Agenda item

Oxford Health NHS Foundation Trust has been invited to present the Trust’s Annual Quality Account for the year 2024-2025.

The Committee is RECOMMENDED to:

a) AGREE to provide feedback on the Trust’s Quality Account.

b) AGREE to finalise the wording of the feedback subsequent to and outside this meeting, and to submit the feedback to the Trust prior to the publication date for the Quality Account at the end of June 2025.

Britta Klinck, Chief Nurse, Dr Rob Bale, Interim Chief Operating Officer for Mental Health and Learning Disability, Angie Fletcher, Deputy Chief Nurse, and Emma Leaver, Interim Chief Operating Officer for Community Health Services, Dentistry & Primary Care, attended to present the quality account report.

The Chief Nurse had presented the quality account report, which was due for public release at the end of the month. The report had supplemented the annual report, highlighting quality priorities and performance. Oxford Health NHS Foundation Trust, a major provider of community and mental health care, had managed services in several regions and community hospitals in Oxfordshire. The Trust had assessed its performance over the past year, set new goals, and aligned with national directives. Despite efficiency challenges, improvements had earned them national recognition. They had prepared for the NHS 10-year plan by aligning with anticipated national priorities.

Members inquired about the Trust's strategy on clinical effectiveness, patient safety, and experience. The strategy focused on staff support, enhancing patient experience and safety, and advancing research. A board committee oversaw quality work, monitored data, and sought improvements. The Trust made progress with 68 peer support workers and established patient forums to include patient voices in decision-making. Continuously evaluating and improving care quality remained a priority.

The Committee requested evidence of measures for staff wellbeing and managing violent behaviour. The Trust implemented conflict resolution training, de-escalation techniques, trauma counselling, and formed a group to reduce violence and aggression, including racial abuse. Campaigns communicated a zero-tolerance policy towards such behaviour. In response to the cost-of-living crisis, they offered financial advice, crisis loans, and support for staff. Improved staff survey results placed the trust among the top ten mental health trusts for supporting, valuing, and engaging staff, and they conducted quarterly surveys for ongoing feedback.

Members also asked about advocating for an Oxford living wage and its recent rejection. Despite acknowledging the high cost of living, the proposal was rejected due to national pay framework constraints and political implications. Nonetheless, the Trust made strides in staffing, particularly through developing nurses from nursing associates and apprenticeships.

Members asked about the effectiveness and uptake of Keystone health and well-being hubs on community mental health. These hubs had high referral levels and were being evaluated for impact using qualitative and quantitative methods. They offered early interventions and guided people to community activities for mental health support, staffed by health professionals, partners, and peer workers who raised awareness and engaged with local communities.

Members also inquired about the Trust's efforts to enhance physical healthcare for those with serious mental illness. The Trust implemented smoking cessation programmes, annual health checks, and physical health clinics within community mental health teams, including home visits if necessary. General nurses in inpatient settings treated patients holistically, acknowledging the link between mental and physical health, and utilised their integrated structure to support both needs, especially in community hospitals.

Members queried the reasons for longer wait times for mental health services, measures taken to improve them, and alternatives for those unable to use digital services. The Trust refined referral processes, eliminated unnecessary steps, and used resources efficiently. Recruitment efforts helped reduce wait times, and they provided face-to-face interventions for those unable to use digital services, ensuring access to services.

The Committee inquired about reduced wait times for children's services in Oxfordshire, the ongoing disparity between demand and capacity, and how the Trust planned to improve timely access, quality, and safety without additional funding. The Trust acknowledged reduced wait times but noted the mismatch between demand and capacity. They aimed to enhance access, quality, and safety through better resource allocation, process improvements, and efficient services, while exploring ways to manage demand within existing resources. They also highlighted the importance of collaborating with the voluntary sector to provide support and manage demand.

Members asked about the Trust's reliance on the voluntary sector and its impact on deprived areas with low community resilience. The Trust acknowledged this challenge and established Keystone hubs, integrated support from both the Trust and the voluntary sector, ensuring necessary services were available even in areas with limited voluntary presence.

The Committee inquired about support for carers, families, and homeless individuals. The Trust had a full-time carers lead who managed activities including care assessments, peer support, and engagement events. Clinicians used the triangle of care approach to involve carers and families in the care process. For those without family support, a key worker was assigned. Crisis services included cafes and a crisis team that carried out home visits and offered round-the-clock support.

Members enquired about minority experiences within the NHS and mental health services, and actions on health inequalities. The Trust applied the Patient and Carers Race Equality Framework (PCREF) to improve ethnic minorities' experiences. They appointed an anti-racism lead to foster an inclusive environment. Recognising that equal treatment did not ensure equity, they tailored support to individual needs. Efforts were ongoing to understand and address barriers to service access, particularly in rural communities, aiming to reduce care disparities.

D/Cllr Poskitt left the meeting at this stage.

Members inquired how the Trust had assessed palliative care services and planned improvements. The trust had set response time targets for family home visits and collected feedback to ensure personalised care. They focused on proactive end-of-life planning and provided clinicians with clear patient and family needs information. Collaboration with care homes had aimed to prevent unnecessary hospital admissions, with district nurses providing regular end-of-life care visits.

Members also asked about the 38 completed reviews and 12 pending ones under the new NHS framework for serious incidents. The pending reviews likely involved ongoing family participation. The Trust aimed to learn from these incidents and enhance safety systems.

The Committee AGREED to:

1. Provide feedback on the Trust’s quality account.
2. Finalise the wording of the feedback subsequent to and outside the meeting, and to submit the feedback to the Trust prior to the publication date for the quality account at the end of June 2025.