1 September – Mental health network webinar

The meeting started by discussing ncurrent issues, including system management and development, funding pressures, pressures on executive teams, the ongoing cyber-attack, the cost-of-living crisis and concerns regarding the upcoming winter.

The group went on to discuss a potential change of attitude to mental health, particularly with regards to the term ‘woke’, and being questioned on why there is increased demand now in relation to previous generations. They noted that, with regards to conversations about the relationship between hardship, mental health and increased demand and support, some individuals and areas feel this is not the role of the NHS and not a priority.

Some spoke of fears that staff and communities are becoming blasé about infection control and the spread of e.g. Covid. They feel NHSE need to pick this up and take action, otherwise there will be a major epidemic of infection spread. They also spoke of the very real risk of strikes and how the trust is collating financial support resources for staff.

Many questioned if boards are fit for the future to tackle issues such as those raised by the group regarding wokeness. Leaders need partnership and collaboration skills. A participant spoke of their experience regarding a PFI, whereby the skillset of the board was not equipped to challenge it, and spoke about recruiting excellent individuals from estate and legal backgrounds to assist.

They shared their disappointment regarding a Daily Mail article criticising the NHS for funding staff networks.

"Good organisations have powerful staff networks that challenge and identify health inequalities."

The group then discussed the rise in suicides in the fire service in recent times has been exponential and debated who is reporting on NHS suicide figures. Someone shared that Professor Louis Appleby leads the National Suicide Prevention Strategy for England, and suggested inviting him to a future meeting.

On the topic of dealing with job insecurity at a range of levels, including within the trust and the system, at NHSE regional level and at the CQC: "This needs to be overcome before talking about positive change."

"The current political dimension and the resulting paralysis experienced over the summer, which affected the trust getting a decision on capital. The price has now increased, and the trust have had to go at risk on a project due to the inability to get a decision from the centre."

The group raised concerns regarding messages from politicians and flagged a recent article in the Times where Steven Barclay spoke about de-prioritising cancer and mental health in order to prioritise elective work. Participants spoke of real concern around political direction and narrative. "The ‘anti-woke’ narrative will likely increase and will affect mental health."

Some felt the ‘anti-work’ agenda is going to be profound. "We ought to push the boundaries of charitable funds to target specific work around the poorest in the community. There is a likely alignment of mental health and community services in Hampshire and a commitment to working together to ensure stability for staff and communities."

"We would value a separate conversation around income generation, including smaller scale, simple but valuable work by other trusts." Someone spoke of recently setting up a charitable arm and numerous board conversations around what can or cannot be done as a foundation trust. The group agreed to discuss this at a future meeting and to hear from those with good systems in place.

Someone shared the following quote from the NHS code of governance:

"The board of directors must satisfy itself that the trust’s vision, values and culture are aligned. All directors must act with integrity, lead by example and promote the desired culture.

"The board of directors should assess and monitor culture. Where it is not satisfied that policy, practices and behaviour throughout the business are aligned with the trust’s vision, values and strategy, it should seek assurance that management has taken corrective action. The annual report should explain the board’s activities and actions taken, and the trust’s approach to investing in, rewarding and promoting the well-being of its workforce."

There is the culture aspect and asked the chairs what, in six months’ time, they would be grateful they had done now.

One participant spoke of this being his first day at the trust and the trust’s unique set of challenges. "My current primary focus is ensuring patient safety. In six months, I would like to have a further understanding of what the trust is doing to promote, audit and evidence culture across all teams and all staff."

The group went on discussing the difficulties in measuring impact with regards to culture.

"One can get outside help from the Leadership Academy regarding cultural change, due to everything needing to come from the top and very little sideways movement and conversations at the trust. Cultural change takes time and involves visible listening, acting and challenging individual teams on how they can make a difference."

Someone mentioned a recent CQC inspection where a chief executive spoke of adopting a ‘just culture’ but was unable to explain what this was.

"When things go wrong, the problem must be fixed where it is, rather than restricting everyone."

"Working with inclusion groups with protected characteristics has resulted in staff reporting that they feel better about culture, however the numerical parameters haven’t really changed."

"The concept of co-production is a significant challenge and learning from colleagues regarding this. This must be led and challenged by the executive."