Quality Report
2009/2010
1
Lincolnshire Partnership NHS Foundation Trust
Quality must become personal and individual to
everyone working in the NHS. We must develop a
culture inside organisations where quality is talked
about – from every GP practice through to every
hospital ward and every board. It means supporting
staff as they step up to the challenge of raising quality,
promoting dialogue and discussion about how things
can be done differently and looking out to the
communities we serve for our inspiration for change.
High quality care for all will be accomplished through
thousands of small changes, through the courage and
leadership of frontline staff, sustained and supported
by an NHS system with quality at its heart.
High Quality Care for all: our journey so far
Quality Report 2009/2010
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Contents
Part 1 - Introduction
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Statement on quality from the Chief Executive
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Part 2 – Plans for 2010/2011
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Strategic context
The Trust’s priorities for improvement
Innovation and research
Goals agreed with commissioners
Service development plans for 2010/2011
Quality management systems
Care Quality Commission’s assessments of the Trust
Board Assurance
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Part 3 – Report on 2009/2010
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Review of quality performance
- Performance against selected metrics
- Regulatory requirements and national targets
- Information governance
- Service performance
- Benchmarking against other mental health trusts
- Performance against goals agreed with commissioners
- What patients, carers and the public say
Statements from local stakeholders
- Local Involvement Network and Overview & Scrutiny Committee
- NHS Lincolnshire
- Comments from Trust Governors
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Lincolnshire Partnership NHS Foundation Trust
Part 1 – Introduction
Statement on Quality from the Chief Executive
May I welcome you to the production of our first Quality Report. You will recall that last year we
produced a quality report that was contained within our Annual Report and Summary Account and
submitted to our external regulator Monitor. It was also made widely available for members of the
public, staff and patients.
The quality report gave a brief overview of quality initiatives that were being undertaken to improve
quality in Lincolnshire Partnership Foundation Trust and informed readers how we did against
selected targets for the previous year.
From 1st April 2010 it is a legal requirement to produce a “Quality Report” rather than a report. The
quality report aims to ensure that quality has the same importance as that of the financial account
but wholly focuses on the quality of services and treatment. The summary of financial accounts
2009/10 will be available via the Trust website.
Lincolnshire Partnership Foundation Trust welcomes the opportunity to publish an annual quality
report that assists the public, patients and others to understand:
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What the organisation has done well
Where improvements in service quality are still required
What the Trust priorities for improvements are for the coming year 2010 /11 and what we aim
to achieve
How service users, staff and others with an interest in the organisation have been involved in
determining these priorities.
The Quality Report is predominantly for members of the public, patients and staff and aims to take
you on our quality journey for the last 12 months and show you our direction of travel for the
forthcoming year.
Our principles and values
2009 has seen us redefine our mission, vision and values. A range of people were involved and
consulted in this to ensure there was clear and wide ownership from our staff, service users,
membership and Governors. Once these were agreed I held a series of twelve road shows to
make sure that staff understood the Boards commitment to upholding these and examine how the
organisation should change as the values become embedded into our everyday work across the
Trust.
Quality Report 2009/2010
Mission
To promote recovery and quality of life through effective, innovative and
caring mental health, social care and specialist community services
Vision
To be the best at what we do
Values
We will RESPECT…
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Recognise and value people’s differences
Ensure we do as we say we do
Support personal recovery and quality of life
Put people first
Enable and support our staff
Continue to work in partnership
Take pride in what we do
Quality priorities in 2009/2010
Improving our organisation through better quality measures and outcomes has been one of our
priorities for 2009/2010.
Work has started on developing meaningful quality metrics that measure “quality of care and
treatment” to service users and demonstrate Patient Reported Outcome Measures (PROMS).
These PROMs will measure the quality of inter-personal interactions and effectiveness of a range
of treatments. Treatments will include clinical therapies but also social activities that have
produced effective health outcomes. These metrics will be a shift away from traditional
performance targets to being focused on service user outcomes and experiences.
The appointment of a Head of Clinical Quality in September was pivotal in our continuing focus on
improving clinical quality. Moreover, the production of the Clinical Quality Strategy has clearly
outlined what is required of the Trust to meet patient expectations of a high quality service.
As part of the Trust’s commitment to tackling social exclusion, the Trust supported the national
Time to Change campaign to reduce stigma and discrimination against people with mental health
problems. The Time to Change project team, led by the Chairman, delivered a positive and coordinated action plan to embed anti-discriminatory practices into all Trust activities.
Last year saw the development of the Commissioning for Quality and Innovation (CQUIN)
framework. These CQUINs were agreed with our Commissioners of services as areas that
required improvement. The Trust is pleased to announce that these measures have now been
completed – these are detailed in Part 2 of this report.
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Lincolnshire Partnership NHS Foundation Trust
To ensure there is transparency and evidence of involvement we have asked key stakeholders to
be involved in the development of the quality report. The Trust has liaised with the overview and
scrutiny committee, NHS Lincolnshire, LiNKS, Governors, Non-executive Directors, Patient
Involvement and Engagement Service Users and Staff to ensure the content reflects their views
and comments.
Quality goals for 2010/2011
We acknowledge that as an ambitious and high performing foundation trust there are areas that
still require improvement and the Board of Directors are committed to ensuring that year on year
improvements are made.
The NHS Next Stage Review; High Quality Care for All (2008) identified the need to measure
quality of care for patients within three core domains. These domains form the bedrock for
developing quality measures and monitoring the performance of providers:
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Patient Safety - that the NHS does no harm to patients, ensuring the environment is safe and
clean, reducing avoidable harm.
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Clinical Effectiveness - understanding success rates from different treatments for different
conditions including clinical measures, complication rates and measures of clinical
improvement.
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Patient Experience - how personal the care is – the compassion, dignity and respect with which
patients are treated.
It is our aim for the forthcoming year to identify three strategic priorities within each of these three
key domains of patient safety, clinical effectiveness and patient experience.
I hope that you find this report informative and that you will be able to assess the levels of
improvements that we are setting out to achieve over the forthcoming years.
The content of this Quality Report is to be approved by the Board of Directors on 4 th June 2010
and to the best of our knowledge the information is accurate.
Chris Slavin
CHIEF EXECUTIVE
Quality Report 2009/2010
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Part 2 - Plans for 2010/2011
Priorities for quality improvement
Strategic Context
The Trust’s quality programme is fully aligned with its broader business strategy to ensure that the
right issues are prioritised at the right time.
The Board of Directors has defined four business objectives and four clinical objectives, in support
of the Trust’s mission statement:
Business Objectives
 To provide clinically effective, high quality services that match or exceed best practice
 To be a competitive and model employer
 To develop strong relationships with stakeholders
 To manage and develop a successful organisation
Clinical Objectives
 Prevention
 Positive Patient Experience
 Improved Mental Health
 Improve life opportunities
 Recovery
Service excellence lies at the heart of the Trust’s Integrated Business Plan for 2010 – 2013. The
Board, in consultation with other parties, has selected a number of key quality priorities for the
coming year.
Partnership Approach to Quality
The commissioner and provider share a complementary approach to improving the quality of
mental health services in Lincolnshire.
The Trust’s quality priorities, which were determined by patients, carers and the public, tackle
pressing local needs. These priorities correlate closely to the Commission for Quality and Innovation
(CQUIN) payment framework, which is managed by NHS Lincolnshire. Seven out of the nine quality
priorities are directly related to the CQUIN indicators, which are detailed on Pages 19 - 21.
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Lincolnshire Partnership NHS Foundation Trust
Summary of Quality Priorities
Patient
Experience
Clinical
Effectiveness
Patient
Safety
1. Improve patient and carer involvement in planning their care & treatment
2. Improve customer satisfaction during the complaints process
3. Involve patients to improve the quality of in-patient areas
4. Release more time to care through more efficient mental health wards
5. Increase the recovery rate for adults using psychological therapies
6. Improve the physical healthcare of the Trust’s service users
7. Reduce suicides through more effective clinical risk management
8. Reduce the amount of medication errors
9. Reduce the number of falls across the older adult in-patient areas
Quality Report 2009/2010
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The Patient Experience
Priority 1 – Personalised Care Planning
Mental health policies have increasingly focused on personalisation
through an emphasis on meeting the wider needs of those with mental
illness, addressing equalities, tackling the problems of social inclusion,
and promoting positive risk management. Self-directed support planning,
including the Care Programme Approach (CPA), is at the centre of this
personalisation focus, supporting individuals with severe mental illness to
ensure that their needs and choices remain central in what are often
complex systems of care.
Rationale
Aim
Current status
Plans
Monitoring & reporting
Related CQUIN
Leads
The CPA is a robust assessment and care planning framework that aims
to ensure that the needs of patients with complex characteristics are
effectively co-ordinated, supporting them in their individual diverse roles
and the needs they have, including: family; parenting; relationships;
housing; employment; leisure; education; creativity; spirituality; selfmanagement and self-nurture; with the aim of optimising mental and
physical health and well-being. Active service user involvement and
engagement is at the heart of this approach, as is a focus on promoting
social inclusion and recovery.
Patients currently report they do not feel involved in their care and would
like to experience more involvement. Consequently the Trust is renewing
its focus on its Care Programme Approach to deliver a service with the
individual using the services at its heart.
To increase patient and carer involvement in the planning of their care
and treatment
In 2009, 47% of service users surveyed felt that they had definitely been
involved in the development in their care plan, whilst 35% felt they had
been involved ‘to some extent’.(source; 2009 Service User Survey by
Quality Health)
 To review key outcomes of the quarterly CPA audit & community
patient survey results
 To evaluate current care plan documentation and usefulness for
patients
 To pilot and implement service user focused revised care planning
documentation within Adult Services
 Following review of pilot (including service user and carer feedback,
roll out revised care planning documentation trust-wide across
services and settings for service users supported by CPA
 Quarterly CPA audits across trust services and settings (reporting
through Quarterly Clinical Quality Report)
 Annual national patient survey results
 Local team and unit patient experience surveys
MH7
Ann Munro (Assessment and Care Planning Coordinator)
Ann Hunt (Director of Operations)
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Lincolnshire Partnership NHS Foundation Trust
Priority 2 – Complaints Process
The Trust actively seeks feedback about its services and recognises the
right of people to comment on or complain about any aspect of the service
they receive. The Trust is committed to trying to resolve things that go
wrong as soon as possible and to give service users and carers a
satisfactory outcome
Rationale
Aims
Current status
Plans
Monitoring & reporting
Therefore, the Trust acknowledges the importance of an effective and
efficient complaints procedure, which enables and encourages
complainants to speak openly and freely about their concerns. They
should be reassured that whatever they say will be treated with the
appropriate confidentiality, sensitivity and care, feeling satisfied with the
way their complaint has been handled and confident that the Trust has
learnt from their experience.
 To increase the level of support for complainants (Listen)
 To achieve greater customer satisfaction and confidence in the
complaints process (Respond)
 To ensure the experiences of service users and carers and relatives
are used to improve the quality of services. (Improve)
In 2009/2010, the Trust received 208 complaints/concerns:
- 132 complaints resolved at service level
- 34 complaints resolved through formal investigations
- 42 concerns via PALS contacts that were resolved within 24 hours
It is hoped that this project will result in an increase in the number of
concerns and complaints recorded, as this demonstrates a positive
approach to empowering service users and carers to raise concerns and
provide feedback.
The project is also seeking to increase the proportion of service level
resolutions, which will demonstrate that staff are better equipped to
resolve concerns and to deliver a more customer focussed service.
 To review current customer care initiatives
 To identify past and current themes/trends regarding complaints,
complaints process and satisfaction of outcome of complaint.
 To apply experience based design to complaints review & evaluation
 Satisfaction survey on complaints handling
 Reports to Clinical Quality & Risk Committee providing aggregated
information on themes and trends of concerns and complaints
 Implementation of actions plans for service improvements identified
through concerns and complaints.
 Customer Care training programme for staff
Related CQUIN
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Leads
Caroline Hainsworth (Complaints Manager)
Kay Darby (Director of Nursing & Strategy)
Quality Report 2009/2010
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Priority 3 – Service User Involvement and Engagement
Rationale
Aims
Current status
Plans
Monitoring & reporting
It is recognised that significant improvements are needed in how the
information received from service users, carers and other stakeholders is
collated and acted-upon. The Trust’s Quality Strategy outlines a move to
using the Experienced Based Design (EBD) approach as one key area of
improvement. The key principles of this approach are:
 Understanding what is good design
 Designing human experiences; as distinct from designing processes
or services, or simply seeking opinions or satisfaction
 Direct user involvement: co-design, participative, interactive
 Partnership between patients, families, health professionals,
managers and designers
 Understand what people (staff, patients, family) naturally do & feel
To involve patients and carers in improving the quality of care and inpatient environment in order to capture, understand, improve and
measure the experience. The goals are to:
 Create designs to follow the natural patterns of those who use the
service
 Create designs that help create positive emotions; or at least Bust the
myth-Patients do not want a ‘gold plated service’ They want a good
experience
 Patients and staff see each other in a different way….as people
 Confidence for action has grown for all avoid stimulating negative
emotions
National and internal patient surveys have identified recurrent themes:
 The need for better information, with regards to both treatment and
additional support services
 The need for more effective care and crisis planning
 In-patients should be feeling safer
 Train patients and carers in using ‘experience based design’ (EBD)
 Liaise with relevant leads to evaluate effectiveness of EBD
 Develop of staff guidance documentation (with the involvement of
service users and carers) which will be publicised to all services
 Support those staff undertaking patient experience survey work
 Introduce survey training for involvement volunteers
 Develop a more robust system of managing feedback
Outcomes will be monitored through the Trust patient experience survey
programme and will be reported to the Clinical Quality & Risk Committee
Related CQUIN
MH13
Leads
Paul Jackman (Head of Strategic Partnerships)
Ann Hunt (Director of Operations)
These three priority areas require significant improvement to increase the quality of the patient
experience. Using a recognised tool such as Experience Based Design will enable staff, patients
and carers to work in a creative yet systematic manner to focus purely on patient/carer need and
experience. Bringing together the three priorities without prescription will enable each ward area to
develop and implement their own individual action plans that will make a difference to patients,
carers and staff within their areas.
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Lincolnshire Partnership NHS Foundation Trust
Clinical Effectiveness
Priority 4 – Releasing time to care
Research carried out by the NHS Institute found that ward nurses in acute
settings spend an average of just 40% of their time on direct patient care.
This is supported by research carried out by Nursing Times, which shows
that nearly three in four ward nurses say that they do not spend enough
time on direct patient care, and 90% of those polled say that patient care
suffers as a result.
Rationale
Designed by nurses for nurses, the Releasing Time to Care programme
offers a systematic way of delivering safe, high quality care to patients. It
provides tools and guidance to help ward staff to make changes to their
physical environment and working processes that will improve quality of
care and heighten safety standards.
The approach, which uses improvement techniques from industry,
analyses the main tasks taking place on a ward. These tasks are broken
into different modules, such as medication rounds and meal rounds, are
then redesigned to ensure they are patient-focused and easier for staff.
Aim
Current status
Plans
Monitoring & reporting
The power of Releasing Time to Care is that change is initiated from
frontline staff, patient and carers as they become enthused and
empowered by seeing the impact that they can have.
The main aim of the Releasing Time to Care programme is to improve
and increase the amount of direct time staff has to spend with patients by
improving the wards to make them run more efficiently, effective and
safer.
We currently have 10 out of 16 wards initiated onto the Programme with
the remaining 6 wards scheduled to start in July 2010
To complete Trust wide implementation of wards onto the Productive
Mental Health Ward Programme by the end of 2010
A measures table has been established for each individual ward which
they display in their ward environment for staff, patient and carers to see.
The measures table includes a baseline of direct patient care time and
one to one therapeutic activity. This is reported to the steering group on a
monthly basis.
Related CQUINs
MH9 & MH14
Leads
Craig McLean (Head of Workforce Development)
Kay Darby (Director of Nursing & Strategy)
Quality Report 2009/2010
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Priority 5 – Increase the recovery rate for adults using psychological therapies
Rationale
Aims
Current status
Plans
Monitoring & reporting
The national Improving Access to Psychological Therapies (IAPT)
programme aims to improve access to evidence based psychological
therapies for people with depression and anxiety disorders which will
promote their mental well being and enable them to move to recovery.
To provide psychological treatments approved by the National Institute for
Health and Clinical Excellence (NICE), that will relieve distress and
monitor outcome measures that demonstrate patients have moved to
recovery thus achieving the national target of 40%.
Year 1 of this quality initiative will focus on the IAPT service. Further
plans will be developed to increase access to psychological therapies for
people with more enduring mental health problems
The Lincolnshire IAPT service achieved 48% of cases moving to recovery
in March; this is above the national target of 40% and the national
average of 36%
 To ensure that service users receive the appropriate treatment in a
timely manner in line with the current NICE guidelines
 To ensure that outcome measures are recorded to monitor the service
users’ progress towards recovery
 To increase recovery rates and work with commissioners to agree
future targets
 To ensure a high quality effective service is delivered by an
appropriately skilled workforce and good supervision
To continue to monitor recovery rates through outcome measures and
report as per the key performance indicators supplied to commissioners
(NHS Lincolnshire) and the strategic health authority (NHS East Midlands)
Related CQUIN
MH11
Leads
Pat Weston (General Manager - Psychological Therapy & Primary Care)
Ann Hunt (Director of Operations)
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Lincolnshire Partnership NHS Foundation Trust
Priority 6 – Physical healthcare
Rationale
The experience of mental health problems or a learning disability and poor
physical health are closely linked. New Horizon (Department of Health
2009) A shared vision for mental health summarised that mental and
physical health are interconnected and both are associated with
significant burdens of physical ill health. Mental distress doubled the risk
of stroke, for example, while coronary heart disease is associated with a
five-fold increased risk of depression. On average, the life expectancy of a
person with schizophrenia is 25 years shorter compared with the general
public.
Aim
Improve the physical healthcare of the Trust’s service users
Current status
Plans
Monitoring & reporting
The Trust has an integrated care pathway tool for the assessment of
physical health status on admission, however some concerns have been
highlighted through complaints and incidents that physical healthcare
problems are not recognised early enough and appropriate treatment
sought.
 Ensure that all inpatients receive a comprehensive physical healthcare
assessment during their stay
 Develop shared care arrangements with GPs to support all community
patients on the Care Programme Approach to access annual health
checks
 Enhancing the physical healthcare skills of clinical staff
 Developing effective policies to support good practice
 Establish baseline information on the number of comprehensive
physical health assessments currently being performed.
 Report against target to Board committee for clinical quality and risk
Related CQUIN
MH12
Leads
Chris Higgins (Matron)
Kay Darby (Director of Nursing & Strategy)
Quality Report 2009/2010
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Patient Safety
Priority 7 – Reduce suicides through more effective clinical risk management
Rationale
Aim
Current status
The continuing reduction of the number of suicides is a national and local
target. New Horizons (Department of Health 2009) builds on the work of
the National Service Framework in mainstreaming suicide prevention
within wider mental health care. The National Patient Safety Agency
(NPSA) also has a focus on suicide prevention as an integral part of
patient safety work within mental Health. Locally the Trust is working to
reduce its suicide rate, and has included this work within the Leading
Improvement in Patient Safety initiative.
To reduce the number of suicides known to LPFT thorough suicides
through more effective clinical risk management.
The number of suicides in people accessing LPFT services has remained
at an average of 9 per quarter (including current service users or service
users within six months of death)
The suicide rate is higher in Lincolnshire than England as a whole - the
average rate per 100,000 for 2005-2007 in Lincolnshire was 10.47,
compared with a national average of 7.92
Over the last five years, around 50% of cases had some previous contact
with the Trust’s services. The Care Services Improvement Partnership’s
Audit Tool refers to 25% of all suicides have been in contact with
psychiatric services in the 12 months prior to death.
Plans
Monitoring & reporting
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LPFT will revise the Clinical Risk Assessment training
Risk Assessment policies and tools will be revised
Investigations and recommendations following suicides will be
managed through the Suicide Prevention group
The suicide rate will be monitored by the Suicide Prevention Group, and
reported internally through the Clinical Policy and Practice committee to
the Clinical Quality and Risk committee.
Externally it will be reported to NHS Lincolnshire through the Quality
Monitoring process.
Related CQUIN
—
Leads
Andrew Skelton (Deputy Director of Nursing)
Kay Darby (Director of Nursing & Strategy)
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Lincolnshire Partnership NHS Foundation Trust
Priority 8 – Reduce the amount of medication errors
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Rationale
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Aims
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Current status
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Plans
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There are potential risks to the safety of service users at every stage
of the medicines management process- when medicines are procured,
prescribed, dispensed, prepared, administered and monitored.
Errors may occur despite safeguards and best practice guidelines
To review and reduce the current level of medication errors
To reduce medication related incidents in all care environments
To keep patient safety and effective medicines management as a key
priority for the Trust
To prevent medicines related incidents that can cause significant
problems and sometimes unnecessary harm or distress
To maintain compliance with all aspects of Care Quality Commission
(CQC) and other legislative guidance for medicines management
The Trust has an assurance framework through the Medicines
Management Committee and Medicines Management Policy that is
working towards medication error reduction.
An action plan has been implemented and is still ongoing, which
demonstrates the recognition of and good practice in the safe and
secure handling of medicines. This action plan was initiated after a self
declaration of non compliance with C4d of the CQC standards in 2009
The priority for the first quarter in 2010/2011 is to establish a baseline
for medication errors, which will enable progress to be tracked
The Trust is to undergo an assessment of its risk management
standards for medicines management
To develop a documented process for managing risks associated with
medicines in all care environments
To implement the recently developed 'nurse competency framework'
for handling and administering medicines, particularly for those staff
who are new to the Trust, qualifying students, or nurses who have
made drug errors.
To actively review and revise all documentation, guidelines, protocols,
and polices surrounding any aspect of medication
The Chief Pharmacist to actively support and be party to the
development of any local action plans or lessons learnt from any
reported medication incident.
Quarterly audits to ensure compliance with C4d standards of the CQC
Monitoring of the risk management processes developed surrounding
medicines in all care environments
Regular reports on reported medicines incidents to the Medicines
Management Committee from the Trust risk management systems
(Sentinel)
Monitoring & reporting
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Related CQUIN
MH8
Leads
Shiraz Haider (Chief Pharmacist)
Ann Hunt (Director of Operations)
Quality Report 2009/2010
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Priority 9 – Reduce the number of falls across the older adult in-patient areas
Older adults admitted to in patient areas may experience falls for a variety
of reasons, for example due to mobility problems, cognitive or sensory
impairment and environmental factors. The impact of these falls and
possible injury to older adult service users and the effect this may have
upon relatives and carers needs to be addressed through effective and
skilled multifactorial assessment and intervention.
Rationale
Aims
Current status
Plans
Monitoring & reporting
Guidance on falls from the National Institute for Health and Clinical
Excellence (2004) underpins the work presently being carried out within
LPFT in an attempt to reduce the risk of falls and possible secondary
conditions, such as fracture, that may arise. Ill health as a result of falls
not only adds risk to the individual and cause distress to relatives and
carers, but may also significantly increase the length of in-patient stay.
To reduce the number of falls occurring to service users within older adult
in-patient areas.
LPFT utilises an integrated care pathway tool which includes a falls risk
assessment, falls management plan and manual handling plan for service
users on admission and these are reviewed regularly throughout the inpatient journey. Falls within the inpatient areas are reviewed by the falls
steering group on a monthly basis in order to identify appropriate risk
reduction measures and interventions.
In 2008/2009, 364 falls were reported in older adult wards and in
2009/2010 there were 411 reported incidents.
 Ensure all older adult in-patients receive comprehensive assessment
on admission, and regular review of falls risk throughout their stay.
 Enhance the skills of staff in determining and managing falls risk.
 Utilise and manage resources effectively within the in-patient
environment in order to reduce risk.
 Develop new strategies to enable falls risk reduction tailored to
identified areas of need
 Assessing environmental design to eliminate the areas of higher risk
Falls are reported via the LPFT incident reporting system, (sentinel).
Statistics are monitored and reviewed monthly by the falls steering group
in order to establish strategies to manage areas of increased or ongoing
risk and need. Support is given to areas of good practice where falls risk
reduction is occurring.
Related CQUIN
MH10
Leads
Glenn Ward (Ward Manager)
Ann Hunt (Director of Operations)
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Lincolnshire Partnership NHS Foundation Trust
Innovation
Given the unprecedented resource challenge, doing what we have always done in ways that we
have always done it is no longer an option. Services and working practices will be reviewed
against five key categories:
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Avoidance of spend: Reducing expenditure by improving procurement and stopping
unnecessary interventions/processes/demands
Reallocation: Transferring resources from one area to another to produce better care and
better value
Disinvestment: Ceasing expenditure on areas/services that have little or no impact on
improving care
Removal of variation: Refining working practices in areas where there are wide variations in
activity between similar teams/individuals
Investment to save: Investing carefully in infrastructure that saves money over the medium and
long term
This innovation agenda is a key element of the Trust’s Organisational Development Strategy and it
will be led by the Chief Executive. Twenty staff have been selected from across the Trust to
develop capacity, skills and innovative practice across the organisation.
Participation in Clinical Audits
During 1st April 2009 to 31st March 2010, LPFT participated in 100% of national clinical audits and
100% of national confidential enquiries of which it was eligible to participate in.
These audits/enquiries included five national clinical audits and one national confidential enquiry
covered NHS services provided by Lincolnshire Partnership Foundation Trust (LPFT). Details of
these audits and the number of cases submitted are listed below.
National Continence Audit
18 cases
No minimum number provided as
number of registered cases not
stated
National audit of the organisation
of Services for falls and bone
health of older people
Organisational data only collected
– not individual cases
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National Diabetes Day
13 cases
No minimum as above
National confidential enquiry into
Homicide and Suicide
Information provided according to
request by coroner
N/A
POMH (UK) – Topic 9 - National
Prescribing Observatory for
Mental Health
20 cases
No minimum as above
POMH (UK) – Topic 8 Medicines Reconciliation
25 cases
No minimum as above
Quality Report 2009/2010
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The reports of 5 national clinical audits, one confidential enquiry and 36 local audits were reviewed
by the provider during 1st April 2009 to 31st March 2010. LPFT intends to take the following actions
to improve the quality of healthcare provided.
»
»
»
Disseminate audit results to all relevant clinicians
Develop and maintain action plans to address shortfall in service provision
Carry out re audit in 12 months time to monitor compliance
Participation in Research
The number of patients receiving NHS services provided or sub-contracted by Lincolnshire
Partnership NHS Foundation Trust in 2009-10 that were recruited during that period to participate
in research approved by a research ethics committee was 154. This increasing level of
participation in clinical research demonstrates LPFT’s commitment to improving the quality of care
we offer and to making our contribution to wider health improvement.
The Trust was involved in conducting 28 clinical research studies and completed 100% of these
studies as designed within the agreed time and to the agreed recruitment target. LPFT used
national systems to manage the studies in proportion to risk. Of the 28 studies given permission to
start, 100% were given permission by an authorised person less than 30 days from receipt of a
valid complete application. None of these studies were established and managed under national
model agreements and none of the studies used a research passport. In 2009-10 the National
Institute for Health Research (NIHR) supported 18 of these studies through its research networks.
In the last three years, no publications have resulted from our involvement in NIHR research (all 18
NIHR studies are still recruiting or in follow-up), helping to improve patient outcomes and
experience access the NHS.
19
Lincolnshire Partnership NHS Foundation Trust
Goals agreed with Commissioners
The Commissioning for Quality and Innovation (CQUIN) payment framework aims to support the
cultural shift towards making quality the organising principle of NHS services by embedding quality at
the heart of commissioner-provider discussions. The CQUIN payment framework apportions a
percentage of providers’ income to meeting quality goals and innovations. The 2010/2011 CQUIN
framework is valued at 1.5% of the total contract value for the Trust, which equates to approximately
£1 million. Indicators MH1 – MH6 and the low secure indicators were regionally mandated, while the
other CQUIN indicators were agreed locally by NHS Lincolnshire and the Trust.
Indicator – MH1
Delayed Transfers of Care to be maintained at a minimal level
Description of indicator
To measure, monitor and inform commissioners and providers regarding
the efficacy of interventions designed to reduce unnecessary Delayed
Transfers of Care and maintain them at a minimal level
Description of metric
Number of patients with a DTOC as a percentage of MH admissions.
Indicator – MH 2
HONOS (Health of the Nation Outcome Scales) - Collect on first assessment/
admission and discharge from care or 6 monthly if in long term care
Description of indicator
To measure, monitor and inform commissioners and providers to ensure
that HONOS scores are effectively reduced indicating a positive treatment
Description of metric
% of people on CPA having a HONOS assessment in last 12 months.
Indicator – MH 3
Mean Length of Stay (LoS) for acute Mental Health (MH) inpatients
Description of indicator
To measure, monitor and inform commissioners and providers to ensure
that the LoS for patients in the care of MH Trusts is kept to a minimum
Description of metric
The Mean length of stay for patients staying in MH Trusts.
Indicator – MH 4
Adults receiving secondary care in employment to increase
Description of indicator
To measure, monitor and inform commissioners and providers to ensure
as many adults as possible that are receiving secondary mental health
services are in paid employment
Description of metric
The percentage of adults (18-69) receiving secondary mental health
services in paid employment at the time of their most recent assessment,
formal review or other multi-disciplinary care planned meeting. Matches
Vital Sign VSC08
Indicator – MH 5
Adults receiving secondary care in settled accommodation to
increase
Description of indicator
To measure, monitor and inform commissioners and providers to ensure
that as many adults as possible who are receiving secondary mental
health services are in settled accommodation
Description of metric
The percentage of adults (18-69) receiving secondary mental health
services in settled accommodation at the time of their most recent
assessment, formal review or other multi-disciplinary care planned
meeting. Matches VSC06 and NI149
Quality Report 2009/2010
Indicator – MH 6
Acute Admissions prevented by intervention of a crisis/home
management team
Description of indicator
To measure, monitor and inform commissioners and providers regarding
the effectiveness of crisis/ home management teams in preventing acute
admissions of mental health patients
Description of metric
Ratio of acute admissions prevented by intervention of a crisis / home
management team
Indicator – MH 7
Improvement in quality of discharge information for Acute Adult
Patients who have had a period of in-patient admission.
Description of indicator
To monitor, measure and inform commissioners that discharge
information is accurate, timely and relevant to patients whilst ensuring the
needs of patients are met, increasing patient safety, clinical effectiveness
and increasing patient satisfaction.
Description of metric
No of In-patients issued, at the point of planned discharge, with a
Wellness and Recovery (W & R) Plan.
Indicator – MH 8
Provide information for adults with a learning disability regarding
consenting to medication.
Description of indicator
To measure and monitor the information provided to people with a
learning disability and their carers with regards to consenting to
medication.
Description of metric
Number of in-patients with a learning disability with a Medication Care
Plan following assessment of capacity to consent to medication.
Indicator – MH 9
Productive Wards (Releasing Time to Care)
Description of indicator
To improve and increase the amount of time staff spend with patients.
Description of metric
Evaluation of changes in practice in 6 wards as identified in the
Productive Ward Project Programme
Indicator – MH 10
Essence of Care to be utilised to provide evidence based practice in
promoting health in in-patient older adult services.
Description of indicator
Reduction in falls of older adults as in-patients leading to reduction in risk
of secondary conditions due to fractures.
Description of metric
Increase of patients with physical healthcare assessment and care plan
within older adult in-patient areas.
Indicator – MH 11
Adults completing psychological treatment moving to recovery
Description of indicator
To measure, monitor and inform commissioners relating to increases to
the proportion of the number of people using IAPT services within
Lincolnshire who are moving to recovery as a proportion of those who
have completed a course of psychological treatment
Description of metric
Number of patients moving to recovery as a percentage of adults
completing a course of psychological treatment.
20
21
Lincolnshire Partnership NHS Foundation Trust
Indicator – MH 12
Annual Physical Healthcare reviews for In-patients with Bi-polar
disorder / Schizophrenia
Description of indicator
To measure, monitor and inform commissioners that in-patients have
been offered physical health checks upon admission in accordance with
NICE guidance. Early prognosis of condition. Prevention of long term
conditions occurring. Increase in quality of life.
Description of metric
Number of in-patients with schizophrenia or bi-polar disorder offered and
accepted NICE health check
Indicator – MH 13
To increase Patient and carer involvement locally.
Description of indicator
To measure and monitor patient and carer involvement working with the
trust to improve the quality of in-patient environments. To inform
commissioners that involvement has increased and carers / patients are
actively involved in audit, action plan and re-assessment.
Description of metric
Improvement in CQC score for patient experience
Indicator – MH 14
Increasing the range of social and therapeutic activities for Older
Adults In-patients at Witham Court
Description of indicator
To increase the number of hours per week older adults can access a range
of structured social & recreational activities whilst residing at Witham Court
Description of metric
Audit in-patients at Witham Court to identify number of inpatients with an
individual activity plan and participation of inpatients in timetabled activities
Indicator – MH 15
Improvement in patient experience through AIMS Accreditation
Description of indicator
To measure, monitor and inform Commissioners on progress towards
gaining AIMS accreditation
Description of metric
Evidence of working towards Accreditation of Inpatient Mental Health
services (AIMS) for the Peter Hodgkinson Centre
Indicator – MH 16
Improvement in information resources to young people and working
towards achievement of "You’re Welcome" status for CAMHS
Description of indicator
To improve services to 11-19 year old service users using a nationally
recognised tool
Description of metric
Young people are offered appropriate information and advice to help them
understand what can be achieved without parental or family involvement
wherever this is considered to be therapeutically beneficial. Young
people, their parents and carers, are offered appropriate information and
advice to help them make safe, informed choices.
Indicator – MH 17
Dementia Care
Description of indicator
To monitor, measure and inform commissioners that LPFT are offering a
timely, responsive and accessible service to people with Dementia.
Description of metric
Completion of assessment for Dementia by a member of the Older Adult
MDT within 24 hours of receiving a referral from ULHT
Quality Report 2009/2010
Low secure service CQUINS for 2010/11:
Indicator
– Low Secure 1
HONOS/HCR 20
Description of indicator
Use of HONOS Secure and HCR 20 for all patients
Description of metric
Indicator
– Low Secure 2
Essen Climate Scale
Description of indicator
During 2010/11 all providers will introduce the use of the tool
Description of metric
Indicator
– Low Secure 3
Empowerment and Involvement of Service Users
Description of indicator
Providers will work with service users to develop a method for involvement
across the service. One such method may be the meaningful engagement
of service users within contract/performance meetings
Description of metric
Indicator
– Low Secure 4
Service User Defined Improvement
Description of indicator
During 2010/2011 providers will implement a service user defined
improvement which will be in place by quarter 4
Description of metric
LPFT to implement one service user defined service improvement from
following list:
(1) Service user defined CPA standards
(2) Use of advanced directives e.g. my future plan
(3) Service user audit e.g. dining experience/ smoking
(4) Involvement in SCG wide service user conference
Indicator
– Low Secure 5
Structured Activity
Description of indicator
There will be a minimum of 25 hours per week per patient of structured
activity. This will be a planned programme of treatment, education and
work taking into account:
 Week and day routine
 Range of therapy programmes including occupational therapy
 Psychological sessions
 Structured activity programmes
 Structured leisure time and unstructured free time
 Access to real opportunities to work
 Substance misuse and offence-related therapy
Description of metric
Indicator
– Low Secure 6
Recovery Planning Tool
Description of indicator
Providers will implement a recognised tool for recovery planning e.g.
Recovery Star, WRAP or DREAM by quarter 4. Once implemented every
patient should be offered the opportunity to complete a recovery plan
Description of metric
22
23
Lincolnshire Partnership NHS Foundation Trust
Service Development and Improvement Plans for 2010/2011
Inpatient Services
The Trust meets the minimum requirements for the provision of single sex accommodation in
inpatient units. However one unit (Brant Ward at Witham Court) breaches the regulations in that
access to a bathroom requires the patient to pass through an area occupied by the opposite sex. The
resolution of this issue is already included in the Trust’s Estates Plan and will be rectified in 2010.
Significant Service Changes
The Trust will develop specific proposals for major service changes which will require consultation
with and support from the Trust’s commissioners. These are:

The full business case and redevelopment of the Trust’s inpatient rehabilitation services –
capital investment c£15m

Agree a plan with commissioners for the provision of inpatient services in Grantham

Determine the future of the Trust’s Continuing Care inpatient unit at Skegness (Holly Lodge)
Service Improvements/Redesign
The key service improvement priorities in 2010/11 which are not included in other service
developments are:
1. Adult
Services:
refocus/redesign
Crisis
Resolution
&
Home
Treatment
Service
2. Forensic Services: implement the relevant recommendations from the Bradley Report, looking
specifically at:
 Basic training for criminal justice staff
 LD input into community forensic services (above and beyond Greenlight actions)
3. The Personality Disorder scoping project, which will cover forensic and victim liaison support in
line with national policy
4. Learning Disability: implement the relevant recommendations from the Valuing People Now
plan and Michael report
5. Substance Misuse
 Develop service model to deliver ‘exit from treatment’ target
 Put in place measures to ensure achievement of National Harm Reduction Targets
6. Child & Family Service: implement the recommendations from the recent government response
to the CAMHS review, looking specifically at:
 Information: reviewing existing leaflets and developing new communication material
 Age appropriate accommodation
 Targeted Mental Health in Schools; SMILES project: developing self awareness in 6-11 year olds
 DNA audit
7. Older Adults Service:
 develop a new service model for dementia inpatient units
Quality Report 2009/2010
24
Quality Management Systems
The Trust develops and embeds quality in the organisation, using a number of ‘quality
managements systems which work hand in hand with the three domains of quality.
PricewaterhouseCoopers – Quality reporting evaluation 2009
Using Experience Based Design (EBD) to Improve the Patient Experience
The NHS Institute for Innovation and Improvement has recently been developing a tool kit that
aims to help frontline staff make improvements their patients really want.
“The EBD approach (Experience Based Design) is a method of designing better experiences for
patients, carers and staff. The approach captures the experiences of those involved in healthcare
services. It involves looking at the care journey and in addition the emotional journey people
experience when they come into contact with a particular pathway or part of the service. Staff work
together with patients and carers to firstly understand these experiences and then to improve
them.” NHSI EBD guide (2009).
Using experience to design better healthcare is unique in the way that it focuses so strongly on
capturing and understanding patients', carers' and staff experiences of services; not just their views
of the process like the speed and efficiency at which they travel through the system. Instead, this
approach deliberately draws out the subjective, personal feelings a patient and carer experiences
at crucial points in the care pathway. It does this by:



encouraging and supporting patients and carers to ‘tell their stories’
using these stories to pinpoint those parts of the care pathway where the users’ experience is
most powerfully shaped (the ‘touchpoints’)
working with patients, carers and frontline staff to redesign these experiences rather than just
systems and processes
25
Lincolnshire Partnership NHS Foundation Trust
Personalisation and the Integrated Business Plan 2010-2013
Advancing the personalisation of services has been identified as a key priority for the Trust.
Personalisation means starting with the individual as a person with strengths and preferences who
may have a network of support and resources, which can include family and friends. They may
have their own funding sources or be eligible for state funding or be able to access a combination
of the two.
Personalisation reinforces the idea that the individual is best placed to know what they need and
how those needs can be best met. It means that people can be responsible for themselves and
can make their own decisions about what they require, but that they should also have information
and support to enable them to do so. In this way services should respond to the individual instead
of the person having to fit with the service.
The traditional service led approach has often meant that people have not received the right
support for their circumstances or been able to help shape the kind of help they need.
Personalisation is about giving people much more choice and control over their lives.
The Trust will address this by:




making sure people with mental health problems can take as much control as possible over
their support arrangements, to pursue their recovery and social inclusion on their own terms
committing to developing a more equal and creative relationship between people using
services and practitioners
closing any gaps of understanding and procedure between local authorities and provider NHS
Trusts’ to make sure self-directed social support can benefit people with mental health
problems
adapting job roles, the organisation of teams and the allocation of resources over time to make
sure services can meet people’s needs and aspirations in more personalised ways.
Leadership
Leadership and its development are necessary at all levels of the organisation, and requires
strengthening. The Trust needs to ensure that its clinicians (of all disciplines) and senior managers
are developed to take on a leadership role to drive up quality standards and improve service
effectiveness.
The challenging financial situation requires clinicians of all disciplines and senior managers to
develop effective co-operation between business units, in order to create the conditions for
innovation and the development of clinically and cost effective high quality care pathways.
Workforce
The Workforce Strategy sets out the Trust’s strategic intentions to ensure that the workforce
delivers best quality customer services as identified in this Integrated Business Plan.
Quality Report 2009/2010
26
The Trust’s vision for the future workforce is to ensure that its workforce will be aligned with the
overall goals of the organisation and to utilise professional skills of staff to add value to quality of
patient care.
Two of the five strategic workforce aims are directly related to the delivery of quality service:
»
Develop a workforce that is highly skilled, motivated and culturally capable
- The Trust aims to promote and continually develop a learning culture to ensure it has a
competent and motivated workforce to deliver a comprehensive mental health service in
Lincolnshire.
- The Trust’s strategy aims to ensure that employees have the necessary skills, knowledge
and attitudes to provide the highest quality healthcare to the population served. It is also a
mechanism to enable individual staff to develop their potential and enjoy satisfaction and
fulfilment in their working lives in providing the above
»
Integrated workforce planning for improved workforce efficiency
- The Trust has an integrated approach to workforce development planning and ensures that
the workforce is considered alongside service, financial, estates and IM&T planning
processes. Robust workforce development plans will to be produced for each of the service
lines taking account of the roles of all professions and their impact upon one another.
- The plans will also influence commissioners of education and training to ensure that there
is a sufficient supply of highly skilled and competent staff available to deliver high quality
mental health and social care services now and in the future.
Information Systems
One of the principle objectives of the Trust’s Information Management & Technology strategy is to
provide increasingly sophisticated information on service delivery that allows intelligent decision
making and directly informs action for improvements in the quality of care
For 2010/11 the key priorities are focused on supporting the key business drivers to:
»
»
»
»
Adopt new ways of working and hence improve both efficiency and cost effectiveness
Reduce operating risks
Improve business management
Meet regulatory, compliance or contractual requirements
27
Lincolnshire Partnership NHS Foundation Trust
Links between quality and resources
The Trust’s Integrated Business Plan for 2010 – 2013 details a continuous drive for performance
improvement, particularly in relation to quality. Given the public sector spending squeeze, this will
require unprecedented levels of efficiency and effectiveness.
If the desired productivity
improvements are to be achieved, the Trust must combine increased efficiency to avoid
unnecessary costs with stronger innovation.
Recent work by the NHS Institute for Innovation & Improvement1 suggests that, in addition to the
ethical, moral, and professional case for taking action to reduce harm and unwarranted variation in
care, there is also a compelling business case for quality. There is growing empirical evidence that
a focus on quality would ultimately provide an effective strategy to contain costs; however this is
reliant on organisation-wide implementation.
The Trust has signed up to the National Patient Safety Agency’s Patient Safety First Initiative in an
effort to ensure a leadership culture and environment that promote quality and patient safety
improvement. This initiative will see the introduction of Patient Safety “WalkRounds” by members
of the Board, who will visit clinical areas to discuss patient safety issues with staff across all
disciplines in order to inform organisational decisions.
1
BMJ 2009;339:b4638
Quality Report 2009/2010
28
What others say about Lincolnshire Partnership NHS Foundation Trust
LPFT is required to register with the Care Quality Commission and its current registration status is
fully registered and has no conditions set by the Commission. LPFT has been registered to carry
out the following regulated activities:

Treatment of disease disorder or injury

Assessment and medical treatment of persons detained

Accommodation for persons who require nursing care or personal care
The Care Quality Commission has not taken enforcement action against LPFT during 2009/10.
During the monitoring period 2009/10 the CQC raised concerns that as an organisation we were
not compliant with Safeguarding Children and Vulnerable Adults standards. Evidence of
compliance was issued to the CQC who accepted that the organisation was meeting all standards.
The challenge from the CQC arose due to another audit that requested information about level 3
(specialist) training. Although LPFTs evidence of compliance was accepted by the CQC, we have
worked to review the provision of Safeguarding training to ensure that we have a capable and
skilled workforce in this area.
This has resulted in the majority of all staff (87%) completing basic Safeguarding training, and over
half (53%) of appropriate staff accessing specialist training. LPFT is continuing to provide this
training, in order to train more staff in advanced Safeguarding practice.
In May 2009 LPFT declared a ‘significant lapse’ against core standard C4 (d) which relates to the
safe and secure handling of medicines. This resulted in our excellent rating for clinical quality
being reduced to good, despite action being implemented in a timely manner.
Measures were put in place to bring the Trust up to the required standard and to provide a
programme of continual improvement through the introduction of regular clinical audit and a
comprehensive review of the medicines management training programme. Link nurses have been
identified within every clinical team working alongside the pharmacy technicians to ensure that the
systems and processes to support medicines management are embedded within the services and
to promote continual improvement. As a result of the measures taken, the Trust is meeting the
recognised good practice and requirements of the ‘Duthie Report – The safe and secure handling
of medicines: A Team Approach’ and was able to declare compliance with the cord standard by the
end of December 2009.
The Healthcare Commission assesses all NHS organisations each year and gives them a rating of
either weak, fair, good or excellent for two things – how good their services are and how well they
use their resources. The 2008/2009 assessment of LPFT is illustrated below - quality of services
slipped from excellent to good, which was attributable to the failure to meet the core standard C4d
(medicines management).
29
Lincolnshire Partnership NHS Foundation Trust
LPFT is subject to periodic reviews by the CQC and the last review carried out in 2008/09 which
focused on the follow-up of adult community mental health services. The following areas for
improvement have been identified:





The need for effective support for service users to get back to work
Better access to out-of-hours services for all service users
Provision of cognitive behavioural therapy for all service users who require it
The need to ensure that care plans have advance directives and contingency plans, and that
they refer to the agreed choice of anti-psychotic medication in case of acute illness.
The need for physical health review to be routinely and systematically carried out for all service
users for whom they are appropriate.
Quality Report 2009/2010
30
Statement of Assurance
The Directors are required to satisfy themselves that the Trust’s annual Quality Report are fairly
stated. In doing so, the Trust is required to put in place a system of internal control to ensure that
proper arrangements are in place based on criteria specified by Monitor, the independent regulator
of NHS Foundation Trusts. The Trust has appointed a member of the Board, the Director of
Nursing and Strategy, to lead and advise on all matters relating to the preparation of the Trust’s
annual Quality Report. To ensure that the Trust’s Quality Report present a properly balanced view
of performance over the year, the Trust has established a Clinical Quality and Risk Committee that
is accountable to the Board of Directors to provide scrutiny and challenge over Trust clinical
performance. The Trust also has quarterly Quality meetings with its main commissioner, and has
shared the draft Quality Report with Governors, Commissioners and the Health Scrutiny
Committee for comment.
To review progress and prepare for the completion of a Directors Statement in the published
Quality Report in 2010/11, the Trust has engaged its external auditors to:

Review the arrangements put in place to ensure the Quality Report framework is robust.

Review the data accuracy of the proposed mandated performance measures

Identify the requirements of good practice internal control systems for data quality.

Provide recommendations to put these best practice arrangements in place in advance of the
2010/11 published audit opinion.
The Trust will manage the implementation of the action plan through the Board Committee
Structure.
31
Lincolnshire Partnership NHS Foundation Trust
Part 3 – Report on 2009/2010 quality information
Review of quality performance
This section details the Trust’s quality performance in a selection of areas in 2009/2010. As the
Trust works with various stakeholders to refine and develop quality metrics, the focus of the quality
overview may change. However, the Trust will provide a narrative around the rationale for any
changes and will report on any that are to be removed. This section also shows the Trust’s
performance against regulatory requirements and national targets.
LPFT’s core business is the provision of specialist mental health services for adults (both working
age and older adults) and children.
For adults and older adults this includes services in relation to:



Common mental health problems (e.g. mild/moderate depression, anxiety, etc)
Complex psychological problems
Severe and enduring mental illness – both functional (e.g. schizophrenia, bipolar) and organic
(e.g. dementia) illnesses
For adults only:



Mental Health Social Care
Substance Misuse
Learning Disabilities
For children this includes specialist community and inpatient services.
Performance Monitoring – Board Assurance
A summary report is provided on a monthly basis to the Board of Directors, outlining the
performance of all the Trust’s services against local and national targets.
Quality Report 2009/2010
32
Performance of Trust against Selected Metrics
Patient Safety
2007/8
2008/9
2009/10
Care Programme Approach seven day
follow-up
98%
98%
96.1%
Access of crisis resolution or numbers
receiving crisis treatment
Target: 1155
Actual: 1614
Target: 1155
Actual: 1342
Target: 1155
Actual: 1698
0
0
0
Infection control: number of MRSA
Bacteraemia and C Difficile infections
Clinical Effectiveness
2007/8
Number of patients with care plans
(patient survey)
2008/9
Not recorded
2063
Oct 08 – Mar 09
Not yet published
1653
Not yet published
Adults: 4%
Older Adults: 1.4%
Adults: 5.5%
Older Adults: 2.6%
Number of drug users in treatment
Adults: 1.9%
Older Adults: 1.6%
28 day readmission
Patient Experience
2007/8
2009/10
2008/9
2009/10
Experience of patients
(patient survey)
Not yet published
Under 16s on adult wards
Delayed transfers of care to be kept at
a minimal level
Not recorded
0
0
Data recorded
differently
Target: 7.5%
Actual: 5.6%
Target: 7.5%
Actual: 0.9%
Patient Environment Action Team Scores:
Site Name
Environment
Food
Privacy & Dignity
2007/8
2008/9
2009/10
2007/8
2008/9
2009/10
2007/8
2008/9
2009/10
Excellent
Good
Excellent
Excellent
Excellent
Excellent
—
Excellent
Excellent
—
Excellent
Good
—
Self
Catering
Self
Catering
—
Excellent
Excellent
Acceptable
Acceptable
Acceptable
Good
Excellent
Excellent
Excellent
—
Good
Good
Good
Good
Excellent
Excellent
Excellent
—
Good
Good
Maple Lodge
—
Excellent
Excellent
—
Self
Catering
Self
Catering
—
Excellent
Excellent
Holly Lodge
—
Acceptable
Acceptable
—
Excellent
Excellent
—
Excellent
Excellent
Good
Good
Excellent
Excellent
Excellent
—
Excellent
Good
Good
Good
Excellent
Excellent
Excellent
—
Excellent
Good
Good
Good
Good
Excellent
Excellent
Excellent
—
Good
Good
Good
Good
Acceptable
Excellent
Excellent
Good
—
Excellent
Good
Acceptable
Good
Good
Excellent
Excellent
Excellent
—
Excellent
Excellent
Long Leys
Court
Ashley House
Carholme
Court
Witham Court
P.Hodgkinson
Centre
Francis Willis
Unit
Pilgrim
Hospital Site
Manthorpe
Centre
Ash Villa
Acceptable
Acceptable
33
Lincolnshire Partnership NHS Foundation Trust
Regulatory Requirements and National Targets
The Trust performance against National targets in 2009/10 is detailed below.
Performance & Assurance
2007/8
2008/9
2009/10
Numbers receiving assertive outreach
Assertive outreach team measures
Numbers receiving crisis resolution
Crisis key measures
Numbers receiving early intervention (support and treatment in early
psychosis
Early intervention key measures
Reduction of emergency bed days/unplanned readmissions within 28
days
Increase the participation of problem drug users in treatment
programmes by 100% by 2008
Predicted
Adults with mental health problems helped to live at home
Predicted
Direct Payments
Predicted
% of mental health clients receiving a carer’s break or specific carers’
service during the year
Predicted
Number of clients receiving a review during the year
Predicted
% of people receiving a statement of their needs and how they will be
met
The proportion of all current referrals holding accurate and complete
ethnicity data for clients
Adults admitted in year on a permanent basis to residential or nursing
care
Predicted
Predicted
Hygiene code (quarterly reporting)
National Health Service Litigation Authority Standards Level 1
Care Quality Commission (formerly Healthcare Commission) core
standards
23/24
1
23/24
2
24/24
3
The traffic light system (red, amber, green) is explained as follows:
Performance is on target,
the Trust is delivering the required
performance and expects to meet
the year-end position
Performance is off target
and not delivering the required
performance, but is expected
to delivery the standard for the period
1
Achieved with the exception of one element
- equality and diversity (C7e)
2
Achieved with the exception of one element
- medicines management (C4d)
3
Declared in April 2010 – subject to CQC confirmation
Performance is not meeting
target and suggests the Trust
is unlikely to meet the
required performance by yearend. Remedial action may be
possible to improve
performance, but is not in
place
Quality Report 2009/2010
34
Information Governance Toolkit
The Information Governance Tool Kit (IGT) is a mandatory requirement that is a quarterly selfassessment with a final annual review. It is split into six initiatives with a number of standards
within each. In order for the Trust to maintain its NHS Network Connections and Annual Statement
of Compliance it needs to meet a subset of the standards at least at level 2. The Trust met these
requirements.
Below is a breakdown of the Trust’s scores against each initiative which also demonstrates the
Trust’s overall rating of 77%.
Initiative
Results
Clinical Information Assurance
66%
Confidentiality and Data Protection Assurance
76%
Corporate Information Assurance
66%
Information Governance Management
84%
Information Security Assurance
73%
Secondary Use Assurance
83%
Overall Rating
77%
Clinical Coding
LPFT was not subject to the Payment by Results clinical coding audit during 2009/10 by the Audit
Commission. However, the Trust has commissioned its annual audit of clinical coding in respect of
finished consultant episodes in line with Information Governance Toolkit criterion 505. The
auditors were approved by Connecting for Health and undertook a sample audit of 100 FCEs in
January 2010. Results were 80.7% primary diagnosis correct; 50.3% secondary diagnosis correct.
This places the Trust on Level 1 compliance.
35
Lincolnshire Partnership NHS Foundation Trust
Service Performance
NHS Trusts are assessed against many national and local targets. These are set to help,
encourage and sometimes require NHS bodies to improve the way they work, the quality of
services and the experience of patients, service users, carers and local people have of the NHS in
their area. Amongst these targets some, such as patient safety, reducing hospital infections and
reducing the time of people have to wait to get the care they need are generally regarded as more
important than others.
The graphs below demonstrate the Trust’s responsiveness to those service users referred into
services for their first appointment. Waiting times are a key issue for the Trust to ensure a timely
service is offered to all service users and as such are monitored on a monthly basis. Occasionally
waiting times do exceed the targets, one of the common themes is that service users are offered
appointments but they choose to decline and wait as their choice, therefore they remain on the
waiting list.
W aiting T im e (w eek s )
12
Substance Misuse Waiting Times
alcohol
prescribing
targets
10
8
6
4
2
0
Waiting Time (weeks)
18
16
14
12
10
8
6
4
2
0
Child & Family Waiting Times
waits
target
Quality Report 2009/2010
36
The number of people receiving Assertive Outreach, Early Intervention and Crisis Resolution
Home Treatment services, has generally exceeded the target number of people to be seen or
episodes of care, demonstrating that the Trust is able to manage demand and add value by
increasing services provided within existing resources available.
245
No.s Receiving Assertive Outreach
number
target
Clients
240
235
230
225
220
310
No.s Receiving Early Intervention
Clients
300
290
280
number
target
270
260
250
Episodes
1750
No. of CRHT Episodes
1500
1250
1000
750
500
250
0
number
trajectory
target
37
Lincolnshire Partnership NHS Foundation Trust
% Readmissions
Re-admission rates to inpatient hospital care, within both the Adults and Older Adults services
have remained below the local targets throughout the reporting period. High quality inpatient care
and planned discharge involving community care teams has resulted in low readmission rates and
preventing a revolving door scenario.
14%
12%
Readmissions in 28 Days - ADULTS
readmissions
target
10%
8%
6%
4%
2%
0%
% Readmissions
12%
Readmissions in 28 Days - OLDER ADULTS
10%
8%
6%
4%
2%
0%
readmissions
target
Quality Report 2009/2010
38
Benchmarking against other mental health trusts
The Trust participates in the Audit Commission’s Mental Health Benchmarking Club. The following
set of charts have been taken from the latest edition of this independent audit and show the Trust’s
position and performance compared to other mental health trusts.
The majority of the graphs have been weighted to allow fair comparison of statistics. LPFT’s
position is indicated by the dark green bar (T22).
39
Lincolnshire Partnership NHS Foundation Trust
(Benchmarking continued)
Quality Report 2009/2010
(Benchmarking continued)
40
41
Lincolnshire Partnership NHS Foundation Trust
Performance against goals agreed with Commissioners
The Commissioning for Quality and Innovation (CQUIN) payment framework aims to support the
cultural shift towards making quality the organising principle of NHS services by embedding quality
at the heart of commissioner-provider discussions. The CQUIN payment framework apportions a
percentage of providers’ income to meeting quality goals and innovations.
In 2009/2010, 0.5% of LPFT income in 2009/10 was conditional on achieving quality improvements
and innovation goals agreed between LPFT and any person or body they entered into a contract,
agreement or arrangement with for the provision of NHS Services, through the CQUIN Payment
Framework. The 2009/19 CQUINS are identified below, 10 of the 13 CQUINS were met, one was
withdrawn (CQUIN 11) from the scheme and two partially met (CQUINs 5 & 8).
Patient Safety
GP practices receiving CPA
CQUIN 1
documentation from LPFT in under
28 days from discharge
CQUIN 2
A reduction in the mortality rate
resulting from suicide for those who
have had contact with LPFT
services within the preceding 12
months. (Open verdicts are
considered by the Trust but not
included in this indicator)
Clinical Effectiveness
Proportion of eligible patients
CQUIN 3
receiving anti-dementia drugs
CQUIN 4
Improving the number of drug users
in effective treatment
 95% under 25 calendar days
A reduction in the mortality rate against the
baseline period of 1st Oct 07 to 30th Sep 08
Further work by both parties to confirm the
metrics by 31st Mar 09
National target is 80% retained in treatment
beyond 12 weeks. Set stretch target of + 5%
of target which equates to a new target of 84
Patient Experience
Improving upon the National
Discharge Summary within 48 hours
 By 31st Jan 30% of all discharge
summaries shall be electronically sent to
GPs within 24 hours following discharge.
 And by 31st Jan of 95% of all discharge
summaries within 48 hours
CQUIN 6
Improving the cleanliness of the
environment
 An improvement upon the 2008/09 PEAT
score within the reported 2009/10 baseline
 80% of patient responses within the 08/09
National patient survey giving a positive
response to the cleanliness of the LPFT
environment
CQUIN 7
Patient Self Reported Experience
CQUIN 5
80% of patient responses within 08/09
National Patient Survey giving a positive
response to their experience of LPFT services
Quality Report 2009/2010
42
Activity Related Metrics which will Improve the Quality of Care Patients Receive
CQUIN 8
CQUIN 9
CQUIN 10
Improvement upon the HCC target
of the numbers receiving Assertive
Outreach
 By September 09 a 4% Improvement
upon the baseline position of 231 monthly
caseload which is sustained to year end.
 i.e. a monthly caseload of 240 each month
from the September reported information
Improvement upon the HCC target
of the numbers receiving Crisis
Resolution
 By 31st March 2010 an 5% improvement
upon the baseline position of 1155
episodes which equates to 1213 episodes
 The agreement of a monthly trajectory by
31st March 2009 to be incorporated into
the action plan
Improvement upon the numbers
receiving Early Intervention (STEP)
 By September 09 a 4% improvement
upon the baseline position of 260
episodes which equates to 270 episodes
per month.
 The agreement of a monthly trajectory by
31st March 2009 to be incorporated into
the action plan
In addition, three innovation scheme CQUINs were also agreed. Payments linked to these
schemes are over and above the 0.5% and held in reserve. Further work is required to develop
clear action plans and trajectories.
Innovation Schemes
CQUIN 11
CQUIN 12
CQUIN 13
Innovative improvement to Patient
Clinical Effectiveness
 IAPT – local stretch targets to be jointly
defined and agreed by both parties by end
of June when the IAPT scheme will have
time to be imbedded.
 The IAPT scheme will address the key
target of improving the % of depressed
people offered psychological therapies as
identified by GPs in the February survey.
Innovative improvement to Patient
Experience
Patient Experience - the development of
patient related outcome measures (PROMS)
at service line reporting level. This could be
measured by agreeing an action plan with
trajectory for PROMS in selected areas. i.e.
by 31st March 2010, we will be reporting on
PROMS in X service lines.
Innovative improvement to Patient
Safety
Safety - development of the safeguarding
agenda. The new post funded in 08/09 has
identified an unmet need both within and
outside the Trust. It is therefore proposed
that the Trust would use the addition non
recurrent funding to appoint 2 additional staff
to provide an educational role to partner
agencies and GPs.
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Lincolnshire Partnership NHS Foundation Trust
What Patients, Carers and the Public say
The process for hearing people’s views
There are a number of formal and informal information gathering activities. These include:










The national patient survey (see above)
Views of the membership and Board of Governors
PAL’S
Complaints, concerns, comments and compliments
Patients experience survey programme
Capture of feedback from Service User involvement events
Capture of ad hoc feedback e.g. service specific consultations
Monitoring of the patient opinion website
Patient reported outcome measures (PROMS)
The Viewpoint survey on Service User experience of stigma and discrimination.
These activities are managed by the membership office, the Service User and Carer Involvement
Champion, and the Complaints Manager.
The current Trust patient experience survey programme includes a requirement for each
directorate to conduct a survey in a minimum of two services per annum, within a planned rolling
programme.
A core set of questions has been provided with flexibility for locally pertinent issues to be explored.
The programme requires services to provide a report on the findings of each survey together with
an action plan formulated in response to the specific issues raised within each service.
A significant piece of work is now being done to align the resources available to ensure that all
sources of information (including all those identified above) are effectively utilized, and result in
meaningful and measurable improvements to patient experience.
Improvements will include:




The development of staff guidance documentation (with the involvement of service users and
carers) which will be publicised to all services
Staff support for those undertaking patient experience survey work
The introduction of survey training for involvement volunteers
A more robust system of managing feedback
Quality Report 2009/2010
Patient Surveys and Action Plans
Services who have submitted survey results and upon whom this report is based on are:














Supporting People
Adult Inpatient services
Adult Recovery services
Older Adults Community services
Older Adult Inpatient services
Primary Care and Psychological Services – Primary Care Lincoln Archway
Primary Care and Psychological Services – IAPT survey
Forensic Community Team
Forensic Inpatient team
Forensic Prison In-reach Team
Rehabilitation team – Long Leys Court
Assertive Outreach Team
Learning Disabilities
Child and Family – all services
44
45
Lincolnshire Partnership NHS Foundation Trust
Messages from the surveys that have been undertaken
Three main themes were recurrent in almost all surveys:

Requests for more information:
This issue fell into two main areas. Service users wanted more information about their mental
health needs and treatment options; and more detailed information about ‘wrap around’ or
additional support services available to them. Typically action plans showed an intention to
encourage staff to discuss these issues with services users and also a commitment to produce
written information.

More effective care planning
Again service users requested more discussion with their care co-ordinators regarding the
content of their care plans. This related to most services although on a positive note the adult
recovery services survey reported only 6% of services users stated they were unhappy with
their care plans. Action plans outlined a response required from team co-ordinators to check
care plans routinely during supervision sessions and to pay particular attention to care plans
when undertaking case note audits.

More effective crisis planning
This issue was addressed within action plans in the same way as the care plan issues are
being addressed.
Despite some fundamental concerns being highlighted, much of the feedback received was
positive in nature. This is again not intended to be an exhaustive list but an overview of some
examples of positive responses.

The Supporting People survey asked Service Users if they felt they received support in the
areas they identified a need. The response was good overall with only 4 teams not achieving a
100% yes reply.

The Adult Recovery team received a response of 84% yes when they asked if their Service
Users has received more help from the service when they needed it.
The IAPT survey yielded a response of 91% of Service Users who felt they were fully involved
in important decisions regarding their care/treatment.
83% of the small sample responding to the Community Forensic team survey were happy with
their care co-ordinator.
The Assertive Outreach team received feedback which included 94% feeling staff treated them
with respect and dignity and 82% rated the service either good or excellent.
The Forensic Inpatient team service feedback included that 80% of service users felt staff
treated them with respect and dignity at all times and 100% of respondents felt safe on the unit.
100% of the small sample surveyed by the prison in reach service felt they were treated with
respect and dignity at all times.
Child and Family Services received positive feedback including 97% of children felt their views
were taken seriously and 85% felt the service they received was good.






Quality Report 2009/2010
46
Examples of actions taken in response to feedback on patient experience include:







Procedures to improve the comfort of waiting areas in Child and Family Services.
Food suppliers and menus have been altered at in patient units and at Doddington Ward
patient feedback is guiding developments to Phase 2.
Supporting People have introduced peer support groups.
Discharge procedures have been changed significantly and improvements made.
Information regarding medication has been made more available to patients and their families.
Peat process has been refined and improved.
Bench marking developed regarding privacy and dignity research.
A Service User Testimonial
Service User and Carer Experience – the voices that matter
Some people would ask “have you woken up on the wrong side of the bed?” I used to say
“I woke up on the wrong side of life.” Like many people with mental health problems, I
suffered most of it in silence, that’s exactly how I felt for many years. Since then, I’ve
been on a very long journey attempting to find meaningful occupational activity. I’ve
volunteered with various charities and organisations but I never felt challenged enough
and found the work meaningless.
Things started to change for me last year when I started to get involved in the service user
and carer involvement team hosted by LPFT. It was the first time since my diagnosis that I
was mixing with people at various stages of recovery at last I felt immense hope. These
were real people who were actually recovering, together with staff from the involvement
team.
I found out how my input as a service user could help influence services that they
provided. After doing a couple of new staff induction presentations I realised I was good at
them and really enjoyed the work and asked if I could be involved with more presentations
and other related work. I’ve also been involved with, meetings, publicity, and attending
and evaluating a mental health first aid course for the trust.
Working with the service user and carer involvement team is really worthwhile, it’s
important to be open about who I am so that I can help myself and others.
I’ve chosen to use my mental health diagnosis and my recovery journey in a positive way.
Being involved has enabled me to blossom and use my skills to good effect. I get the
support I need and I am valued. My self-esteem has improved; my sense of achievement
is good. This experience of being involved has enabled me to move into paid employment
with a national charity, I would thoroughly recommend getting involved with the service
user and carer involvement team
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Lincolnshire Partnership NHS Foundation Trust
Statements from Local Stakeholders
Local Involvement Network and Overview & Scrutiny Committee
This statement has been prepared jointly by the Lincolnshire Local Involvement Network (LINk)
and the Health Scrutiny Committee for Lincolnshire.
General
The Lincolnshire Local Involvement Network (LINk) and the Health Scrutiny Committee for
Lincolnshire welcome the opportunity to comment on Lincolnshire Partnership Foundation Trust’s
first Quality Report. The LINk and the Health Scrutiny Committee for Lincolnshire are always
mindful of the particular needs of Lincolnshire, in terms of its rurality and the challenges in terms of
health inequalities. We are aware of the legal requirements in terms of the content of the Quality
Report, with its resulting reliance on technical language and acronyms, but would like the Quality
Report to reach as wide an audience as possible in an accessible format.
Priorities for 2010-11

The Lincolnshire LINk and the Health Scrutiny Committee for Lincolnshire support the nine
priorities in the Trust’s Quality Report.

We are pleased to see the emphasis placed on first three priorities relating to the “Patient
Experience” and in particular the first priority (The Care Programme Approach). In relation to
the Priority 2 (Complaints Process) we are pleased to see the resolution of 42 (out of a total of
208) complaints within 24 hours during 2009-10, together with the aims and plans to improve
the response to complaints in the coming year. In relation to Priority 3 (Service User and
Engagement), we are aware of a number of service user reference groups which have
developed recently, which support the delivery of this priority.

For Priority 5 (Increase the Recovery Rate for Adults Using Psychological Therapies), the LINk
and the Health Scrutiny Committee for Lincolnshire suggest more emphasis on cross referral
and dual diagnosis, for example on alcohol or drug dependency, so that patients are treated as
a “whole person”. We also believe that there is significant link between alcohol misuse and
smoking. This would further demonstrate partnership working.

In relation to Priority 7 (Reduce Suicides Through More Effective Clinical Risk), we would like
to see clarification over the suicide rates, in terms of how many are known to the Trust and how
many occur in Lincolnshire as a whole.
Clinical Audits
We would like to have seen more detail on the local clinical audits, in which the Trust has
participated.
Conclusion
The LINk and the Health Scrutiny Committee for Lincolnshire believe that the Quality Report is
representative and provides a comprehensive statement of services provided by Lincolnshire
Partnership Foundation Trust.
Quality Report 2009/2010
48
NHS Lincolnshire
NHS Lincolnshire endorses the areas identified by Lincolnshire Partnership Foundation NHS Trust
(LPFT) for improvement for 2010/11 and the associated initiatives as detailed within the Quality
Report as:

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




Improve patient and carer involvement in planning their care and treatment, using the Care
Programme Approach
Improve customer satisfaction during the complaints process
Involve patients to improve the quality of in-patient areas
Release more time to care through more efficient mental health wards
Increase the recovery rate for adults using psychological therapies
Improve the physical healthcare of the Trust’s service users
Reduce suicides through more effective clinical risk management
Reduce the amount of medication errors
Reduce the number of falls across the older adult in-patient areas
Commissioning high quality, safe patient services is our highest priority and the areas identified will
enhance the patient experience and improve patient safety and clinical outcomes.
The Trust’s quality priorities, which were determined by patients, carers and the public, tackle
pressing local needs correlate closely to the Commission for Quality and Innovation (CQUIN)
framework, which has been developed by NHS Lincolnshire and LPFT. Seven out of the nine
quality priorities are directly related to the CQUIN indicators. The local priorities identified by NHS
Lincolnshire as CQUIN indicators for 2010/11 include:

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






Improvement in quality of discharge information for Acute Adult Patients who have had a period
of in-patient admission
Provide information for adults with a learning disability regarding consenting to medication
Productive Wards
Essence of Care to be utilised to provide evidence based practice in promoting health in inpatient older adult services
Adults completing psychological treatment moving to recovery
Annual Physical Healthcare reviews for In-patients with Bi-polar disorder / Schizophrenia
To increase Patient and carer involvement locally
Increasing the range of social and therapeutic activities for Older Adults In-patients at Witham
Court
Improvement in patient experience through AIMS Accreditation
Improvement in information resources to young people and working towards achievement of
"You’re Welcome" status for CAMHS
Dementia Care
49
Lincolnshire Partnership NHS Foundation Trust
In terms of performance against the 09/10 CQUIN indicators, the following indicators were
achieved:










GP practices receiving CPA documentation from LPFT in under 28 days from discharge
A reduction in the mortality rate resulting from suicide for those who have had contact with
LPFT services within the preceding 12 months. (Open verdicts are considered by the Trust but
not included in this indicator).
Proportion of eligible patients receiving anti-dementia drugs
Improving the number of drug users in effective treatment
Improving the cleanliness of the environment
Patient Self Reported Experience
Improvement upon the HCC target of the numbers receiving Crisis Resolution
Improvement upon the numbers receiving Early Intervention (STEP)
Innovative improvement to Patient Experience
Innovative improvement to Patient Safety
The following CQUIN indicator was partially achieved:
 Improvement upon the HCC target of the numbers receiving Assertive Outreach
The following CQUIN indicator was not achieved:
 Improving upon the National Discharge Summary within 48 hour target
NHS Lincolnshire supports the Service Development and Improvement Plans for 2010/2011 and in
particular the focus on addressing same sex accommodation issues and the planned service
improvements associated with the Crisis Resolution and Home Treatment Service.
NHS Lincolnshire notes the CQC rating of good for 2008/09 for LPFT against a rating of excellent
for the 2 previous years and the measures that the Trust is taking to address this with regard to
safeguarding training and medicines management.
NHS Lincolnshire notes the areas of good performance during 09/10 such as levels of readmission
to both adult and older adults remaining well below target and within national best practice, and
increased access to crisis resolution has been achieved and sustained. Further NHS Lincolnshire
notes areas of underperformance where a 5% increase in individuals accessing assertive outreach
was not achieved. NHS Lincolnshire is working with the Trust to support full achievement of the
national targets during 2010/11.
NHS Lincolnshire supports the work underway to improve the patient experience and the focus on
treating all patients with dignity and respect and notes the progress across a range of initiatives to
raise standards.
NHS Lincolnshire endorses the accuracy of the information presented within the LPFT Quality
Report and the overall quality programme performance will be reviewed through the formal
contract quality review process.
Quality Report 2009/2010
50
Governor Comments
Values
Value people's differences. “Fine - essential even - but it should be in the context "within one
society". Rationale: This is one of the dilemmas that England and other nations/countries of the
United Kingdom have living within the bedrock of a Christian culture and a liberal democratic
political system. After all, only England NHS has foundation trusts.”
Priority 1 – Personalised Care Planning
“Excellent objective - our patients must have the right to feel they have the right degree of
ownership of their treatment programme”
“We need to collectively work on this involvement aspect – I believe there are some good initiatives
coming out of N Essex Partnership in this area of involvement”
Priority 2 – Complaints Process
“Excellent Approach”
“Were there any unresolved complaints? If Not I suggest we confirm all complaints made during
the year were satisfactorily resolved”
It is hoped that this project will result in an increase in the number of concerns and complaints
recorded… “Excellent”
Satisfaction survey on complaints handling “V. Good”
Priority 3 – Service user involvement and engagement





Direct user involvement: co-design, participative, interactive “Good”
A Real Partnership between patients, families, health professionals, managers and designers
Understand what people (staff, patients, family) naturally do & feel
Bust the myth patients (service users?) do not want a gold plated service. “No evidence shown
for the existence of this myth. Or is this just a useful cliché?”
The need for better information, with regards to both treatment and additional support services
“Essential”
Priority 5 – Recovery rate for psychological therapies
The Lincolnshire IAPT service achieved 48% of cases moving to recovery in March; this is above
the national target of 40% and the national average of 36% “Excellent”
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Lincolnshire Partnership NHS Foundation Trust
Priority 6 – Physical Healthcare
“Perhaps some attention needs to be highlighted in relation to Patients with Mental Health
problems who undergo treatment in A & E departments”
Priority 6 – Reduce suicides
LPFTs suicide rate has remained at an average of 9 per quarter. “How does this compare with
national statistics?”
Innovation
“This could be an area for proactive staff governor and staff member involvement and ideas - let’s
tap into and maximise this valuable knowledge resource”
“Mentioned research but no mention of our links (if only briefly), to universities, not only good for
PR but it would boost LPFT staff and others involved in these links.”
Workforce
“Fully agree with all items”
Acting on Stakeholder Feedback
The above comments from local stakeholders will be considered in the delivery of LPFT’s
2010/2011 quality priorities and in the development of the Trust’s broader quality improvement
agenda.