The following presentation was presented to Members:

(Public Pack)Item 6 - EPUT Presentation Agenda Supplement for Health and Wellbeing Overview and Scrutiny Committee, 12/01/2023 19:00 (thurrock.gov.uk)

The chair thanked Rita Thakaria, Alex Green and Paul Scott for being here this evening and presenting to members.

Councillor Polley thanked officers for the report and referred to Safety First and some of the successes and investments, she referred to the 32% reduction in fixed ligature incidents in 2021/22 and noted that surely the aim would be 100%. Councillor Polley stated there were no figures from previous years to compare this figure against and requested that some further data be provided. Alex Green offered to provide this information outside the meeting and stated that an extension programme of work was in place across all the inpatient environments and being ligature free was difficult in an environment that changed all the time with the focus on the reducing the risk of ligature altogether and therefore the self-harming behaviour. To try and create more therapeutic environments, patient face to face, engaging in conversations and deescalating situations. Within the national benchmarking and in comparison, with other providers they were doing reasonably well.

Councillor Polley also referred to the reduction in the data on prone restraint in the presentation and stated this information should be shared with providers as acute behavioural disorders were not necessarily identified to be as acute as they were. Alex Green stated that a lot of work had been undertaken to reduce the number of primary restraints, stated that “no restraint was a good restraint” and why therapeutic time with patients was so important and agreed to share specific data from performance reports around the different types of restraint.

Councillor Pothecary stated it was important to know that the fixed ligature was within the national benchmarking and questioned whether this was the same for absconsions and primary restraint. Alex Green stated she would need to check specifically but these were monitored month by month, but the data would include a number of different types of absconsions.

Councillor Pothecary then referred to the Channel 4 Dispatches program and questioned whether those people who had been identified in program had been sacked or whether they were still worked within the mental health service. Alex Green stated this was a small number of staff who had now left the organisation.

Councillor Ralph stated he appreciated the report being presented this evening, appreciated the work that was being undertaken and acknowledged the work being undertaken to transform the services but had concerns over the use of the social media by patients which were not giving a true representation of the working being undertaken and questioned whether there were any controls that could be put in place. Paul Scott stated this was a national phenomenon, not unique in Essex, which was quite new as social media had been developed. The approach taken was not to stop them but to try and make sure that person was heard and engaged with. This was a sign that every time sometime someone reached out on social media was because they had not been heard. When those people were heard, action could be taken and then there would be a lesser need to go onto the social media to express themselves.

Councillor Ralph referred to “being on watch” and questioned what measures were being put in place to prevent staff from falling asleep whilst on duty. Members were informed that a safety alert around sleeping had been implemented to prevent this from happening. There was clear guidance for managers, the wellbeing of staff was important, making sure staff were not undertaking observations for too long, focusing on engagement rather than just observation, site buddies would be in place, undertaking spot checks and there were clear guidance and processes in place to manage this.

Councillor Ralph referred to reoccurring visitors and questioned how that was being managed to which Alex Green stated focus would be on shorter lengths of stays, the work being undertaken on Section 117 and the aftercare of people how to prevent the readmission into hospital was important. The focus would be helping patients at the right time, intervention close to home and prevent hospital admissions.

Councillor Fish questioned what the challenges were of staff recruitment to which members were informed there were not enough clinically qualified staff working in mental health across the country. Therefore, were competing within the mental health trust and the private sector. Continually trying to recruit locally and nationally with focus on overseas for recruitment. With the redesign of workforce to draw on other skills from other different professions.

Councillor Polley raised her concern on the Bank Staff who may also work for agencies and questioned whether there was anything in place to try and monitor and control those staff working evening shifts who may have already worked a day shift. Alex Green stated this was difficult to control when relying on agency staff. There were internal controls, such as the health roster to ensure staff took appropriate breaks, program of works was in place to try and reduce number of banking agency staff. The aim would be to make this a great place to work so that agency staff would want to come and work with them.

Councillor Polley also questioned whether improvements being made on the time a patient would remain in hospital or were longer stays being seen, before they would be stepped down. Alex Green stated that improvements had been seen in the lengths of stay which was really good. Herself and the Executive Medical Director met to consult on a weekly basis to specifically look at length of stay and try to reduce those but was very dependent on individual care and treatment plans. Were very close to the national benchmark for lengths of stay but wanted those stays to be personalised so that people were there for the right length of time and to get them home with the right care and support.

Councillor Ralph thanked officers for the presentation and the committee had learnt a lot from this evening’s questions. Members suggested that an update on this item be added to the work programme for the next municipal year.

At 7.45pm, Alex Green and Paul Scott left the meeting.