Letter from Kevin Bond, Director of Mental Health Services
Dear Colleagues
RE : TRANSFORMING COMMUNITY CARE
It is rare for me to write to everyone in this way, but I feel the need to do so as we are at the cusp of needing to make some big decisions about our future. In the last 7 or so years, we have all worked incredibly hard to transform the services available to local people. We have been imaginative and able to get significant investment to improve services. We are now more than twice the size we were and are sited in an array of new buildings/facilities and offering many different types of innovative care. Whilst we are not completely finished, in the time I have been privileged to lead the services I am very proud of the changes we have made and you all should be likewise. I hope the future will allow us to protect the innovative services we have and indeed go on to develop more and wider ones. We cannot however continue as we are as an organisation and will need to make changes to ensure the future continues to be bright in response to government policy for the NHS.
I am writing to you to encourage ongoing conversations about our future as a service and to introduce the website which is now available, for any questions you may have.
As most people will know it has been government policy to separate the provision of services (us) from commissioning (the people who decide what to buy for the local community) for some years now. The recent document Transforming community care has reinforced this and requires as a first stage more thorough separation from commissioning and business readiness in our services. Such changes are taking place all over the country, in fact many areas have formed separate organisations for provision already in response to this.
In a nutshell government policy is for contestability and the development of a market, in which we (the mental health services) will be treated like any other provider of services and the services we run will be open to competition. This will be happening whatever we chose to do about the future. The important thing is that we decide how to respond to this and continue to be high quality and develop so we keep such contracts.
Is this something to be worried about?
No, not if we are high quality, cost effective and well organised to meet the future. This is where the need for more conversation comes in, as we must change to meet this new era. In some possible ways of arranging ourselves this could bring in more innovation, new contracts and greater participation for staff and service users, should we organise ourselves thoughtfully.
What are the choices we have then?
Whilst we cannot remain as we are, as we have to respond to the transforming community care initiatives and we have to be business ready, there are different ways in which we could chose to arrange ourselves and these are explained in more detail on the website which is now available, along with a facility for you to ask any questions and get any answers to these. We could suggest being a local organisation on our own, or with partners (assuming others might want to join us in the future), or be part of a much larger organisation which would of course be less local (again assuming any big trusts might want us as part of their business). Any organisation we set up of course could be designed how we wish it to be, hence the need to set up discussions and communications to get the broadest possible ideas.
Who actually makes the decision on what our organisation will be in the future?
The trust board have the final say, but are keen to understand the thoughts of people following exploring options. The provider board (as things have begun to be separated) has suggested its preferred options to work up a business plan for 3-5 years on. People will be consulted further on this.
What about my NHS pension and conditions of service if we change the type of organisation?
If a new type of organisation were selected Lord Darzi strongly suggested that under a model of an integrated provider organisation staff transferring into it would be able to keep their NHS pension entitlement. We believe this will be the case and would not make any changes that put this at risk. Likewise we would make any arrangements with a view to protecting, or even possibly bettering conditions where suitable. Many organisations who have changed to a new form have maintained all the present conditions. We need the best staff and will do nothing to damage our ability to keep present and get future staff who are passionate about caring for people.
Like many discussions of this kind there appears to be a preferred option. Isn’t this just a done deal?
No, but we do believe that exploring in detail a social enterprise model with the conditions as expressed above may be the most flexible way of protecting the developments we have already made and continuing to create innovative solutions for future care. We also think it may be the best way to seek new opportunities and put staff and service users more in control of the service. Obviously we had to review different models to be able to present something meaningful to you. We also have to draw up a business plan for 3-5 years based on something. We will however ensure continued full discussion to ensure whatever shape or organisational form is best for the future of services.
On a personal level I have made clear that I will ensure that at some point in the new year people (staff and involved service users/carers) get a chance to more formally express their views to me to guide the advice I give personally on the future of the service. Whilst as you know I support examining the possibility for a social enterprise of some sort as I believe it is most likely to produce the best security for the service and innovation continuing, I will as promised only personally continue that path if the majority of staff/service users and carers concur. I must stress again though that the trust board of course has the final decision not I, however having tried to advise on the best approach I will ensure to represent your views.
What about the future then?
We as providers have to separate properly from commissioners. A decision on the direction we (mental health) as an organisation need to take, has to be made by April 2010 to allow us to make all adjustments we need to and be able to act and be treated like any other business and our competitors. We will then have a year to order ourselves in the new format whatever that may be.
What next?
We will ensure using internal meetings, the web site, Hope Street (whom many of you will have met now) and all other means possible that a full discussion/consultation takes place and then present you with a business plan and ideas for your further consultation and discussion.
I encourage everyone to get involved. These are a complex set of issues and can I know sound like ‘blah, blah, blah’, but they are vital to us, if we are to continue progressing towards providing all our services such that we would be happy for our own families to use them should they ever need to.
As ever I am happy to come to teams, chat with individuals and communicate in any way you wish to receive ideas, explain and answer questions and as mentioned the website is available too.
Please, please try to keep an open mind and get involved in helping us shape our future. We all want to get the very best for services.
Regards
Kevin
