Awards and achievements in 2020-2021

Our simple strap line is “Brilliant care through brilliant people” and below is a small selection of how our brilliant people have been recognised for the brilliant care they are providing.

In a year when much of the focus was around COVID-19, KMPT was still able to find a little national award success in amongst the pandemic, as well as hosting their own KMPT awards to reward the amazing effort from all staff across the Trust.

Many of the larger awards across the country were either cancelled or postponed due to coronavirus and so submissions were greatly limited as was the capacity of teams to be able to dedicate time to submitting nominations; however, despite this, we were delighted to be placed in some very prestigious awards nevertheless.

The Mental Health and Wellbeing Awards are a UK-wide celebration of excellence in mental health and well-being interventions, plus the celebration of inspirational mental health stories; hosted by the Mental Health Awareness Programme.

The overall winner was Ben West who was nominated by KMPT for the outstanding work he has done around mental health and encouraging change as well as challenging people to speak more openly around suicide and other charity work.

Other finalists included Dementia envoy, Keith Jennings, Peer support worker Mark Holmes, volunteer Louis Coelho and lived experience advisor Louise Jessop as well as Adel Murphy who
we featured in the Trust’s own magazine, Connected, for her community work around promoting mental health.

The Rosewood Mother and Baby Unit received acclaim this year when they were selected from 38 applicant to receive a garden makeover as part of the RHS Chelsea Flower Show 2020 competition for ‘RHS Greening Great Britain for Friendship Garden’ to live on in an NHS mental health trust in England.

And lastly the HSJ Value Awards was a platform for KMPT to truly shine in 2020 with the Criminal Justice Liaison team shortlisted as finalist in the Mental Health Service Redesign category and our own Vocational rehabilitation team crowned as winner of the HSJ Value Award of the Year 2020 after being shortlisted three times in a row in both the HSJ Awards and HSJ Value Awards in previous years.

Technology

The Trust recognises that Information technology (IT) is an essential clinical tool, with widespread benefits for both staff and service users. The use of IT impacts the quality of clinical outcomes, patient safety and patient satisfaction.

The Trust’s Clinical technology strategy aims to support staff to deliver and improve the quality of those services and how we work with partners to ensure that our service users and carers experience continuity of care at all times.

There has never been a time of greater demand on these services and as a result to our commitment to using and maximising digital technology, we have been able to offer virtual clinical consultations using Attend Anywhere and virtual group therapy through video conferencing on Lifesize throughout the year.

Objective one in our Clinical technology strategy is to develop our clinical engagement practices to ensure we digitise the correct process. Progress against this objective includes: successfully completing the rollout of Windows 10, ensuring we have stable and secure operating systems; successfully completing a virtual telecoms consultation and engagement exercise involving 264 people, including staff, patients and carers; delivering a programme of systematic staff engagement to ensure clinician led innovations are delivered; holding a successful RiO workshop exploring with clinicians what we can do to improve the user friendliness of RiO; refining and refreshing our digital governance structures to improve accountability and oversight of the work that falls within its remit.

Estates

The biggest achievement for the estates and facilities teams in the last year has been the seamless delivery of services throughout COVID-19 including the additionally services that have been necessary. There has been no reduction in cleaning standards supporting the Trusts infection control measures, maintaining a compliance rate of 98% over all inpatient and outpatient areas. Cleaning responsibilities have been increased to include the rooms of COVID-19 positive patients to release clinical staff from these duties and all planned maintenance requirements have been achieved to maintain compliant standards.

The catering service delivery has been expanded to include providing meals for staff. The centralised switchboard has maintained a 24/7 service delivery throughout.

Setting up Jasmine ward as a cohort ward brought significant works for the teams with building works, cleaning etc. The temporary closure of Ruby ward in support of Medway Foundation Trust, who needed to create additional hospital capacity for patients with COVID-19 in a matter of four days, was an immense task but hugely successful with clear communication and support amongst all of the teams involved.

Whilst COVID-19 has applied significant pressures to an already busy workload for the teams, business as usual has been maintained to include the sale of Canada House, the release of Elizabeth House back to its landlord, opening Britton House as a hub for the Medway teams. Sarre and Flete have long been vacant properties; Sarre has now been leased to East Kent Hospital Trust and the use of Flete by Kent County Council is nearing completion.

Our capital programme was delayed getting under way but with the excellent support of our consultants will become one of the most successful years for delivery of schemes seen with over 60 schemes in the programme.

Quality improvement successes to celebrate

Clinical care pathways

The Clinical care pathways project has been evolving over the past 18 months. The context however continues to be, to maximise the quality, safety and outcomes for people using our services and support staff delivering care whilst understanding our use of resource by a balanced and interdependent approach of:

• Implementing consistency of care through designed care pathways across Community recovery and Acute care groups
• More reliable, safe and evidence-based care
• More efficient and managed use of staff time
• Understanding the costs of delivery
• Collection of outcomes relating to interventions
• Supporting clinicians with agile working
• Organising clinical resources with a balanced and managed system of office and home-based clinics
• Optimisation of the estate to match the delivery requirements of the care pathways.

The Care pathways project offers a way to drive the implementation of evidence-based practice to best support positive recovery outcomes for people using our services. This includes supporting improvements in physical health and social inclusion which are known to benefit mental health outcomes. It also provides information on where this is failing so resources such as staff, buildings and technology can be targeted effectively.

The key clinical principles we have adopted within the integrated care model are:

1. All components are needs led (i.e. age itself is not a barrier to receiving any component)
2. If a component is commenced within a ‘community’ team (younger or older adult), and the patient is well enough to continue to engage with this whilst under home treatment or inpatient care, then they will continue with that component
3. Interventions have been grouped into three clinical thematic pathways
   1. Mood Disorders
   2. Psychotic disorders (unusual experiences)
   3. Complex Emotional Difficulties (CED)
4. Within each thematic pathway there are elements for: psychological therapy, daily
   life (practical support), medications, family friends carers, physical healthcare and
   self management

Clinical outcomes

From September 2020, we have been able to link patients on specific components with their outcomes and report accordingly.

The clinical outcomes have been overwhelmingly positive which is excellent news and something which should be celebrated.

The graph below is an example of the improvement in clinical outcome as the result of one of therapeutic components within the pathway.

*The graph shows areas of difficulties such as wellbeing, problems, functioning and risk decrease throughout the course of treatment.*

The evidence from the clinical care pathways components, specifically Initial Interventions, has been used the drive and inform a revised skill mix in community services. This has allowed staff to be aligned with the best use of their time and skills to the benefit of patients and also increase staff satisfaction levels.

Development of Crisis line

In April 2020, the Trust responded to the COVID-19 pandemic and the significant pressures on the NHS 111 service by operating its Single Point of Access service as a system wide, public facing crisis line for mental health. By the end of May 2020 demand had risen by 50 per cent and it quickly became apparent that significant changes were needed.

A completely new operating model was implemented, moving away from an assessment service to access KMPT services to a telephone triage service more akin to a 111 clinical assessment service that signposts, provides advice and guidance and refers into the right specialist service. This work in turn has lead to the wider system work to develop a single crisis line and pathway for mental health, working with other providers including KMPT, Mental Health Matters and the ambulance service, SECAmb.

The changes required involved implementing an entirely new web-based telephony service; implementing new screening and triage tools which are based on the UK Mental Health Triage Scale; recruiting and training enough staff to provide a 24/7 service; introducing a revised governance structure with performance, patient safety and quality meetings introduced to better ensure the safety of the service and continue to improve user experience.

As a result, the Crisis line will handle in excess of 30,000 referrals by the end of 2021, compared to 13,000 in 2019. Abandoned call have reduced from nearly 50 per cent to 2 per cent and the introduction of a Threshold Assessment Grid (TAG) means that the team are able to assess the severity of a person’s mental health problem and identify, at the earliest opportunity, the level of risk and next steps.

The aim is that the service will be able to operate as a true health-based contact centre, with consistency in working practices with settings such as NHS 111.

Quality improvement collaborative – Sexual safety on mental health wards

The Sexual Safety Collaborative was established in response to a CQC report on sexual safety on mental health wards. It aims to support inpatient mental health teams in all mental health trusts maintain and improve sexual safety on wards using QI techniques.

KMPT’s Upnor ward has been involved in this piece of national work completing the benchmarking tool against the Collaborative’ s standards and using QI tools and resources to ensure safety of patients on the ward.

Rebalancing quality assurance and quality control

The use of Cliq checks is now an established practice within the Trust to audit and monitor our quality standards. These checks provide clinical managers with indicators of where standards have not been met or where potential issues may be developing.

Overall compliance with these standards continues to improve across all care groups and from an assurance perspective there are areas where we have done consistently well.

Inpatient service

• Progress notes – the average quality over the past year has been rated at 95 per cent
• The number of fully completed medication charts has improved dramatically – an incredible piece of work
• Since its relatively recent introduction to CliQ, the development of care plans to meet needs relating to diabetes has been impressive.

Community services

• The team has consistently achieved 100 per cent for follow up appointments. This involves ensuring that an appointment has been made and adhered to
• The average quality of risk summaries across all teams over the past year has been 81 per cent
• Triangulation (risk summary and care planning)

Place of safety

• The average quality of therapeutic observations over the past year has been 96 per cent
• NEWS2 has been rated at an average of 91 per cent
• Discharge progress notes have been at an average of 97 per cent over the past year.

Older adult inpatient

• Mental Capacity Act compliance
• Falls (assessments and care plans)
• Deprivation of Liberty (DoLS) – good across the board
• Moving and handling (assessments and care plans)
• Initial risk summary