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Special review into mental health services - an open letter from Ifti Majid, Chief Executive, Nottinghamshire Healthcare

Today, the Care Quality Commission (CQC) published its report of the special review into our mental healthcare services commissioned by the Health and Social Care Secretary in January 2024, under Section 48 of the Health and Social Care Act 2008.

The review has been conducted under three main parts: 

  • A review of available evidence relating to the care and treatment of Valdo Calocane.
  • A review of the quality and safety of our services. 
  • An assessment of the improvements made at Rampton Hospital.

The report published by the CQC today covers two of these, we expect the review of the care and treatment of Valdo Calocane to be published in the summer. You can read the report on the CQC website.

So, firstly I want to say that we are absolutely committed to providing high quality, effective and safe care to those of you who need it most, and that is why this report makes difficult reading because it is clear that sometimes we have let down patients and their families and for this, we are truly sorry.

External inspections are an important way of helping us learn and make the improvements that are needed.  We didn’t wait for the special review to conclude to begin making improvements to staff and safety and developing much more of a learning culture across our services. 

These improvements have included: 

  • Successful recruitment campaigns have made significant gains in nursing, including recruiting more than 75 nurses and healthcare assistants to work at Rampton since the summer, with 20 more joining us very soon; at Highbury Hospital we have zero healthcare assistant vacancies.
  • Every single one of the people waiting to be seen in our community mental health services has been risk assessed and a crisis plan agreed with them so that they know who to contact if they become more unwell.
  • Therapeutic observations have been a common theme throughout our improvements, and we have now audited more than 1,100 therapeutic observations and these demonstrate that in 97% of instances observations are now working well.
  • Reviewed our crisis line offer in its entirety and secured an upgraded telephony system which will support a reduction in the number of unanswered calls.
  • Deployed more senior nursing leaders into our inpatient services, and strengthening the way that clinical and operational leaders work together across our services.
  • Invested in bed management support with a clinical lead who has oversight of those patients who are being cared for further away to enable them to be cared for closer to home.
  • Implemented daily safety/staffing demand huddles where we review staffing levels, ensuring that senior clinical and operational colleagues have an accurate overview of the demands upon the service.
  • Working with our partners across the Integrated Care System on mental health transformation, including embedding mental health practitioners in Primary Care Networks, expansion of eating disorder services, substance misuse and homeless support, employment support for people with mental health conditions and more.
  • Transitioning at pace to the national Patient Safety Incident Reporting Framework (PSIRF) which is already enabling greater learning and improvement.

I would really like to use this opportunity to say that at any one time we deliver care and treatment to tens of thousands of people and the vast majority of our 10,000 colleagues are providing care in a kind and compassionate way, often in challenging circumstances. Holding on to this, I am committed to improving the quality and safety of our services. We will work relentlessly to ensure all of our patients and their families receive the high quality of care they deserve. 

As we continue with our improvements, I know we can rely on the support of our all our partners across the health and care system, our communities, our patients and their families and carers. We want to make a real difference and I think together we can continue to improve our services, care and safety for everyone who comes into contact with us.

The full report can be found on the CQC website.





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