"Caring for Patients and Staff? Or simply cutting the service to the bones to save money?"

About: Lancashire Care NHS Foundation Trust / Adult mental health

(as a staff member),

As a staff member I wish to share my concern about the future of our Mental Health Services. Particularly those for older people. Also for the way the Trust is treating the staff.

Very soon Ridge Lea will close and some of the service users will move into the Oaklands Unit. This is a Unit originally designed for older service users with organic illness. It was then changed to accomodate older people (those over 65 years) with functional Mental Health problems. Now the Unit is to be altered once more to accomodate people from 18 upwards. The two services will become one. These client groups can have very different needs and the possibility of a serious incident occuring is one of the concerns of staff.

Beds have been greatly reduced the idea being that service users will be looked after in the community. Very often it is the home environment that is making the mental health problems worse. It is my understanding that there are very few people - staff or service users - who feel this is a positive move forward yet still LCT forge ahead with their plans. I believe that staff members are reluctant to voice their opinions for fear of being seen as negative. The result is that we become of culture of 'yes men' - afraid to say what we truly believe.

Inpatient staff will very soon be working 12 hour days. This works well for some people. However for some it is impossible. These people have worked faithfully for 20 or more years. Those who are unable to change their home arrangements are now being encouraged to find another job.

Very caring.

The majority of staff love their jobs and those who are allowed to will continue to give the best care they possibly can despite the struggle to staff the wards to a safe level. Despite the fact, I feel, that no one is listening to us.

I believe that LCT care more about saving money and keeping managers in jobs and less about the well being of service users. Even less about the well being of their staff.

I don't expect this to be published. I would however like somebody with some influence and courage - to do something about it.

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Response from Lancashire Care NHS Foundation Trust

We are sorry to hear about your concerns and understand that this might be an anxious time for you. However, Lancashire PCTs are working collaboratively to agree the optimum bed numbers for Lancashire. Previously we have consulted on our plans to create new inpatient units and more recently on the development of the Oaklands Unit in Lancaster and the closure of Ridge Lea which will retain locally accessible services for adults of all ages. The alternative would be admission to the new inpatient unit being developed at Whyndyke Farm in Blackpool and when we consulted on options last year, this wasn’t supported. Oaklands is a modern, fit for purpose unit with single ensuite rooms and we are committed to investing in it to improve the patient environment. Throughout this process, clinicians have been involved at all stages. Oaklands will have a maximum bed occupancy of 18 which means we can provide an extra care area for people who are more acutely unwell and a designated area for people with complex needs and physical frailty. There will also be a variety of recreational and therapy spaces to meet differing needs. Locally, service users and carers who have been involved in the inpatient reprovision programme, are supportive of investing in fit for purpose units to enable people to only be in hospital when they really need to and be supported by community services. We are concerned if staff feel they cannot speak out and we would encourage staff to do that so the issues can be debated and we can find some common understanding and shared solutions.

In terms of the changes to the shift pattern, following two years of extensive research into shift patterns and working practices, followed by a period of consultation with staff, a new shift pattern has been identified and was implemented on 1 June. The new pattern was suggested by nursing staff from within the Trust and endorsed by staff side. The shifts have long rest periods (90 minutes) built into the working day and only require staff to come into work 14 days out of 28. The new shift pattern is able to accommodate part time staff and requests for flexible working in response to individual needs. Prior to the implementation of the new shift pattern, every member of nursing staff was given the opportunity to have an aspirational interview to raise any issues they have and to express any preferences with regards to their future role and working arrangements.

The introduction of the new shift pattern will support the Trust in making the best use of its resources which is crucial in the current economical climate. More importantly, it has ensured that all wards have optimum staffing levels and a fair spread of support with admin and housekeeping. This will enable clinicians to spend more time with service users and undertaking training to improve the quality of care that is provided.

It is recognised that this change has been significant and every effort has been made to balance individual needs with those of the service. The Trust is grateful for the flexibility and commitment shown by the majority of its nursing staff throughout this change and will continue to support anyone that is having difficulties.

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