Towards Outstanding - what it's really all about

I am glad to be back writing my blog about a great week I had on my return from a lovely break last week.  Thanks very much to Buki and Andy for writing the blog in my absence.

I wanted to start this week's blog by telling you about something really powerful that happened at this week's Trust Board meeting. As most of you know, a lot of what we discuss at the Trust Board meeting is prepared in advance, including reports from committees, updates on projects and awards to our staff for great performance or on the occasion of their retirement.

An important additional feature of the Board meetings is that any member of the public can attend and make a contribution if they so wish. This week the mother of one of our service users attended to tell us of the frustrations and problems that she had encountered in accessing treatment for her son, understanding how the team that provides his care work, as well as what additional treatment and support options were available to both her and him.

At the end of a fascinating discussion between her, the Board and the senior management of the team who were also attending, she was able to be reassured and know more about what they could do for her and him.  Whilst our children’s services have made really good progress and all children are now seen within 18 weeks for their first assessment, we still have much to do. The personal experiences  of people using our services is as important as the timeliness of access. This is why our quality priorities are so important – providing Safe, Personalised, Accessible and Recovery focused services. The team were also able to get further insight into how those services were being experienced by our users.

But what the discussion also demonstrated to all of us, more powerfully than any committee paper or report, was the real direct human impact that our services can have on the lives of families in our community - and in particular the importance of always striving for new ways to hear the voices of our users and their families, ensure they receive services they need, and ensure those services match the values to which we aspire to be - caring, approachable, take responsibility and deliver excellence.

It also demonstrated beyond doubt how right it is that we determinedly continue our journey of improvement to become an organisation that is truly outstanding, in all we do and how we do it.

The North Staffordshire Children and Young Peoples IAPT Youth Council were also at the board to receive the Team Spotlight Award for the fantastic work they have been doing. Two of the young people, Chair Jaymee Smith and Kirsty Booth gave a very positive presentation about their journey of recovery and the positive impact the Council had had for them personally which was very emotional.

The council have been instrumental in giving young people more of a voice in determining the way our CAMHS services are designed, delivered and monitored. They have been innovative in generating new ideas to get young people more involved, including sharing useful materials via social media, developing a series of positive peer-to-peer messages and producing a mental health myth busting presentation which has helped to improve health and wellbeing and encouraged more young people to engage in CAMHS services. They have also developed the CAMHS pages on the Trust’s website to make them more accessible to young people, and continue to play an important role in all stages of recruitment across CAMHS services. A video outlining their work is available on our YouTube page here. Their role will continue to grow as our CAMHS service transform to ensure children, young people and families are central to everything we do and continues on its journey towards outstanding.


The Individual Spotlight Award was presented to Dr John Sorensen, Psychological Services Leader for adult mental health inpatient and community services. Dr Sorensen has been instrumental in leading the change that has taken place within our clinical directorates to improve psychological interventions. This has included embedding psychologists and therapists in multi-disciplinary teams, working more flexibly, and supporting staff to move towards new ways of working.

He has been involved in developing the strategic vision and supporting staff and clinical directors to implement it. This work has been difficult and challenging at times, but he has continued to put in a lot of energy and vision to get this completed. This has led to the development of a number of highly effective programmes offering high intensity psychological interventions and enabling patients to move towards recovery as they transfer from our adult inpatient to community services. These include the Recovery from Depression programme, designed for people with recurrent and severe depression, and Dialectical Behavioural Therapy which supports those with life-threatening self-harming behaviours.

We also bid a happy retirement at our Trust Board to a number of staff, including Julie Farrar, Team Leader with our Rapid Assessment, Intervention and Discharge (RAID) service. Julie started her NHS career in 1992 and became part of the liaison psychiatry team when it was first developing. She has remained with the team ever since and has played a significant part in the development of the RAID service.

Don Walsh has always been an extremely valuable member of staff since he began working for the Trust in 1987 as an Occupational Therapy Technician. He worked within community rehabilitation services before becoming a professional lead for Allied Health Professionals and managing the Rehabilitation Service. Don is a valued member of the management team where he has been able to motivate, inspire, listen and support others.

Karen Flannigan qualified in 1989 and initially worked in inpatient areas before transferring to community mental health services. She has achieved qualifications in Behavioural Family Therapy and for the past few years has worked as a Community Nurse Therapist in the North Staffordshire Wellbeing Service. Karen is always available to help and guide people and is well-liked and respected by her colleagues, who will miss her greatly.

We also wished a long and healthy retirement to Lewis Chingono, Team Manager with the Autism Spectrum Assessment Service; Reginald Lawson, Health Records Administrator; Sue Laird, Modern Matron, Lynette Mills, Health Care Support Worker, Karen Cooper, Community Psychiatric Nurse; and Deborah Hall, Senior Practitioner, with the Access and Home Treatment service.

As always, I prepare a Chief Executive Report to the Board which outlines so many positive achievements this month - please do take a look via the Board Papers, available here.


As part of the Staffordshire and Stoke-on-Trent Sustainability and Transformation Plan (STP) System Leadership/OD work stream that I lead, we were delighted to welcome Helen Bevan, Chief Transformation officer from NHS Horizons, this week to an event at Longton Rugby Club where she led the STP through a creative Accelerated Design Event for Stoke and Staffordshire's organisational development and Improvement community.

Over 40 people were  developed and  trained to lead change, sharing  skills and harnessing the enormous enthusiasm and positivity from the day. Attendees will now help teams to deliver innovative healthcare approaches  across Stoke-on-Trent and Staffordshire. The whole STP will meet on 23 March  to understand and use this model of change, growing teams  of skilled people able to lead and share good practice from within our own community .


The results of the 2016 annual NHS Staff Survey have now been published and confirm the journey we are making Towards Outstanding. Here are the headlines:

  • In 2016 our Staff Survey continues to build on improvements made in 2015.
  • Over 20% of the survey's 27 indicators demonstrate significant improvement, with none in statistically significant decline.
  • Comparing like for like figures with 2015 we see that over 70% of indicators have an improved score in 2016.
  • We have achieved above average scores against comparative NHS organisations in a third of areas.
  • The strongest areas of performance are in reporting of errors and near misses, plus the percentage of staff experiencing harassment, bullying, discrimination or abuse at work.

The results also show:

  • Staff engagement levels have increased.
  • Staff perceptions of the Trust continue to improve.
  • Combined Healthcare is longer an outlying trust for experience of physical violence.

Our strongest areas of improvement over the last 12 months are:

  • Staff confidence and security in reporting unsafe clinical practice.
  • Organisation and management interest in and action on health and wellbeing.
  • Fairness and effectiveness of procedures for reporting errors, near misses and incidents.
  • Percentage of staff receiving an appraisal.
  • Staff satisfaction with resourcing and support.
  • Percentage of staff witnessing potentially harmful errors, near misses or incidents in the last month.

The results show areas where the Trust can focus its improvement in the coming year, including the percentage of staff attending work in the last three months despite feeling unwell, because they felt pressure from their manager, colleagues or themselves and staff recommendation of Combined as a place to work or receive treatment: whilst this has improved - there is more improvement we need to make.

These results confirm that staff recognise and are witnessing the improvements we have made over the past year as an organisation. It's particularly welcoming that our staff have improved confidence in reporting unsafe clinical practice and that the percentage of them witnessing potential harmful errors has declined, but despite improvement there is no room for complacency.

Coming on the back of our recently announced improved rating of 'Good' by the Care Quality Commission, we will now study the results of the survey in detail and embed any lessons learned in our overall improvement journey Towards Outstanding.


As we move to nine weeks to ROSE Day on 13 May, we're stepping up our efforts to ensure everything is in place for a successful launch and everyone is ready.

As part of this, every member of staff will shortly be receiving a Staff Boarding Pass, a self-assessment ready reckoner they can use to confirm they have taken all steps necessary to be ready for a successful go live. Super users and directorates are also receiving special editions of the Boarding Pass, so they can confirm everyone for whom they are responsible is ready.


As you all know we are sad that Tom Thornber, our Director of Strategy and Development is leaving us at the end of the month, I was able to publically thank him at the Board for all he has done for us. We have now created Tom's replacement as an exciting new post in partnership with North Staffordshire GP Federation to support the next stage of our journey of developing a North Staffordshire Multi-specialty Community Provider. We advertised the post nationally and interviewed last week – I will let you know as soon as I can who we have appointed.


As you all know we have been doing all we can to minimise the planned cuts to substance misuse services across Staffordshire. We have had some recent good news of the potential for a small amount of funding through the Police Commissioner and partners to be able to prove a small amount of extra services. whilst this is positive – it still is nowhere near enough funding to enable the same level and numbers of staff we have had to date.

Both myself and the Board have been so incredibly impressed with the professional way our staff have managed the service changes which have had a significant personal impact on many people. I was delighted to meet with some of the team alongside Andy Rogers, our Director of Operations last week to sincerely thank them and find out if there was anything else we could do to support them. They are an inspiration to us all and totally live our values everyday – they were so patient centred it was heartwarming.

I finished the week on Friday being part of stakeholder panel for the Chief Operating post at University Hospitals of North Midlands NHS Trust (UHNM). There was a strong field which was really positive and hopefully they will be able to make an appointment – our partnership with UHNM is very important as part of our integration of physical and mental health – all candidates outlined how they would continue to work in partnership with us which is great.

On Friday afternoon I was pleased to join partners in Stoke-on-Trent Health and Wellbeing Board for a development workshop reviewing how we can strengthen the impact the Board is able to have in improving the health of the residents of the City. It was a really positive event  and one I really enjoyed – the more we work in partnership and join together our priorities and resources , the more we will achieve for our communites .

So all in all a busy and enjoyable week!