Annual Review 2020/2021 - Improving Lives - Greater Manchester Mental ...
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Annual Review
2020/2021
Greater Manchester Mental Health
NHS Foundation Trust
Improving Lives
Contents
Message from the Chair and Chief Executive 06
Greater Manchester Mental Health at a glance 08
Our approach 10
Our Five Year Strategy 12
Highlights for the year 14
20/21
Looking into the future 28
Recovery Plan Workstreams 30
Get involved 32
Simon Ayela-Uwangue
Staff Nurse
Annual Review 2020/21 5
Welcome to the Trust’s Annual Review for 2020/21 and
our look to the future. A more detailed look back can
be found in our Annual Report and Accounts 2020/21.
2020/21 was a year we will all never All staff have played a part in finding and
forget. The NHS had to deal with the implementing solutions whilst at all times
biggest health emergency in its history. ensuring that safety, compassion and care
Working through this, whilst continuing remained at the forefront of everything we
to deliver safe and effective services, and do.
remaining safely staffed has been a huge
achievement. We are immensely proud
of the Trust’s response to the COVID-19
pandemic with staff across all our services
adapting quickly, decisively, and selflessly in
the face of the challenges.
Vaccine Centre
The Curve
6 Greater Manchester Mental Health NHS Foundation Trust Annual Review 2020/21 7
Our year of achievements and response
to the COVID-19 pandemic
In last year’s Annual Review, we reported In March 2020, we activated Gold In July 2020 we were pleased to announce impact of COVID-19. GMMH’s participation
on the Trust’s response to the COVID-19 Command to lead our emergency that responsibility for the future provision was a huge success, with a total of 620
pandemic and how immensely proud planning and response and this continued of mental health services in the Wigan participants recruited, finishing 8th overall
we are of the workforce’s response throughout 2020/21 and continues to be in Borough would transfer from North West in the league table of 107 Trusts. The team
to the crisis. During the year we have place today. Boroughs Healthcare NHS Foundation Trust also began delivering a telephone survey
worked together as one team to find and (NWBH) to the Trust on 1 April 2021. By to see how service users were coping
implement solutions at a relentless pace, We also introduced a COVID-19 Recovery welcoming Wigan Borough services, we during the pandemic, which also allowed
taking decisions (big and small) that would Planning Group in May 2020 to co-ordinate will benefit from the sharing of expertise, us to inform people of the symptoms
previously have seemed inconceivable. the Trust’s COVID-19 recovery plan and lead experience and local knowledge and the of COVID-19 at a time when awareness
Our frontline clinical teams and corporate the Trust’s reconstruction and progression opportunity to offer more integrated raising was crucial and identify and signpost
support services adapted quickly, going the to ‘new normal’ working conditions. care pathways and achieve economies people who were struggling with their
extra mile to ensure that we continued to Recovery continues to remain our primary of scale. Our new colleagues and service mental health.
safely meet service users’ needs. focus ensuring we are enhancing the users would be joining a high-performing
support and wellbeing offer for our service specialist trust with a key voice in shaping Our thanks to colleagues across the
users. Linking into the command structures and improving mental health services across organisation for their efforts during
Ella Manfredi in each of our four localities and at a Greater Manchester. 2020/21 to improve the lives and support
Staff Nurse Greater Manchester level has been vital and optimistic futures for our service users, their
continued to participate in regional and The Trust’s Research and Innovation team families and their carers.
national arrangements and discussions. provided vital support to essential services
during the pandemic. Many colleagues
Throughout the year, we continued to put were redeployed to frontline services that
our staff at the heart of our efforts; to offer needed extra support. This included putting
them as much support as possible during some of our nurses back onto inpatient Neil Thwaite
this unprecedented time. This included wards, helping in the catering department, Chief Executive
supporting frontline staff to access the taking blood in community clinics, and
appropriate PPE, antibody testing, lateral delivering PPE across the Trust.
flow testing, health and wellbeing advice The team rose to the challenge
and support and also supporting over of continuing to provide research Rupert Nichols
1,200 staff to work effectively from home. opportunities during lockdown through Chair
We also supported managers to identify innovative ways of working; and in doing
suitable redeployment opportunities for so, supporting vital research into COVID-19.
staff who were unable to continue in This included contributing towards a
their substantive roles because of the risks global study looking into the psychological
present by the virus. We also undertook
additional recruitment to ensure that the
workforce was in place to support our
services and included campaigns to recruit
aspirant nurses and NHS returners.
Copies of our full Annual Report and Accounts 2020/21 and Quality Account
2020/21 are available to access on our website at www.gmmh.nhs.uk/publications.
8 Greater Manchester Mental Health NHS Foundation Trust
160
Greater Manchester Mental Health 65,000
at a glance 6,400 sites
staff (wte) service users
We are one of the largest specialist mental
health providers in the country, supporting
more than 65,000 service users across our
local, specialist, substance misuse and prison
populations. We employ over 6,400 whole
£373.8m
Total annual
time equivalent (WTE) staff and provide
services from over 160 locations across the income
North West of England, as well as working
with people in their homes and local
communities.
We offer: Living Wage
• Local mental health services to the people £14.7m Foundation
of Bolton, Manchester, Salford and Trafford 2020/21 Capital
and Wigan, a combined population of Expenditure Employer 10 specialist
•
around 1.3 million people
Substance misuse services to people in
research
Bolton, Salford, Trafford, Bury and Cumbria units
• Services to over 8,000 people in prisons
and secure accommodation in the North
West of England Over 7,000
• Highly specialised mental health services
for the region and wider NHS in England
Recovery Academy
Students
Our Scope
Bolton, Salford and Trafford
Mental Health and Addiction Services
Manchester Over 224
Mental Health Services
Bury
11,000 ‘Good’ Apprentices
Members CQC Rating
Addiction Services
Cumbria 200
Addiction Services volunteers
Wigan
Mental Health Services
Elected seats on our
As a Foundation Trust, we are accountable to our local communities through our Council
of Governors and are regulated by NHS England and NHS Improvement (NHSE and I) and 24 Council of Governors
the Care Quality Commission (CQC).
*Wigan Services from 1 April 2021 *Cumbria Services until 1 October 2021 Figures correct as of August 2021
10 Greater Manchester Mental Health NHS Foundation Trust
Our approach
The Trust’s five-year Strategy 2019 - 2024 significant and often above average mental
-‘Delivering Excellent Care and Supporting health needs of our local populations.
Wellbeing’ sets out the Trust’s strategic During 2020/21 the Trust’s planning
vision - ‘Working Together to Improve processes were suspended in order to
Lives and Support Optimistic Futures’ - and respond to the COVID-19 pandemic.
future direction of travel. It guides how The Trust however continued to progress
the Trust leads and enhances services in delivery of its strategic objectives as part of
collaboration with users, carers, staff and the measures put in place to support service
partners. users and staff during the pandemic.
Our Strategy is aligned with the NHS Long To deliver our vision we are focused on
Term Plan, Greater Manchester Health and achieving five key strategic aims and
Wellbeing Strategy, commissioner strategies objectives:
and locality plans and responds to the
Work with service users and carers to achieve their goals by
1
delivering high quality care
Create an outstanding place to work, ensuring staff feel valued and
2
are supported to reach their potential
Continuously improve services for users through research,
3
innovation and digital innovation
Work in partnership with others to improve wellbeing and
4
improve stigma
Be a sustainable, well-led organisation that delivers social value
5
Our five core values underpin how our staff and volunteers work together to care for our
service users and deliver our vision.
12 Greater Manchester Mental Health NHS Foundation Trust Annual Review 2020/21 13
Our Five Year Strategy
Our Vision Working together to improve lives and Our Strategy Delivering excellent care and supporting
support optimistic futures wellbeing
Objective One Objective Two Objective Three Objective Four Objective Five
Strategic Objectives
Work with service Create an outstanding Continuously Work in partnership Be a sustainable, well-
users and carers to place to work, ensuring improve services with others to improve led organisation that
achieve their goals by staff feel valued and for users through wellbeing and delivers social value
delivering high quality are supported to reach Research, innovation challenge stigma
care their potential
and digital
technology
Quality Improvement Supply, recruitment Research and Service users, Financially sustainable
• To improve and retention Innovation Communities and and well governed
Programmes of Work
outcomes Voluntary, Community
Outstanding place to Digital Safe, effective
and Social Enterprise
• To deliver safest work and supportive
sector (VCSE)
care environments
Transforming our
Integrated care
• To integrate care workforce Productivity
around the person Public sector
Outstanding leadership Delivering Social Value
and management Trusted partnerships
development
Best care, every day Compassionate, Best outcomes Individualised, Sustainable services,
Aims
supported, motivated seamless care adding value
staff
We inspire hope We work together We are caring and We value and respect We are open and
Values
compassionate honest
14 Greater Manchester Mental Health NHS Foundation Trust Annual Review 2020/21 15
Highlights for the year Improving Supervision
Quality improvement The supervision project started in January Innovation teams are looking at change
2020 with an overall aim to increase the ideas focusing on the quality of clinical/
Quality improvement (QI) is an integral element and a key strand of our five Year Strategy.
compliance rate for supervision to 85% professional and managerial supervision,
Our QI strategy was launched in May 2019 and has been delivered throughout 2020/21.
by 31 December 2020. safeguarding supervision and patient
The strategy incorporates three key enablers and three core Quality Improvement Priorities
safety considerations, culture around the
(QIPs), which have driven our approach to continuous improvement, supported the delivery
The project achieved 80% of supervision importance and benefits of supervision
of our QI activities, and our wider vision for QI. Our QIPs for 2020/21 comprised:
compliance at the end of 2020 and has and appropriate documentation.
1. To improve outcomes now moved to Phase Two.
2. To deliver the safest care
The Improving Access and Quality of
3. To integrate care around the person
Supervision project is delivered as a
Breakthrough Series Collaborative and
We have made significant progress against these 2020/21 priorities for
has a twofold aim;
improvement. Summaries of our key achievements are detailed below. Each
achievement reflects the immense commitment of our staff, services users, and 1. Improving quality of supervision based
carers to continually improving quality. Quality highlights for the year include: on an appropriate set of standards as
developed by the innovation teams
2. Achieving 85% compliance of
supervision by 31 December 2021
Quality Improvement Priority One: To Improve Outcomes
Red2Green Days Building an Improvement Culture
(Adult Forensic service and North Manchester community services)
The Red2Green Days Project was first discharges noted in April 2020 to March
introduced during the Multi-Disciplinary 2021 compared to the previous year. This programme includes six wards Change ideas include promoting civility,
Team (MDT) Board Round following the Progressively discharges have caught up based at our Adult Forensic Services the introduction of daily huddles, star
development of Red2Green Operational and then exceeded admissions in the working alongside three community of the week, a re-design of clinical team
Guidelines. last financial year supporting inpatient teams in North Manchester as part of a meetings processes, promoting health
flow and reducing OAPs (24% reduction Breakthrough Series Collaborative. The and well-being, increasing the uptake
Each patient has an identified discharge from previous financial year). During the aim of this programme is to build an of staff taking a break, mood jars,
date following an initial MDT review and last financial year 136 Bolton patients improvement culture within the teams. incorporating health and well-being into
all barriers are discussed each day with were admitted to other divisions and staff huddles, improving communication
a focus to resolve these before this date, 211 patients from other divisions within An initial questionnaire has been between SLT and team, improving zoning
where clinically appropriate, for a safe the Trust were admitted to Bolton. This developed in order to provide a baseline meetings and creating a ‘new starters’
and effective discharge. All actions are demonstrates that Bolton resources were assessing the culture within the teams. group.
allocated the same day with an expected utilised more to support overall bed Two Learning Sessions have taken place
resolution to maintain green days. pressure within the Trust. and teams are working collaboratively This is a longer-term project, which will
to identify and share change ideas and continue across 2021/22.
This project has seen a number of positive The Red2Green Days QI Project is now testing using PDSA cycles.
outcomes and productivity gains. This complete and the project team is currently
has included a 31% increase on yearly looking at sustainability of improvement.
16 Greater Manchester Mental Health NHS Foundation Trust Annual Review 2020/21 17
Quality Improvement Priority Two:
To Deliver the Safest Care
Reducing Restrictive Practice Falls Reduction
The project aim for this collaborative is to 2020, innovation wards have progressed Following a temporary pause, owing to So far, innovation wards are focusing on
decrease use of restraint by 20% by 30 with their change ideas and participated COVID-19, plans to re-start the Reducing change ideas relating to observations,
November 2021 across innovation wards. in two Learning Sessions. Following this, Falls QI project were initiated in November updating the falls management and
future plans will involve more wards 2020. prevention training pack, and increased
The importance of this project and its participating in a Breakthrough Series mobility protocols.
aims lie within the context of the Mental Collaborative which will run for a year Phase Two of this programme will be
Health Units (Use of Force) Act 2018 each. This is expected to be an ongoing delivered using the Breakthrough Series In addition, the GMMH Trust’s Falls
which have a goal of reducing the use project. Collaborative approach. Group is working on reviewing the Falls
of restrictive interventions and delivering Policy and establishing an Oversight Falls
Innovation wards participating in the Protocol. The first Learning Session is
care which has a trauma-informed Breakthrough Series are all later life wards
approach and a focus on human rights. scheduled for April 2021.
across the Trust as well as our Chapman
Barker Unit (CBU).
The key areas this Quality Improvement
Project is focused on are: The aim is to reduce the number of
inpatient falls by 15% and associated
• Robust monitoring systems and harm across innovation wards by 31
processes December 2021.
• Implementation of the evidenced-
based Safewards intervention
• Increasing PMVA training compliance
to ensure sufficient numbers of
substantive staff are trained
• Continuous improvement of the
PMVA training package with a focus
on prevention
The Phase Two Reducing Restrictive
Practice project is being delivered as a
Breakthrough Series Collaborative with
seven wards across the Trust (Blake,
Phoenix, Holly, Oak, Buttermere, Juniper,
and Irwell wards).
Since the start of Phase Two in October
18 Greater Manchester Mental Health NHS Foundation Trust Annual Review 2020/21 19
Quality Improvement Priority Three:
To Integrate Care Around the Person
Trauma Informed Care Mental Health Optimal Staffing Tool (MHOST)
The Trauma Informed Care (TIC) QI • Development and delivery of one MHOST is a data collection tool which The aim of these meetings was to ensure
Project group was formed in June 2020. day TIC training for clinical teams in is designed to calculate the level of robust, reliable data collection which is
The group has involvement and input Bolton, recovery academy training dependency of patients over a 20-day consistent between wards.
from across the MDT and lived experience and TIC adopted as standard into period in order to make assessments Data collection for this project was
experts, linking into the positive and safe PMVA training. about the requirements for staffing. completed in October 2020 and a report
agenda, and supervision projects. • TIC is now incorporated into GMMH was produced.
self-harm policy and toolkit and It also takes into consideration the quality
The project is now guided by standards posters are ready for distribution to of patient care over this period, so in Key recommendations from this first
produced from national examples of inpatient areas. addition to the dependency level, metrics phase included a review of bed occupancy
good practice and key drivers for change. such as incident numbers, staff wellbeing for PICU wards taking into consideration
Key areas of focus include: Phase Two of the project will be delivered and activities on the ward are also flow across services, appropriate use
as a Breakthrough Series Collaborative collected. of observations and a review of the
• Contributing to the positive and safe
with some ongoing recruitment in order budgeted establishment for PICU wards.
agenda
to ensure a blended approach; teams The five PICU wards at GMMH have been
• Understanding the prevalence and involved in meetings supported by the QI
that have already been testing ideas
impact of trauma on service users and team following the structure of a Clinical
(have experience) and those that are new
staff Microsystem approach.
to testing but represent different areas/
• Developing an understanding of TIC services of the Trust.
for the whole workforce
• Compassionate Leadership The overall aim of the project is to
demonstrate adherence to seven
Robust monitoring systems and processes standards of TIC by 2024 across GMMH.
of these priorities are in place using QI
methodology and audit.
Phase One work has been ongoing across
the Trust and we have achieved some
positive results, including:
• Development of ‘know each other’
workbooks for inpatient and
community areas.
• Development of compassionate
leadership training.20 Greater Manchester Mental Health NHS Foundation Trust Annual Review 2020/21 21
Additional Quality Improvement activities • So far, the project team has developed change ideas focusing on removal of
requirement for face-to-face gatekeeping, benchmarking referrals against referral
In addition to our core, formal Quality Improvement Programmes, Quality Improvement principles, reducing the threshold for referrals to HBT, crisis plans included on referrals,
support has also been directed at a number of additional actives including: escalation of concerns to team managers, interface meetings, supportive supervision
with staff to improve referrals for teams and weekly audit reviews by operational
Substance Misuse Services (SMS) Medical Review Project managers to consider trends.
• Representatives from community SMS Teams participated in a Process Mapping Increasing Feedback and Patient Experience data
Workshop focusing on the process and content of Medical Reviews. The project team
identified some key areas for improvement and are currently working on constructing a • The GMMH Customer Care Team, service users and service user feedback
driver diagram and change ideas to take forward. representatives from across the Trust participated in a number of process and value
stream mapping workshops focusing on patient feedback systems across the Trust.
Sexual Safety National Collaborative • The project team worked on a ‘Feedback Cause and Effect Diagram’ looking at current
systems and documentation, service users and staff.
• Chaucer ward and Blake ward are participating in the Sexual Safety National
• Next steps include the development of a driver diagram and identification of change
Collaborative which re-started in September 2020. National collaborative meetings and
ideas to drive improvement forward.
workshops are continuing, and the wards also receive support from a designated QI
Coach from the Royal College of Psychiatry.
Mental Health Act (MHA) Documentation
• The collaborative is due to end in September 2021 and during the last three months
the wards will work on developing a ‘change package’. • The Mental Health Act team in collaboration with the QI Team and Innovation
Manager have participated in process mapping activities, focusing on MHA assessment
Redwood Ward: AIMS Standards Implementation paperwork.
• The purpose was to identify challenges and areas for improvement whilst considering a
• The GMMH Inpatient Recovery Workstream-Demand and Capacity group has reviewed
business case for introducing an electronic system to replace current documentation.
the standards from the Accreditation for Working Age Inpatient Mental Health Services
(AIMS-WA) document and selected 11 standards to be implemented at Redwood
Ward.
James Noel Susan Murphy
• Following a QI approach and utilising relevant tools the project is aiming at improving Audit Facilitator Activity Co-ordinator
patient flow and reducing length of stay. The project started in October 2020 with an
aim to reduce length of stay or time of reaching DTOC by 30% by end of March 2021.
• The project team has tested change ideas relating to the aim of admission and barriers
to discharge but work has been on pause the last two months due to COVID-19
related pressures.
Community Mental Health Team (CMHT) to Home Based Treatment (HBT) Referral
Pathway
• Bolton Early Intervention Team and North East Manchester CMHT are working
collaboratively to support patients earlier in their crisis and reduce the likelihood of
inpatient admission by increasing referrals to HBT.
• Key drivers for this project include direct referral and acceptance on the assessment
pathway, overview of cases and effective use of crisis beds.22 Greater Manchester Mental Health NHS Foundation Trust
Care Quality Commission (CQC)
We continue to respond to the improvement opportunities identified by
the Care Quality Commission (CQC) in 2019/20, including through the
implementation of a more robust system for ensuring supervision compliance
and by progressing our plans to build the new Park House development on the
North Manchester General Hospital Site.
Positive performance
key national performance requirements, however achievement of national targets was
suspended during the COVID-19 response and recovery in 2020/21 which also saw
20/2
We remain a well performing organisation with a track record of delivering quality,
operational and financial performance. The NHS Oversight Framework sets out the
the suspension of CQUIN targets applicable for mental health trusts. The Trust’s key
performance indicators and reports reflect this as appropriate during the period. In line
with the national guidance, we reported our performance against the framework were
appropriate for assurance purposes.
Financial performance
We delivered a positive financial position at the end of 2020/21 and maintained low levels
of financial risk throughout the year, whilst also achieving the cost efficiencies required
for future sustainability and making significant capital investment. The overall income
and expenditure position shows delivery of a net retained surplus of £3.854 million. The
operating surplus for the year was £5.206 million.
We continue to recognise the need to sustain the improvements delivered this year,
whilst also strengthening our productivity in other areas in 2021/22. We will apply our
Operational performance standardised quality improvement framework to deliver efficiencies in our acute care
pathway, workforce, digital approaches, pharmacy and corporate services.
Our Improving access to Psychological Therapies (IAPT) services demonstrated ongoing
improvements and we achieved both the 6-week and 18-week referral to treatment Equality of service delivery
targets at Trust wide level.
We have continued to develop systems and initiatives to support the delivery of its Equality
The target for Early Intervention Referral in 2 weeks was not met in March 2020, however Diversity and Inclusion Strategy and meet the statutory requirements of Public Sector
we demonstrated good performance overall for the year achieving above target at 63.4%. Bodies under the Equality Act (2010). The Trust has been guided by the NHS Equality
This is positive performance given the impact of COVID-19 due to the reduction in face-to- Delivery System (EDS2), which is a framework to improve outcomes across key domains
face assessments to reflect social distancing requirements. of equality and improve the Trust’s contribution to reducing health inequalities in the
communities it serves.
In terms of Reportable Out of Area Placements (OAPs), we saw an increase during 2020/21
which reflected the system wide pressures caused by the management of the COVID-19
pandemic. It remains the Trust’s aspiration to minimise OAPs as much as possible and
Practitioner
Organisational Development
Deepthi Nambiar
support people as close to home as possible.
Staff sickness absence rates were above the locally set target for the rolling 12-month
period however showed improvement from the position in 2019/20 and includes the
impact of COVID-19 pandemic related sickness. This improvement reflects our approach to
promote employee health and wellbeing and improved sickness absence management.
We are looking forward to working toward achievement of the 2021/22 key performance
indicators as we move from the COVID-19 pandemic response and embed the new ways
of working to improve services for service users and carers.Annual Review 2020/21 25
For all staff, we continued to offer Lateral Flow Testing kits, antibody testing, and towards
the end of 2020, we began our COVID-19 vaccination programme for all staff.
For staff who worked from home during the pandemic, we knew it was crucial to stay
in contact, so they remained feeling part of the Trust, even if they saw very little of their
teams and colleagues in person. We completed a survey for the 1,200 members of staff
who had been working from home since the start of lockdown in March 2020. We
received an amazing 87% response rate which meant we could accurately gauge how
staff felt about their work/life balance. We also learned that many people would like a
50/50 split between homeworking and being site-based, and this provided a valuable basis
to begin work on a Homeworking Deal.
Staff recognition and reward was as important as ever during 2020/21 and even though
Asia Sam many trusts made the decision to postpone their annual awards ceremony, we went ahead
Support Worker with a virtual event hosted by Neil Thwaite, Chief Executive, Chair Rupert Nichols and the
Executive Team. We also included highlights from our GMMH Superstars and celebrated
our teams across the footprint of the Trust for their hard work over the year. Award
winners and highly commended teams or individuals were sent a sweet treats hamper the
week after the awards ceremony.
We were pleased to receive the results of the 2020 NHS Staff Survey in early March 2021.
Alan Hudson The results identified several themes, which showed positive improvements across many
Fire Safety Advisor areas. As our main tool to measure culture, we are always delighted to see improvements,
but recognising that staff completed this survey amid the COVID-19 pandemic we were
happy to see these improvements continued even whilst staff were experiencing new and
Supporting our staff different working environments, whether this be at home or in different wards or teams,
alongside balancing this with the pressures of the pandemic on their home life too.
During 2020/21 supporting our staff during the pandemic was one of our main priorities.
Our HR team provided as many resources as possible including resilience training, Our vibrant staff networks grew from strength to strength during the year. The networks
supporting staff who were juggling working with home-schooling, bereavement and are independent bodies set up by volunteers from GMMH staff to work for the interests of
trauma counselling, as well as signposting to the wide variety of help on offer such as the their members and the wider community they reflect.
Greater Manchester Resilience Hub and the NHS People website.
• Black Asian Minority Ethnic (BAME)
Protecting those staff who were more vulnerable was vital - as we learned more about • Lesbian Gay Bisexual and Trans (LGBT+)
COVID-19 during 2020 and 2021, the disparities of risk and outcome of COVID-19 • Disability network
were so much higher for people of Black and Asian ethnic groups compared to white
British ethnicity. As a Trust we supported colleagues from these backgrounds by carrying As independent bodies, the networks are self-governing, and meet regularly to provide
out thorough risk assessments and adjustments were made to keep our staff as safe as peer support and agree strategies to support the Trust in how we ensure our diverse
possible. communities feel supported.
Under the lockdown guidance, workers who were identified as clinically extremely During 2020/21, Tony Bell, Non-Executive Director, was appointed the role of Wellbeing
vulnerable were supported to work from home by Gold Command to ensure they Guardian for the Trust. As the Wellbeing Guardian, Tony works inclusively to encourage
remained as safe as possible. a model of wellbeing leadership, to increase advocacy and ownership of the mental and
physical wellbeing of all our staff.26 Greater Manchester Mental Health NHS Foundation Trust Annual Review 2020/21 27
Becoming digitally enabled Research and development
As our reliance on technology grew in 2020/21, our IM&T team worked relentlessly The Trust’s vision for research and innovation is to become a leading mental health
to quickly and efficiently provide digital solutions which allowed for vital support and research institution. The Trust’s aim is to improve its understanding, treatment and
therapy to continue via video consultations, as well as staff to continue to meet safely outcomes of mental health problems and wellbeing for its service users, carers and staff
via Microsoft Teams and coordinate our response to the pandemic. The Digital Strategy by ensuring equitable access to opportunities for development and participation in high
2019 – 2022 was already a strong foundation from which we were delivering our digital quality research. The Trust is committed to co-production of research, ensuring that the
aspirations, however COVID-19 led to some of the objectives being accelerated. Thanks to involvement of people with lived experience of mental health difficulties is prioritised. In
their incredible work, over 1000 members of staff continued to work remotely to ensure order to achieve this, the Trust has developed six strategic priority areas for Research &
compliance with lock down, and members of the IM&T supported front line workers in Innovation for the next three years:
ensuring they could keep themselves and their patients safe. Digital technology played
a huge part in enabling patients to stay in touch with family and friends while visits were 1. Make sure our research matters - Ensure our research and innovation activity is
suspended and IM&T provided a vital lifeline to the outside world. relevant to the priorities of communities of the Trust serves, the Trust itself and the
wider NHS
All this happened whilst IM&T maintained and enhanced our clinical record system, clinical
2. Access for everyone - Maximise the opportunities for the communities served to
tools, and prescribing technologies.
engage with research and innovation activity
They strengthened our ORCHA library of tried and tested health and wellbeing apps to 3. Improve outcomes - Inform and improve clinical services by innovation adoption,
include those which could support anyone struggling during the pandemic. Our talented research involvement, dissemination and translation
developers also designed a bespoke GMMH app for staff to record their lateral flow test 4. Sustainable research infrastructure - Maximise financial opportunities and income
results. GMMH was one of the first trusts to do this and we were asked may times to from research and innovation ensuring value for money and sustainability of research
share this by neighbouring organisations. infrastructure
5. Mental health research leader - Assist the Trust in achieving its aim of being a
All our staff worked incredibly hard throughout 2020/21, but special thanks must go to leading organisation for mental health research and innovation
the IM&T team whose remarkable efforts ensured we could continue to offer care and 6. Use research and innovation to close the inequalities gap - Ensure the Trust’s
support in the most unprecedented time the NHS has ever experienced. It is no wonder research includes an emphasis on prevention, wellbeing, inclusion and reduction of
IM&T won Team of the Year in the Annual Staff Awards ceremony in December 2020. stigma, discrimination and inequalities alongside developing treatments for established
mental health problems
Improving our environment
In January 2021, the Trust received Research and innovation successes in 2020/22 included:
planning permission for the
transformation of our adult inpatient • The creation of three new Research Units
unit in North Manchester. This is a £105 • Delivering a number of successful grant applications
million investment to rebuild our adult • Adapting our dementia study portfolio to ensure continued, safe
mental health unit (Park House) on the involvement
North Manchester General Hospital • Successfully delivering the EXPO trial in our substance misuse services
site. Under the plans, our patients and • The launch of the consent to approach the database to further enhance
carers will benefit from a new, purpose- research recruitment opportunities for staff; and the implementation of
built inpatient unit which will greatly Otsuka Health Solutions’ Management and Supervision Tool (MaST) within
improve the quality of specialist care for GMMH to support the evaluation of risk of crisis and complexity to a
adults and older people severely affected sophisticated degree
by mental health problems including • We also launched our new Mental Health Nurse Research Unit (MHNRU)
schizophrenia, psychosis, depression, which supports the development of research skills and knowledge amongst
and dementia. mental health nurses22
28 Greater Manchester Mental Health NHS Foundation Trust
Looking into the future Lead Provider Collaborative
GMMH is proud to be the Lead Provider
GMMH is proud to be transforming the way we deliver for Adult Secure Services for the Greater
Manchester Provider Collaborative
mental health and social care across our communities. Programme from 1 October 2021.
This is in line with NHS England’s self-harm and coexisting substance use. NHS-led Provider Collaboratives offer the
commitment, and national work which This new, exciting phase of mental health opportunity for providers to work together
is ongoing to support new models of care and wellbeing will be codesigned with each other and with service users,
community mental health care. A new and coproduced with staff, service users, patients, commissioners, partners, and
community-based offer will include access carers, key stakeholders and our vibrant local stakeholders. With an identified lead
to psychological therapies, improved Voluntary, Community and Social Enterprise provider who takes on the clinical and
physical healthcare, employment support, colleagues. financial responsibilities, we will all work
personalised and trauma-informed care, together to design and deliver services
medicines management and support for which respond to the needs of the Greater
Manchester population, creatively and
imaginatively.
The Curve
GMMH Trust HQ When it comes to secure services, as
the lead provider, we will work with our
partners Pennine Care NHS Foundation
Trust, Cygnet Healthcare and Elysium As lead provider, GMMH will have greater
Healthcare to improve access and ensure oversight of the whole care pathway and
a smooth transition through the care our improved relationships with providers
pathway. will mean we can set consistent standards
and ensure they are met.
Judy Moser
Physical Health Team Leader In turn this will lead to consistent recovery
outcomes and present opportunities to
embed quality improvement which we
will draw from the expertise from all the
providers within the collaborative.
This collaboration will tackle specific health
inequalities in terms of access and outcomes
and will actively invite, and act on expert by
experience feedback.
GMMH is also a provider partner within two
other provider collaboratives – Child and
Adolescent Mental Health Services led by
Pennine Care NHS FT and the North West
Eating Disorder collaborative led by Cheshire
and Wirral Partnerships NHS FT.30 Greater Manchester Mental Health NHS Foundation Trust Annual Review 2020/21 31
Recovery Plan Workstreams
Service Users and Carers - Gill Green, Director of Nursing and Governance
• Appointed Head of Service User/Carer Engagement and Experience. • Recovery Academy now offering a full programme, both virtual and face to face.
• Dedicated service user lead appointed in addition to carer lead. • A subscription based business plan is being developed to further increase the offer.
• Relaunch of service user and carer feedback process that now provides real time data at both Trust,
Network and individual team level.
Workforce Service Offer - Task and Finish Groups Physical Healthcare/ IPC
Andrew Maloney, Director Deborah Partington, Director of Operations and Gill Green, Director of Nursing and
of HR and Deputy CEO Alice Seabourne, Medical Director Governance
Implementation of the Implement GM Crisis pathways Community Transformation Healthier Patient Pathways • The Physical health Strategy is under
GMMH People Plan review including face to face listening
• Implemented mental health urgent care • New community mental health offer for • Implementation of weeklong ‘Perfect week’
focused on four key events and online surveys for clinical staff
areas, co-located with acute hospital people with SMI – a local core (Living Well) events across all GMMH localities including
committments: feedback.
partners. MRI and Wythenshawe are the mental health team and specialist teams. system partners).
only areas outstanding. Bolton, Salford, • Evaluating new roles such as a dedicated
1. We are safe, physically • Closing the gap between primary care and • Deliver a test of change in Trafford for
North Manchester and Wigan complete. wound care nurse and resuscitation
and mentally healthy and CMHT care – building on the experience of Reason 2 Reside (R2R) guidance across
officer to enhance the service delivery.
safe. • Development of suitable crisis alternatives, the Living Well pilots and the personality GMMH (used in GM acute settings with
i.e. crisis cafes, listening lounges in all disorder workstream. positive outcomes). • Continue to roll out the vaccine
2. We are open, inclusive
GMMH localities and in partnership with programme to both staff and service
and staff have a voice. • Joining up interventions – especially • Agree and Implement Admission,
the VCSE sector. users.
3. New ways of working psychology. Treatment & Discharge Standards.
• Working in partnership with the VCSE • To roll out the flu and covid booster
and delivering care. • Adding capacity from the voluntary and • Consider and implement the findings from
sector, increased the provision of crisis campaign in line with the Joint
4. Recruiting and retaining third sector in terms of both staffing and the ongoing PICU review.
beds with gatekeeping completed by HBT Committee on vaccination and
our staff. interventions available. • Increase the spread and scale of the Safe
enabling 24/7 access. immunisation guidance.
• A system that includes the perspectives of wards programme on all the AOWA wards.
• Strengthening of the 24/7 helpline and • Delivering an enhanced offer of IPC via
both staff and service users. • Use clinically approved and validated
links with NHS 111. Through positive education and training in addition to the
• A reduction in bureaucratic processes – a measurement tools to review ward acuity management of outbreaks.
communications the service is now
new approach to assessment, formulation, and undertake a review of all in-patient
receiving over 25,000 per year. • Responsive to national IPC changes to
care planning and risk assessment and services.
• Engaging digitally with acute partners guidance.
management. • Consider LoS variation between teams/
through the national ‘urgent care by
wards and take local and individual actions.
appointment’ scheme. Pharmacy
• Benchmark A&E practice with similar trusts
and consider any learning. • Ongoing development of EPMA for
• Scoping and planned implementation of a Community Services to support remote
‘future state’ patient flow system. clinics.
• Review the GMMH approach to DTOC • Business case for implementation of
and MOATS, including escalation and electronic prescribing completed and
assurance. supported through national funding.
Team established to deliver programme.
Business Support - Suzanne Robinson, Director of Finance and Liz Calder, Director of Performance and Strategic Development
• Ongoing engagement with the GM system for capacity planning. vaccination programme.
• Improved efficiency gains through digital automation and implementation of Robotic Process Automation (RPA). • New financial governance and reporting systems established.
• Ongoing work with the data warehouse to incorporate data sources. • Finance systems and processes have returned to business as usual.
• Expansion of information available via Tableau including support with capacity planning and the delivery of the32 Greater Manchester Mental Health NHS Foundation Trust Annual Review 2020/21 33
Get involved
Become a member Volunteering
If you have used our services in the We recognise the value volunteering
last five years, or are a member of the adds to the experiences of our service
public who is interested in having a users and their families and carers, and
greater say in how we develop our to volunteers themselves. If you are
services, become a member of GMMH. interested in becoming a volunteer,
please visit our webpage:
Email: membership@gmmh.nhs.uk www.gmmh.nhs.uk/volunteering
Call: 0161 358 1607
Work for us
Our staff are passionate, patient-
focused and committed to working
together to help people to live well.
We employ a diverse workforce that
reflects the communities we work
with and welcome applications from
people who are newly qualified or
more experienced. To find out more
about working for us, and to view our
current vacancies, visit the NHS Jobs
website (www.jobs.nhs.uk) or email
us at recruitment@gmmh.nhs.uk
Mel Russ
Community Team Leader Elizabeth Hampson
Staff NurseGreater Manchester Mental Health NHS Foundation Trust Bury New Road, Prestwich, Manchester M25 3BL Telephone: 0161 773 9121 Website: www.gmmh.nhs.uk This information can be provided in different languages, Braille, large print, interpretations, text only, and audio formats on request, please telephone 0161 358 1644. © Greater Manchester Mental Health NHS Foundation Trust
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