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Farewell Robert Nesbitt, ridiculously-titled ‘Company Secretary’

Robert Nesbitt retires as ‘Company Secretary’ at Norfolk and Suffolk NHS Foundation Trust (NSFT) this week on a fine salary and pension.

In many ways, the career of Robert Nesbitt exemplifies all that has gone wrong at NSFT.

Before the merger which created NSFT, Robert Nesbitt was ‘Director of Community Engagement’ at Suffolk Mental Health Partnership Trust (SMHPT) and earned between £60,000 and £65,000 in 2008-9. Even back then, the gravy train started to accelerate and in 2009-10, his salary increased to between £65,000 and £70,000.

What followed were cuts which devastated mental health services, with euphemisms such as Cost Improvement Programmes (CIPs) and ‘radical pathway redesign’ and the merger of Norfolk and Waveney Mental Health Foundation Trust (NWMHFT) and SMHPT.

In 2011-12, the year during which NWMHFT and SMHPT merged to form NSFT, the combined income of the trusts in Norfolk and Suffolk was £221.24 million.

In 2016-17, the most recent annual report and accounts shows that NSFT had an income of £215.7 million, £5.54 million lower than five years before in absolute terms. During the same period, inflation was 11.85 per cent. If NSFT’s funding had even just kept pace with inflation, its 2016-17 budget would have been £247.5 million.

In effect, at least £31.8 million has gone missing from mental health services in Norfolk and Suffolk. In real terms, NSFT’s funding has been cut by thirteen per cent.

Since the establishment of the CCGs in 2012-13, the number of referrals to NSFT has increased by 48 per cent. If NSFT’s funding had increased in proportion to inflation and referrals, it would be £366.3 million, more than £150 million higher than it is.

In the year of the merger, NSFT had 190 permanently employed doctors. In 2016-17, the number had fallen by more than a quarter to 138.

In the year of the merger, NSFT had 1297 permanently employed nurses. In 2016-17, there were 187 less nurses, a fall of 14.4 per cent.

NSFT has closed at least one-third of its beds. With the on-going bed closures, it is hard to keep track of the cuts.

The impact has been devastating.

NSFT became the first mental health trust to be put into Special Measures after being rated Inadequate by the Care Quality Commission (CQC) which found that NSFT did not have enough staff or beds after the savage cuts.

NSFT then became the first mental health trust to be put into Special Measures for a second time after being rated Inadequate by the CQC which found that NSFT did not have enough staff or beds for a second time. Commissioners at the CCGs failed to provide NSFT with the money to put matters right. Now, the Chief Officer of the lead CCG for mental health has been imposed as Chief Executive of NSFT, even though he was rejected as unappointable by NSFT’s own service users and carers.

People have paid with their lives. Back in 2011-12, the Annual Report stated that there were 89 unexpected deaths of NSFT service users. By 2016-17, this had more than doubled to 184 deaths.

While all this has been going on, what happened to Robert Nesbitt?

Robert Nesbitt became the Trust Secretary of NSFT. When we ran a quiz, most people guessed Robert Nesbitt would be paid between thirty and forty thousand pounds per year.

Robert Nesbitt’s salary was no longer published as he was no longer on the Board, even though he exercised influence and took part in Board discussions as though he was. However, we know from a Freedom of Information Act request that while in-demand front line staff suffered real terms and often absolute pay cuts from downbandings, pay freezes or one per cent pay rises, Robert Nesbitt’s salary had increased to £81,618 per year.

It appears that Robert Nesbitt’s title of ‘Trust Secretary’ wasn’t grand enough for him. We watched with amazement as the Board of NSFT wasted time changing his job title from the meaningful ‘Trust Secretary’ to the utterly-ridiculous ‘Company Secretary’. This happened in front of an Improvement Director while NSFT was in Special Measures. It was an illuminating demonstration of NSFT’s priorities and values. Remember, this is the same mental health trust which removed the number of unexpected deaths from its Annual Report when it became too high.

But with a new grandiose private-sector job title, Robert Nesbitt, who organised reports and papers for the NSFT Board, seemingly needed more money.

As Director of Nursing, Jane Sayer, and Director of Operations, Debbie White, were ‘awarded’ £10,000 pay rises between CQC failures, an expensive ‘benchmarking’ report was commissioned from management consultants to see if Robert Nesbitt was paid enough. We find that strange, because we haven’t seen ‘benchmarking’ reports commissioned into the salaries of staff on the front line which is the group which is in demand and difficult to recruit.

So, we submitted a Freedom of Information Act request.

It seems the Agenda for Change pay scales were not enough for Robert Nesbitt. The ‘benchmarking’ exercise recommended that he be moved off the inadequate Agenda for Change pay scales. He was previously a Band 8d.

In June 2017, Robert Nesbitt was moved to the ‘Very Senior Manager’ scheme and his salary increased to between £90,000 and £95,000 per year.

So, in less than ten years, as mental health services were slashed and failed and people paid with their lives, Robert Nesbitt’s salary increased by between £25,000 and £35,000 per year, an increase of between 41.6 and 58 per cent.

The median average salary of staff at NSFT has increased by a mere £101, from £26,557 in 2011-12 to £26,658 in 2016-17, an increase of 0.38 per cent. This is a pay cut of more than eleven per cent in real terms.

It perhaps isn’t surprising that NSFT doesn’t appear to have a problem recruiting ‘company secretaries’ but does have a problem recruiting doctors, nurses and other front line staff.

How very convenient to substantially boost Robert Nesbitt’s salary twelve months before his retirement: the taxpayer will be paying his pension for a long time to come and it will, unlike mental health funding, increase each and every year with inflation.

It will be interesting to see if Robert Nesbitt’s female deputy is promoted and paid his exorbitant salary. Or is it just jobs for the boys at NSFT?

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