Foundation Trust Proposal

Sutton 1 in 4 Network‘s response to the consultation document on Foundation Status for SW London and St George’s Mental Health NHS trust.

  1. This is a response on behalf of Sutton 1 in 4 Network to the consultation document “Making Life Better Together – Our Plans for becoming and NHS Foundation Trust” published by the SW London and St George’s Mental Health NHS Trust in March 2011.
  2. Our responses to the questions posed in the consultation document are set out in order.

Question 1: Do you have any comments on our reasons for wanting to become an NHS Foundation Trust?

Our Key points:

  • We are amazed that it’s taken the Trust to apply for Foundation Trust status in order for it to aspire to excellence and accountability. Historically and currently the trust has continued to have the lowest ratings for inpatient care in surveys undertaken by Care Quality Commission.
  • Whilst it states that it has improved it performance, it is still in the ranks lower than the best performing mental health trusts. We believe that SW London and St George’s has considerable and extensive scope for improvement.
  • Sutton 1 in 4 Network wants to play a part in ensuring that the services provided to the people of Sutton meet their needs and are delivered with respect for the people who receive them.
  • Our experience of the Trust is that although it does consult users about a range of issues and developments. Many of our members feel that their views and experience is often ignored and overridden.
  • That the weight given to these views, needs, and experiences is low. It does not appear to take local concerns into account in planning its services.
  • Often it feels the Trust has already decided on a course of action before any meaningful consultation takes place. It feels that the patient/user experience does not drive the service
  • The Trust talks the talk but not walk the walk. This attitude is not conducive to public confidence and therefore our confidence in the Trust is at a low level.
  • We are concerned that the Trust because of its power and influence drives the commissioning process rather than the needs of Sutton people being the key driver.
  • We want facilities for Sutton people to be provided by an organisation that does actually deliver high quality and excellent services and that listens, learns and acts from the people that use it services. Without doing this it will not inspire trust. or confidence There is a lot to be done before the SW London and St George’s Trust can meet these criteria.
  • We feel that rather than seeking Foundation Trust status at this time, SW London and St Georges Trust need to demonstrate that it can make dramatic and sustainable improvements to ,the quality of its services ,its care pathways and patient/user experience.
  • The service user needs to be the driver of the service.
  • The Trust needs to re-examine the way it works with other service providers particularly in the voluntary sector and show a commitment to being a partner that values diverse and different ways of working rather than absorbing them redefining them.
  • The Trust needs to examine its relationships with voluntary sector and user organisations. It needs to be able to demonstrate that it can be a partner not just the monopoly as it is at the moment

Question 2: What do you think about our vision and values?

Vision: A future in which people with mental health problems have the same opportunity as others to participate in and contribute to our communities

Our Key points:

  • The Trust’s proposed vision and values are admirable. However, experience shows that in practice it has a long way to go to ensure that they are consistently put into practice It needs to ensure that all parts and all levels of staff in the organisation reflect these values.
  • It is not clear from the consultation document how becoming a Foundation Trust would change a culture which in practice still espouses a “we know what is best for you” model and which widely fails to allow the people who use its services to make decisions guided but not dictated by professional staff.
  • The Trust needs to articulate a much clearer sense of purpose and philosophy of care about f its key activities. For example, legal requirements aside, it is not clear what therapeutic purpose is served by inpatient treatment, nor is the “recovery approach” clearly explained.
  • The Trust does not need Foundation status in order to be able to explain to its users the basis for its decisions on resource allocation, or to demonstrate how proposed changes in the way its services are provided will improve the quality of outcomes for service users.
  • The Recovery College is a valuable initiative but it should not be allowed to divert attention from the fact that the Trust has a poor record in relation to treating the people with dignity and respect.
  • Recovery and Well-being principles should be the core of all its day to day practice Its workforce need to demonstrate through their practice, that they have the skills, attitudes, and attributes to promote mental and emotional health and wellbeing in those it serves.
  • There needs to be a management system that weeds out/or re-educates staff whose skills and attitudes are not meeting the required standard. It needs to recognise that some individuals require a different types of support and that the recovery college courses may not meet these needs.

Question 3: Do you have any views or comments on our service plans for the future? Key point

We shall give a more detailed reply to this question in our separate response to the Clinical Services Strategy of South West London and St George’s Mental Health Trust.

Question 4: Do you agree that twelve is the right minimum age to become a member of the Foundation Trust?

Our Key point:

  • No, our view is that the minimum age should be 16, however it should listen to all service users whatever their age

Question 5: Do you agree with our proposals to have a separate constituency for users and carers?

Our Key point:

  • The proposals do make it clear that users and carers will be elected separately. However, it is arguable that an even clearer distinction is needed between user and carer members. It is important to recognise that the interests and concerns of users and carer are different. We feel that the proposal that user members should have been in touch with the Trust in the past 5 years discriminatory. No other groups have such a restrictive condition

Question 6: Do you have any views on the proposed subdivision of the public constituency?

Our Key point:

  • The public constituency is divided geographically by London Boroughs and “the rest of England and Wales”. This seems clear and manageable.

Question 7: Do you think our proposals for staff members are the right ones?

Key point:

  • The legislation requires provision to be made for staff members. And therefore seems an irrelevant question.

Question 8: Do you agree with the proposed number and mix of Governors on the Council of Governors?

Our Key points:

  • We believe that there should be 2 user representative from each borough who are elected by user members from that borough We feel that there should be 1 user representative from the rest of England and Wales. We also feel that there should be 5 Carer representatives also elected by carer members from the individual boroughs Deputy’s should be allowed if users reps cannot temporary attend Council of Governors meetings
  • The requirement for users and carers to outnumber other members of the Board of Governors is under the proposal barely met. We feel that this needs to be changed.

Question 9: Do you have any views on what the Trust should be called if we become an NHS Foundation Trust?

Key point

  • The name of the proposed trust is not a major issue for us.

Sutton 1 in 4 Network
May 2011