“Boss talks about working in ‘challenging environments”

Mental Health and Social Care Trust boss talks about working in ‘challenging environments’

Paul Taylor (Manchester Evening News)

June 16, 2011

When the tragic case of Peter Thompson hit the headlines last week, Jackie Daniel had already spent more than a year grappling with the implications of a death which was, as a coroner said, “wholly preventable”.

A voluntary in-patient with alcohol and drug problems, 41-year-old Mr Thompson was refused entry to a ward at Edale House mental health unit in Manchester because he would not surrender a bottle of vodka. He fell asleep in the corridor at around 8.10pm and ten hours later was found to be cold and unresponsive.

The inquest heard he died from a combination of alcohol and anti-psychotic medication, but would have lived had he been taken to accident and emergency during the night. Recording a verdict of “death by misadventure contributed to by neglect”, coroner Nigel Meadows said he would write to Manchester Mental Health and Social Care Trust laying out recommendations.

As chief executive of that trust, Daniel had already thought long and hard about what went wrong in the hours leading up to Thompson’s death in April 2010.
“It was tragic,” she says. “No-one watching the CCTV footage can fail to have been moved by what they saw.

“The vast majority of our staff are excellent and whilst the outcome of the organisation’s internal disciplinary procedures are a confidential matter, two staff members involved in Mr Thompson’s care no longer work for the trust and have been referred to the Nursing and Midwifery Council.”

Daniel says the trust has managed to stay in touch with Thompson’s family throughout the process and has “apologised profusely” for what happened.

“We let them down. We let Peter down,” she says. “Last week, when there was a lot of media interest and publicity about it, staff were stopping me as I was walking round in the organisation saying we feel almost ashamed on behalf of those nurses. They feel a sense of responsibility. It’s interesting that the whole organisation felt that sense that we’d not  met the standard of care. We’d failed in our duty of care.”

There has been an action plan, reviewing staff training as to how to deal with people under the influence of drink and drugs, and Daniel has done a lot of talking to staff about their feelings about the incident and what flowed from it.

This one catastrophic failure was a setback in the midst of much progress by a trust which, before Daniel’s arrival three years ago, had collected a crop of bad headlines.

There were months of industrial action after the dismissal in 2007 of senior nurse Karen Reissmann, who had spoken out about cuts and privatisation. It was ranked as one of the worst-performing mental health services in the country before chief executive Sheila Foley quit in 2008 following an independent report which concluded that there had already been too many changes of leadership.

By October 2008 – by which time Daniel had been in place only a few weeks – the NHS Commission had “serious concerns” about Manchester’s “weak” mental health services. She says now that lack of continuity in management meant the trust had not worked properly right from its inception in 2002.

“I’ve worked in a number of failing organisations and done some interesting turnarounds,” she says. “It was not difficult to see why it was where it was.”

After three years of stable leadership, the latest Care Quality Commission rating for the trust’s services is “good”. A more recent unannounced inspection was “very positive”, says Daniel.

But catering to the mental health of a city with unemployment, huge drink and drug abuse problems, chronic physical ill health, deprivation and crime remains a huge task.

“This is one of the most challenging environments I have worked in,” says Yorkshire-born Daniel, who came into the health service as a nurse, then ward sister before moving into management. “It’s not just the issues I came to tackle three years ago, it’s the field of mental health which is challenging, the amount of stigma and discrimination, lack of understanding and awareness, and the fact that it affects one in four of us at any one time.”

Manchester Mental Health  and Social Care Trust has 2,000 staff, three inpatient units with a total of 230 beds, 13 community mental health teams and various other dedicated teams, including one dealing with inmates of HMP Manchester. The trust must find savings of five per cent every year for the next five years, something which Daniel does not seem daunted by.

What is perhaps more daunting is the task of ensuring that mentally ill people are served well by all the various statutory agencies with which they come in contact.

In common with Chief Constable of Greater Manchester Peter Fahy and governor of HMP Manchester Richard Vince, Daniel voices an aspiration for connectedness between various services – what politicians might call a “joined-up” approach.

“Some of these people are touching all of the services,” she says, citing the example of patients with mental illness who may end up homeless, unemployed, in and out of hospital and even prison, thereby coming across the radar of a host of government agencies.

“Instead of putting our hands up and saying ‘Over to you’ and asking someone else to carry the burden, we have got to look at how we are doing across the piece in Manchester.”

Copy of Paul Taylor Manchester Evening News

See at the Manchester Evenings News Website

http://menmedia.co.uk/manchestereveningnews/life_and_style/s/1423878_mental-health-and-social-care-trust-boss-talks-about-working-in-challenging-environments that show the Hauntingly cctv footage of Peter Thompsom’s  last precious moments on earth before being left  dead on the hospital floor for ten hours.  Manchester coroner Nigel Meadows told the inquest: “It seems to me undeniable that the jury came to a conclusion the death was wholly preventable. I concur with that.” :-           http://menmedia.co.uk/manchestereveningnews/news/s/1423001_coroner-slams-hospital-over-patient-who-died-after-being-left-lying-on-floor-for-10-hours