By Lauren Monaghan, Junior Local Democracy Reporter
An NHS trust has been told it must abandon an “organisational culture of denial” in order to prove it has changed following a catalogue of failings.
The Health and Adult Social Care Scrutiny Committee at City Council met today (September 19) to discuss progress at Nottinghamshire Healthcare Trust (NHT).
The committee heard an update on the trust’s Integrated Improvement Plan, which aims to address the damning findings of an inspection by watchdogs from the Care Quality Commission.
The commission carried out a series of unannounced inspections of NHT’s mental healthcare provision across the second half of 2023, after hearing of serious concerns on care quality and safety.
The inspections also followed the Nottingham attacks carried out by Valdo Calocane, who fatally stabbed students Barnaby Webber and Grace O’Malley-Kumar, and school caretaker Ian Coates, in June 2023.
Calocane had previously been under NHT’s mental health care for two years.
The commission published its reports in January and March this year, with NHT’s overall rating dropping from ‘requires improvement’ to ‘inadequate’.
It found poor access to mental health care, high demand, long waiting lists, lack of inpatient beds and difficulty accessing crisis care.
A fast Secretary of State-commissioned ‘Section 48’ review in January this year saw also saw outcomes of NHT’s services being published in March and August.
From these reports, NHT was placed within Segment 4 of the NHS National Oversight Framework- for NHS Trusts whose very serious and complex problems require intensive support.
The trust’s resulting improvement plan includes five programmes delivered across four phases to ensure it can deliver the right improvements.
NHT’s Chief Executive, Ifti Majid, spoke of the trust’s ‘Safe Now’ approach and visible improvements, including improved crisis team response times and reduced waiting times when accessing local health teams.
Committee Chair, Councillor Georgia Power (Lab), questioned how NHT has shown to Nottingham people that they have understood previous inspections’ findings.
Diana Hull, Chief Nurse at NHT, said: “The lack of defensiveness, the genuineness around the impact of what the lack of improvement has had on the community we serve.
“We are talking to more and more people, not just people who want to tell us a good thing, we are meeting with people where things have gone wrong, really listening and using that information to improve.”
Jan Sensier, Executive Director of Partnerships and Strategy at NHT, said: “This organisation was pretty insular, thinking that we knew best and I think we are [now] much more humble and more open to hearing from our patients, communities and others who offer expertise.”
However some councillors still had reservations about some areas of progress.
Councillor Sajid Mohammed (Lab) said: “I think it’s very important that we get clarification and assurance that you have understood issues of how you got here.”
He added that the “organisational culture of denial” within NHT needs to change to allow openness, complaints, whistle blowing and better communication and proof of that change.
Cllr Power mentioned a lack of proactive NHT acknowledgement of the inspections put out online.
Councillor Maria Joannou (Lab) said: “It’s been failing for a long time, what I’m having difficulty understanding is how managers at the top just didn’t see [failings].
“Councillor Power [previously] read a very powerful list of people that had committed suicide, people that had been let down- what was happening when you were receiving that information, why wasn’t it enacted on?
“It took the tragic [Valdo Calocane] event to feel ‘something is not right here’.”
Mr Majid said that he did not believe trust improvements only started after June 2023, saying: “It’s come about, historically, by not listening to scrutiny, not listening to feedback at the CQC.
“If I look back five years, you can see that things changed in response to feedback but it didn’t change sustainably.”
Councillors frequently pointed out a lack of robust evidence and figures to prove that change had been implemented to improve NHT’s faults.
