NHS Adult Community Mental Health User Survey 2023
The national NHS Adult Community Mental Health Service User Survey 2023 has been published and a summary of the results and helpful background and context are below.
The total number of NSFT respondents for each question of the survey varied between 50 and 278.
For NSFT, a summary of the results – where improvement has been made and where further work needs to be done, working with our partner organisations, service users, families and carers is as follows:
Areas of strength – where NSFT performs better than the national average
- NSFT offers better support to service users waiting to access care and treatment from our mental health services compared to other organisations. 65% of NSFT service users surveyed were offered support in 2023 compared a 59% national average.
- 46% of NSFT survey participant received talking therapies in the previous 12 months and a greater proportion of them felt their waiting times were better than the average national response for other organisations. 62% of respondents felt they had an appropriate wait or had no wait at all at NSFT.
- Work has taken place at NSFT, led by our People Participation Team over the past 12 months to raise the profile of the national Friends and Family Test and the importance of capturing people's feedback and experience of care; the result of this effort are demonstrated in the increase of service users being offered the opportunity to leave their feedback, an increase both in data historically at NSFT as well as when compared to the national average. This has resulted in a greater amount of insight to help us make improvements in the future as a result of feedback from service users, families and carers.
Where NSFT needs to make further improvement
- 15% of NSFT service users who took part in the survey were waiting over 6 months for care and treatment compared to a 12% average amongst other organisations.
- 37% of service users felt the wait for care and treatment was too long at NSFT compared to a 34% average amongst other organisations.
- 27% of NSFT service users surveyed said they didn’t get the help they needed from our mental health teams, compared with a 20% average, nationally.
- 60% of NSFT service users have a care plan and of those, only 36% are fully involved in their care plan, deciding together what care and treatment they receive. The national average comparison is an average of 64% and 41%.
- NSFT service users need to be more involved in discussing medication throughout the care pathway.
- When asked whether support provided by NHS Mental Health teams met their needs,17% of NSFT respondents said they felt the support provided fully met their needs compared to 29% nationally and 40% of those responding on care and treatment received from NSFT felt their needs were not met compared to 29% nationally.
Action our Trust is taking to make improvements to achieve better outcomes and experiences for our service users, families and carers
There are four specific areas relating directly to the results from the survey where we are working with service users, families, carers and partner organisations to make improvements. Each area will have an Executive lead, along with a Delivery lead to ensure improvement takes place across our care and clinical teams, as well as support required from other teams across our Trust. These are:
Waiting times for care and treatment
As an organisation, two of our core priorities link to this area; improving health and improving care.
Demand for mental health services remains high across the country but in order to improve the experiences of our service users, families and carers, it is vital we do all we can to improve access and the quality of our clinical services.
Waiting times for our NHS Talking Therapies services, or better known as wellbeing services have reduced significantly over the last six months. Across both Integrated Care Systems in Norfolk and Suffolk, access, waiting times and outcomes all met the national expectations in December 2023. This is the culmination of many months of hard work and collaboration with system partners, as well as a continuous cycle of review and improvement.
There is more work to be done to sustain this, along with traction to ensure other community-based services see improvements in access and waiting times. It is vital that the perceptions and experiences of our service users, families and carers see and feel these improvements too.
Help and support from our mental health teams
Our Trust wide ‘Models of Care’ work programme at NSFT is focussing on reviewing the care and treatment service users receive, standardising treatment pathways and reducing variation.
A number of community transformation programmes are taking place across NSFT which both directly and indirectly influence community mental health services. We will continue to place focus and attention on community mental health services to ensure we collectively, with our service, families and cares, together with our partner organisations improve outcomes and experiences for our local communities.
Improvement in how care plans are developed and implemented
Good practice is emerging in relation to performance monitoring and compliance with care plans in a number of areas across NSFT. West Suffolk in particular has seen improved focus and support for our service users, families and carers with regard to their care plan. Learning and improvement in some of our current care groups and services is being reviewed and will be rolled out across NSFT.
NSFT continues to use and promote the use of Dialogue Plus Care Plans across the Trust which will also help further improve compliance in terms of both numbers and the quality of our care plans.
Medication
Following the previous year’s survey results, our pharmacy department spent six months working collaboratively with GPs to make improvements in this vital area. This work has had a positive impact as the latest survey results demonstrate that the gap against the national average has been almost closed in many areas relating to medication.
However, further improvement is needed in making sure we discuss the side effects of medication with service users, families and carers (NSFT 35%, national average 41%), as well as understanding how our service users are getting on with their medication (NSFT 74%, national average 77%).
Further partnership work is now required with GPs and NSFT staff around communicating with service users about how they are coping with their medications and fully discussing any potential or existing side effects experienced.
Wider organisation transformation, including regional and national support
NSFT continues to work with and be supported by its partners, including NHS Norfolk and Waveney, NHS Suffolk and North East Essex Integrated Care Boards and NHS England on its journey of improvement. This strategic oversight, coupled with the arrival of NSFTs new Chief Executive Officer in November 2023 is supporting our Trusts transformation and improvement programme at pace.
Our CEO is embedding four key priorities across NSFT since her arrival: improving care, improving health, improving culture and improving value.
Improving our culture and the way we do things at NSFT is vital to support long term, sustainable improvement. Our CEO has launched an organisation-wide staff change programme, called Listening into Action, which will make it easier for our clinicians to lead change.
We continue to invest in people participation in our Trust, and we are engaging widely. This is a proven approach which our CEO has adopted widely in previous trusts and has led to fast-paced and widespread change for the benefit of staff, service users and patients. We are confident that this programme will lead to further positive improvements in our culture, as well as improvements in health and care outcomes and experiences for our service users, families and carers.
NSFT has recently appointed an interim Chief Transformation Officer, Dr Sarah Cornick, who is supporting the Trust at all levels to ensure we place more focus on supporting our clinical leadership, as well as redesigning service pathways and processes to result in better outcomes and experiences for our service users, families and carers.
In addition, in response to feedback from our service users, carers, families and working with our partner organisations across both the Norfolk and Waveney and Suffolk and North East Essex Integrated Care Systems, we are transforming the ways in which we provide services, aligning what we do to place based teams across Norfolk and Suffolk.
Through developing a ‘place-based’ future leadership structure, our Trust will be better positioned to harness the benefits of working collaboratively to benefit service users.
Our Future Leadership Structure built around place as well as service line will enable staff to reduce unwarranted clinical variation and deliver consistent, service user-centred care across systems of care. As a specialist mental health provider, it is also likely that our economies of scale will mean more targeted, intensive and longer-term input for people with more complex needs will be provided at this wider community or ‘place’ level.
Building on learning about what works well internally as well as across peer organisations including Sussex Partnership NHS FT, Lancashire and South Cumbria NHS FT and Oxleas NHS Foundation Trust, we are working towards implementing a place-based leadership model. This new way of working, bolstering clinical leadership will support our journey to good and outstanding. The new future leadership structure will be in place and operational by October 2024.