Southern Health NHS Foundation

Introduction

To many members of the public, it is a mystery as to what the various public organizations actually do.  Government is in the process of devolving a number of these public bodies down to local authorities.  Since April 2013, public health has been one of these areas.  Hampshire County Council have combined the new responsibility for public health with Adult Social Care and called the new scrutiny committee, the Health and Adult Social Care Select Committee (HASC)

It is not until an item appears on the Health and Adult Social Care Select Committee agenda where the operations of a particular body are being publicly scrutinized that some light may be shed on their function.   One such body is The Southern Health NHS Foundation Trust, which was created in the early years of the 2010 parliament.  Its function is described on its website as;-

About the Trust

We provide community health, specialist mental health and learning disability services for people across the south of England.  we’re one of the largest providers of these types of service in the UK.

We employ around 9,000 staff who work from over 200 sites, including community hospitals, health centres, inpatient units and social care services  (Covering regions such as Wiltshire, Dorset, Hampshire, Oxfordshire and Buckinghamshire).

We might be large, but our service users and patients are still at the centre of everything we do. Being person centred is one of our six Trust values. Our aim – to provide high quality, safe services, which improve the health, wellbeing and independence of our patients and service users.

Our services include:

  • Mental health services
  • Community services
  • Learning disabilities services
  • Social care

Involving local people

Southern Health is also a Foundation Trust. This means that local people have greater involvement in the way we develop and run our services. It also gives us more flexibility in the way we can manage and invest our finances, allowing us to be more responsive to the needs of local communities.

Mazars Report Reviewing Deaths Of People With A Learning Disability Or Mental Health Problem In Contact With Southern Health NHS Foundation Trust April 2011 To March 2015

The Southern Health NHS FT has come under criticism following the death of a service user in its care, Connor Sparrowhawk.  A jury inquest ruled that Connor’s death was contributed to by neglect.  Detail covered by the BBC in a report in 2013 as well as many other forms of media.  As a result an independent review was commissioned by a group called Mazars and on 9 February that report was the subject of scrutiny by members of Hampshire County Council’s HASC.  Item 6 – Mazars Report Reviewing Deaths Of People With A Learning Disability Or Mental Health Problem In Contact With Southern Health NHS Foundation Trust April 2011 To March 2015.  A copy of the Mazars final report can be found by clicking the previous link.  Reading through it you will see that it runs to 254 pages in very technical NHS prose with the use of frequent acronyms, not making for easy reading by I would suggest even for health professionals never mind the public or indeed HASC scrutiny committee members.

One would think that the most important part of the report would be the recommendations, of which there 23 directed at the Southern Health Trust NHS FT, 7 to the Clinical Commissioning Groups in the area and 9 national recommendations.  The overview of those recommendations starting on page 37 and continuing to page 44 are as follows;-

Trust Recommendations:

The 23 recommendations were grouped in the following categories;-

  • Board Leadership and Oversight
  • Monitoring mortality and unexpected deaths / attrition
  • Thematic reviews
  • Reporting and identifying deaths
  • Quality of investigation reporting
  • Timeliness of investigations
  • Involvement of families
  • Multi-agency working
  • Deaths in detention and inpatient deaths
  • Information management

The were 9 recommendations directed towards the Commissioners and 7 National recommendations (with basis for recommendation where relevant).  The response from Southern Health Trust (Shown in appendix 2) is not cross referenced and in my view does nothing more than say sorry for the trust’s failings, rather than use this as an opportunity to learn from mistakes, but more importantly demonstrate to the public that these failings will not happen again.

Hampshire County Council Health & Adult Social Care Select Committee (HASC)

It has been a very positive action by the coalition Government of 2010 to 2015 to devolve much of its public health responsibilities to local authorities and allow local councillors to scrutinize the functions of the numerous Health bodies.  It was for this reason that a special HASC meeting was convened on 9 February 2016 to ask questions of The Southern Health NHS Foundation Trust on the background to Connor Sparrowhawk’s death and whether other deaths during the period April 2011 to March 2015 could have been prevented.  During the questioning of the Health representatives, Katrina Percy, Chief Executive Officer, Dr Chris Gordon, Chief Operating Officer and Dr Lesley Stevens all of of Southern Health NHS FT and Dominic Hardy, Director of Clinical Operations – NHS England (Wessex), the word transparency was frequently used, but as you will see by reading the Mazars report and then reading the agencies’ responses, the technical language used makes the whole exercise anything but transparent.

The scrutiny meeting, as most council meetings was a meeting held in public and not a public meeting.  Meaning that the public can attend and listen to proceedings, but cannot speak unless they have previously asked to do so.  It was under this protocol that two governors of the Southern Health NHS FT presented themselves at the beginning of the meeting.  Protocol permits them to speak for 10 minutes (any excess time at the discretion of the Chairman).  The panel is made up proportionately of elected County Council members plus representatives from the District Councils,  This proportionality means that the Chairman and the Vice-Chairman are from the ruling Partly, namely Conservatives.  John Green, one of the two governors spoke disparagingly of the way the Foundation Trust operates.  At the 10 minute mark he indicated that he was on his last page from which he was giving his deputation when the Chairman refused to allow him a few more minutes to complete his very disturbing version of past events.  A shame, because it would have benefited the panel to hear what John Green had to say in its entirety.  It is my hope that when the Minutes are published that we do eventually get to hear his story.  Nevertheless John Green has had comments regarding the Foundation Trust printed in the Daily Echo.

Without the comments of John Green, one would wonder why Monitor, the Foundation Trust Board of Governors who act as an oversight board (much in the same way that School Governors act for schools) did not know what was happening during the five years covered by the Mazars report, nor indeed the Care Quality Commission.  However, John Green points out that the Governors are powerless to be that critical friend to the Foundation Trust and that unbelievably the Chairman of the Board of Governors is also the Chairman of the Foundation Trust.  An obvious conflict of interests and not the basis for proper governance.

One of the recommendations was that the Southern Health NHS FT be invited back in six months to give an update on how many of the recommendations they have been able to action.