Questions and answers

Although we can’t expect any national injection of funding to dramatically improve services, Our Big Plan is already helping us save money to reinvest in some priority areas.

• Since mid-April, our mental health optimal care project has cut the amount of costly out-of-area placements by half, providing care closer to home, while resulting in a better experience for families and visitors.
• We have likewise reduced annual spending on agency staff by more than a £1million since May last year. And we are working to save more money by organising rosters better, which will ensure staff are not burnt out by working excessive overtime.

But we know that poor care is the most expensive care. That’s why we will always prioritise changes that deliver service improvements.

The Oliver McGowan Mandatory Training on Learning Disability and Autism is the Government's preferred and recommended training for health and social care staff to undertake.

Hospitals and other NHS providers in Nottinghamshire aim for three in every ten staff to undertake the training. But we set a higher target of 85% which I am proud to say that we achieved this month.

But we want to go further still and have now included this training into the induction learning for all staff and are asking existing staff to complete the training as a priority.

We will be offering a range of ways for people to get involved – online and face to face.

We are already planning a face-to-face session with young people involved in the Youth Impact Board and an online meeting for our patients who are living in our forensic hospitals.

We anticipate we will hold a series of face-to-face meeting to share more with you about the specific programs and areas we need your involvement and engagement in with one of the first being around paid involvement with the Trust.

We are just starting out on building our approach to how patients and carers can advise on and oversee both our improvements and how people are involved in working with us to improve our services. This group will really help us get the basics right. And I think it’s extremely helpful to have your experience of involvement work, so that you can agree terms of reference and decide how you want to hold the plan (and us) to account.

The first stage of Our Big Improvement Plan really focussed on actions to ensure our services are safe now. But now that we have made a lot of progress with this work, we can tap into the wealth of ideas and feedback from our service users, patients, and colleagues – to deliver the changes they want to see.

We want to involve you to support us monitoring progress and there are opportunities now to coproduce service specific activities like therapeutic observations through our Quality Improvement programs, work around Care Planning … as we move on and make the improvements we must, there will be more opportunities to work together on co designing and developing our shared plans.

Paid for involvement isn’t something the Trust has offered recently, however alongside refreshing our Involvement Policy we will be discussing paid involvement in the late Autumn.

You are right we have lots to do to make the improvements we all want to see for people in a mental health crisis to be able to ensure there is a consistent, quality response for all people impacted in our communities across Nottinghamshire – but we are starting to make some improvements.

• Breaking down barriers between NHS services to improve transition when patients are referred in or discharged back to primary care
• Making sure patients can access crisis services out of hours including access to telephone support whenever it’s needed as well as home visits.
• Setting one single high standard of care for patients wherever they live to avoid postcode lotteries.
• Developing a carer/service user reference group to embed experience at the heat of service transformation and design services that allow us to meet national expectations in a way the best serves the local population.
• Our local mental health teams have significantly increased contact with people waiting to be seen in the community, to agree crisis plans and ensure they have an up-to-date risk assessment even when they are struggling to engage with our services or primary care.
• We are also working to improve alignment between our teams, primary care and talking therapies, helping to reduce waiting times as well as communicate more effectively when patients move between services or disengage from treatment. 
• Our community teams now give greater priority to risk management at every stage of the patient pathway. They ask more questions about whether families have been involved in decisions; whether GPs have been informed; and if risks have been referred to appropriate agencies.
• Colleagues also benefit from advice on medicines management from our new specialist pharmacist prescribers, who can prescribe medicines faster and review treatment as well as ease pressure in areas such as acute and emergency care and primary care, including out of hours services.
• In the last month we have achieved our target for the Oliver McGowan E-Learning. This is vital because of the higher proportion of our patients living with a learning disability or autism as well as mental health issues.
• There is a lot more work needed to deliver all the improvements we want for our patients, carers, and their families.

Once we have addressed all immediate safety concerns, we aim to support colleagues to embed improvements over the long term.

There is a range of support and help including training on a range of topics for Family cares and it’s offered through the Care Hub here are the contact details.

• Website: Carers Hub | Nottingham City and Nottinghamshire County
• Tel: 0808 802 1777
• Email: carershubinfo@carersfederation.co.uk
• WhatsApp or Text: 07814678460

A range of community nursing services delivered by Primary Integrated Community Services (PICS) on behalf of Notts Healthcare are to transfer back to the Trust under new contractual arrangements, which we hope will continue to improve quality, create more consistency, and improve efficiency across Nottingham and Nottinghamshire.

PICS currently provides a community service for patients across the Broxtowe area (Nottingham West), on behalf of Notts Healthcare while patients across the rest of Nottinghamshire receive our in-house services.

While we understand some patients may be concerned about this development, we’d like to reassure you that anyone receiving specialist community nursing services from PICS will experience minimal changes when the transfer comes into effect on 1 January 2025. PICS colleagues affected will be protected by TUPE rights and can transfer into the Trust if they choose to. 

We hope that the move will provide more opportunities and benefits to patients, for example fewer appointment cancellations when short term absences occur and improved referral to treatment time.

We are working with PICS and other local partners to mitigate any wider impacts and to enable a seamless transfer of services. Following the move, we will continue to review and improve the service to align with other localities across the county.

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