Agenda item

Berkshire Healthcare NHS Foundation Trust

To receive an update on the performance of Berkshire Healthcare NHS Foundation Trust and the outcome of the Trust wide CQC inspection.(30 mins)


Julian Emms, Chief Executive, Berkshire Healthcare NHS Foundation Trust and David Cahill, Locality Director – Wokingham, Berkshire Healthcare NHS Foundation Trust, updated the Committee on the performance of the Trust and the outcome of the Trust wide Care Quality Commission (CQC) inspection.


During the discussion of this item the following points were made:


·         Berkshire Healthcare NHS Foundation Trust were the main providers of mental health services and community physical health services across Berkshire.

·         Following a Trust wide inspection by the CQC the Trust had been rated ‘Good’ overall.  Only 20% of Trusts had been rated ‘Good’ and no other combined Trust, or Mental Health Trust had been rated ‘Good’ in South East England.

·         Older People’s Mental Health Services (community) had achieved an ‘Outstanding’ rating and the End of Life Care Service had received an ‘Outstanding’ rating for caring.  All community physical health services had been rated ‘Good.’  The Community Mental Health Services and the Community Learning Disability Team, some of which were jointly provided with the six Berkshire local authorities had received ‘Good’ ratings.  All services located within the Borough had received a ‘Good’ rating, including WestCall.

·         Three core services had received compliance notices.  Learning Disability Inpatient wards had been rated ‘Requires Improvement’ overall and had been rated ‘Inadequate’ for Effectiveness.  Older People’s Inpatient Mental Health Services had been rated ‘Requires Improvement’ for Safety and Effectiveness.  The Child and Adolescent Mental Health inpatient ward (Berkshire Adolescent Unit) had been rated ‘Good’ overall but had been rated ‘Requires Improvement’ for Safety.

·         Before the report had been published immediate action had been taken when possible which had been agreed by the CQC:

  • Ligature risks had been removed as far as possible;
  • Mixed Sex Accommodation concerns had been addressed;
  • Privacy and dignity concerns on Campion Ward (Learning Disability inpatients) had been addressed;
  • GP service commissioned for Campion unit.  Visiting took place twice a month;
  • The seclusion room on Campion now met Mental Health Act requirements.

·         Action plans were in place for all three services.  Staff development in progress included:

  • Management of ligature risks;
  • Management of patient observations;
  • Risk assessment;
  • Communication skills;
  • Leadership

·         Consistency was integral to the success of the Trust.  Those services which had been rated ‘Outstanding’ had good clinical leadership and management in place. 

·         The plan was for compliance to be achieved by September 2016.  Many of the concerns raised were the responsibility of the Trust to develop.  However there were three areas where system support was needed to facilitate improvements:

  • Delivery of the Learning Disability Transformation Plan;
  • CAMHS waiting times;
  • CAMH inpatient services and providing a building fit for purpose for the Berkshire Adolescent Unit.

·         Julian Emms outlined how the Trust planned to move to ‘Outstanding.’ 

·         Councillor Blumenthal asked whether the CQC inspection report had produced any surprises.  Julian Emms commented that on the whole results were as anticipated although the Learning Disability Service had not performed as well as expected.

·         In response to a Member question regarding safeguarding and child protection, Julian Emms indicated that these were well embedded within the Trust.

·         Councillor Dolinski questioned what action was being taken to move the Trust leadership to ‘Outstanding’.  Members were informed that the senior Board had been rated as strong.  With a dispersed organisation based across many locations leadership needed to be good throughout.  A leadership development programme was part of an Organisational Development Plan.  Clinical leadership was also under development.

·         The Committee discussed the Child and Adolescent Mental Health Service (CAHMS) which had been rated ‘Good’ overall.

·         Julian Emms explained how it was decided if a child or young person required urgent care. 

·         The commissioners had invested £1million into reducing waiting list times.  Extra staff had been recruited and month on month wait times were reducing.  The wait time for non-urgent services was approximately 12-18 weeks and it was hoped that wait times would reduce to no more than 12 weeks by the end of the financial year.  Nevertheless, referral rates had increased by 7%. 

·         Members were notified that many referrals to CAMHS were for children over 10.  More needed to be done at an earlier stage and preventative measures were key.

·         David Cahill commented that the Trust was working with the Local Safeguarding Children’s Board and Involve on providing multi-agency support for families whose children were waiting for CAMHS.

·         Members asked about the recruitment of skilled staff.  The Committee was informed of support for professional training, such as a course for Physician Associates offered in collaboration with the University of Reading. 

·         With regards to CAHMS non-urgent waiting times, Councillor Jones asked what the national average was and what the best and worst waiting time rates were across the country.  The Committee was informed that the average waiting time was a year, the best was approximately 12 weeks and the worst, a couple of years.  4-6 weeks would represent outstanding waiting times but were unlikely to be consistently achieved due to the current economic situation and the need for greater early intervention.  ‘Do Not Attends’ also had an impact on waiting times.

·         Councillor Blumenthal asked why the rate of young dementia sufferers in Berkshire was higher than the national average.  She was informed that a very successful service for younger individuals with dementia was operated in Berkshire and that it was better identified than in some other areas.

·         In response to a question regarding dentists, Julian Emms indicated that the Trust provided community dentistry and also the dental services for Broadmoor Hospital.  There was not a recruitment problem in this area.

·         The shortage of GPs, nurses and physiotherapists locally was discussed.  In response to a question from Councillor Jones, the Principal Democratic Services Officer indicated that she would ascertain the number of GP vacancies in the Borough.

·         Members asked about the use of agency staff.  The Committee was advised that the Trust only used approved agencies and had improved the terms and conditions for internal ‘bank staff’ who provided cover for planned and unplanned shortfalls in staffing.

·         Councillor Dolinski stated that many newly qualified GPs chose not to stay in the area as it was an expensive area to live.  Julian Emms commented that the Trust and the Council would be working together around One Public Estate, looking at freeing up estates and land for housing. 


RESOLVED:  That Julian Emms and David Cahill be thanked for the presentation.


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