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Health Service Journal: The worrying truth about mental health services: The King’s Fund on NSFT’s failure

Helen Gilburt, a fellow in health policy at The King’s Fund, writes:

The example of Norfolk and Suffolk Foundation Trust provides a stark reminder of the risks associated with undertaking whole-system transformation at scale and pace.

To pre-empt increased financial risk and deliver efficiency savings, the trust engaged in delivering a vision of implementing recovery-orientated care. Its trust service strategy outlined large reductions in staff, changes to skill-mix requirements and service reconfiguration including a reduction in acute beds and a redesign of the way that services are delivered.

In 2015, the Care Quality Commission rated the trust “inadequate” and placed it in special measures. The trust’s own analysis found that there was insufficient evidence to support the rationale for change and workforce skills requirements, and that the timescale had been too limited to consider all the factors required to successfully implement change.

The self-proclaimed architect of the catastrophic ‘radical redesign’ at Norfolk and Suffolk NHS Foundation Trust (NSFT), Kathy Chapman, has been promoted to be the NHS Confederation‘s Programme Manager, Mental Health Intelligence and Leadership Programme.

Back in 2013, clinicians who warned about the cuts were accused of ‘shroud waving‘ and ostracized. NSFT claimed services would be ‘enhanced‘.

NSFT is now talking about ‘positivity’ as a part of ‘Putting People First’, its expensive HR strategy from management consultants April Strategy. Yet condemnation of ‘negativity’ was exactly what NSFT used to suppress evidence-based dissent from clinicians as Kathy Chapman’s radical redesign was ruthlessly forced upon NSFT by Maggie Wheeler’s Board: staff were told that only ‘positive’ contributions to the consultation were welcome.

At a recent Board meeting introducing ‘Putting People First’, Leigh Howlett gave the example of staff talking about their own problems to service users as an example of poor ‘negative’ behaviour. Perhaps, just perhaps, Leigh Howlett could reflect upon her own culpability as a ‘positive’ member of the NSFT Board which destroyed services and staff morale?

Here is an alternative interpretation of ‘negative’ behaviour posted on our website by David Walter:

Last year I was admitted as a voluntary patient at risk of suicide. I was having my blood sugars tested one day and the nurse suddenly burst into tears. I tried to comfort her and she talked to me about what was distressing her.

She was having to face redundancy and the awful business of applying for her own job, or rather one of the reduced number of positions being offered. Her interview was imminent and she explained that in effect she was competing for that job with a friend and colleague of over 20 years.

The whole redundancy programme was a disastrous mistake in terms of wasting money and losing high quality, skilled, experienced, dedicated staff. But on top of all that, it was an inhumane process that caused harm to people and crippling damage to morale.

The need for mental health services is growing. Our government has its priorities all wrong and is failing to provide the resources needed. The NSFT is mismanaging what it is being given, when anyone who is responsible for their own or anybody elses money knows how vital it is to get the priorities right and use reduced income in the most effective, value-focussed way possible. And over and above this, the mistreatment of staff and the anxiety raised among service users who fear the support will not be there when they need it means they (NSFT) are in danger of creating even more mental ill health.

I look back on my time in that unit and am amazed at the professionalism and the humanity shown me by the staff in the midst of all that they were going through. Ladies and gentlemen I salute you!

It is worth remembering that King’s Lynn, where David was an inpatient and staff were made redundant, now has a severe recruitment crisis.

Perhaps we should all try to be positive about the proposed £36 million of cuts at NSFT?

Click on the image below to read the full article on the Health Service Journal website:

HSJ The worrying truth about mental health services

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