To approve as a correct record the minutes of the meeting held on 23 January 2024.

The Chair in moving the minutes noted that the requested information that had been provided by the Trust following the previous meeting and she thanked the officers for providing this. She asked if the RAG rating against actions completed that had been circulated included any discussion as to their impact. She further asked what the approach to those actions was that were deemed to be overdue and was there any further context that could be provided.

The Deputy Chief Executive and Chief People Officer, GMMH stated that this information that had been provided was a summary and he reassured the Group that more detailed information and data tracking sat behind each individual action. He stated that this information was regularly provided to the Board so there was constant oversight of this work, and these actions were constantly reviewed, particularly noting the Chairs comments in relation to safeguarding.

Decision

To approve the minutes of Greater Manchester Mental Health NHS Foundation Trust: Improvement Plan Task and Finish Group meeting held on 23 January 2024 as a correct record.

Report of the Associate Director of Operations, Associate Director of Nursing and Quality and Associate Medical Director Manchester Care Group

This report provides an overview of the progress being made by Workstream 5 – Leadership and Governance.

The Task and Finish Group considered the report and accompanying presentation of the Associate Director of Operations, Associate Director of Nursing and Quality and Associate Medical Director Manchester Care Group that provided an update regarding the progress to date on the Greater Manchester Mental Health NHS Foundation Trust (GMMH) Improvement Programme, with specific reference to Governance and Leadership.

Key points and themes in the report included:

·         Describing the actions taken to improve governance arrangements;

·         Describing the actions taken to improve leadership arrangements;

·         Describing organisational wider improvements, with reference to Manchester specific actions; and

·         Next steps.

Some of the key points that arose from the Task and Finish Group’s discussions were: 

·         Who would sit on the Evidence Review Panels that were being introduced;

·         Commenting that visibility of senior staff was very important as it set the tone of the organisation;

·         Recognising the important role the new Chief Executive would have in setting the correct tone for the whole of the Trust;

·         What was the approach to appointing the new Chief Executive;

·         Had issues relating to senior leadership visibility been identified through the Freedom to Speak Up mechanism;

·         Had any consideration been given to implementing a ‘mystery shopper’ type programme to seek an additional level of assurance that poor practice was eradicated; and

·         How was the patient voice that articulated their experience of care captured.

The Deputy Chief Executive and Chief People Officer, GMMH described that the Evidence Review Panels would assess and test the actions identified, and the panels would be bespoke to the specific issues being considered, adding that these would include service user and staff representatives. He said that the outcomes of these Panels would be recorded and scrutinised by the Board. The Chair commented that information on the outcomes of these Panels should be included in any future update reports to meetings of the Health Scrutiny Committee at the appropriate time.

The Executive Member for Healthy Manchester and Adult Social Care commented that the Shanley report had identified the lack of visibility of the former Chief Executive and Board Chair as a significant issue and had contributed to feelings of lack of empathy. He said that he would encourage the new Chief Executive, once appointed to visit the Community Mental Health Teams and meet with staff. He placed on record his appreciation to the Chief Operating Officer, GMMH for his frank and honest dialogue that he had engaged with him over the previous 18 months, especially around the issue of Community Mental Health Teams.

The Associate Director of Operations, GMMH stated that regular visits were undertaken by senior leaders to meet with services and staff were very open to conversations and felt comfortable to raise issues. The Associate Director of Nursing and Quality, GMMH also commented that leadership visibility on the wards was very important, with regular walkabouts on the wards were now embedded. She also referenced the importance of Matrons on the wards as a visible role model and as a point of contact. She  ...  view the full minutes text for item 6.

The Executive Member for Healthy Manchester and Adult Social Care will provide any relevant oral update to the Task and Finish Group.

The Executive Member for Healthy Manchester and Adult Social Care commented that since the Group had last met the report ‘An Independent Review into the care and treatment provided by Greater Manchester Mental Health NHS Foundation Trust: Published January 2024’ written by Professor Shanley OBE had been published. He commented that the report contained no surprises to himself, adding that he recognised that this was testament to the honest and often blunt conversations that had been held between the Trust and the Council over the previous 18 months. He commented that this detailed report conveyed the complexity of the challenge that the Trust faced.

The Executive Member for Healthy Manchester and Adult Social Care sated that it was important for the Council and local political leaders to rebuild the confidence in the Trust that had been severely undermined following the BBC revelations.

The Executive Member for Healthy Manchester and Adult Social Care informed the Group that in recognition of the ongoing concerns regarding out of area care, the March meeting of the Provider Collaborative Board would be considering this issue with the intention of agreeing a system wide response to this issue.

The Executive Member for Healthy Manchester and Adult Social Care then invited the Executive Director Adult Social Services to address the Group to describe the actions taken by the Council to support GMMH.

The Executive Director Adult Social Services informed the Group that she had been working with colleagues from the Trust to best support them to help protect the most vulnerable people in Manchester. She commented that through these improved working practices the performance data that was routinely provided by the Trust had vastly improved. She commented that the formal and informal governance arrangements to support GMMH had also improved and been strengthened, adding that initially weekly informal meetings had been established and more formally she Chaired the Assurance and Governance Group meetings. She added that it was recognised that there was still a significant amount of work to be done, especially around the issue of demand and risk, noting that the issue of staff retention and recruitment that had been discussed at previous meetings of the Group remained a national issue. She commented that work was underway to review the levels of social workers in Community Mental Health Teams to ensure that the correct resources were allocated. She added that the importance of mental health social workers and the role they played in regard to earl intervention was understood. She stated that a social worker consultant role would be funded to support staff at GMMH, adding that those staff were under significant pressure. She added that consideration was also been given as to how the Control Room could be best used to support GMMH and the Community Mental Health Teams.  She informed the Group that a workshop would be convened in the next few weeks that would bring partners together from across the local health system to specifically consider the prevention agenda.

Decision

To note the  ...  view the full minutes text for item 7.

The Subgroup are invited to formulate and agree recommendations for inclusion in the Task and Finish Group’s final report.

The Members of the Task and Finish Group were invited to formulate and agree recommendations for inclusion in the Task and Finish Group’s final report. Following agreement of the final report, the final report would be submitted to the next meeting of the Health Scrutiny Committee for endorsement by the Committee.

Decision

The Task and Fish Group agree that the following recommendations to be included in the final report.

1.    The Health Scrutiny Committee shall continue to be involved in reviewing the implementation and outcomes of the Greater Manchester Mental Health NHS Foundation Trust: Improvement Plan.

2.    The Group recommend that a meeting of the Health Scrutiny Committee in the new municipal year be dedicated to hearing from a range of different service users and patient groups who would be invited to share their experience of the impact of the Trusts Improvement Plan.

3.    The Health Scrutiny Committee to consider a report that provides an update on the implementation of the Greater Manchester Mental Health NHS Foundation Trust: Improvement Plan in the Autumn of 2024. The new Chief Executive and Board Chair to attend this meeting when scheduled.

4. The Group encourages the incoming Chief Executive Officer to undertake walkarounds and engage with frontline staff, including staff in the Community Mental Health Teams as soon as is practically possible following their appointment.

5. The Group encourages the Trust to undertake a rigorous peer review once the new Chief Executive is appointed.

To review and agree the Subgroup’s terms of reference and work programme and consider any changes or additions that are necessary.

The Task and Finish Group considered the terms of reference and future work programme and were invited to make any amendments. The Group noted that this meeting concluded the work of the Task and Finish Group.

Decision

To note the report.