'I will work relentlessly' - New mental health boss sets out to turn around trust 'under pressure and in distress'
Norfolk and Suffolk Foundation Trust
The new boss at the region's failing mental health trust has admitted he hears about the service's disastrous radical redesign "most days" as he set out his plans to turn fortunes around.
Professor Jonathan Warren started in the chief executive role at Norfolk and Suffolk Foundation Trust (NSFT) seven weeks ago, and has spent that time meeting staff and learning about the organisation.
He said: "It's been fantastic, whenever you go to services you meet the most wonderfully dedicated, committed staff, who are delivering great care to patients and that's really important.
"I think particularly in an organisation which feels under pressure and in distress.
"But let's not pretend, we do have some problems, particularly in our core services, and by our core services I mean our core CAMHS [child and adolescent mental health services] - we've got particular problems there - and in our crisis services."
And he said decisions made many years ago, before NSFT was rated inadequate by regulators three times, still haunted the organisation - such as the radical redesign which saw hundreds of mental health jobs axed.
He said: "There are certain events that hang heavy on the organisation. I hear it most days and of course we've got to understand the stress that's caused and be prepared to listen and understand where that distress has come from. But some how we need to move on from it."
Prof Warren said there were five key issues he was looking to take on immediately, such as bringing down the number of people sent out of area for treatment, waiting times, and staffing problems.
Prof Warren said when he started there were 93 people being treated outside of Norfolk and Suffolk due to a lack of beds, but as of yesterday he said this was 46.
"To be clear, that's still 46 too many," he said. "The other issue that sticks out is the culture of the organisation, it's a very centralised culture."
He said this stemmed from the organisation feeling under pressure, and therefore employing too many layers of bureaucracy before a decision could be made.
"Decisions are taken here [in Norwich] that really don't need to be taken here," he said. "At the moment everything is set up that every decision gets taken basically in this office."
He said he wanted to empower staff to make decisions, and address the number of managers the trust had compared to clinical staff.
"I think one of my key jobs and among the most important jobs, is trying to get staff to really believe," he said.
"That's my concern, I stand in front of groups of staff, they say 'I've seen three of you before, what's different?'
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"I can only repeat my commitment to the role. I'm a nurse by background, I started nursing at 18 in an old Victorian asylum in Surrey."
And he said his experience at NSFT's buddy trust, the outstanding-rated East London Foundation Trust (ELFT) meant he knew how to turn the organisation around.
"ELFT was not always the success that we see now," he said. "We got there from really special measures to where it is now, I've done it before."
"I will work relentlessly."
Prof Warren also said he would be fighting for more money for mental health, as it was revealed last month that the east of England had the lowest spend per child for mental health.
He said: "We always want more money and I will fight for money for mental health. In some ways I'm the last person, when I give up the fight the money is lost.
"But there becomes a time when you say we've got what we've got.
"Demand is rising in mental health care. Our biggest problem is in our ADHD where there's been an exponential rise.
And while he said that was positive, as it meant more people were aware of their mental health, it did also present challenges.
When pushed on whether this meant the trust did not have enough cash, Prof Warren said: "Of course I would want more money but some of the restrictions on us can't always be money, it can be access to the right staff."
He said the trust was working to support student staff better as a way to boost numbers.
He said: "I don't think historically we have treated some of our students as well as we can."
And he added: "Our waiting lists are coming down."
But Prof Warren acknowledged one of his biggest challenges was going to be convincing staff, patients, and their families that this time, things would be different.
He said: "The trust has been in, over a short period of four years, the only mental health trust in special measures, and it's been three times - we were only out of it for a very short time.
"There have been a few of me through the door.
"What excites me is making life better. I've seen how mental health affects families and individuals, and I've seen the difference that fantastic services can make, and there's nothing as joyful really than watching that."