Wednesday, October 11, 2006

The "Sidelined" Dec 2004 Day Services Report In Birmingham (Update)

Sue Turner the CEO of the Birmingham & Solihull Mental Health Trust in Birmingham UK promised to do an investigation as from June 2006 into why an important Patient & Public Statutory Involvement Forum Report recommending tracking patient satisfaction after any Day Services were altered in Birmingham had never reached her or the Trust Board in early 2005.

The PPI Forums were set up by Govt in 2003 to be independent monitors of the patient's experience and perspective .

Finally as of yesterday on the 10th Oct 2006 Sue Turner's investigation was issued as below.

There are still a number of important concerns surrounding the Trust's willingness to properly create records of patient satisfaction in order to make available means whereby their experience of changing services can be checked deeply enough and independently as was supposed to be done if the Dec 2004 Reports recommendations had been adopted. The Report does not even appear to have been "adopted" by the Board even though Dr Lynne Jones has reportedly written twice now that the recommendation to track the patients own voice after Day Services are changed are simple good practice .

Investigation into the Tall Trees Report (Author Sue Turner CEO)


The Trust Board approved the strategic direction for day care services in 2004. In line with Government policy on ‘social inclusion’ this set out the Trust’s intention to reorganise existing day care services so that people with mental health problems are better able to enter/re-enter work and are supported to enjoy social participation in mainstream community services. The first stage toward implementing this strategy involved the reconfiguration of services known as ‘Tall Trees’ located on our Uffculme site, Moseley.

Fortnightly consultation meetings were held with service users directly affected by these changes from May 2004 through to September 2004. These consultations were facilitated and chaired by User Voice. Proposals were presented to Birmingham City Council’s Health Overview and Scrutiny Committee, the Trust’s own internal patients’ forum, and a range of other meetings/forums. This was the first major service change proposed by the Trust since the inception of Public and Patient Involvement (PPI) Forums.

In September 2004 I met with members of the PPI Forum and Lynne Jones MP to review the Trust proposals concerning ‘Tall Trees’ services and the consultation processes which had been undertaken. At this meeting it was agreed that ongoing consultation with service users was important, but that these should be auditable. As a result, a parallel stream of work and joint discussions were initiated with the PPI Forum to clarify expectations and intentions concerning:

  • Day-to-day consultation with service users.

  • Ongoing auditable consultations with service users about future priorities and changes.

  • Formal consultation processes for significant service changes and developments.

  • How members of the PPI Forum might join internal Trust meetings overseeing social inclusion strategies.

Led by our Executive Director of Strategic Development, aspects of this parallel work was delayed due to her period of ill health (October 2004 – February 2005).

The reconfiguration of services previously based at Tall Trees has been completed and the Board have received two reports (June 2006 and September 2006) detailing the follow-up audits of service users following this.

Specific Issue

In our Board meeting in June 2006, a member of the PPI Forum questioned why a report produced by the Forum in December 2004 had not been acted upon. That report is shown at attachment 1. I have now completed an audit trail and can confirm the following:

  1. The Forum report was emailed to our Director of Corporate Affairs on 20th January 2005.

  1. This was acknowledged on 21st February 2005.

  1. A fuller response was dispatched 22nd February 2005 by our Executive Director of Strategic Development.

  1. The PPI Forum report specifically recommends a follow-up audit of patients who had been attending Tall Trees centre by early February 2005. More generally that auditable consultation should be undertaken in relation to any other proposals to reconfigure day services.

  1. The written response (22nd February 2005) is shown at attachment 2. It confirms:

    • Follow-up audits in February 2005 would be premature.

    • A Project Board and Service User Advisory Group would be established to oversee implementation and follow up.

    • Representatives of the PPI Forum are invited to join the Project Board

  1. The PPI Forum minutes show that the Forum made reference to “auditable consultation’” at their meetings held in February 05, March 05, April 05, September 05 and February 06. In particular, the minute in September 05 states “auditable consultation – the document was adopted at the Trust Board meeting” (September 05). In February 06 PPI Forum minutes make reference to auditable consultation having been carried out on changes in ‘workability’ services.

  1. I have found only one reference to the actual PPI Forum report itself. This was in February 05 where the minute reads “Also concern at the lack of response to the report on Day Care services. Send the report to Jonathan Shapiro, Chair of the Board”. The Forum support officer has confirmed that this did not happen due to the receipt of the letter from our Executive Director of Strategic Development on 22nd February 05.

Assessment and Conclusions

  • Acknowledgement of the report was tardy, and informal.


  • I have agreed with the Forum Support Officer that hard copies of correspondence will be used in the future, and our Trust Board Secretary/Company Secretary will be routinely copied in.

  • The Forum report was not formally received by any of our formal Board sub-committees.

  • The essence of the Forum report has been acted upon.

Further action:

  • PPI Forum minutes will be routinely forwarded to the Trust and reviewed in our Patient Experience Board sub-committee.

  • The recent appointment to our PPI liaison post should avoid any similar reoccurrence in the future.

  • Should there be any outstanding concerns by PPI Forum members these will be raised when they meet with me on a quarterly basis.

Sue Turner

Chief Executive


An email by way of response has been sent to Sue Turner from Paul Brian Tovey , ex Vice Chair of the PPI , and copied into Dr Lynne Jones M.P, In Selly Oak Birmingham UK. , one of the Joint Chairs of the all party mental health sub committee. Essentially the email expresses the concerns of others succinctly enough and has asked to be put as a question to the Board meeting of 11th Oct 2006 :

"In the light of the CEO's investigation does the Board Intend to adopt the good practice of the Day Services Report (Dec 2004) which asks in essence not for staff audit of the patient's voice but in fact an auditable record of the patient's own voice about their satisfaction or not when services are varied and changed around them at Day Centres in Birmingham ? "

Overnight Dr Lynne Jones M.P. backed this position consistent with her concern too and copied Mr Tovey into her response to Sue Turner CEO to his question to put to the Board on 11th Oct 2006 (See Below )

----- Original Message -----
Cc: P Tovey
Sent: Tuesday, October 10, 2006 9:56 PM
Subject: FW: Question To The Board

Could you please let me have a copy of your reply?


House of Commons

1 comment:

Birdy said...

Hey thanks for the link!
You know, I was reading and this whole time I thought you mean Birmingham, Alabama. Ha!