A week of meeting, events and milestones to lay the foundations

Hi all

This was a week that appeared to be packed full of meetings, events and milestones that concentrated on laying the foundations for real long term and fundamental transformation and progress, as well as confirming external approval for our strategic approach.


Last week week saw our programme to introduce locality working pass significant milestones.

Phase 1 formally completed on schedule on Friday 6 July. Following formal consultation, I am delighted that the appointments of the new Clinical Directors (CD) and Associate Directors (AD) has taken place. These are:

  • Stoke Directorate – Jane Munton-Davies (AD) and Dennis Okolo (CD)
  • North Staffordshire Directorate – Samantha Mortimer (AD) and Darren Carr (CD)
  • Specialist Services Directorate – Ben Boyd(AD) and Darren Perry (CD)
  • Acute & Urgent Care Directorate – we currently have a remaining vacancy for the post of Associate Director and Carol Sylvester has been appointed as Interim Clinical Director.

Phase 2 commenced on the 4 June 2018 through formal consultation and closed on the 4 July 2018. This phase relates primarily to the senior Professional Leadership Structure within the Trust concerning Heads of Nursing, Allied Health Professionals, Psychology, Social Work and Medical Associate Directors. This phase was led by the Trust’s Medical Director, Dr Buki Adeyemo and Director of Nursing and Quality, Maria Nelligan.

The next part of the process will involve considering any feedback received to date as part of the consultation, ensuring we have responded where required and confirming the structure moving forwards leading to the appointment of any vacancies

Phase 3 – Configuration of Associate Clinical Directors & Clinical Leads, and all Service Managers, AHP and Psychology Leads and Quality Improvement Lead Nurse – begins this week

Phase 3 of the locality restructure focuses on the Management structures within each of the newly established Directorates. These include the roles of Service Managers, Quality Improvement Lead Nurses, Clinical, Psychology and AHP Leads. The newly appointed CDs and ADs will lead this phase, including ownership of the launch and the resulting consultation under a Management of Change process. This will be co-produced by teams themselves.

Can I remind all staff that, if you have any questions about our plans, how they affect you and the opportunities it offers, please get in touch either with the project lead, Nicky Griffiths, the HR Team or alternatively you can use our dedicated web page http://localities.wpengine.com/ including an FAQs page and a web form you can use to ask us anything you like and get an answer. You can, if you prefer, even ask a question or give us a comment anonymously.


It was a real pleasure to see two projects from Combined making the finalists in the mental health category at the recent HSJ Patient Safety Awards and many thanks to our Director of Operations, Jonathan O’Brien, for representing the Executive Team at the event.

The first was medication reduction in a Learning Disability inpatient service. Antipsychotics and antidepressants are often prescribed for people with a learning disability without appropriate clinical indications and a substantial number who are prescribed drugs for the purpose of behavioural management can safely have their medication reduced or withdrawn. Prescribing often starts at a specialist level and is then passed onto primary care resulting in GPs overseeing the management and prescribing long term, often unnecessary, medications. The aim of this project was to improve the quality of life of people with a learning disability admitted to our Assessment & Treatment unit by reducing the potential harm of inappropriate psychotropic drug use.

The second was for our High Volume User Pilot. A small number of patients make frequent attendances to emergency departments and account for a disproportionate amount of the total Accident and Emergency (A&E) workload. The team is made up of registered mental health staff working in collaboration with the British Red Cross, both having expertise in reach work to support complex health and social care needs. The team works in collaboration with the UHNM, the ambulance service and local Clinical Commissioning Groups, all of which have signed up to a data sharing agreement to support a system wide approach to the reduction in attendances at A and E.


I was pleased to attend the Staffordshire  Overview and Scrutiny Committee last week with my STP colleague Dr Abid Khan, Medical Director at Midlands Partnership Foundation Trust and Jonathan O’Brien, our Director of Operations. We were there to discuss with councillors the Together We’re Better STP Mental Health Programme.

It was a thoroughly stimulating and enjoyable session and we were able to tell a great story of how joint working across the whole of Staffordshire and Stoke-on-Trent is bearing fruit and delivering real results for local patients and their families.

We were able to report real progress:

  • New IAPT services for people with Long Term Conditions across Staffordshire
  • Improved support for frail elderly via outreach services – supporting winter pressures
  • Integration of mental health into place based locality teams –  MPFT and NSCH redesigning to align with this
  • Alliance Boards established to support integration
  • 24/7 Crisis and Home Treatment Services for adults – now recurrently commissioned across Staffordshire
  • Development of Mental Health Crisis Care Centre including increased capacity for Place of Safety at Harplands Hospital

  • STP is currently ranked 4th out of 44 STPs for Out of Area Placements as at  November 2017

  • New Psychiatric Intensive Care Unit (6 beds) to open in Autumn 2018

  • Development of Pan-Staffordshire suicide prevention campaign

  • Latest data shows fall in three-year rolling total of suicides across Stoke and Staffordshire

  • GPs and wider primary care staff to have suicide prevention training in 2018/19 – on track


Tuesday evening saw a meeting of all the Chairs and CEOs from across Staffordshire and Stoke-on-Trent. It’s always useful to be able to come together as a whole group to talk through the challenges we face system-wide and share insights and lessons with each other.

I was asked to present alongside Neil Carr, Chief Executive, Midlands Partnership NHS Foundation Trust and Dr Shammy Noor, Chair of the South East Staffordshire and SeisdonPeninsula CCG the work we are doing together to support integrated locality working and integrated teams.

It was really positive that progress is being made with great examples given, including from Shammy, the Lichfield Care Home Project, which has achieved:

  • Much lower demand on GP
  • Higher continuity of care for patients
  • Lower ambulance conveyance
  • Lower admission rates
  • Less form filling
  • More confidence in the care homes
  • Direct access to a range of services (i.e. not back through the GP)
  • Patients know who will be coming to visit them


The week ended on a real high as I opened the first ever Together We’re Better Digital Conference. Gwyn Thomas, who has been a fantastic help to Combined over many years advising on our Raising Service Excellence (ROSE) programme, is also the STP Digital Programme Director for the STP. Gwyn has an incredible track record in digital and an enviable network of contacts and friends on whom to draw.

A packed audience of over 100 digital leaders and personnel from across our patch were able to hear from a range of external speakers from Leeds to the Wirral and from Hampshire to Bristol. All of them were happy to share their experiences and lessons-learned to inform the Staffordshire and Stoke-on-Trent Digital Strategy.

We livestreamed the opening sessions – which you can watch at:https://www.facebook.com/NorthStaffsCombined/videos/1864355016958258/

The event also featured an introductory video welcome from the STP Chair, Sir Neil McKay, who unfortunately was unable to attend the event due to a prior commitment, but who wanted to stress his own personal commitment and support for our digital vision. You can watch his video below.


Wednesday was a lovely day for me as it was my sons graduation – an important step in his journey to becoming an qualified fully fledged accountant. The University of Birmingham organised a wonderful ceremony held in the very historic great hall, I felt very emotional on two counts, firstly as a proud mum and secondly the amount of diversity of the young people with so much hope and positivity for their future. Our pre-planned celebratory meal was gate crashed by the need for a full size screen showing of the England match!