APPENDIX 10
Joint memorandum by Mental Health Services
of Salford NHS Trust and Ashworth Hospital Authority (MH 29)
INTRODUCTION
1. Mental Health Services of Salford NHS Trust
(MHSS) is a specialist Trust providing general mental health services
for adults and older people in the City of Salford and a wide
range of specialised and forensic mental health services for the
people of Greater Manchester, the North West of England and a
wider area. Ashworth Hospital Authority (AHA) provides high secure
psychiatric hospital services for catchment population from the
North West, the West Midlands and the north western parts of Greater
London.
POLICY BACKGROUND
2. The Government's strategy paper "Modernising
Mental Health Services: Safe, Sound and Supportive" identifies
the objective of Government policy relating to high secure psychiatric
services as being ". . . . to improve the quality and accessibility
of secure hospital services . . . . to promote better integration
of secure provision and extend the range of clinical provision
. . . Maintaining the highest possible levels of public protection
will remain our top priority" (paras 4.22 and 4.24).
3. Section 41 of the Health Act 1999 enables
the Secretary of State for Health to establish for the first time
NHS trusts responsible for providing high secure services.
4. A great deal of effort and practical
work is currently focusing on the establishment of three new NHS
trusts, including general mental health services, forensic and
medium secure services and the high secure services at Ashworth,
Broadmoor and Rampton. The planning of the organisational change
is being actively taken forward in the North West by the Mental
Health Services of Salford and Ashworth Hospital.
PURPOSE
5. The purpose of this memorandum of evidence
is to describe the ongoing partnership working, designed to improve
services for patients and strengthen the contributions of staff,
that underpins the alliance between MHSS and AHA. This "on
the ground" partnership working is an essential contribution
to the planned organisation change and is a distinctive contribution
to the achievement of the Government's policy aims in the North
West.
EXAMPLES OF
PARTNERSHIP WORKING
6. AHA and MHSS have a history of collaborative
working, that extends over many years. This was formalised in
1998 by the establishment of a "strategic alliance"
focusing on collaborative relationships and partnerships that
would improve services and promote cultural change. The alliance
is producing a number of benefits.
— Better understanding among staff
of the demands and opportunities of working in different services.
— Recognition of some similarities
between different services.
— Cultural change—the modernisation
of attitudes.
7. The following are some examples of partnership
working:
— Women's Services. The appointment
in 1999 of a senior consultant psychiatrist from MHSS to work
part time at Ashworth. The joint funding and establishment of
a post of Women's Service Development Manager to work in both
organisations. Closer links between the Women's Service at Ashworth
and the recently established Women's Unit in the Edenfield Centre
medium secure service at MHSS.
— Staff Exchanges in Services for People
with Severe Mental Illness. Secondments of clinical team leaders
from Ashworth Hospital to the medium secure service and the high
dependency service at MHSS, with a particular focus on referrals
and rehabilitation. Secondment of a senior nurse manager from
MHSS to Ashworth to develop the Ashworth nursing strategy. Secondment
of a senior nurse manager from Ashworth to MHSS, where he is now
working as Clinical Governance Co-ordinator for the Salford Services.
— Training and Education. AHA staff
attend a clinical leadership course provided by MHSS; other AHA
staff act as mentors for other staff on the course. MHSS and Ashworth
have jointly appointed a trainer who has developed and provided
training courses on clinical supervision and team building. Clinical
staff and service managers from Ashworth participate in the "Managing
Health Services" course for which MHSS is an accredited provider.
— Clincal Psychology. AHA staff attend
the monthly psychology service meeting at MHSS. Two Psychology
staff (a consultant clinical psychologist and a cognitive behavioural
therapist) have been seconded from MHSS to AHA.
— Other Clinical Staff and Professions.
A forum for occupational therapists working at Ashworth, MHSS
and the Scott Clinic (the medium secure service serving Merseyside)
has been established. The NHS chaplains from MHSS and Ashworth
meet regularly with colleagues from Manchester and Trafford to
consider how the chaplaincy services for people of all faiths
should best be provided for people with mental health problems.
CONCLUSION
8. These examples demonstrate the good practice
that has been developed in the North West. They are symbolic of,
and contribute to, changes in attitude and culture that are benefiting
services and patients across the whole mental health system. They
complement and underpin organisational change, and play an essential
role in achieving the Government's policy objectives.
9. This work does not come cheap. It takes
a lot of time and effort from all kinds of clinical and managerial
staff. These are staff who are already hard pressed, working in
some of the most challenging conditions in the NHS—in inner
city acute mental health services or in forensic and high secure
services. It is therefore essential, if the Government's policy
objectives for developing mental health services and for integrating
the high secure services more closely into the mainstream of the
NHS are to be successfully achieved, that the Government continues
to fund and increase the funding allocated specifically to this
development work.
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