'Fit for the Future' is a robust programme of organisational change which responds to the concerns identified in the 'Review of governance and management arrangements at Avon and Wiltshire Mental Health partnership NHS Trust on behalf of NHS South of England'.
'Fit for the Future' addresses the recommendations of this report, published (26 July 2012) and sets out our future direction.
Following publication of investigation reports into the care given to two unrelated service users of the Trust who were involved in homicides, the Board of NHS South of England requested a review in order to be assured that corporate and clinical governance arrangements, clinical leadership and wider stakeholder engagement were robust and patient safety assured.
The review concluded that the Trust culture was "centralist, top down and target-driven, bureaucratic and controlling" with a "dominating emphasis on targets many of which were of questionable clinical validity". It states: "there is an urgent need to change the culture and leadership from one of central control to one in which all staff are positively engaged and involved in determining and delivering safe, high quality care".
The AWP Board accepted the report, which was written in January 2012. Since its completion, the Trust's former chair has resigned and the Trust's former chief executive has retired. The Trust now has a new chairman, Mr Tony Gallagher, and has begun the process of recruiting a new chief executive.
Fit for the Future is a programme of organisational change which sets out how the Trust will improve to better meet the needs of patients. It includes a commitment to strengthening the involvement of clinicians in management decision making and as a first step in doing this the Trust's professional council is being strengthened to help provide a stronger clinical voice.
The programme also sets out actions to:
- Decentralise management and increase local service accountability
- Establish a clinical engagement strategy which covers quality and safety
- Improve service user and carer involvement in strategic business units
- Improve staff engagement and morale
- Increase Board scrutiny, including recruitment of a clinician as a non-executive director
- Restructure executive functions to ensure effectiveness
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The new chairman, Mr Tony Gallagher said, "There are some very important lessons here and I am determined that we will create a new, less centralised leadership model that is strongly informed by the needs of our local communities and our service commissioners. We will put service users and carers at the heart of everything we do. Our overarching objective will be to radically improve outcomes for service users and to improve our staff's ability to make a real difference."