STARK accounts of staff and patients feeling let down have been put to the chief of a troubled mental health trust.
Tees, Esk, and Wear Valleys NHS Trust has faced calls for a public inquiry after another inspection by the Care Quality Commission (CQC) uncovered more problems last year.
Chief executive Brent Kilmurray defended efforts to turn things around at a Stockton Council meeting this week.
But not before he faced a whistleblower and former employee – as well as accounts from staff and a patient retold by a councillor.
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TEWV was told a “poor culture” was seen on some of its wards after inspectors visited forensic services last summer.
While patients said they were able to provide feedback and suggestions on improvements through ward meetings, CQC inspectors also spotted “interventions which were not always respectful and kind”.
The report went on to find staff did not always feel respected, supported and valued – with workers in forensic services describing a “toxic culture”.
Thornaby councillor Luke Frost lodged a motion last month calling for Stockton leaders to request national leaders launch a public inquiry into the troubled trust.
Cllr Frost read out emails he’d been sent at this week’s adult social care and health select committee after telling trust chiefs he felt “let down by the trust”.
The member for Mandale and Victoria said: “I want to read an email that made me feel emotional and angry at the same time:
“‘The failings I’ve endured as a result of seeking help from TEWV have left me traumatised, chronically suicidal, and a shadow of my former self.
“‘I consider myself alive today not because of TEWV but in spite of them’ – that to me does not read of great leadership, or any journey to change.”
Cllr Frost told the panel he’d also received messages from trust staff.
He added: “Some of them talk about being left alone at night, rapid inductions and asking new members of staff to shadow them without prior knowledge – the response back was thank you for raising your concern, carry on.
“That’s the culture and leadership I see from TEWV.”
‘Journey to change’
TEWV launched its “journey to change” in 2021 – a five year plan to turn itself around.
Mr Kilmurray apologised to those who’d had difficult and bad experiences at the trust.
But he told Cllr Frost they were working to change.
The chief executive said: “This whole piece of work we’re trying to do around our journey to change is to try to get underneath a number of the issues you’ve highlighted.
“We do provide forums for people who have concerns, anonymously or named, to come forward and raise issues.
“We do try, where we can and we have enough information about the issue raised, to address those and signal a way forward.”
The trust boss added there were “pockets in the organisation” which had issues but said they were working on it – pointing to a “big piece of work” in forensic services launched this week.
Mr Kilmurray said: “The real clear golden thread through our plan is around culture and addressing some of those issues – that’s something which was identified at the very beginning of this journey.
“That’s a big piece of work to get through and it’s going to take us a little time, I’m afraid, to do.
“The leadership work we’re doing is a really massive start.”
He added it was complex and a “work in progress” but believed they were taking “significant steps forward”.
Facing the whistleblower
Mr Kilmurray took the top job at the trust in summer 2020 in the wake of troubles at West Lane Hospital – now Acklam Road.
Last year, the chief executive said there was a lot of work still to do in the wake of the latest CQC verdict – with staffing pressures a “common issue” and absences at an all time high.
Cllr Ray Godwin revealed he had “blown the whistle” at the trust at a council meeting last month after almost three decades at the organisation.
He told the committee they’d been continually reassured TEWV was making progress – but he simply didn’t believe it was.
Cllr Godwin said: “The friends and family surveys in forensic services have deteriorated – your staff retention and sickness are as high as they’ve ever been.
“The (forensic) service has deteriorated from good to inadequate.
“I was employed in forensic services for 28 years – 26 happy years and two years where I raised concerns to the board at all levels, both as a governor and as a member of staff.
“I also raised concerns as a councillor, I’ve raised concerns to the CQC and the end result was, in my personal experience, that TEWV didn’t address any of it – and that’s clearly evident in the CQC report.”
Chess pieces
Cllr Godwin also claimed there’d been “no consequence at all” for senior leaders at the trust in the wake of its troubles.
He accused the trust of “moving chess pieces” when it came to a management shake-up – and criticised the board for being “unable to hold the executive directors to account” for problems.
Cllr Godwin added: “How are you going to assure us things are going to change? “We’ve had three years – and 19 months under your reign Brent – without change.
“On a personal level, none of my concerns made any difference because we’re sat here today – which proves they were not acted on, listened to, or were able to be turned around.”
Trust chiefs disagreed with Cllr Godwin’s views.
Mr Kilmurray said there had been “significant change” since he took up the chief executive post – saying they were “on a journey” with complex issues to face.
He added: “I’m not going to comment on accountability conversations, or issues on individuals, but one thing highlighted was there has been significant turnover and change in the senior leadership and in the organisation.”
The chief executive also said they were increasing the clinical leadership at the trust.
“We’re changing the shape of the leadership team, we’re changing the emphasis and the conversations in those leadership teams which will drive that change.
He added: “We’ve got a good plan – we’ve got momentum now. We will see that change.”
Turning round an oil tanker
Trust board chairman Paul Murphy didn’t agree with Cllr Godwin’s “chess pieces” analogy.
He added: “We have, in the months since Brent arrived, changed the medical director, the HR director, the finance director, corporate affairs and had four non-executive directors coming from outside.
“So this feels like a fresh team. It’s not the same team that it was.”
Families and campaigners called for an inquiry into the trust last year after a string of deaths.
Mr Murphy told the committee there was an “almost complete turnaround” in the TEWV board – with the panel hearing how attitudes had changed.
He added: “It’s not the same atmosphere on the board because the events of West Lane and the CQC have shaken us and made us refresh the way in which we do our business.”
The board leader also stressed it wasn’t the “same old, same old”.
Mr Murphy added: “The whole tone has changed – I think there is an air of humility about TEWV these days.
“We recognise we haven’t got it right quite a lot of the time and we need to do more listening.
“And really listening – active listening.
“Not just pretend listening, but really listening to what people are saying to us.
“That includes families, carers and patients.
“But like Brent says, it doesn’t change overnight.
“It is an oil tanker.”
‘Our feet are to the flames’
The CQC rated forensic services inadequate in their latest report – with the whole trust still judged as “requiring improvement”.
Despite the answers, Cllr Godwin did not believe senior leaders had been accountable at TEWV for its problems.
He added: “None of these people have lost their jobs, been disciplined or held up in public for their failings – what about accountability?
“Are we going to have any accountability within TEWV, or are we just moving on?”
Mr Kilmurray declined to comment on individuals – but added TEWV was “significantly held to account” by its regulators, the CQC, NHS England through its accountability regimes.
“Our feet are to the flames,” he added.
“We’ve got no doubt we’re being held to account for our actions here and people within the system want to see us make progress.
“To go back to Cllr Frost’s comments – and the emails he’s received.
“That’s my accountability really – to those people to make sure we can change to make things better.”
Culture concerns
Cllr Frost then read out another letter from a member of staff who “feared the trust’s whistleblowing policy”.
He added: “I recently read Brent Kilmurray’s latest blog with growing despair. Myself and my colleagues have worked tirelessly throughout covid.
“We often have such poor staffing that we’re unable to take breaks or complete optimum patient care tasks.
“These environments are often so busy that we’re unable to take adequate PPE breaks, remaining in masks and gear for eight, ten or 12 hours at a time.
“It’s amazing they feel they can come to a ward member with stuff like this, but not to any leadership within TEWV for fear of it being spread as whistleblowing.
“We talk about culture in the organisation – I think this is something that I feel has to be looked at.”
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Mr Kilmurray didn’t disagree – but added they had processes in place and people did raise issues.
The chief executive said: “We’re not saying it’s endemic or massive, but people will come forward with a complaint.
“I won’t get into the specifics but people within the organisation have many different routes which they can use to actually raise their concerns via Freedom to Speak Up, or directly to the CQC which I know people do from time to time.
“I’m sorry that member of staff doesn’t feel able to use those routes which are anonymous – but we’re doing our best to reinforce them.
“We want to create an environment where people do feel free to raise those through management so they’re heard and we act on those concerns.”
TEWV bosses will appear before the Tees Valley joint health scrutiny committee next month which will decide whether it wants to write to the Secretary of State and back a public inquiry.
Councillors on Stockton’s health select committee will then decide their own stance on the inquiry calls.
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