6th April 2019

Speaker – Chris Lawrence Chairman of the HPFT

Chris began his presentation by telling us a little about his background first as a non-executive Director in 2012 then as Chairman for the last 5 years being re-elected to that role just 2 years ago.

He then proposed to reflect on the HPFT’s journey over the last 5 years and its transformation, through difficult times, to what it is today.

With reference to the NHS and the £20 billion investment over the next 5 years and the need to address substantial difficulties,  Chris argued that it is essential to increase staff pay to address recruitment issues leaving limited extra cash for other investments.

He stated that he believed that the Trust often punches above its weight adding that it has never been in deficit and yet, managed to invest in King Fisher Court a state of the art in-patient facility.

This improvement was necessary (investment £125 – 130 million) and while it seems that the focus has been on “In-patient” facilities, in reality the Trust is very much community based.  NB there are some 450 beds fewer than 10 years ago

He feels that Social Services are the soft underbelly with transitioning being very important.  The Carers role is essential and the Trust is intent on meeting carer’s needs and assist them in their essential contribution.

In the area of partnership working, the Trust has produced a Sustainability Transformation Plan.  This STP entitled “A Healthier Future” was led by Tom Cahill the Chief Executive, aimed at

  • improving the health and wellbeing of our local population
  • improving access to care
  • ensuring that care and support is provided efficiently and sustainably.

Chris reasoned that it has become clear that commissioning groups led by GPs has not worked as intended. Instead it has become fragmented, bureaucratic and very challenging.  NHS England and NHS Improvements (all Acts of parliament) are struggling to improve legislative limitations. What is needed is to configure care around the individual, more collaborative commissioning and bringing social care more central and within the community. However, there is little money for investment.

Chris stated that we need new hospitals. Watford hospital being right next to the football ground is not the best location.  Harlow Hospital is also in need of improvement.  He was hopeful that they can be improved and suggested that MH considerations be at the centre.

Chris reported that the Trust has just signed a contract with the Commissioners addressing “Parity of Esteem” which he claimed was a positive statement of the Commissioners confidence in the Trust’s ability to deliver.

With regard to the recent CQC inspection the Trust is waiting for their response.  However, they have received a letter indicating that what the CQC team saw, was better than they had expected.  A first draft of their report for fact checking is expected in April and the final report in May.  Chris said that he is confident that the rating of “Good” will be maintained.

Dick reminded Chris that the group was invited to provide feedback to the CQC and moreover, Diane took part in a telephone interview with them.  Terry outlined how we went about it and the format of our response.

Chris went on to talk about personnel changes within the Trust beginning with the appointment of Sandra Brookes (highly regarded) to replace Jess Lievesley (a tough act to follow).  There have also been two non-executive changes – David Atkinson (Finance) and Dianne Herbert (HR & Media) appointed and the Trust is about to create a new “Development” post for a non-executive Director.

At the National level, NHS Improvement have made available some £50,000 to the Trust to invest in a “competency movement” ie to identify the competencies staff need to deliver Trust services at the required level of performance. Terry enthusiastically commented that this was indeed a positive step in staff training.

Chris also reported that the demand for services and support is high and still growing in

  • child and adolescent services
  • frail and elderly
  • support for carers

During general discussion the subject of support for those with long term and complex illnesses was again raised.

When asked just what was most important to her, Diane W replied that as she was going to be 80 this year and is finding it harder to cope with her sons who are never likely to get better. She went on to ask for just a little extra support but was saddened that this is just not happening.  What she would want is someone who could pop in to their flat, handle their post, have a chat, look around for what is needed in day to day living issues like just checking the fridge. This she felt would keep them just a little better occupied and safe.

Francis mentioned the case of her father-in-law (97) who is receiving help from Age UK and the use of PIP being used to engage support workers.  It was suggested that a register of people be created who could do this support work (it was thought that a list might already exist but no-one was clear)

MIND, it was further suggested, tend to focus on the young.

In the 27 years existence of the group, Dick suggested that some things have got better. In his estimate, community care will work for say 75% of the people but not for the other 25% (the most expensive) for these nothing, for the better, has changed.

Keeping Diane’s two boys out of hospital he thought was a considerable saving to the system.  What is now needed is a level of support between hospital and support at home.  It would incur a cost but would still be a considerable saving over the costs of hospitalisation.

Chris agreed that they don’t want them in hospital if basic needs can be covered.  Hospitals recognise that continuing MH conditions are not fixable in hospital and better care/support is required.

Chris brought up the issue of dealing with frequent attenders at A&E. Some analysis is taking place so that they might be better treated elsewhere.  In this context Chris briefly outlined the role of street triage, the use of the 136 suite at Kingfisher Court (where they can be kept for 24 hours) instead of a police cell. It was also noted that the police and fire service are also increasingly dealing with MH cases.

Kevin commented on the lack of BME representation in groups such as ours and on the Trust’s Board.  Adding that while he believes, we are getting better, we need to be more BME friendly.  He also mentioned difficulties to gaining access to spiritual care of a friend who is Jewish.

This prompted Chris to talk about the Chaplaincy Team (led by Richard Allen) and the increasing awareness of the spiritual needs and the challenge of managing the numerous faiths.

Ann introduced the difficulties that confidentiality can cause and briefly outlined her personal experience.

Dick related his experience over the group’s 27 years of existence as:

  • for the first 9 years we spoke but were not listened to
  • the second 9 years we were listened to but not heard
  • the last 9 years we were listened to and heard
  • now we want action to be taken

Chris finished with praise for the Trust’s staff in that the work they do has been tremendous and stressed that the Trust really needs to hang on to them.

The group thanked Chris for his contribution in the usual way.

Attending: Dick & Hazel L, Brian L, Terry G, Margaret I, Ann R, Maggie E, Tim & Francis W, Angela D, Michael A, Rod N, Diane W.

Apologies: Rod C, Norma Y, Zib L, Sarah W,

Minutes of last meeting (7th March 2019)

Matters arisingThere were no matters arising

Francis reported back on the working party meeting that she and Tim convened with Dick and Hazel in attendance. (Unfortunately Rod was in hospital and couldn’t attend as planned.)

Francis circulated some examples of the printer’s designs for viewing and gave the expected costs of design and printing of our material as follows.

 Item                 Design costs               Print costs               Cost per unit

Poster                        £30                          £20 for 100                        50p

Leaflet                       £60                          £115 for 1000                   17.5p

Laminating some posters for outside use was mentioned but no costs given at this stage

Discussion went on to agree that the colour scheme of Yellow and Blue be used to be consistent with the website and indeed it is a good contrasting combination.

In broad agreement with guidelines included in the last meeting’s minutes, Francis outlined the sections of textual content but a detailed draft has yet to be agreed.  The working party also discussed the likely inclusion of photographs (eg as in our group photos on the website) and noted that some members may not like to be identified.

Another suggestion was to include a map to help identify the location of 139 Leighton Buzzard Road.  The possible use of a flyer was also mentioned but not yet explored in any detail.

Distribution was identified as a factor that would, from previous experience, be hard work and help from all members would be required.  It was agreed that we keep the distribution to Herts and Dacorum locations and to include Doctors Surgeries, Sports Centres, Herts County and Dacorum Local offices HPFT office sites etc.  Since there will be a turnover of posters and leaflets in these locations it was recognised that there would also be the need for their periodical replacement.  A suggestion that this could be weeks or months was made.  However, it was suggested that we could test out (by checking one or two locations) to determine an optimum replacement period.

Discussion went on to acknowledge that Rod’s Coffee morning group could also be targeted with our materials but not without his agreement.  Some of our group also attend Rod’s group but many others cannot or do not want to attend evening meetings.

While exploring other ways to distribute the promotional material Tim stated that we will receive a digital version of the material from the printers.  This opened up the possibility that copies could be sent out by email.  We might then approach HPFT and CIH (and their local hubs in Berkhamsted and others) to send it out to their members on our behalf.

There was some discussion about including another contact phone number on the material and the possible use of a second phone specifically for that purpose suggested. However, no discussion was held as to how this might work

Date of the working party’s next meeting was not yet agreed.

Upcoming speakers – not discussed as there was insufficient time.

 Any Other Business – there was none

Date of next meeting –2nd May 2019