IN DEPTH: Mental health chief on ambitions to transform troubled trust

Stuart Richardson, NSFT chief operating officer. Picture: NSFT

Stuart Richardson, chief executive of Norfolk and Suffolk NHS Foundation Trust - Credit: Archant

The new chief executive of the region's mental health trust has said he is determined to consign its longstanding troubles to the past once and for all.

In a wide-ranging interview with this newspaper, Stuart Richardson, who is approaching the end of his first year in post, outlined his ambitions for the troubled trust - both as a provider of mental health care and as a place of work.

He acknowledged a range of issues the Trust has faced in recent years, from low staff morale to struggles coping with demand for its services, which have torn families apart and caused suffering for vulnerable people in Norfolk and Suffolk.

The former learning disability nurse, who spent three years as the Trust's chief operating officer, said he was desperate to make the Trust capable of delivering the level of care the region sorely needs - and make it a happy, proud place to work again.

He spoke of his disappointment at the recent results of a damning staff survey and revealed plans to sell part of Hellesdon Hospital to help finance its work in the community.

And he said he was confident the Trust could finally put an end to controversial out of area placements - a practice that has blighted it for several years.

Mr Richardson was appointed the Trust's chief executive in July 2021, following the controversial dismissal of predecessor Mason Fitzgerald, after it emerged he had falsified his CV in the application process.

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On staff dissatisfaction

Mr Richardson said he was "deeply troubled" by the Trust's recent NHS staff survey results, which exposed continued unrest among staff members.

More than half of the participants said they would be uncomfortable with their loved ones receiving care from the Trust and three-quarters felt the Trust did not have enough staff for them to do their jobs confidently.

Mr Richardson said: "I was disappointed to see the results and am incredibly worried that so many of our own staff would not recommend our care to their loved ones.

"That is one of the best measures of success we work towards, so it is sad to hear this view expressed - although I understand why staff may feel that way.

"As a Trust, we need to create a more open and honest working environment. We want and need to learn a lot from these staff survey results."

On staffing levels

Mr Richardson said the Trust was making concerted efforts to recruit staff members to help ease the pressure on its existing workforce.

He said since 2018, the total staff force at the Trust had increased from 3,800 workers to around 4,700, but it still needed re-enforcement.

He said: "We added around 900 new staff members in the last year, most of who were clinical but we are also dealing with a national shortage of doctors and mental health nurses - every trust is struggling with that.

"We are looked at what new posts we can add and how we can attract more psychiatrists and peer support workers."

He said a recent recruitment event held by the trust saw the appointments of 15 new support workers and that the Trust was seeing success with overseas appointments too, with 20 international nurses already recruited and a dozen more expected to start in April and June.

On out of area placements

Despite repeated pledges to end the practice over the years, NSFT continues to be forced to send vulnerable people out of area for their care.

Mr Richardson said that currently 12 people are being cared for away from Norfolk and Suffolk, as demand for mental health beds continues to outstrip the local supply.

He said: "Out of area has been a big worry for us and today we have 12 that we are preparing to bring back.

"We did have March 2022 as a target to end this, but NHS England has pushed that target back to March 2023. I am confident that we will be abe able to meet this."

Stuart Richardson, NSFT chief operating officer. Photo: NSFT

Stuart Richardson, NSFT chief operating officer. Photo: NSFT - Credit: NSFT

On working with GPs and primary care

Mr Richardson said one thing the Trust was keen to focus on was making sure people can have intervention as early as possible to drive down referrals to specialist services.

He said a key way this could be achieved was by enjoying mental health practitioners were available in GP surgeries to intervene as soon as people raise their concerns.

He said 25 mental health practitioners had already been deployed, with the Trust looking to add 20 more in this financial year, pledging to invest £5m this year in primary care.

He said: "We trialled this in Breckland during the pandemic and did see a reduction in referrals and prevent people from going on waiting lists.

"I previously worked in a mental health trust in Manchester and that is what we did there and saw good results.

"The idea is that if people are able to access mental health practitioners at their GP, it reduces the likelihood they will reach crisis point and need to be referred.

"This will then allow us to focus more thoroughly on people with serious mental health issues that need the help of our crisis and community teams."

On the impact of the pandemic

Like all areas of health care, Mr Richardson said the pandemic had resulted in more and more pressure being piled on the Trust.

He said that in 2020, the Trust saw a 16pc increase in demands for its community mental health services, with another 21pc increase the following year.

He said: "My view is that there is a generation of people who will be living with the impact of Covid for an incredibly long time and that do not yet fully understand the impact it will have on mental health.

"I feel there will be a very large number of people that have not yet reached out for help and we have to be ready for that.

On the incoming CQC results

The Trust was visited in November by the Care Quality Commission, with inspectors due to publish their findings in the current week.

The regulator has found the Trust to be requiring improvements in each of its last three inspections and in 2018 was put into special measures for the third time, where it remains.

While Mr Richardson expects it to be a few weeks until the Trust learns its latest result, he admitted he knows improvements have to be made.

He said: "I think despite a very difficult year we have continued to see some areas of improvement, but we still have a very long way to go.

"I am proud to work here and proud to be chief executive, but the most important thing is that we have to be able to provide the support in the community people need and we have to become a better place for people to work.

"I am fully aware of problems the Trust has had in the past, so I want to create an environment that is open and honest and where staff feel their are listened to and their concerns are heard. A fresh start."