5th October 2017

Minutes of the meeting

In attendance: Dick & Hazel L, Brian L, Tim W, John & Margaret I, Dianne W, Terry G, Zib L, Terry G. Sue C.

Apologies: Lawrie and Chris S, Angela D, Rod C, Francis W, Carenza W.

Minutes of last meeting – were accepted as a true record of the 7th September meeting.

Matters arising – There were no matters arising

Guest speaker:  Dr Jane Padmore Executive Director Quality & Safety at the HPFT

Dick introduced Jane and asked her if she would begin by giving us a brief history of her past career which she willingly agreed to do.

She started by telling us that her childhood aim was to become a teacher but after being injured in a motorbike accident and the consequential involvement with care/nursing that aim changed and she wanted passionately to become a nurse.

Subsequently she joined the Maudsley Wimbledon and became a Community Psychiatric Nurse dealing with Personality and Eating Disorders.  After some 15 years in Adult services including working on First Episode Psychosis and some new proposals, she moved over to CAMHS in 2000.

Here she worked with young offenders and could see that their not attending appointments was largely due to the fact that they were not “brought” by others.

After completing her Masters, she became the Lead Clinician for Lambeth CAMHS and was the first nurse to get this post.  Unfortunately, after only four weeks in post, she had to deal with 2 young Service Users who had murdered a third. All were well known to the service but the service got involved too late to stop this happening. Following this, she gained her Doctorate working with the issues surrounding street gangs in the area.

She returned to the Maudsley and set up an Adolescent Unit and was charged with finding a way to generate income to sustain the unit over the next years. In this role she felt more like a business person than a nurse. She felt similarly about following an academic route and wanted to stay in nursing. At this point she saw a Director of Nursing Post which she wanted but did not yet feel qualified.  Then the vacancy arose for Deputy Director of Nursing at the HPFT under Oliver Shandley (the Head Nurse) which she applied for and got and loved it.

When Oliver left the HPFT to become Head Nurse for London, Jane applied for the post and started as Head Nurse last December. Her remit is extremely wide covering Nursing, Social Workers, Spiritual Care, Therapies, Diversity, Confidentiality, Safety, regulatory issues, Health Effectiveness

She went on to remind the group that the trust covers some 80 sites across 4 counties – Herts for all services, Bucks for learning Difficulties, Norfolk also for Learning Difficulties, Essex for learning Difficulties, wellbeing, community and one other.  She felt that she had inherited a fantastic staff and teams across the services. As an example of how the Executive Team keeps its focus, she reported that they start their meetings with a review of Service User and Carer incidents experienced in the last week.

Terry asked the first question which was about confirming information gleaned from a radio report of the Tory Conference which was about their intention to reinstate the Nurses Bursary and introduce a new scheme termed ‘Earn and Learn’.  This to ensure that more nurses are to be trained on-the-job for 2 years to associate level then a further 2 years apprenticeship to a full qualification.

She hadn’t heard about it so couldn’t confirm but would welcome it if it was true.  She went on to say that the HPFT, together with Herts University, are piloting a Band 4 Nursing Associates Scheme lasting 2 years with release for classes at the University plus on-the-job experience.  They have funding for 59 places and have 40 currently in training.

Sarah acknowledged the work being done by CAMHS and then went on to highlight the fact that most carers who attend the CIH Mental Health Forum are carers of loved ones with schizophrenia.  This enduring problem leaves suffers effectively stuck in secondary care.  Excluding Mind or Turning Point, she pointed out that there are very few agencies providing services to this group and the social element of their life is missing.  Dianna agreed.

Jane stated that with 20% vacancy rate, the Trust must have a different approach and think in radically different ways ie to create a ‘cultural shift’ in the way things are done.  She gave examples of how individuals could make local decisions for themselves rather than seek permission from above.

Other examples from the group were shared and the issues of what the HPFT culture has meant to carers including the role of confidentiality assisting front line staff to ‘clam up’ when there is an incident.

In response to Dick’s negative comment about the Good to Great Strategy, Jane introduced a recently published “Great Care Great Outcomes” promotional device. This was based on a triangular sheet that is printed both sides. Each corner of the triangle folds down to form 4 smaller triangular panels each with a key message. These triangular panels  can also be formed into a 4 sided pyramid.

She highlighted the Trusts Mission and 5 Values printed on it and went on to identify and explain the 5 areas of focus that has been communicated to their staff. Namely:

  1. Make sure the service user and carer experience is the best it can be
  2. Improve the staff experience for your colleagues
  3. Find opportunities for innovation and improvement
  4. Make sure that everything we do adds value so we make the biggest difference possible
  5. Develop relationships and partnerships that help us better meet the needs of local populations.

Dick stated that had he seen this information beforehand, he would not have made his negative comment.

Terry asked Jane to think about using the following quote with her staff that he had come across that might be helpful that says “Good is not good enough when even better is expected”

He also asked her to consider the weakness of meeting staff training needs by the so called “Mandatory Training”.  While this does indicate to staff its importance, it does not include mandatory listening when attending or implementation afterwards.  It should be replaced with the concept of mandatory performance on the job.  As training is always a means to an end, ie performance on the job it is something that line managers need to nurture and own.

Hazel raised the issue and some discussion ensued with HPFT involvement with the Coroner, Coroner’s Courts and the support offered to families.  Jane emphasised – learning from incidents, candour and transparency and the offer of family debriefings in this regard.

Terry raised the issue of some service users with BPD not engaging with the service. He gave an example of a Carer with 2 teenager children whose wife no longer engages and is the source of pressures that he and his children are having to bear.  Is there any extra help for those individuals who do not engage and are still clearly unwell, to get them to re-engage.

Jane reported that Andrew Nichols, who reports to her, is about to publish a new BPD Pathways document which recognises this issue.  Terry replied that he had already commented on an earlier draft and would welcome seeing the final version.

When asked “If you could change one thing in the delivery of front line services, with a stroke of a pen, what would that be.  Jane replied that is would be getting the “fundamentals of care for every person right first time”.

Progress on Web site development

Terry reported that at our September meeting we considered

  • Finding other ways to attract members
  • Putting the site back up asap with some improvements
  • Trying out a new design together with a new approach but was not clear what should that be

He reported that the new site is now back up and running.  It is still mainly written to inform New Carers and to signpost the main agencies and HPFT services. It now contains some additional information about the group but does not yet strongly sell the benefits of membership. Some sections have been edited some enlarged with some more descriptive material and some have had pictures added.

He acknowledged that once existing members have read the fixed content, the only other reason to visit the site was for a record of what was said at a particular meeting.  In order to get members to keep on visiting the web site, it would be helpful if we could include information about upcoming events eg carer meetings, HPFT or CIH workshops and any general news items of interest to the group.

Questions he addressed when putting the site back up

  1. find a way to include important issues, news items and research reports (but remembering that we need members to spot, gather, signpost or write copy for these articles – However,  will members want to contribute?
  2. be more interactive eg let people comment and share their views

There is still much more work to do particularly to make it search engine friendly and to get familiar with the new interactive “Blog” facility. This new blog facility will allow us to flag up items of report or upcoming events. Now when any member finds out something of interest or concern that they wish to share with the group, we can include it. (only through me as the administrator at the moment)

Additionally, for each blog posted, there will be a facility for people to comment on the information posted. So as to ensure that we do not publish any inappropriate comments, (anyone might see our blog) I will monitor them first and moderate or remove them before they go live.

We must remember that our membership and attendance at meetings is restricted to carers in mental health and people in or close to the Dacorum area.  Our web site, on the other hand, is open to the world with no restrictions. Accordingly we need to be aware of the accuracy of what we put on the website and particularly blogs.

With all the information included on our site (such as minutes, events, news etc) this allows those members not able to attend our meetings to be kept up to date but only if the accuracy and quality of the minutes is adequate. However, some members might decide that they prefer not to attend meetings to get information and or put their point across. In that situation, we become more of an on-line group with few members meeting face to face. This clearly is to be avoided for several reasons (see below) including that where our Speakers would only think it worthwhile if there were a reasonable number of faces before them.

The main suggestions to reach the many carers out there who do not have access to the web, was to write a leaflet that we could distribute in key places.  This leaflet would also include our web site address for those who would want to find out more.

In order to promote the benefits of joining the group and attending meetings we need to identify what people get out of actually attending our meetings and hopefully to keep re-attending.

Terry proposed that we concentrate on the intangible things like:

  • The importance and charisma of the speakers we invite
  • Enjoying a couple of hours respite from their loved one
  • Receiving support (you are not alone and you will be listened to by the group)
  • The additional social interaction not normally available when stuck at home in a caring role

Dick still saw it as his task to provide a first draft of the leaflet and agreed to take these factors on board.

Hazel reported her concerns about including personal telephone numbers on the web site.  Terry reported that land lines were not included but Dick’s mobile was.  Dick agreed that his mobile number and email address remain as the first contact.

Upcoming events  – Dick reminded the group about the Quiz night 7th October and Terry reminded the group about the HPFT’s Recovery Week from the 9th  – 12th  October 2017 and Rods coffee morning at St Pauls 17th Oct 11:00 am-13:00 if he gets out of hospital in time

Any Other Business – There was none

Date of next meeting – will be the 2nd November 2017. Our speaker will be Jo Clack of “Rethink Mental Health”