is feeling. It is very often a 24-hour-a-day, seven-day-a-week role and can be challenging and stressful at times. “We’ll arrange our meeting at a place convenient for them – whether it’s their home, at the team base or somewhere else that is private and suitable for their needs – and will often just sit and talk. “Caring can be very draining and that is why we are here – we offer a place where people can come and say that they are struggling and not

feel guilty,” added Catherine. “The feedback we have received so far has been really positive. Often when the assessment is completed people will tell us we have helped to make things easier for them. “They also really value being able to talk to someone who understands.

“CARERS FULFIL A KEY ROLE – IT’S VITAL WE LOOK AFTER THEM” Two Carers’ Leads who played fundamental roles in the introduction of the post in Norfolk have spoken of the enjoyment they get from helping people and inspiring colleagues. Jill Curtis and Pip Everett were appointed as Carers’ Leads for the North Norfolk, south Norfolk and Norwich city community teams in 2013. The two played an instrumental part in helping push carers higher up the agenda at NSFT, with specific Carers’ Leads roles created as a result of their input. Since then, they have been working hard to not only support carers, but also train colleagues. “Before becoming a Carers’ Lead, I’d spent 15 years within mental health as an assistant practitioner and support worker,” said Jill. “Pip and I always had a special interest in carers and would work holistically making sure we included them and offered them support. “In 2008, in collaboration with other like-minded assistant practitioners, we set up the Carers Lead Advisory Group to share good practice and create equitable services for carers. “As Carers’ Leads we work alongside carers to co-produce and co-present staff awareness and training sessions, Recovery College courses and NSFT

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strategies. Above all, we act as an advocate for carers and will listen, and respond to queries, and go out and meet with people to see what we can do to help. I feel that it is vital for us to look after carers. They play an absolutely key role and help take some pressure off statutory services, such as those we provide. That is why it is so important for us to invest in their wellbeing and offer them whatever support they need.”

“FROM MY OWN CARING EXPERIENCE, I UNDERSTAND THE IMPORTANCE AND VALUE OF BEING INVOLVED IN YOUR LOVED ONE’S CARE”

Jill and Pip are helping services collate evidence detailing how they involve carers in treatment and decisions about their loved ones. They are also developing a questionnaire, which services will use to gain feedback about what they have done well and areas where they could further improve. “I have always believed in supporting carers and working together wherever possible,” said Pip. “They are a very valuable resource and experts in their own right. “No one puts their hand up and asks to be unwell, and equally no one asks to be a carer. It’s often a position which carers find themselves in, without choice or being asked. There is no manual showing the rights and wrongs but through information and education, carers can be given the tools of how to support their loved ones as well as looking after themselves.

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“From my own caring experience, I understand the importance and value of being involved in your loved one’s care. At times when carers can feel isolated and overwhelmed, having someone to talk to and listen to their experiences can make situations a little more manageable.”

“OUR SERVICES SHOULD BE CARER-CENTERED, NOT JUST PATIENT-CENTERED” Carers from across central Norfolk are becoming more involved in their loved one’s care thanks to a drive to change culture which is being led by the area’s two Carers’ Leads. Emma Thomas and Tiff Cecchini are delivering specialist training to help staff in Norfolk Central Acute Services and the Crisis Home Resolution Team (CHRT) to identify carers before offering them appropriate support. “It is important for staff to engage and support carers, and for us to make our services not just patientcentered, but also carer-centered,” said Emma. “As such, a lot of our focus is around training and promotion and helping colleagues to ‘own’ the principles of the Triangle of Care. “There is a lot of research which shows that looking after carers can also help their loved one to remain well while boosting their recovery. It’s also important to remember that they are experts and know what works for their loved one and what doesn’t. By working more closely with them, we can tap into that wealth of knowledge and tailor the care we provide much more effectively.” Emma and Tiff have put links in place on each inpatient ward to share best practice and receive

updates on laws such as the Care Act. They provide packs for carers whose relatives have been admitted, giving phone numbers, visiting times and other information to help demystify their experience, as well as details of other areas of support, such as the Wellbeing service. They also run a weekly support group, which is open to anyone who is looking after someone with a mental health need. “The group is really informal and gives people the chance to get advice and peer support in a safe and confidential environment,” added Emma. “They can be really candid and say exactly what is on their mind, and no one will judge them.

“IT IS IMPORTANT FOR STAFF TO ENGAGE AND SUPPORT CARERS”

“It also gives us the chance to help improve communication with the ward. For example, if someone comes along and tells us they weren’t invited to a review meeting, we can report that back so that action is taken. “The feedback we have had from those attending the group has been very positive. They really appreciate the fact we are normalising the role and showing them they are not alone.” The support group meets every Wednesday in the Board Room at Hellesdon Hospital between 7pm and 9pm. Anyone caring for someone with a mental health need is welcome to drop in.

In your words... “The nurses who visit me are excellent. They listen, discuss, advise and take time and patience to understand my multiple problems. Their visits are such a reassurance to me. Nothing is too much trouble for them.” Service user Community Older Persons Team “I felt all staff showed a caring and compassionate attitude towards the care received. I take my hat off to all the staff at all levels and thank you for being so caring and understanding.” Service user, Poppy Ward, Woodlands, Suffolk “I hardly know where to begin in my enormous task of passing on our deep gratitude to you all. The incredible hope mixed with sincerity that was shown to us throughout her time in Wedgewood helped us as a family to “pull through”, what was a dark time for us all. THANK YOU for giving us back our precious daughter.” Carre, Southgate Ward, Wedgewood House, Bury St Edmunds “Just to say the help and support I have received has been amazing and having someone to ring for advice and support has made me feel more secure in dealing with my Mental Health issues. I don’t feel so isolated and alone.” Service user, Great Yarmouth Community Service, Northgate Hospital

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COMMITMENT TO CARERS RECOGNISED WITH GOLD STAR NSFT has been awarded a gold star in recognition of its commitment to ensuring carers are fully supported and involved in decisions about care.

Gary Page, NSFT Chair, said: “We are committed to placing our service users and carers at the heart of everything we do, and cemented this when we launched ‘Improving Services Together’, which makes it clearer how their voices will be heard.

The Carers Trust presented NSFT with the star for successfully achieving the first stage of the Triangle of Care. NSFT is one of only 18 NHS trusts across the country to achieve the accolade.

“We are really pleased that we have received the gold star and will continue to build on these strong foundations in the future as we drive through further improvements for our service users and their carers.”

The award came following a lengthy evaluation process, during which every inpatient service and Crisis Resolution and Home Treatment (CRHT) Team completed an assessment explaining the steps they take to involve carers. A detailed report was also submitted to the Carers Trust and a presentation took place before the application was peer evaluated and a final decision made. Sharon Picken, NSFT Service User and Carer Involvement Lead, said: “We are delighted to have become one of just 18 trusts to be awarded a gold star.

“Our staff have shown enormous enthusiasm for the project, and have all worked really hard to make sure that the true principles of the Triangle of Care are embedded in our everyday working practices. “Achieving this standard underlines our commitment to ensuring all of our services and teams can support, listen to and engage with carers to make sure that the care we provide is joined up, person-centred and of the highest quality.” The Triangle of Care programme, the remainder of NSFT’s services will also complete assessments to evaluate how well they are working with carers.

The Triangle of Care was launched in 2010 as a therapeutic alliance between carers, service users and staff. NSFT became a member of the scheme in 2014, with the aim of supporting and promoting recovery in mental health by ensuring that carers are fully involved throughout the recovery journey and able to access support, and that services value the vital role they play. For more information about the Triangle of Care, visit www.carers.org/news/mentalhealth-and-triangle-care

IMPROVING SERVICES THROUGH SPECIAL ROADSHOWS Service users have been given the chance to share their views on the care provided by our Trust along with ideas for improving the experience people have when accessing mental health support at a series of special roadshows. NSFT’s three Suffolk modern matrons have been touring the county over the past few months, gathering feedback and listening to people’s ideas about how services could be improved. They have also given out information about the wide variety of help which the Trust provides during visits to Haverhill, Felixstowe, Bury St Edmunds, Sudbury, Stowmarket, Woodbridge and Thetford, in Norfolk.

Tara Brown, Modern Matron for East Suffolk, ran the events with Kris Panvalkar, who is based in West Suffolk, and Lianne Nunn, who covers the Wellbeing Service, access and assessment, autism diagnostic service, recovery college and learning disability inpatient services. “We wanted to make it as easy as we could for people to give us their feedback so that we can work

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together to further improve the services we provide,” said Tara. “This was a completely new initiative for us, and built on the work we do at regular forums which take place in Ipswich and Bury St Edmunds. By going out into the community more widely, our aim was to capture more people’s views and ideas so we can make some real changes for the benefit of our service users and their carers.”

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TAKING ACTION TO IMPROVE SERVICES FOR BME COMMUNITIES More will be done to publicise the wide range of help and support available to Black and Minority Ethnic (BME) people with mental health difficulties after a specially-commissioned survey showed that some communities in Suffolk were not aware of the services on offer. The pledge comes after NSFT commissioned Healthwatch Suffolk to carry out an extensive survey to find out more about the experience BME communities have when using mental health services. As well as better publicity, NSFT will carry out more training with staff to ensure services are culturally sensitive while continuing to run events to promote mental wellbeing, as well as organising seminars to promote mental health to faith leaders. The commitment comes following the Healthwatch survey, which formed part of the ongoing Open Mind project, which aims to improve mental health for BME communities as well as their access to services. Nearly 775 people were asked for their views, while a series of focus groups also took place so that people could describe their experiences in more detail. The results, which were showcased at a half-day conference in Ipswich, showed: • The majority of people (90% of Chinese respondents, 33% of white British and 20% of black or black British Caribbean respondents) find mental health difficult to talk about • 75% of black British respondents can talk to family and friends about their mental health issues, but 60% of Bangladeshi respondents could not, indicating there are some wide cultural differences

and our communities to look at how to improve on the way we deliver our services and address some of the cultural, social and systemic barriers that exist, which often can leads to inequalities among certain groups of people.

• Faith and belief is important for 40% of white respondents when thinking about their mental wellbeing. This rises to 80 – 100% for most BME respondents • Only 10% of white British people would approach their faith leader to discuss their mental health problems • 100% of Asian British and Bangladeshi respondents aged 35 and over would approach their faith leader to discuss their mental health problems • 90% of BME people said it was not easy to find information about mental health services • 87% of BME service users said that staff were ‘very helpful’, compared to 62% of white British respondents • Almost half of BME services users said that mental health services were not culturally sensitive, with one in four saying that they were asked questions that were not acceptable to their culture or faith Ravi Seenan, Equalities and Engagement Manager with NSFT, said: “We were delighted to be able to work with Healthwatch Suffolk

“KEY TO THIS WORK WILL BE INCREASING PEOPLE’S AWARENESS OF THE SERVICES WE PROVIDE SO THAT EVERYONE HAS THE SAME ACCESS TO HIGH QUALITY SERVICES”

“The survey produced some really interesting results and we have already drawn up some actions to address some of the points which were raised. Key to this work will be increasing people’s awareness of the services we provide so that everyone has the same access to high quality services and the opportunity to improve their mental health and wellbeing. “We will now share the findings of this survey with our partner organisations including voluntary and statutory groups, staff members and our service users and carers, so that any issues can be addressed and appropriate cultural adaptations made to services.”

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Academy celebrates its first graduation A unique academy which provides newly-qualified staff with additional training and support as they make the transition from university to work has celebrated a successful first year after seeing its inaugural cohort graduate.

total of 18 staff based in Norfolk recently graduated from the academy, which was launched by NSFT in Norfolk 2014 to support staff as they moved from study into the workplace. The successful candidates were all presented with certificates from Lady Dannatt during the Trust’s AGM in the autumn. The initiative originally began as a pilot project designed to respond to statistics which show a large proportion of nurses across the country leave within two years of qualifying. The academy tackles this by providing a valuable support system during the first year in post as newly-qualified nurses make the transition into the workplace. In addition, it also gives them the chance to get together every fortnight to complete their mandatory training, along with additional specialist training and masterclasses, in turn ensuring they are able to deliver high quality care to patients. The Norfolk Academy – originally known as the Nursing Academy– proved such a success that its Suffolk counterpart opened in June last year. The model has now been adapted to become a Newly Qualified Academy, open to return to practice professionals as well as those who have just finished university.

Trudii Isherwood, Training Manager at the Trust’s Education and Development Department, said: “We had some excellent feedback following the academy’s first year, with our newly qualified staff telling us it helped them feel valued and gave them opportunities for personal development. They also told us they feel engaged and have a real sense of their Trust and professional identity, which is great news. “The idea behind the initiative was to give the newly-qualified staff a strong support network and structured further development during their first year in post as well as strengthening the relationships they developed as students.”

“WE ARE DELIGHTED THE ACADEMY HAS PROVED SUCH A SUCCESS SO FAR AND LOOK FORWARD TO WELCOMING OUR NEXT COHORT OF STUDENTS”

For more information visit: www.nsft.nhs.uk/nursingacademy

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Special event to help grow talent Support staff who play a vital role in providing NSFT’s services were given the chance to find out about opportunities for personal development while learning more about existing initiatives offered by the Trust at our very first Talent for Care event recently.

he day-long event was open to clinical and non-clinical staff to give them the chance to explore ways in which they can progress their career. The event was arranged as part of the Talent for Care and Widening Participation Partnership pledge. This focuses on developing support staff so that they can deliver better services, improve their skills and take on new challenges while helping trusts like NSFT attract more people to a career in the NHS. It has been introduced by Health Education England partly in response to statistics which show

that people in Bands 1 to 4 make up a significant portion of the NHS workforce, with the Trust employing a total of 1,629 staff – the equivalent of 40% – in these roles. The pledge is divided into three key objectives: • Get in - giving more people the opportunity to start their career in a support role • Get on - supporting people to be the best they can be at their job • Go further - ensuring people are given the chance to progress their career The Trust recently signed up to the pledge to formalise many of the

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initiatives it already has in place to develop and grow its workforce, including apprenticeships, work experience and foundation degrees. It also demonstrates our Trust’s continued commitment to offer support staff the chance to gain new opportunities to become highly skilled, flexible and able to meet future healthcare challenges.

“OUR FIRST EVER TALENT FOR CARE EVENT WAS A GREAT SUCCESS WITH LOTS OF STAFF FROM ACROSS THE TRUST ATTENDING”

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Around 125 people attended the day at Lynford Hall, near Thetford, and were given the opportunity to take part in workshops and a Q&A session with Chief Executive Michael Scott. During the afternoon, Michael also presented six special awards in three categories, for long-standing service, going the extra mile in quality of care/customer service and giving outstanding support to teams/colleagues.

“OUR STAFF ARE THE BEDROCK OF EVERYTHING WE DO, AND WE ARE COMMITTED TO SUPPORTING THEM AND HELPING THEM TO MAXIMISE THEIR TALENT FOR CARE WHILE DEVELOPING THEIR OWN SKILLS”

Kim Boggan, Talent for Care Lead with NSFT said: “Our first ever Talent for Care event was a great success, with lots of staff from across the Trust attending and taking the chance to find out more about the opportunities available at out Trust. My colleagues worked extremely hard to put this day together and make it a success. “Our staff are the bedrock of everything we do, and we are committed to supporting them and helping them to maximise their talent for care while developing their own skills. Not only is it good news for those individuals, but also means our service users are receiving their care from motivated, enthusiastic staff.”

“I ABSOLUTELY LOVE MY JOB... I’M VERY LUCKY!” A Contracts and Performance Assistant who was offered a permanent job after successfully completing an apprenticeship has described how the opportunity paved the way into a career she otherwise would not have considered. Molly Grange joined NSFT in November 2014 and completed a year-long level two business and administration apprenticeship course before she was offered a substantive job. She started her permanent role in November 2015, and has now begun studying for her level three qualification. “I never thought that I would work in a business environment as it wasn’t something I’d considered exploring before,” said Molly, 21, who lives in Norwich. “But the apprenticeship really opened my eyes to the possibilities, and has given me a better idea of what I would like to do in the future. “I began my substantive post the day after completing my apprenticeship, which was fantastic as it has allowed me to continue developing the skills I learnt during the year. I now look after the data on out of area placements and go to the specialist patient panel to discuss cases. I absolutely love it and am very lucky.” Molly spent 18 months working in retail after completing her A-levels as she was unsure which career path to follow. And although she admits she didn’t have any knowledge of apprenticeships before starting her course, she would now recommend them to anyone. She even promotes apprenticeships as part of her role, as well as inspiring others at NSFT’s recent Talent for Care event by giving a

presentation outlining her own positive experiences. “It has been ideal for me as I have learnt so much,” added Molly. “I would recommend it 100% and have told so many people about apprenticeships and where they can lead you. “I’m a health ambassador for the Trust, which means I go into schools and colleges and to career events to promote apprenticeship opportunities at NSFT. I really enjoy that part of my role and think that talking to someone who has been there, done it and is living proof that apprenticeships do work can have a really positive impact on students. “NSFT has been very supportive with helping me to progress my education and I’m grateful for all the help I have received. I want to stay at the Trust and climb as high as I possibly can and make the most of the opportunities I have been given.” Insight | Spring/Summer 2016 71

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“IT’S GIVEN ME THE CHANCE TO MAKE THE MOST OF NEW OPPORTUNITIES” A former business manager who is about to begin a mental health nursing degree has credited the Talent for Care programme as opening up new opportunities which he otherwise would never have had. me really well as it has meant I can bounce ideas off colleagues and learn from them while also studying. Being able learn while getting paid has also allowed me to complete courses I otherwise wouldn’t have been able to fund myself.

Danny Willcox joined NSFT seven years ago as an activities assistant working with the occupational therapy team. The move was a complete career change from his previous role as manager of an outdoor activities company. But since moving to the NHS, the 42-year-old hasn’t looked back, and has embraced every opportunity to progress his career or complete additional training. “I moved to NSFT as I wanted a better work/life balance and more opportunities, and was looking for something which would be a complete contrast and allow me to work with more people,” said Danny. “I arrived with limited qualifications as I had never been very academic, but was then given the chance to complete a year-long vocational related qualification (VRQ) through Lowestoft College, which opened the door for me to study for a degree.” Danny completed his foundation degree at University Campus Suffolk in just 18 months while also working as an Assistant Practitioner for NSFT, providing meaningful and purposeful activities to help service users towards recovery. Since graduating in October 2015, he has secured a new job working on an older person’s ward at the Julian Hospital and will begin his training to become a mental health nurse in March. “I applied for my new job as I wanted to get more involved with

“IF YOU’D TOLD ME SEVEN YEARS AGO THAT I’D HAVE COMPLETED ONE DEGREE AND BE ABOUT TO START A SECOND, I WOULD HAVE LAUGHED!” clinical work on the ward while I complete my nursing degree, my current area was unable to facilitate this; I find it’s the best way to enhance my own learning,” added Danny, who lives just outside of Norwich. “I’m looking forward to starting my new role and my nurse training, which should take around 18 months to complete.

“I MOVED TO NSFT AS I WANTED A BETTER WORK/ LIFE BALANCE AND MORE OPPORTUNITIES”

“I’m really grateful to the Talent for Care team, who have opened up lots of different opportunities for me. Learning while on the job has suited

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“I feel like I have built up a reputation at the Trust and it’s nice that I have been recognised and given the chance to make the most of the opportunities on offer. If you’d told me seven years ago that I’d have completed one degree and be about to start a second, I would have laughed! “I’ve recently completed a threemonth secondment with the Talent for Care team and help project manage the introduction of the Care Certificate at NSFT. That has given me a much better understanding of the pathways available to people, and has also led to me to become an ambassador for workplace learning so that I can encourage other staff to make the most of the opportunities which are available to them.”

Trust pledges support for Time to Change Our Trust has lent its support to a national campaign designed to tackle the stigma surrounding mental ill health by signing the Time to Change Employer Pledge.

hief Executive Michael Scott signed the pledge in the run up to national Time to Talk Day, earlier this year. The pledge underlines NSFT’s commitment to reducing stigma around mental ill health, with a particular focus on the workplace. By signing, the Trust has joined a growing movement of more than 300 employers in England to take the pledge and commit to tackling discrimination while keeping their staff well at work. NSFT will now show its commitment to the pledge by developing an action plan of anti-stigma activities it will undertake. “Although mental health problems are common, nearly nine out of every 10 people who experience them say they face stigma and discrimination as a result,” said Mr Scott. “In some

situations, this can be even worse than the symptoms themselves. “We are committed to working together to tackle this discrimination, and fully support Time to Change, which is England’s biggest programme to challenge mental health stigma.

“CONVERSATIONS ABOUT MENTAL HEALTH CAN HELP STRENGTHEN FRIENDSHIPS, AID RECOVERY AND BREAK DOWN STEREOTYPES”

“By signing this pledge, we are publicly showing our support for the campaign, as well as the importance we place on safeguarding the mental health of our staff.

“Conversations about mental health can help strengthen friendships, aid recovery and break down stereotypes, so we would encourage everyone to get involved with this fantastic initiative and help take the stigma out of something which affects so many.” Insight | Spring/Summer 2016 73

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Sign up now for a fulfilling career People keen to work directly with patients and service users are being encouraged to consider signing up for an apprenticeship and taking the first step towards a rewarding healthcare career.

SFT is urging anyone interested in a caring role to think about completing an apprenticeship, which would give them the chance to earn while they learn while gaining a route into the NHS. The Trust has appointed 15 apprentice Clinical Support Workers (CSWs) across the Trust over the past few months, who work under supervision from senior staff to deliver basic care. It is now hoping to add to that number by attracting more people looking for a rewarding and varied clinical career, in turn replicating the success it has had appointing apprentices to nonclinical positions, such as admin roles and customer services.

“ONCE I’VE FINISHED THE APPRENTICESHIP I HOPE TO GO ON TO DO A DEGREE SO THAT I CAN GRADUALLY WORK MY WAY UP AT NSFT”

Helen Bell had always wanted a job in healthcare, but put her plans on hold to work as a beauty therapist while her two children were younger. She jumped at the chance

Photo: Helen Bell

Photo: Rebecca Bilham

of the applying when she saw the apprentice CSW role advertised, and took up her position in February.

NSFT provides, as well as the all the different roles which are involved in delivering care.

“I had done some health and social care work before and decided when my children got a bit older I’d like to dip my toe back into it,” said Helen, 29, who lives in Kings Lynn. “It was the ideal opportunity for me.

“It’s exciting for my future as further down the line I will be helping with memory assessments and carrying out various tests, so will be really hands on.

“I will spend six months shadowing doctors and nurses carrying out home visits as part of the Dementia and Complexity in Later Life team before moving into adult recovery. It’s really good as it gives me an insight into the different services

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“Once I’ve finished the apprenticeship I hope to go on to do a degree so that I can gradually work my way up at NSFT.” Rebecca Bilham, who lives in Norwich, applied for the apprentice CSW role while finishing her A-levels, and joined the Trust in

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August. She now works with the community Dementia Intensive Support Team (DIST), based at the Julian Hospital in Norwich.

you the chance to get a year of experience while earning a wage and continuing to learn. For me, it was the ideal solution.”

“I had preconceived ideas that apprenticeships were all about sitting in an office, answering phones and making tea,” said the 18-year-old, who is completing her studies at City College. “But the role is not like that at all and is very hands on.

Julie Shrimpton, Clinical Team Leader with DIST, said: “Rebecca is frankly amazing. She has joined a very big and busy team, and is studying and learning whilst experiencing lots or new situations. She has taken all of this in her stride and to the benefit of the patients; we have had really positive feedback from relatives stating what a calming effect she has had whilst visiting.

“I WOULD DEFINITELY RECOMMEND APPRENTICESHIPS”

“I have a similar role to a support worker and go out with a member of the DIST team to visit patients in the community and do things like chat to them, liaise with their family and make them a cup of tea or something to eat. The fact that I am shadowing a member of the team all the time is really helpful as I get to ask questions, learn from them and see how they handle situations firsthand, which makes a real difference. “My favourite part of the job is meeting new people. I work with a lot of older people and really like listening to their stories and finding out about their life. I find it really interesting” “Before I started the apprenticeship, I didn’t know what I wanted to do. Now I plan to apply for a band 3 position when I’ve finished the apprenticeship and go on to do an assistant practitioner foundation degree. I can’t see myself doing anything else. “I would definitely recommend apprenticeships. Even if you are still working out what you want to do in the long-run, they give

“I’M SURE SHE WILL GO FAR IN HER CAREER WITH THE ENTHUSIASM AND DEDICATION SHE HAS SHOWN IN THE LAST FEW MONTHS”

“Rebecca shows so much initiative and motivation to learn and her confidence grows every day. She is a very valued member of the team and we are all very proud of her.” Assistant Practitioner Kim Martins, who is Rebecca’s supervisor, said: “Rebecca is very motivated in her learning and appears to want to continue to enhance her role within the team. “I’m sure she will go far in her career with the enthusiasm and dedication she has shown in the last few months.” For more information about apprenticeship opportunities at NSFT, contact Jane Stringer on 01603 421564 or by email at jane.stringer@nsft.nhs.uk

WORK FOR US People looking for a rewarding career in the NHS and within mental health can keep in touch and find out more about the opportunities available and what it’s like to work for NSFT after a new microsite and Twitter feed were launched.

The new approach to recruitment has seen an exciting range of career choices across Norfolk and Suffolk advertised to a wider range of people via the @NSFTjobs Twitter account and the microsite, which was launched in the spring. Available at www.nsft.nhs.uk/workfor-us the site includes: • Links to NSFT’s latest vacancies and full NHS jobs listings • Videos on working for the NHS and the variety of jobs on offer • A link to our @NSFTjobs Twitter feed • Details of upcoming recruitment fairs and events • Highlights of our innovative Nursing Academy • Information on apprenticeships, work experience and temporary positions In the future there will be detailed career profiles, additional video content and a more detailed recruitment calendar.

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It was complete chaos… we thought it was the end of the world A doctor who decided to pursue a career in mental health after witnessing the devastating effects a suicide bombing had on his brother has spoken frankly about his experiences in war-torn Baghdad and the impact it has had on his life.

asir Hameed was working as a junior doctor in the accident and emergency unit at the city’s Al-Wasiti Hospital for Reconstructive Surgery when the Iraq war began in 2003.

He spent most of the war at the hospital as it came under siege, during which time he treated an injured British journalist, was threatened by looters, had a gun held to his head and calmly removed a grenade a patient had brought onto the ward. Yasir even fired an AK47 into the air to frighten off thieves intent on stealing medical supplies – an event later documented by American journalist Dexter Filkins in the New York Times’ bestseller ‘The Forever War’. On 9 April 2003, Yasir heard the news on the radio that Baghdad had fallen and the American army and Iraqi people had toppled the statue of Saddam in Al Firdoos Square, less than a mile from his workplace. Al-Wasiti then became the area’s only functioning hospital, with Yasir the only junior doctor on duty as many staff could not reach work due to disruptions in public transport and the deteriorating security situation. “During that time I saw lots of things I will never forget,” said Yasir, who moved to the UK in 2009. “It was complete chaos and I remember looking through the window seeing the American army and the looters in the street, and one of the doctors saying they thought it was the end of the world. “On the days following the fall of Baghdad, looters went on the rampage and destroyed most government buildings,

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including hospitals and museums. At the time, the American army didn’t have orders to protect these facilities, so the looters were free to do whatever they wanted. “We were lucky because two days earlier we had admitted Paul Pasquale, a British technician who was working for Reuters and was injured when the Americans wrongly targeted his hotel. His colleagues contacted the American army and they immediately sent a group of Marines to protect him and our hospital. I don’t think Paul will ever know how grateful we were to him.

“I AM PRIVILEGED TO HAVE RECEIVED EXCELLENT SUPERVISION FROM THE CONSULTANTS AND OTHER PROFESSIONALS AT NSFT AND REALLY ENJOY MY JOB. “ Yasir Hameed

“Lots of people were injured and some families had had some very traumatic experiences. We would treat their wounds and carry out surgical procedures, but really couldn’t help them with the emotional side.” Although Yasir had been intrigued by mental health, it wasn’t until his 27-year-old brother Uday suffered lifechanging injuries and post-traumatic stress disorder (PTSD) following a suicide bombing six years later that he decided to specialise.

He explained: “Uday was working with the Minister of Foreign Affairs when he was involved in the suicide bomb attack. One minute he was in the office talking about football with his colleagues, then the blast came and he was suddenly surrounded by bodies of four of them. “He was badly injured and lost his left eye and his face was disfigured. It was such a big thing for me to see changes in my brother. He had all of the symptoms of PTSD but has never had treatment and has become more snappy and angry with his children as a result.” Spurred on by his brother’s plight and the things he had witnessed in Iraq, Yasir later relocated to the UK and started his psychiatry training with NSFT in 2010. Since then, he has gained experience working in various placements before moving to the 20-bedded Glaven Ward at Hellesdon Hospital, where he is in specialist training in general adult and old age psychiatry. Yasir has clocked up a range of achievements since, including helping to provide better working conditions for his peers, boosting education and training and improving the experience which patients and carers have while accessing care. He has made such an impression since joining the Trust that was shortlisted as one of four finalists in the Higher Psychiatric Trainee of the Year category in the Royal College of Psychiatrists Awards 2015. He was also named as a ‘mental health hero’ by the Eastern Daily Press newspaper as part of their recent Mental Health Watch campaign. “I decided to retrain as a psychiatrist because of my experiences in Iraq seeing the effects of mental trauma on people in a warzone,” added the 37-year-old, who lives in Norwich with his wife and three children. “During my time in Iraq and while working as a GP in Yemen, I also found that lots of people with mental health problems get ignored, which inspired me to do my bit to help them. “I am privileged to have received excellent supervision from the consultants and other professionals at NSFT

and really enjoy my job. It’s no secret that it can be very stressful, but we try and give the best care we can to people from all walks of life so that they can move on with their lives. “One of the great things about the NHS is that lots of the doctors have qualified overseas, which means there are lots of diverse people working in the same team. For me, being able to speak Arabic and having knowledge of the Middle Eastern culture is really useful when I assess patients with various mental health problems, as that background understanding helps me work out if what they are experiencing is part of their culture or part of their mental illness. “I think the NHS is the best health system in the world. Its workforce comes from diverse backgrounds and they are united in sharing the same desire to provide the best possible care. That is really important.” Julian Beezhold, Consultant in Emergency Psychiatry with NSFT, nominated Yasir for the Royal College of Psychiatrists Award. He said: “Yasir has been contributing immensely towards change for the better for patients, carers, staff and students. “He is always humble and self-effacing, an absolute pleasure to work with and very highly rated by patients, carers, junior and senior clinical and non-clinical staff.” To read a short article written by Yasir about the incident with the grenade, visit http://www.cmaj.ca/content/early/2009/07/20/ cmaj.091127.full.pdf For Dexter Filkins account of the days following the fall of Baghdad and the AK47, which uses Yasir’s family name of Mousawi, go to http:// www.nytimes.com/2003/04/12/international/ worldspecial/12BAGH.html?pagewanted=all

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THREE NEW NEDS JOIN MENTAL HEALTH TRUST Three new non-executive directors (NEDS) with a wealth of experience in mental health, finance and management have been appointed to NSFT’s Board of Directors.

Photo: Tim Stevens

Photo: Jill Robinson

Photo: Ian Brookman

Bishop Tim Stevens and Ian Brookman joined the Trust on 1 December, with Professor Jill Robinson beginning on 1 January.

currently part-time finance director at Ormiston Families, a regional charity which supports children and young people from across East Anglia.

Tim, from Bury St Edmunds, began his church career as a curate and held various roles in Canvey Island, Chelmsford and West Ham before he was appointed Bishop of Dunwich in 1995. In 1999, he became Bishop of Leicester with responsibility for managing an annual budget of £9m and leading a diocese of one million people from a diverse range of backgrounds. Tim also spent six years chairing the Bishops’ Bench in the House of Lords, where he contributed to national debates by speaking on the behalf of 26 bishops.

As well as helping to improve the finances at a range of different organisations, he has played a key role in enhancing the performance of schools and helped establish a not-for-profit start-up organisation to take over the provision of library services across Suffolk. He also serves as a trustee for a national academy chain.

In addition, Jill spent a year working as a psychological therapist for NSFT, and has also held honorary appointments at universities and in the NHS.

He applied for the role of nonexecutive director after retiring so that he could focus on health policy while making good use of the knowledge and experience he built up during his career. Ian, who lives near Bury St Edmunds, has spent his career working in management and finance and is

Jill, who lives near Diss, has become a NED after spending more than 35 years working in mental health, education and research, most recently as Executive Dean and Professor of Healthcare Practice at University Campus Suffolk (UCS). She started her career as a mental health nurse and held a variety of roles working with young people and in the community before moving into education, and has since worked at both the University of East Anglia and UCS.

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Lead Governor Guenever Pachent said: “We are really pleased to have recruited three new high calibre non-executive directors. Their knowledge and expertise will be vitally important and we look forward to working closely with them over the coming years.” NSFT Chair Gary Page said: “I am delighted that we are able to welcome Jill, Tim and Ian to Norfolk and Suffolk NHS Foundation Trust. They bring with them a wealth of experience in a wide range of different areas, and will make a valuable contribution to our discussions at Board and shaping our plans for the future. “I look forward to working closely with all three as we continue to drive through quality improvements at the Trust for the benefit of our service users and their carers.”

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TRUST REAPPOINTS CHAIR FOR A FURTHER THREE YEARS Gary Page has been reappointed as Chair of NSFT for a further three years from April 2016.

NEW DIRECTOR OF FINANCE FOR NSFT Our Trust has welcomed a new Director of Finance and Deputy Chief Executive to help drive through our ongoing plans for improvement.

His reappointment follows a comprehensive appraisal process that included seeking the views of Governors, stakeholders, services users and carers, staff, board members and Monitor’s Improvement Director. The feedback praised the work Gary has done over the past year and expressed the view that he was the right person to continue leading NSFT over the next three years.

“OVER THE PAST THREE YEARS, GARY HAS PLAYED A KEY ROLE IN HOLDING THE TRUST TOGETHER”

The Trust’s Council of Governors’ Nominations Committee echoed this view, by recognising Gary’s significant contribution to the Trust as Chair, including helping it work towards exiting special measures and making further improvements to services for the benefit of service users and carers. Gary said: “I am delighted to be reappointed as Chair of the Trust at a time when mental health is high on the public agenda. I am very much looking forward to carrying on working with the Board of Directors and Council of Governors, our hard-working staff, service users and carers and other stakeholders to

ensure our Trust continues to make progress in delivering safe and high quality services. As a foundation trust, the task of reappointing a new Chair for NSFT falls to the Trust’s Council of Governors. Lead Governor, Guenever Pachent, said: “Over the past three years, Gary has played a key role in holding the Trust together, and leading its efforts to improve services for service users and their families. His significant contribution to the Trust has been reflected in the high esteem he is held by service users and carers, and staff and partner organisations. “The Council of Governors unanimously approved his reappointment as Chair and looks forward to working with him in helping the Trust exit special measures and highlighting the need, both locally and nationally, to ensure mental health services are treated equally with physical health.”

Julie Cave joined NSFT in December from the Norfolk and Norwich University Hospital NHS Foundation Trust (NNUH), where she spent six years as Director of Resources with responsibility for estates, IT, contracting, finance and performance. During this time, she was also accountable officer for the Eastern Clinical Research Network and executive lead for cancer, which gave her the opportunity to help further develop services for the benefit of patients. Julie brings with her nearly 30 years of experience in the NHS, having begun her career in the south east where she worked as a regional finance trainee and financial accountant before relocating to East Anglia in 1991. After spending four years at East Suffolk Health Authority, she moved into acute services, holding senior positions at both NNUH and James Paget University Hospitals NHS Foundation Trust.

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Double role for NSFT’s Gary An electrician who spends his days maintaining NSFT’s buildings has spoken of the satisfaction he gets from his second role as an ambulance First Responder.

ary Shaw, who has spent the past four years with the works department at Hellesdon Hospital, in Norwich, began volunteering with the East of England Ambulance Service in October – and hasn’t looked back since. He works with three others who take it in turns to cover the area around his home village of Sparham. He can be called to anything from a heart attack to respiratory problems, diabetic comas, heavy bleeding and choking,

and is first on scene to respond before the ambulance crew arrives. Gary joined the First Responders after having a life-long interest in human biology, which was triggered when his father’s partner sadly died of a heart attack in front of him when he was eight-years-old. Since then, he has taken numerous first aid courses and spent time working with Norfolk Fire and Rescue Service responding to incidents before deciding to enroll with the ambulance service.

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“I loved human biology at school and earned a first aid badge when I was around nine or ten,” said Gary, who is also a football referee and has volunteered for the RSPCA. “That interest in first aid and helping people and animals has carried on all my life. “I have done a lot of training and decided to sign up as a First Responder so that I could put those skills to good use. I am really enjoying it so far.

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“Our role is to be the first on the scene and to support and maintain life while keeping the person’s relatives calm. The ambulance crews do an amazing job and are always following on behind us, so you know that support is not far away. “We respond to everything from heart attacks and respiratory problems to comas, choking and heavy bleeding. The only things we don’t help with are car accidents or very young babies. “It’s a really rewarding job and very varied. When you arrive somewhere the patient is often not responding, but by the time you leave you can feel you have given them that second chance. I also see people in the town who recognise me and come up and pat me on the back, shake my hand and say thank you, which is really nice and makes you feel you’re your help is really valued.” Gary gave up his weekends to complete his training as a First Responder, and sat exams afterwards. As part of the role, he is also given the chance to go out with

an ambulance crew twice a year to give him first-hand experience of the pressures they face.

“IT’S A REALLY REWARDING JOB AND VERY VARIED”

He now carries special badges to put on his car whenever he is on call, as well as medical equipment such as a defibrillator and oxygen cylinders. “The training we receive is excellent, and kicks in as soon as you arrive at the scene,” added the 58-year-old. “You take a big breath, walk in and get straight on with it. “I never talk about what I have seen while on shift when I get home – I just keep it wrapped up inside myself and pick myself up to go and help the next person. “The ambulance service do offer support as the role can be quite traumatic, so I know there is help available if I need it.”

In your words... “I would like to thank you for finding the time to fit me into your hectic schedule and for all the effort you have invested in me. I very much appreciate all that has been done for me as it all helps to make some sense of my life.” Service User, Adult Autism Team, Haymills House, Stowmarket “We will never be able to thank you enough for your kindness, support and medical expertise. You will never know how much our lives have been transformed for the better after our first consultation with you.” Service user and carer, Haymills House, Stowmarket “Having someone to speak to about my problems and understanding how I’m feeling helping me to try and cope with what I’m going though. Someone to listen... It did help me put things into perspective that should I need any more help I can contact you.” Service User, Suffolk Wellbeing Service “Psychiatric assessments can be very difficult …but even though I was a little nervous her bedside manner made it easier than I thought it would be.” Service User, Dementia & CLL Community, Carlton Court, Carlton Colville “For those needing support with depression or anxiety it is a good start to get positive help for mental health.” Service user Wellbeing Service Norfolk & Waveney

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Answering the tough questions NSFT understands that people need to know the answers to their questions and the issues that concern them. To ensure the Trust fully answers people’s concerns, Insight will cover some of the recent stories hitting the headlines, and the directors will take up the challenge.

Welcome back to Newsround, we hope you found the first issue informative and that our attempts to bring you up to date on some of our more challenging issues, is helpful. Some of the issues our directors will discuss in this edition include the independent review commissioned to look at the numbers of unexpected deaths in our Trust; and how we are doing on our community waiting lists.

ASK MICHAEL If you would like to ask Michael a question directly you can do so via: emailmichael@nsft.nhs.uk and he will get back to you as soon as possible. You can also keep up to date with our news and views via the Trust’s news pages at: www.nsft.nhs.uk/news, follow us on Twitter @NSFTtweets, or on Facebook at: www.facebook.com/NSFTrust

We’ll also look at the challenges we continue to work through with our new electronic patient record, and update you on our plans to continue to improve quality alongside the results of our Mock CQC inspection, with the formal CQC inspection on the near horizon (as we go to print). Financial pressures continue, as for the rest of the NHS, but I am pleased to say our position has already begun to slightly improve, and we continue to negotiate with our commissioners to try and jointly create the best deal for local mental health service users. Our new finance director and deputy chief executive Julie Cave will tell you about that in more detail.

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So, there are certainly plenty of things that continue to keep us busy. But, I can honestly say it feels like things are beginning to change and that slowly but surely we are making that cultural leap of faith we needed to make things better for our service users and our staff. If you don’t trust my word on that, just go to the awards special in this issue and read what staff and service users say about our staff. I think you’ll agree it’s pretty inspirational stuff, and is just a few examples of the excellent work our staff do every day. The last time I spoke to you I talked about our Trust being at a ‘turning point’, but turning into what? For me that has always been simple – turning our Trust into a better place to receive services and into a better place to work.

“WE ARE MAKING THAT CULTURAL LEAP OF FAITH WE NEEDED TO MAKE THINGS BETTER FOR OUR SERVICE USERS AND OUR STAFF”

To help us get there we recently launched our Strategic Goals. Bureaucratic though that might sound, these goals are all about helping us make those changes for the better, in summary: Improving quality and achieving financial sustainability… by developing our leadership and management capability and retaining a skilled and responsive workforce Working as one Trust … by sharing best practice and learning across the Trust… and making sure our values are reflected in everything we do Focusing on prevention, early intervention and promoting recovery… maximising face-to-face clinical time… developing evidencebased clinical strategies which improve outcomes and are coproduced with service users, carers and commissioners… working with other agencies to keep people well and to support recovery All of this needs to be delivered, of course, but the starting point for me is about being ‘One Trust’. If we succeed in this alone everything else can be achieved. I like to think of it as a crowd funding

project – if we collectively use our energies as colleagues, service users / cares and stakeholders to work together in a positive and respectful way – shaping NSFT into one, joinedup organisation – we all can become part of the Trust’s success.

AND WHAT DOES SUCCESS LOOK LIKE? IT’S ABOUT OFFERING EXCELLENT MENTAL HEALTH CARE TO PEOPLE WHO CAN TRUST IN US, DELIVERED BY CARING AND COMPASSIONATE STAFF, WHO ENJOY THEIR JOBS.

I’m pretty confident that we’re doing quite well on the caring and compassionate staff – even CQC told us we were good at that – but there are already so many more positive steps being taken. We recently had a visit from Stephen Dalton, the Chief Executive of the NHS Confederation’s Mental Health Network. We discussed the range of improvements introduced across

services since the CQC inspection in 2014, including initiatives to reduce out of Trust placements and the use of temporary staff, improved use of seclusion and restraint, and the best ways to lobby for fairer funding from the Government. The email he sent to us after his visit captures for me where NSFT is today, not yesterday or a year ago, or even two years ago: “Many thanks for taking the time to host my visit to your Trust and please pass on my thanks to your very impressive staff who were kind enough to meet me. “Clearly, you have much to be proud of and I couldn’t help but reflect on the disconnect between that CQC poster in your reception that describes you as “inadequate” and the experience I had….” He’s right, I am proud! Things may still not be perfect, and I don’t for one minute lessen the seriousness of the matter for anyone who has a less than good experience of our services, or in working for us. But you are being listened to, you are being heard, your views are important to us and they are being used to help us continue to improve.

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ection ir d t h ig r in g in v Mo on finances

As with many other public sector organisations, NSFT is continuing to face financial pressure which resulted in a deficit of £8.9m at the end of the financial year. We asked Director of Finance, Julie Cave, who took up her role just before Christmas, what steps the Trust will be taking to balance its books.

“The current financial climate has been tough for everyone, including NSFT. Like all other public sector organisations we’ve faced difficult challenges as demand for our services has increased while our funding has reduced. As a result, we ended up with a deficit of £8.9m at the end of this financial year. “This is an improvement upon the deficit of £9.4m we were originally forecasting. And this improvement has been due to the vigilance of our staff and their determination to save public monies wherever we can.

“THIS IS AN IMPROVEMENT UPON THE DEFICIT OF £9.4M WE WERE ORIGINALLY FORECASTING”

“Over the past year or so, we have joined forces with colleagues from across the country to lobby for fairer funding while also taking up a robust stance locally. We are involved in frank discussions with our commissioners about the level

of income we receive, and will continue to press for a fairer deal in our annual budgets.

“MY PRIORITY IS TO DEVELOP A FINANCIAL PLAN WHICH IS PRACTICAL, DELIVERABLE AND DOES NOT COMPROMISE THOSE SERVICES WHICH ARE SO VITAL TO SO MANY PEOPLE”

“It is also essential, however, that we make sure we have good data and can evidence everything we do and show why we need that additional income. We need to make sure the right processes are in place and that everyone at the Trust is following them – and that is something we will be focusing on further over the coming months. “We also need to look at how we can be more efficient. We have already established a programme of cost-saving projects, which we will be reviewing going forward. However, all of the ‘quick win’

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solutions, were exhausted some time ago, so we need to start looking at ways of delivering our services differently to save money without compromising on the quality of care we provide. I am keen to hear from anyone who has any ideas which could help, however small or simple they may seem. As a Trust, we are all in this together. As such, we need to work together to think about how we recover from this position. “Reducing our spend on agency workers and increasing the number of substantive staff we employ is also vitally important, as we find ourselves paying a premium for these temporary staff which would be better spent elsewhere. We are a public sector body and have a responsibility to spend taxpayers’ money as efficiently as possible. This is one area we will be focusing heavily on in the coming months to ensure we are providing good value for money. “We should never forget that the only reason we are all here is for our service users, and they must remain at the heart of everything we do. As such, my priority is to develop a financial plan which is practical, deliverable and does not compromise those services which are so vital to so many people. “It won’t happen overnight, but I am confident that with everyone’s involvement, backing and belief we can return to a positive position within the next three years.”

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Independent experts appo inted to lead unexpected deaths inquir y

The number of mental health patients who take their own lives has hit the headlines again recently. We asked Dr Bohdan Solomka, Medical Director, what the Trust is actively doing to look into the matter.

“The safety of our service users and our services is paramount. One single avoidable death is one too many – which is why we have commissioned an independent investigation to conduct a review into unexpected deaths and suicides at NSFT. “Our Trust is a high reporter of unexpected deaths and serious incidents, but we are also a Trust which demonstrates low levels of harm to our patients. We take this matter very seriously and that is why we are looking into all of the facts.

“ITS AIM IS TO HELP TO ESTABLISH WHETHER NSFT IS AN OUTLIER IN TERMS OF NUMBERS, PATTERNS OR TRENDS AND TO ENSURE WE ARE FULLY CONFIDENT THAT OUR SERVICES ARE AS SAFE AS THEY CAN BE”

“Verita, a leading agency for independent inquiries, has been appointed to lead the review which will examine how the Trust

investigates deaths and learns lessons, while looking at how the number of unexpected deaths compares with national rates. “Its aim is to help to establish whether NSFT is an outlier in terms of numbers, patterns or trends and to ensure we are fully confident that our services are as safe as they can be. “The work began in February and will be as thorough and informed as possible, held in two parts, with a report on phase one ready by the end of May, and the report on the second phase ready in the summer.

be learned, that there is consistency, sound challenge, that families and carers are offered the opportunity to contribute to the process of investigation, and Identify potential themes.

“Verita’s work ranges from specialist support and advice on challenging operational and strategic matters, to reviews and investigations of complex, sensitive issues. The company is being supported by Colin Vose, an independent clinical reviewer who has worked on suicide investigations and has a long career in the NHS.

“This will be followed by phase two, which will appraise our suicide prevention strategy and examine our Trust governance around investigating deaths set against guidance in the new NHS Serious Incidents Framework.

“During the first phase of the review Verita will look at several key areas, including comparing NSFT’s rates of unexpected deaths with national trends, reviewing our internal investigation process to examine if it is sufficiently rigorous for lessons to

“We look forward to receiving its report so that we can understand whether there are any issues which we need to address to further improve the safety of our services for the benefit of everyone in Norfolk and Suffolk.” Read more about suicide and its causes on pages 21-28. Insight | Spring/Summer 2016 85

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oned out ir g in e b ll ti s s e Lorenzo issu NSFT recently introduced its new electronic patient record system, Lorenzo. Teething problems have been raised and Insight asked NSFT’s Director of Strategy and Resources, Leigh Howlett to explain the real issues at the root of Lorenzo and what is being done to put them right.

“In May last year we went live with Lorenzo, our single electronic patient record system, and became the second mental health Trust in England to do so.

“WE WILL CONTINUE TO LISTEN TO OUR STAFF”

“Moving to a single clinical system had long been a key objective of ours, especially as we had 10 ageing patient information systems, multiple electronic and paper service user records, and a variety of local processes and documentation.

“There is still much to do to make Lorenzo really effective for our staff so, while a lot of changes have already been made in response to feedback, we will continue to listen to our staff about the ongoing improvements we need to make, particularly around the following:

“We now have one system that centrally keeps each Service Users’ health record electronically and securely; ensuring that staff looking after them has quick and easy access to their information, wherever they are and whenever they need to. “As we expected, the changeover has been a massive challenge. We fully appreciate it has been tough for frontline staff who are learning and using a new system, new processes and new ways of working, all while doing their job. However, it’s still very early days and what they have achieved so far is magnificent and they are to be congratulated in how they have risen to the challenge.

SYSTEM PERFORMANCE The main feedback we get from staff is that the speed and system reliability could be improved. This is difficult to easily resolve as the reason for slow and inconsistent performance could be caused by hardware, Trust infrastructure, the national N3 network and Spine services or by the Lorenzo software itself. A lot of time and effort is going into finding a resolution, both internally and with the Lorenzo supplier, CSC, and we have made a number of software upgrades and changes which, from feedback, have made a noticeable difference and we will continue to work on this as a priority.

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PROCESSES AND PROCEDURES With the new system came new Trust-wide processes and standard procedures to help staff use the system efficiently and effectively. Since go-live we have been visiting staff to make sure that these processes and procedures are being used as intended and are making their working lives easier. We have recently revised and published new versions in-line with staff feedback and will continue to make improvements as this will ensure service users receive a more responsive, consistent and comprehensive service.

DATA AND REPORTING Lorenzo will provide us with up-todate information and reporting which is essential for clinical safety and complying with our commissioning requirements. Both of these rely on information being captured, entered and maintained in-line with our processes and procedures. The reports are taking some time to get right as we need Lorenzo to be used thoroughly to gather the amount and quality of data for testing. We are working closely with our staff to make it as easy as possible to enter the necessary information and are keeping commissioners informed of our progress.

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Focusing on safety and embedding learning

Last year, NSFT was placed in special measures after receiving a critical report from the Care Quality Commission (CQC). We asked Dr Jane Sayer, Director of Nursing, Quality and Patient Safety, for an update on the progress which has been made to improve quality as the Trust moves towards its next formal CQC inspection.

“The CQC results were an important marker for us, acting as a turning point for the Trust and focusing our minds clearly on the improvements which needed to be made. “Our focus since has been on enhancing safety, embedding learning across the organisation, engaging more effectively with staff and service users and ensuring all of our services are of the highest quality. We’ve made a number of changes to help us achieve those goals. “We’ve opened Thurne Ward, at Hellesdon Hospital, which has had a huge impact on reducing out of Trust placements by ensuring people with acute mental health needs can be assessed closer to home. £3.6m has also been invested in additional staff for our inpatient and community services, helping us achieve safer staffing levels. “We worked with 1,300 individuals to draw up a set of values which cement the standards people should expect when using our services (see page 38), and have developed a new strategy to involve service user and carers in our development (see page 56).

“Safety has been another key focus. We’ve improved training and reviewed the way we work with people who may become aggressive, reducing the number of times service users need to be restrained. “A new ‘safe wards’ programme has been introduced, helping inpatients stay calm and reducing the chances of violent behaviour. We’ve also brought in an early warning tool in our inpatient services, which alerts staff to potential problems with workforce or patient safety, so that action can be taken before the issue develops. Finally, we’ve introduced a mental health crisis line, in partnership with Mind, to provide vital help to people before their problems escalate. “One thing that has remained constant throughout this time of change has been our dedicated and hard-working staff. They were highlighted by the CQC as being ‘kind, caring and responsive and skilled in the delivery of care’ and have played a crucial role in driving through the improvements from which our service users are now benefiting.

“A PRIORITY FOR HAS BEEN ENGAGING FULLY WITH OUR SERVICE USERS, CARERS AND STAFF”

“Despite these improvements, we are not complacent and recognise there is still further work to be done to continue embedding the high quality standards to which we all aspire across all of our services and localities. “Recently, we commissioned our own Mock CQC inspection to really test how much we have improved, but we still have a way to go. “This will take time and won’t be easy – especially in the face of unprecedented financial pressure and increasing demand for services – but we are determined to do what we can to get our own house in order. Key to this will be continuing our focus on addressing the mistakes of the past while ensuring we learn from them in the future for the benefit of everyone who uses our services.” Read more about the Mock CQC inspection on page 42) and more about our progress to further develop the effectiveness, safety, and sustainability of our services when the Quality Account 2014/15 is published on at the end of June by visiting: www. nsft.nhs.uk/qualityaccount

Insight | Spring/Summer 2016 87

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aiting lists w n w o d g in g in r B Waiting lists within adult community services in central Norfolk have reduced significantly over the past eight months – which is great news for patients who are now receiving care more quickly. We asked Debbie White, Director of Operations for Norfolk and Waveney, what the Trust has done to bring about the improvement.

“One of our key priorities is making sure our service users can access the care they need as quickly as possible, so it has the greatest impact on their recovery. Reducing our waiting lists is a key element of this – and an area where our community services have made great progress over the past few months. “In July 2015, our waiting list for adults who needed access to community services in central Norfolk stood at over 500. This meant that service users were having to wait for longer to receive the right care and treatment, which we didn’t feel was acceptable.

GPs and GP surgeries. By improving links to primary care it is hoped we can manage our referrals more actively, this should have real advantages for NSFT staff, Primary Care staff and, most importantly, for our service users. “Another important change has been the creation of a managed waiting list. Overseen by a clinician, this allows us to rate each case based on risk and urgency so that the most pressing are given priority. One practitioner also acts as a single

“Since then, we’ve focused our efforts on reducing this list and have introduced several initiatives which have brought the number of people waiting for treatment down to 43 at the start of this year, and at the end of March 2016 the number of individuals waiting for first engagement with the team was 24. “Over the next few months the Central Adult Community Team will be adapting its staffing structure and model. Key to this will be forming smaller (than existing) teams in the City, South and North Localities. These teams will be closely linked to 88 Norfolk and Suffolk NHS FT (NSFT)

point of contact for each service user and their GP, and takes responsibility for providing clear information about their likely waiting time, in turn, reducing stress on teams. “Despite these improvements, we recognise that some service users still have to wait for their appointment. When this happens, we are, where appropriate to the individual’s needs, proactively signposting them to other sources of care where they can find support in the interim. “Although we have seen improvements, we appreciate that waiting lists will always fluctuate and are therefore not complacent. We will continue our focus on keeping waits as short as possible in the coming weeks and months so that our service users can get the care they need as and when they need it.”

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Transforming our learn ing disabilities care

Across the country, an increased focus is now being placed on improving services for people with learning difficulties following the Winterbourne View scandal. We asked Alison Armstrong, Director of Operations for Suffolk, what is being done across Suffolk to make sure people receive the best possible care.

“Last year, the Government launched a national drive, called ‘Transforming Care for People with Learning Disabilities’ (LD), which aims to prevent unnecessary hospital admissions, while also reducing the number of people receiving treatment out of area. “Fully supportive of these aspirations, we have been working with our partners at the county council and local clinical commissioning groups (CCGs) to make sure they can be replicated in Suffolk. “The key objectives of the national programme are to develop a sustainable model of care with a stronger community focus which reduces the use of inpatient services, offers more choice and provides more intensive support at an early stage. The target for completing this work is March 2019. “In Suffolk, we have already begun redesigning services for people with learning disabilities and mental health issues, working with commissioners, our service users and carers. This has seen us recruit new specialist Learning Disability

Nurse posts, with staff to work in GP surgeries, as well as providing additional staff training.

“THE KEY OBJECTIVES ARE TO DEVELOP A MODEL OF CARE WITH A COMMUNITY FOCUS, MORE CHOICE AND WHICH PROVIDES MORE INTENSIVE SUPPORT AT AN EARLY STAGE”

“We have also agreed with our partners how our services should look in the future, and are now looking in detail at how they will be financed. At the same time, we are reviewing the care which service users who live in supported units are receiving to ensure it meets their needs, while out-of-hours support is being improved so that potential crises can be de-escalated. “Plans are also in place to invest and improve our inpatient unit at Walker Close, in Ipswich, while our Triangle of Care work (see page 66) - which ensures carers and family members

are fully involved in the treatment their loved one receives - is also now being rolled out to include LD services. “This is a long-term transformation and improvements will not happen overnight. That said, we are confident that working jointly across health and social care will mean the people of Suffolk can benefit from a first class learning disability services which will continue to meet their changing needs. “This drive to deliver as much care as possible outside of a hospital setting is already happening elsewhere and is bringing benefits to Suffolk patients with complex mental health rehabilitation needs. It comes after we introduced a new model of care at Suffolk Rehabilitation and Recovery Service, our 10-bedded inpatient rehab unit in Ipswich, to improve the services people receive while reducing their length of stay. “The new model, which has been phased in over the past few months, is already proving a success, with one patient in particular now discharged to supported housing after staying at the unit for more than a decade. “Although there will inevitably be challenges as we change the model of care we offer to people with learning disabilities, the initiative at Suffolk Rehabilitation and Recovery Service shows what can be achieved when new ways of working are introduced.

Insight | Spring/Summer 2016 89

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Diary Dates We have a busy schedule of events taking place across the county in the coming months which will give you the opportunity to improve your wellbeing, keep informed about Trust developments and provide you with the opportunity to get more involved by attending service user and carer forums and membership events.

SERVICE USER AND CARER FORUMS

BOARD OF DIRECTORS 9.30am - 12.30pm

DIARY HIGHLIGHT: These monthly forums keep NSFT service users and carers informed about local issues and provide the opportunity to comment on service developments and get involved.

EAST SUFFOLK Service User & Carer Consultation & Development Group Last Thursday of each month, 10.30am - 12.30pm Cooperative Education Centre, 11 Fore Street, Ipswich, IP4 1JW WEST SUFFOLK Suffolk Continual Improvement Partnership Middle Wednesday of each month, 12pm - 2pm F Block, Hospital Road, Bury St Edmunds, IP33 3NR WEST NORFOLK West Wellbeing User Group First Tuesday of each month, 5.30pm - 7.30pm Fermoy Unit, King’s Lynn, PE30 4ET NORTH NORFOLK North Service User & Carer meeting Second Wednesday of each month, 1pm - 3pm Jubilee Family Rooms, Aylsham, NR11 6JG

GREAT YARMOUTH AND WAVENEY Eastern Wellbeing Service User Forum Alternating between third Tuesday of each month, 4 – 5.45pm and the third Thursday, 5.45 – 7.30pm Held at the Oaktree Centre, Northgate Hospital NORWICH City South Service User & Carer Forum First Wednesday of each month, 3pm - 5pm Open, Norwich The ImROC/Recovery Forum First Wednesday each month, 12.30 - 2.30pm The Open, 20 Bank Plain, Norwich NR2 4SF Dementia Focus Group Third Tuesday of each month, 10am - 12pm Julian Hospital, Norwich, NR2 5BE

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June 23, 2016 September 22, 2016 November 24, 2016 Elisabeth Room, Endeavour House, 8 Russell Road, Ipswich, IP1 2BX May 26, 2016 October 27, 2016 Brancaster Room, Marriott Centre, Hellesdon Hospital, Drayton High Road, Norwich, NR6 5BE July 28, 2016 Main Hall, Hellesdon Hospital, Drayton High Road, Norwich, NR6 5BE

ANNUAL GENERAL MEETING Please see our website: www.nsft.nhs.uk for details about our next AGM

COUNCIL OF GOVERNORS July 7, 2016, 1pm – 4.30pm King’s Centre, King Street, Norwich, NR1 1PH October 6, 2016, 1pm – 4.30pm Elisabeth Room, Endeavour House, 8 Russell Road, Ipswich, IP1 2BX

NSFT MEMBERSHIP EVENTS The following events are for Members of NSFT. To find out more about becoming a Member contact Peter Haylett, NSFT Membership Officer, on 01603 421468 or Email: membership@nsft.nhs.uk

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Council of Governors special event – Dementia theme Thursday 10 November, 12.30pm - 4.30pm Jerwood Dance House, Foundry Lane, Ipswich, IP4 1DW Dementia Awareness Training The session times (apart from Ipswich) are 2pm - 4.30pm Monday 25 April Diss, Park Hotel Tuesday 3 May Lowestoft, Kirkley Centre Tuesday 31 May King’s Lynn, Providence Street Community Centre Thursday 2 June Newmarket, Parish hall of Our Lady Immaculate and St. Etheldreda Catholic Church Thursday 23 June Bury St Edmunds Library, Conference Room Thursday 14 July , 2.30pm - 5pm Ipswich Library, Lecture Hall

NORFOLK & WAVENEY & SUFFOLK WELLBEING SERVICES Offering a range of support to improve your wellbeing and help you cope with stress, anxiety and depression, with free taster and mindfulness courses across the counties, For more details and to keep yourself informed on all the news, visit: Norfolk and Waveney: www.wellbeingnandw.co.uk Suffolk: www.readytochange.org.uk

OTHER EVENTS Suffolk VASP The Suffolk VASP (Voluntary and Statutory Partnership) for mental health is an open forum for anyone with an interest in mental health. It is formed of several local VASPs across Suffolk. To find out more about this organisation and their events email: vasp@bsevc.co.uk or visit their website at www.suffolkvasp.co.uk Suffolk User Forum (SUF) SUF gathers, records and collates the experiences of mental health service users in Suffolk and make recommendations or commendations to providers and commissioners. They also aim to inform service users of developments in mental health care. To find out more about SUF visit: www.suffolkuserforum.co.uk Mind Mind provides advice and support to anyone experiencing a mental health problem. They campaign to improve services, raise awareness and promote understanding. Your local Mind also provides services which include supported housing, helplines, drop-in centres, employment and training schemes, counselling and befriending. For more information and to access your local Mind for information on upcoming events, go to: www.mind.org.uk Relate Relate services include relationship counselling for individuals and couples, family counselling, children and young people’s counselling and sex therapy. For more information about regular workshops and meetings, go to: www.relatenorfolksuffolk.co.uk

In your words... “I felt reassured there was someone to understand and who took my case seriously and was willing to provide support for me at home.” Service user, Psychiatric Liaison Service, Norfolk “Just wanted to give a recommendation to Lark Ward. They are exceptionally dedicated members of staff who, in a crisis, are quite capable of maintaining a calm, professional and compassionate front.” Service user, Lark Ward, Woodlands, Ipswich “We are thrilled to be able to say that J is thriving at the moment… He is in his second year at university… I would like to take this opportunity to thank you again for all you did for him.” Relative “Words cannot explain how thankful I am. When I was sent here I didn’t even want to see daylight, but almost five months later and it was hard to keep me in the unit… my journey was far from a walk in the park, but it’s been my most rewarding experience yet. Thank you so much for all the memories, good relationships and most of all, support. You’ve made me realise how great life can be in just a few months… You got me through it!” Service user – 5 Airey Close, Adolescent Inpatient Unit, Lowestoft

Norfolk and Suffolk NHS Foundation Trust values and celebrates the diversity of all the communities we serve. We are fully committed to ensuring that all people have equality of opportunity to access our service, irrespective of their age, gender, ethnicity, race, disability, religion or belief, sexual orientation, marital or civil partnership or social & economic status.

Trust Headquarters, Hellesdon Hospital, Drayton High Road, Norwich, NR6 5BE Tel: 01603 421421 Web: www.nsft.nhs.uk â&#x20AC;&#x2DC;Like usâ&#x20AC;&#x2122; at: facebook.com/NSFTrust Follow us: @NSFTtweets

PATIENT ADVICE AND LIAISON SERVICE NSFT PALS provide confidential advice, information and support, helping you to answer any questions you have about our services or about any mental health matters. Email: PALS@nsft.nhs.uk PALS Freephone: 0800 279 7257 Produced by Norfolk and Suffolk NHS Foundation Trust, June 2015.

If you would like this leaflet in large print, audio, Braille, alternative format or a different language, please contact PALS and we will do our best to help.

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