Public Board of Directors meeting summaries

This is a short summary of the Board of Directors meeting held in public on 3 June 2025.  Minutes of the meeting will be published on the Trust website. 

Patient story 

This month the Board welcomed Adam and Alyson to talk about health literacy and the need to ensure the information we produce is accessible and relevant to our audiences.  A project focused on how we create easy read materials is underway, to ensure we have consistent approaches to developing letters and patient information that people with a learning disability (and wider literacy/accessibility requirements) can read, understand and remember.  Adam and Alyson will be raising awareness of the project amongst colleagues as it develops, and ask everyone to consider the needs of our patients and communities when creating written information. 

Chair’s update  

Selina Ullah provided an update on her recent visits to Trust services including the Derwent Unit and Crisis and Liaison team and reflected on the great care our teams provide, often whilst under great pressure.  Selina also provided an update on the official opening of Bluebell Ward, which took place in May. 

Selina reflected on the number of changes taking place across the NHS and her participation in conversations across the Joined Up Care Derbyshire system.  She continues to receive regular feedback from Trust governors, including how the changes affecting Trust colleagues are being experienced. 

Recruitment of two new Non-Executive Directors is underway, given the terms of office for Tony Edwards and Geoff Lewins will come to an end later this year.  Selina has recently undertaken appraisals for all Non-Executive Directors and the Chief Executive and new objectives are in place for the coming year. 

Chief Executive’s report 

Vikki Ashton Taylor provided the CEO update in the absence of Mark Powell this month.  The report provided a national update on changes taking place across the NHS, together with new developments, including a best practice suicide safety toolkit. 

The CQC (Care Quality Commission) had recently visited the Trust’s older adult acute inpatient services and shared positive feedback which commended colleagues working in these services.  We now await a formal report from the visit. 

Vikki provided an update on Derbyshire’s NHS Talking Therapies services which will be provided by Vita Health Group from 1 July 2025, with the support of Everyturn, following a new tender process being undertaken.  Vikki thanked all Trust colleagues who have provided an excellent service through the Talking Mental Health Derbyshire team over recent years. 

Integrated performance report 

Many Trust services are meeting or exceeding national performance levels, with dementia diagnosis rates, community mental health contacts and individual placement and support (IPS) figures being given as examples of particularly high performance. 

Challenges continue to be experienced in waiting times to access adult autism spectrum disorder (ASD) assessments, and in reducing the number of out of area placements.  It is anticipated that the opening of the new acute units will support this reduction in the coming months. 

The Trust ended last year with a financial deficit. As a result of bringing the new inpatient facilities into use through the Making Room for Dignity programme (see below), a valuation led to an impairment of £23.8m which was the main driver of a reported out-turn deficit of £25.2m (before adjusting for technical adjustments). A number of required technical adjustments offset this deficit to return the Trust to its adjusted break-even position. From a performance perspective, the Trust delivered a break-even position against a £6.4m deficit plan.   

Our cost improvement plan for 2024/25 was delivered in full, making higher than anticipated savings in some areas including through the reduced use of agency staffing.  We know the current financial year will be challenging as we work to achieve financial balance.  The Trust currently has a £400,000 savings gap to identify from the overall target of £14.7m this year. 

People metrics confirmed improvements in tools to manage staff absence and occupational health processes, with access to fast-track support being available to colleagues who are affected by organisational change.  This week the Trust welcomed colleagues who are joining Derbyshire Healthcare to create an in-house Employee Relations team (moving away from the service being offered through the People Services joint venture).  This change is in order to provide prompt resolution to any ER cases within our services, supporting teams and colleagues when any issues arise through a compassionate approach. 

Quality and safety data shows a decrease in the number of complaints being received about Trust services, and a positive increase in the number of risk assessments and care plans in place.  Use of seclusion has increased, which has coincided with the opening of the Trust’s new services and further focus will be placed on how we better use activities and de-escalation facilities in the new units. 

A new style performance report will be developed ahead of the next Board meeting, to report performance in line with the new NHS Performance Assessment Framework. 

Making Room for Dignity programme update 

An update on the various elements of the Making Room for Dignity programme was shared with the Board, who thanked all colleagues who had been involved in the programme to date. 

• Bluebell Ward – which offers 12 beds for older adults with functional mental health diagnoses, opened in January.  An official opening of the new ward, which is located on the Walton Hospital site in Chesterfield, took place in May.  Positive feedback has been shared by patients, carers and colleagues and the Board noted a recent benefits realisation report which confirmed the new environment had resulted in a reduction in the number of risks registered. 

• Derwent Unit – the new 54 bedded acute inpatient unit opened in March on the Chesterfield Royal Hospital site. 

• Carsington Unit - the new 54 bedded acute inpatient unit opened in May on the Kingsway Hospital site in Derby. 

• Radbourne Unit – refurbishment of the Radbourne Unit on the Royal Derby Hospital site is due to commence shortly.  Two wards supporting male patients will remain at the site although internal moves have taken place to minimise potential disruption to patient facing services. 

• Audrey House (Enhanced Care Unit) and Kingfisher House (Psychiatric Intensive Care Unit or PICU) are in the final stages of completion and will open to patients in the coming months. 

The new units are designed to promote a therapeutic model of care which will promote recovery and reduce people’s length of stay in our services.  The new acute units and PICU will also provide additional capacity to support people within Derbyshire, thereby reducing the number of people being supported out of area. 

NHS homicide review 

The Board received an update on the Trust’s plans to implement learning following the serious incident in Nottingham in June 2023.  Funding has not been identified to create a standalone assertive outreach team and risks are currently being mitigated within the current model of care. 

Other papers shared for information 

The Trust Board also received reports on the following topics, in line with the Board’s Forward Plan: 

• Gender pay gap 

• Medical appraisal and revalidation 

• Learning from deaths 

• SEND annual report 

• Modern slavery statement. 

Board Committee assurance reports 
These were shared following recent meetings of the Mental Health Act Committee, People and Culture Committee, Audit and Risk Committee, Finance and Performance Committee and the Quality and Safeguarding Committee. 

The next meeting of the Board of Directors will take place in public on Tuesday 22 July from 9.30am.  Details will be available on the Trust website ahead of the meeting. 

Patient story

This month the Board welcomed Richard to the meeting, to share his experience of the Trust’s Living Well services in Derby (Derby Wellbeing).  Richard spoke about how the flexibility offered by the service supported his individual needs, building his confidence and understanding of his condition. 

Richard also highlighted the value of receiving advice from people who also had lived experience of mental health conditions and how he would be working with the Trust to support the future training of junior doctors, from an expert by experience perspective.  Richard also spoke about the flexibility of Living Well offering support in non-clinical spaces and the therapeutic benefits of spending time outdoors and focusing on his own fitness.  

Chair’s update

Selina shared details of her engagement activities over recent months, including several service visits to teams which provided detailed insight into Trust services.  She had recently spent time with the Trust’s finance team, adult crisis team and colleagues in the Mental Health Act Office.  Selina reflected on the level of risk managed within our services and the tremendous work our teams do in supporting people in their home environments.  

Selina also spoke about a recent Board Development session that had taken place in a community setting, to explore how we can better engage with local communities and tackle health inequalities.  She also thanked the family of Barry Whitehead for their kind donation to the Trust’s Dementia Rapid Response Team.  Barry’s grandson, Jack, had raised money to donate to the team in his memory, by completing a half marathon.  

Finally, Selina welcomed new members of the Council of Governors, following the elections that took place at the start of the year. 

Chief Executive’s report

Mark confirmed that Bluebell Ward in Chesterfield had opened since the Board last met in public, and that positive feedback about the new environment had been received by people who are receiving support from the team and their carers. The new Derwent and Carsington Units are also due to open in the coming weeks. 

Last month the Integrated Care Board (ICB) confirmed the new provider of Talking Therapy services as Vita Health.  As one of many local providers, the Trust is engaging with the new provider to ensure a safe transfer of the service for both staff and patients.  In the coming weeks the Trust would need to close its waiting list for Talking Therapy services as part of this transition on 1 July 2025. 

Mark’s report also provided a national update including the new planning guidance that had been issued at the end of January.  This outlines ambitions for neighbourhood health models, which build upon the neighbourhood health services already in place across Derbyshire.  Whilst sharing his disappointment about some of the de-prioritisation of national targets for mental health, learning disability and children’s services, Mark confirmed that the Trust’s Strategy and delivery plan outlines local priorities in line with the new planning guidance. 

Integrated performance report 

• The Trust is in line with its financial plan to deliver a £6.4m deficit by the end of 2024/25.  Key risks to achieving this position are being carefully managed and include the number of people receiving care out of area and an increased acuity of patients on our wards, leading to higher than usual observation levels. 

• The Board were pleased to note that occurrences of restrictive practices including restraint and seclusion had reduced in line with teams’ focus on patient safety and environmental improvements.  A focus on supporting people who are clinically ready to be discharged from our services with their wider housing and social care needs was seeing a reduction in the length of time people stay in the Trust’s inpatient wards. 

• Operational performance continues to be strong, with increasing number of people receiving dementia diagnoses, accessing services for children and young people and perinatal support.  Some areas of high demand continue to experience waiting times to access appropriate support. 

• Turnover amongst Trust staff had started to reduce, with a focus on stay surveys as well as exit interviews to understand more about the reasons why people choose to stay or leave their role in the Trust.  Absence rates had slightly increased over the winter months and additional wellbeing support was being provided. 

Strategic Plan 2025-28

The Strategic Plan was approved by the Board of Directors.  This outlines how we will achieve the actions in the new Trust Strategy over the next three years and follows ongoing engagement with colleagues.

Freedom to Speak Up

The half-yearly report to the Trust’s Board of Directors reflects trends in data over the last six months, and steps being taken to support a speaking up culture. Recent data reflected that patient safety concerns remain relatively low, as are concerns reported around bullying and harassment.  Of note, the guardian had experienced an increase in the number of queries being received by Trust staff, with worker safety and wellbeing being an emerging theme.  The Board agreed to triangulate this feedback alongside the results received in the recent staff survey and ensure HR support is in place for any people related issues or concerns. 

Staff Survey

Whilst the national staff survey results remain under embargo, the Trust’s Board of Directors discussed ways to act upon the feedback received through the most recent survey, to make meaningful changes in response to Trust staff. 

Board Committee assurance reports

These were shared following recent meetings of the Mental Health Act Committee, People and Culture Committee, Finance and Performance Committee and the Quality and Safeguarding Committee. 

Wider reports were shared for information/approval including an updated version of the Trust’s Constitution, details of the Joined Up Care Derbyshire Provider Collaborative and the regular learning from deaths report.   

The next meeting of the Board of Directors will take place in public on Tuesday 3 June from 9.30am.  Details will be available on the Trust website ahead of the meeting. 

Summary of the Board of Directors meeting in public, January 2025

This is a short summary of the Board of Directors meeting held in public on 14 January 2025.  Minutes of the meeting will be published on the Board Meetings page on the Trust website. 

Trust Chair, Selina Ullah, opened the first meeting of 2025 sharing how much she is looking forward to the year ahead.  Whilst acknowledging there will be challenges, particularly with restricted funding, Selina shared her optimism about potential opportunities and achievements for the Trust during the coming year.   

Selina welcomed new Non-Executive Director, Andrew Harkness, to his first meeting of the Board of Directors.  Andrew started in post this week and brings a wealth of experience in population health management and health inequalities. 

Staff story

This month’s meeting opened with a focus on our internationally qualified colleagues, working in the Hartington Unit in Chesterfield.  The Board welcomed Faisal, Ansha and Abirami who joined the Trust in 2024 from India and Pakistan. 

The team shared the collective experiences of seven international nurses who started working on the wards at the Hartington Unit last year, discussing learning and recommendations including the value of pastoral support and the suggestion to include a buddy system, together with the need to provide more information on local housing and cultural adaptations.   

Chair’s update

Selina shared details of her engagement activities from November – January, including several service visits to teams which provided detailed insight into Trust services.  She recognised colleagues were passionate about our services and working hard in face of various challenges to deliver high quality care. 

Selina had also visited the teams based at the Radbourne Unit as part of the Trust’s annual Christmas competition.  She reflected on the diversity of people supported by the unit and the positive feedback she received. 

Finally, Selina shared her thanks with governors who would shortly be ending their term of office and stepping down from the Council of Governors. 

Chief Executive’s report 

Mark also shared details of service visits and confirmed he would be meeting colleagues and patients at the new Bluebell Ward later this week. He thanked everyone who had supported the successful opening on the new Bluebell Ward for older adults on 7 January.  He confirmed that wider learning would be used to inform the subsequent moves of our acute inpatient services. 

Mark’s report provided a national update on the ongoing Change NHS engagement ahead of the new 10-year health plan this Spring.  He also shared details of a recent report from the Centre for Mental Health, focused on care beyond beds. 

An update from the East Midlands Alliance was shared with all partner providers.  Mark noted positive development in CAMHS services across the East Midlands supporting a greater number of children and young people in the community. 

Integrated performance report 

• In partnership with East Midlands Ambulance Service (EMAS), a new Derbyshire mental health response vehicle commenced in October and is dispatched to mental health-related incidents between 4pm and midnight, seven days a week. The initiative aims to provide support in the community, reducing the number of people attending A&E for mental health needs.  To date the results are promising: in 2023, 55% of the patients with a mental health need seen by EMAS were conveyed to hospital. In November 2024, following the launch of the mental health response vehicle, this figure had reduced to 12% and the latest data places this between 7-9%. 
   

• The Trust is providing levels of Talking Therapies support that is above locally commissioned activity.  We currently await the outcome of a recent ICB procurement process and will work with future providers to support ongoing service delivery.  The Board noted concerns about local people waiting to access the service, with current waiting lists already high.  The Trust is working hard to discuss management of the forthcoming transition for both patients and colleagues. 

• The number of inappropriate out of area placements remains an ongoing challenge and the Board acknowledged the impact of this on patients and families.  Teams are also proactively managing high lengths of stay, people who are clinically ready for discharge and opportunities wider than admission. The pilot of a new seven day a week community mental health service has also commenced.   

• The Trust’s financial position is on track to deliver the planned deficit.  Training and appraisals compliance has increased and the Trust is part of a national review of statutory and mandatory training.  From a quality perspective, seclusion rates are reducing in our inpatient services, leading to restrictive practice as required. 

• The CQC re-visited the Trust’s acute inpatient units in December.  Following this visit we received positive verbal feedback on the improvements put in place since their visit in spring 2024.  This reflects significant progress at both the Radbourne and Hartington Units, which we expect will be confirmed in a new report shortly.  The Board thanked colleagues involved in making these positive changes across our acute units.  Whilst there is still work to do to embed these changes and continue our improvements, this is really positive news and reflects the progress made by our teams. 

Board Committee assurance reports 

These were shared following recent meetings of the Mental Health Act Committee, People and Culture Committee, Finance and Performance Committee and the Quality and Safeguarding Committee. 

Wider reports were shared for information including the regular learning from deaths report and an update from the Trust’s guardian of safe working.   

The next meeting of the Board of Directors will take place in public on Tuesday 4 March from 9.30am.  Details will be available on the Board Meetings page on the Trust website ahead of the meeting.