Agenda item

Report of the Chief Executive, Tees, Esk and Wear Valley NHS Foundation Trust

The Chief Executive submitted a report (previously circulated) providing Members with a general update and progress in relation to the CQC inspection report, since the last meeting of the Joint Committee held on 14 March 2022; and outlining the Trusts response to questions raised by this Committee. A presentation accompanied the report.

It was reported that the Trust had implemented a new governance and organisational structure on 1 April 2022, developed following feedback from staff, patients, families, carers, governors and partners; that two Care Groups had been established, Durham, Tees Valley and Forensic Care Group and North Yorkshire, York and Selby Care Group, enabling the Trust to be better aligned to the two Integrated Care System; and that two lived experience directors had been appointed for each care group. Reference was made to the role of the lived experience directors and the recruitment of additional peer workers across the Trusts services.

It was also reported that a new integrated performance Board Assurance Framework had been introduced; work was being undertaken to improve risk management, including establishment of risk groups at executive and care group levels and improved reporting to the Board and its committees through a new risk escalation framework. Members were informed that the revised governance arrangements had been developed to strengthen the Trusts leadership structure and capacity.

The submitted report stated that the Trust had an overarching People plan aligned the Board Assurance Framework, built around three key strands of recruitment and retention, staff wellbeing and experience, and culture.

Details were provided of recruitment and retention for the Trust; vacancy rates were currently 7-8 per cent; the number of employees had increased by 5 per cent in the previous 18 months; and the time taken to send conditional offers and commence pre-employment checks had vastly improved from 8+ weeks to 2 weeks following the introduction of a digital pre-employment checking system. Members also noted that staff absence remained a challenge, however absence rates had remained lower than neighbouring Trusts over the past two months.

In relation to staff wellbeing and experience it was reported that the Trusts People and Culture Directorate was being restructured to increase the focus on workforce planning, health and wellbeing and staff engagement; and the work undertaken to improve staff wellbeing was outlined. Reference was made culture and staff feedback; it was reported the Collective leadership model had been made clearer to ensure that responsibility and ownership was transparent, this included increased clinical leadership and the appointment of two full time Lived Experience Directors; four staff networks were in place across the Trust; and a range of sessions were in place to enable staff to talk with each other and share ideas. The trust’s response to the National Pulse Survey Quarter 1 2022 was outlined and members noted the response rate of 29 per cent which was second highest in the North East and North Cumbria region.

Reference was made to the CQC Action Plan and progress made within Secure Inpatient Services (SIS) and CAMHS. The key areas of focus for SIS were outlined and details were provided of the work undertaken in relation to staffing, which included review of staffing in three formal meetings per day; introduction of a Healthcare Assistant council, ward improvement groups and fundamental standards group; and face to face two day inductions for new staff. Members noted that training compliance for safeguarding level 3 was 95.98 per cent; and that a member of the corporate safeguarding team was now based within SIS offering direct support, supervision and involvement in clinical care.

In relation to governance it was reported that a new model of care and professional practice had been launched; there were increased staff wellbeing activities and a SIS wellbeing group launched; and the policy in relation to the use of mobile phones by staff within the perimeter was being reviewed and a ‘safe area’ where staff can use electronic devices was being developed.

Details were provided of the key areas of the work programme for children and young people’s services; the Keeping in Touch (KIT) process which had been introduced, was monitored daily and 97 per cent of children on the waiting list had KIT contact; and the Trust were recruiting to alternative roles to meet the increase in demand.

It was reported that the Trust had moved to a nationally mandated framework, i-THRIVE, a whole system and evidenced-based approach in supporting families with their emotional wellbeing and mental health needs; the key components of the framework were outlined and it was noted the framework draws a clear distinction between treatment and support. Members were advised that an internal restructure of CAMHS was undertaken to align with i-THRIVE; and that the Mental Health Support Teams in schools and voluntary community sector providers had seen approximately 1,500 children and young people last year in the wider system, who would have historically come into the trust. Members noted that the mental health support in schools was an anticipated coverage of 50 per cent by the end of 2022/23.

Discussion ensued regarding the leisure activities and education for service users;  concerns in relation to recruitment of registered nurses; and Members requested further information regarding the Lived Experience roles.

Following a question regarding children and young people, Members were advised that there had been an increase in demand for services following Covid, but this was at a lower level; and following concerns regarding wait times in relation to an autism diagnosis, Members were assured that there was a bubble of support for those on a waiting list and that wait times were comparable to national benchmarks. Members requested an update on CAMHS at a future meeting.

It was noted that the CQC continued to monitor the Trust.

RESOLVED – (a) That the thanks be extended to Tees, Esk and Wear Valley NHS Foundation Trust for their informative update.

(b) That updates be provided at a future meeting on the Lived Experience roles and CAMHS.