Meeting Tim Smart, interim chair of Southern Health NHS Trust.
Today we had a follow up to our meeting with Mike Petter, to talk more about how Southern Health NHS Trust can make things better for people with learning disabilities who need to use their services.
In the room was:
- Tim Smart, interim chair of Southern Health NHS Foundation Trust (since 5 May).
- Jackie Scarrott, co-chair of Trustees at My Life My Choice.
- Shaun Picken, vice chair of Trustees at My Life My Choice.
- Michael Edwards, My Life My Choice founder and trustee. Also known as The Godfather.
- Kate Evans, Campaigns and Communications Coordinator at My Life My Choice (there to take these notes)
- Sara Ryan, Connor’s mum.
- Jason Warner, Lead Nurse for the Learning Disability Team in Oxford, Experience and Engagement Lead (employee of Southern Health).
Tim started by explaining his background and why he is interim Chair.
He said: I retired from my job as Chief Executive of King’s College Hospital NHS Foundation Trust in spring 2015. I said that I would only come back to the NHS if I could help with mental health provision. When I saw Tom and Sara Ryan on the news at the Southern Health Board meeting in January, I cried. I got in touch with NHS Improvement to ask them how I could help. When Mike Petter resigned, they made me interim Chair. I am only interim Chair because I have not been appointed by the Council of Governors. They will eventually appoint somebody to be Chair.
One of the first things I did as Chair was to postpone an extra-ordinary meeting of Governors, which wasn’t a popular decision. I did it because it going ahead would have caused legal action to be taken by the people mentioned in the resolutions. That would have wasted time and money.
Some of the Governors went ahead anyway.
Shaun: We were at that meeting. I found that the Governors were interested in talking to families but not to people who have a learning disability.
We explained to Tim that we had some pre-planned questions to ask him.
Shaun: What is your direct experience of working with people who have a learning disability?
Tim: I’m not a nurse or a doctor. I came to work in the NHS as a Chief Executive of a hospital after 30 years at Shell and at BT. So I have no clinical experience.
As equalities champion at BT I found opportunities for people with autism. But I wouldn’t pretend this was extensive experience.
When I was at King’s, my colleague Jonathan Michael wrote Healthcare for All. After this I met people with learning disabilities at King’s. I remember 2 things. One was a woman who told me that the most difficult thing for people with learning disabilities is that GP appointments are only 10 minutes long, and she needed much longer to talk about what was wrong. The other was a man who wanted to be involved in clinical trials.
But I don’t have any direct clinical experience.
Shaun: I like your honesty.
Tim: I’m very honest and I’m very straightforward. It gets me into trouble sometimes. I’ll always listen and I will put patients and service users first.
Jackie: How do you plan to engage with people with learning disabilities and their families?
Tim: I hope this meeting is the start of it. I welcome input from all quarters. I know this could cause me to become overwhelmed, but I do mean it.
I want to make sure that I’m meeting with groups of people with learning disabilities, families, mental health patients and survivors. I don’t have a fixed idea of how I can do this, but am open to suggestions.
Jason: Have a think about this. It’s my job to support Tim in this. I meet with groups of people with learning disabilities who have had support from Southern Health, and they give me feedback about the services. My team will tell Tim what people say.
Tim: Nothing can compensate for face to face meetings, listening to each other and hearing each other.
The other week I went to Evenlode, which is a medium secure facility for people with learning disabilities. It’s a very challenging environment. Patients are usually there for 3 to 5 years and are part of the criminal justice system. Talking to you and talking to those young men is very different. The spectrum of people with learning disabilities is huge. I’m not sure how we could come to engage with this huge spectrum.
Jason: There is a group that I’m helping at Evenlode. You should come to the meetings. There has been a problem with how senior members of Southern Health engage with this.
Tim: I had never seen staff under as much stress as they were at Evenlode. They told me 2 things. They feel isolated. They also said that things had improved in the last 3 months since a particular staff member had left.
Sara: CQC has found problems with Evenlode after the last 3 years. This isn’t acceptable – that staff and patients endured 3 years of misery before things started to improve.
Shaun: Is the Slade House site in Oxford going to be sold and if so where is the money going? Mike Petter told us that any money from the sale would be used to improve learning disability services in Oxfordshire.
In the plan we have for this year, there are no plans to sell the building.
I give you my assurance that when the board does discuss what to do with it, it will be done in public.
Shaun: But will the money be kept in Oxfordshire?
Tim: We have no plans for that building.
Sara: What happens if someone else in Chair?
Tim: It’ll be up to them.
Sara: So that means nothing.
Tim: It means as much as what Mike Petter said.
The board will discuss this matter in public.
Shaun: What is your vision for health services for people who have a learning disability in Oxfordshire as we make the transition away from Southern Health?
Tim: I am going to see Oxford Health at 3pm and this will be an important topic for our meeting. I can report back after this.
My view is what the NHS needs to enable is people with learning disabilities to fulfil the potential they want to fulfil.
Shaun: The problem I have is that we keep getting empty promises. I have epilepsy. If I get put in Southern Health I could have a fit and die and it will all be for nothing.
Tim: I have been assured that the transition of services to Oxford Health will be complete in October. I will hold people to that.
For the record, I want to give me unreserved personal apology for the failings of care that have affected Dr. Ryan’s family. Situations like those that happened to Connor, in my experience of big acute hospitals they are called “never events”. They should never happen. When one does, it is always discussed by the Board of Directors. I need to understand why it never happened.
Sara: I can tell you why it didn’t. It’s because they didn’t give a shit.
Jason: The Learning Disability Team might be being broken up. So we need to talk about how the rest of the NHS can include people. It’s important that we keep telling Commissioners what needs to happened to include people.
Tim: I want to say something in response to Sara. Number 1: I don’t do social media. Number 2: I do give a shit. This is why I’m here.
Jason: I think you’re in a room where everyone gives a shit.
Shaun: Tim, I respect that you gave an apology to Sara.
Tim: We need to remember… I need to remember that we are all human.
I have a 26 year old. I don’t know what I would have done if it were him.
Sara: Southern Health have put us through absolute hell for 3 years.
Jason: We going to create change that means something.
Shaun: Mike Petter said that he would try and get some funding for our charity to train GPs in carrying out health checks. We have heard nothing since we last met with Mike. Can you help us?
Jason: Good pitch! I can give some context here… A few years ago I worked with My Life My Choice to go around GP surgeries and give everyone (doctors, nurses, receptionists) training about treating people with a learning disability. It really worked and the number of health checks in Oxfordshire went up. But now there is no money to do this work, and the number of health checks is going down. Mike Petter was looking into getting money from the Charitable Trust.
Tim: I’ll have to take this away and look into it. Please email me the details.
Jason: We shouldn’t really need extra money to do this. It should already happen.
Tim: There are 2 things working against us. One is the £2 billion deficit in the NHS. The other is parity of esteem.
Shaun: What is that?
Tim: The health service doesn’t regard mental health and learning disabilities as equal to physical health.
Jason: You also need to be careful not to put mental health and learning disabilities together because they are not the same thing.
Tim: I’m learning that.
Jackie: Could you please explain why Katrina Percy is still the Chief Executive of Southern Health?
Tim: Well there’s a straightforward answer to that question. It’s because nobody has fired her and she hasn’t resigned.
Shaun: Why not?
Tim: Sharon Shoesmith was dismissed from her job at Haringey Council by Ed Balls after the Baby P scandal. She was then awarded almost £3 million in damages.
I have committed that by the end of June I will have gone through the processes necessary to determine whether or not any members of the board should leave.
Jackie: How will we know? Will it be on the telly?
Tim: None of the reports written about Southern Health have laid the blame at the door of Katrina Percy. Everybody has rights. I’m trying to make sure that when I make a decision it is based on a rigorous examination of the evidence and cannot be overturned.
Sara: As long as you look at the evidence through a clear lens and not through an NHS-can’t-rock-the-boat clouded lens.
Tim: People are contacting me with an enormous range of views. Some people are telling me the exact opposite to you.
Sara: Shaun has the same disbelieving expression as me.
Tim: They are.
Shaun: I believe you! But when so many people have died I just don’t understand how anybody could think this board are doing a good job.
Jason: That is the view of most people I come into contact with. When we go out wearing these Southern Health NHS lanyards we get asked by people what is going on.
Tim: I can’t say any more. But you will know my decision by the end of June.
Jason: If it helps, everyone locally is working as hard as they can to help people.
Tim: Everybody in the NHS comes to work to help the people that they’re serving. Some of them might make mistakes but it doesn’t make them a bad person. My job is to make sure that the right governance system is in place to enable people to do a good job.
Sara: It is an issue from the top. Of choosing to take over failing services in Oxfordshire and not being able to improve them. They were greedy and took on more than they could manage.
Shaun: Tim, even if you stop being Chair, can you still come to these meetings? You seem like a good person who isn’t trying to BS us.
Tim: That’s one of the nicest things anyone has ever said to me. I do want to help, the only problem is that I plan to move to North Yorkshire and do more trout fishing. But I want to come back for meetings.
Tim: I keep coming back to my personal value of integrity.
Jason: I think we have a chance this summer, working with organisations like My Life My Choice and Oxfordshire Family Support Network, to really make things better.
Tim: I am really grateful that all of you have given me an hour of your time. This is much more important that sitting in an office staring at reports.
Sara: But you have read Mazars?
Tim: No. I don’t need to because it’s wrong.
Sara: You were doing so well…
We ended the meeting here. Jason, Tim and Sara left, and Kate asked the My Life My Choice champions how they thought the meeting went.
Michael: It went reasonably well. He was honest, especially to Sara, and I think he meant that apology. I hope to god that he stays. He was prepared to listen to our comments and criticisms.
Shaun: He was very direct and very emotional. Overall I thought he was straight talking, a nice man, and I hope that good will come out of this.
Michael: I hope we get that funding. He’s one of the best guys I’ve dealt with.
Kate: What? In the 20 years you’ve been doing this?
Michael: Yeah. He was prepared to sit there and listen.
Kate: Jackie, what do you think?
Jackie: It was very good.
Jackie: Because Sara shut him up.
Shaun: When he said about Mazars being wrong?
Jackie: Yeah. He’s alright, I think.