Introduction

Welcome from the Chair and Chief Executive

Kevin Lockyer started in his role as Chair at Lincolnshire Partnership NHS Foundation Trust on 1 May 2021 and Sarah Connery was formally appointed as Chief Executive in September 2021, after being Acting Chief Executive since October 2020.

Welcome to the annual report and accounts for Lincolnshire Partnership NHS Foundation Trust. Whilst this report is mainly a reflection of the twelve months ending on 31 March 2022, we would also like to take the opportunity to outline some of our plans for the future.

We would like to express our continued and sincere thanks to each and every person in our Trust, for their outstanding contribution to keep services functioning during these very challenging times. We have been incredibly proud and impressed with the commitment and passion of our staff, volunteers, members and partners, as we have continued to deal with the COVID-19 pandemic. It has undoubtedly been the biggest challenge we have ever faced, and we know that without this unfaltering dedication, our organisation would not be where it is today.

Despite the ongoing challenges, we continue to develop and improve, and we have seen many achievements during the last year that should be acknowledged.

Work has started on our new acute mental health wards at the Peter Hodgkinson Centre Lincoln, which will provide individual ensuite bedrooms for the first time. As well as improving privacy and dignity for patients, it will also improve natural light, outside views, access to outdoor space, and provide a modern and relaxing therapeutic space for our patients. We look forward to opening the doors in March 2023.

We continue to plan similar improvements for the adult acute ward at Boston. However, significant increases in construction costs are affecting projects across every sector. This means that we are having to revisit options to make sure we can deliver a comparable development in an affordable and sustainable way. We remain committed to making these important changes to improve our patients’ experience.

We continue to work closely with, and appreciate the support of our partners, including several charities and voluntary organisations, Lincolnshire Police, Lincolnshire County Council, district and borough councils, clinical commissioning groups and other NHS organisations.

We have worked strongly as a Lincolnshire health and care system in our response to COVID-19, particularly with the roll-out of the COVID-19 vaccination programme. As well as continuing productive and positive conversations as we start to move towards our new integrated care system approach from July 2022.

We have also further developed our new Mental Health, Learning Disability and Autism Alliance. This brings together all interested organisations, including the voluntary and community sector, to prioritise and deliver important outcomes for people with mental health problems, learning disabilities and autism in the county. We look forward to sharing more about our plans in the coming year.

What has become clear over the last two years is the growing demand for mental health, learning disabilities and autism care and support. We have seen a substantial increase in demand for all services, but particularly for our talking therapies, psychosis, eating disorder, autism diagnosis and all children and young people specialist services. In some areas this has meant we have longer waiting times for assessment and treatment than we would like. We are focused on working with commissioners to agree additional investment and review current ways of working to reduce waiting times. 

Additional investment has already been agreed in many areas and we have been expanding our teams to create additional capacity. This has included a new countywide children and young people complex needs service, which subsequently went on to win a Children and Young People Now Award for Mental Health and Wellbeing. Our steps2change service is also expanding and we’re working on making Lincolnshire one of 26 new maternal mental health hubs, bringing together maternity services, reproductive health and psychological therapy under one roof.

We have also continued to focus on increasing our capacity to support people in crisis. Our 24 hour helplines for adults and young people and their families have been well used since their launch in 2020. Additional crisis support has been introduced with the expansion of community Night Light Cafes across the county. We’ve also introduced our pilot Mental Health Urgent Assessment Centre, which is one of only a handful of similar services being piloted nationally. We are very interested to see the impact this has on supporting people in crisis and relieving demand on other local services such as A&E, ambulance services and the local police.

Our ambition to support people to live well in their communities remains resolute and this work continues to be the focus of our large scale community mental health transformation programme.  

During the year, the programme has achieved much:

• introducing and expanding its integrated place-based teams
• expanding community funding for community groups and organisations
• working with community hubs to build strong local networks
• developing close working links with primary care
• embedding dedicated mental health support aligned to GP practices.
   

We’re delighted to say that extra funding has been agreed for us to expand this programme to the rest of the county. We are looking forward to working with local communities to design services which work best for them. Alongside this, we will also be expanding our specialist services like personality and complex trauma and community rehabilitation across Lincolnshire.

Staff recruitment remains one of our biggest challenges, especially with the expansion of our workforce to meet demand. However, we have ambitious plans in place to meet these challenges and were very pleased to welcome our first cohort of international nurses to Lincolnshire during the year. So far, we have nurses from countries including Kenya, Ghana and Trinidad and Tobago and we are supporting them to take the examinations needed to be able to practice mental health nursing in the UK. Once registered with the Nursing and Midwifery Council, we look forward to welcoming them to our inpatient wards.

There have been so many fantastic developments over the last year we cannot fit them all into this introduction, however, please spend the time to review our highlights on pages 15 to 20 which really shows just how much we have achieved.

We are very much looking forward to what the next year will bring, with further investment in services and collaborating with our staff, partners, service users and carers on how we can further improve the care we deliver.

    Kevin Lockyer, Chair
 

Sarah Connery, Chief Executive

Who we are

Lincolnshire Partnership NHS Foundation Trust was established on 1 October 2007 under the National Health Service Act 2006. It was the first NHS mental health organisation to become a foundation trust in the East Midlands.

Being a foundation trust means it reports to the local people through its Council of Governors and is regulated by an independent body called NHS England and Improvement.

The most important part of being a foundation trust is that it brings the organisation closer to the people who matter most. It wants local people, service users and carers and those who support and represent them, to have much more influence over how it goes about planning and delivering services.

It has around 9,000 members, drawn from the local community and its own staff.  It has elected governors to act on its behalf and those governors play a crucial role in everything the Trust does, including appointing its Chair and non-executive directors.

There are also many other benefits of becoming a foundation trust, such as greater financial freedom. Foundation trusts are able to invest and borrow funds and can reinvest surpluses too. This allows the Trust to plan better for the future, and to take decisions about how services are run, knowing the level of available funding.

The Trust can also enter formal partnerships and joint ventures with other organisations outside the NHS  such as voluntary organisations or housing providers.

What we do

The Trust is the principal NHS provider of mental health services and also provides some learning disability, autism and social care services in the county.

Apart from some very specialist services that can only be provided by other organisations outside the area, the Trust provides the full spectrum of mental health care across Lincolnshire, including:

• Talking therapies for mild to moderate mental health issues such as anxiety or depression.
• Community services for people of all ages who are recovering from severe or long-term mental illness, including perinatal mental health concerns.
• Crisis resolution and home treatment for when someone becomes unwell and needs support to prevent them needing hospital admission.
• Mental health inpatient care for people experiencing a severe, short term episode of mental illness.
• Mental health rehabilitation for people with severe or long-term mental health problems who require support in returning to the community to live independently.
• More specialist services, including learning disabilities and autism support, personality, and complex trauma, eating disorders, veterans, dementia, and some social care, for adults, children, families and older people.
• Specialist psychological therapies.

The Trust also provides some services in neighbouring areas of the country, including, child and young people mental health and wellbeing services in North East Lincolnshire.

The work of the Trust is increasingly community based. It provides a wide variety of mental health, learning disability and social care services in close partnership with colleagues in local councils, clinical commissioning groups, charitable and voluntary organisations, as well as with service users, carers and their representatives. The Trust always aims to provide people with alternatives to admission. Where appropriate,  the Trust provides treatment, care and support outside a formal hospital setting.

Summarised below is a snapshot of who we are and what we do.

For the 12 months leading to 31 March 2022, we:

• Supported some 53,000 people who have accessed our services over the last year by:
  • Attending outpatient clinics or appointments.
  • Receiving contact from one of our community teams, crisis and home treatment teams or specialist services.
  • Being admitted to one of our 14 inpatient wards.
• Operated from some 40 sites providing services in:
  • Lincolnshire to a population of just over 766,000* across an area of 2,646 square miles.
  • North East Lincolnshire to a population of just under 160,000** across an area of 74 square miles.
• Supported people in around 200 inpatient beds, the majority of which are on our main sites in Lincoln, Grantham and Boston.
• Employed 2,847 staff including bank staff (2,657 in 2020/21): 2,289 females (2,133 in 2020/21) and 558 males (524 in 2020/21).
• Had a membership of circa 9,300 (down from 9,700 in 2020/21).
• Worked with an annual expenditure budget of circa £120 million (this remains the same as 2020/21).

*Source: ONS 2020 Mid-Year Population Estimates/ GP Registrations October 2021 (NHS Digital)

** Source: North East Lincolnshire Data Observatory ONS 2020

Highlights of the year

A snapshot of a busy year.

From innovative service transformations to national awards and recognition, the past year has seen many highlights for the Trust:

Managing the pandemic

Services have continued to effectively manage the impact of the COVID 19 pandemic and responded effectively to any outbreaks in services. Infection prevention continues to be a high priority across services. Teams have adapted to new ways of working, including increased use of technology to continue to support service users throughout.

Partnership

As part of continued work to develop Lincolnshire’s Integrated Care System (ICS) the county developed the new Lincolnshire Health and Care Collaborative. It was developed as a local partnership to drive forward high quality, cost effective integrated health and care services across the county. The core key objectives are:

• care closer to home
• prescribing
• musculoskeletal pathways.

These three programmes support the system’s work to come out of the national NHS recovery support programme, which Lincolnshire is currently sitting in tier 4 (the highest level of escalation, previously known as special measures).

Work has continued on the transformation of community mental health support, as part of a system wide review of integrating community resources to support people with serious mental illness and improving access. During the year the programme has :

• extended the introduction of integrated place-based teams
• further expanded community funding for community groups and organisations
• developed close working links with primary care practices with dedicated mental health support in local areas
• further developed community hubs to support accessibility and worked with the Trust’s secondary mental health services to review current case loads and work with the community sector to broaden the support people can access.

During the year we received additional funding to roll out the work to date to further areas of the county, expanding from the pilot sites in Boston, Grantham, Gainsborough and Lincoln.

The Trust continued to collaborate closely with partner organisations, both in Lincolnshire and the Midlands. We became part of two new Midlands Provider Collaboratives for eating disorders and children and young people mental health services during the year. The provider collaboratives also include forensic services and veterans. These collaborations ensure that patients across the East Midlands are put at the centre of the care provided and consistently experience great outcomes, wherever they live.

As a Trust we launched wave 11 of funding for Lincolnshire’s Managed Care Network. Supporting community groups and organisations with funding to provide meaningful activities and support for people with lived experience of mental illness in our community.

During the year we also handed over the ongoing management of the Managed Care Network to Shine Lincolnshire who will coordinate the funding from Lincolnshire County Council to further grow the network, with continued support from LPFT.

Staff developments and appointments

The Trust was pleased to appoint Sarah Connery as the Trust’s substantive Chief Executive in September 2021, following her acting up arrangements over the past year. The Director of Finance and Information was also appointed with Mark Platts taking up the post on a permanent basis.

The Trust continued to perform well in the national NHS annual staff survey and was pleased to see that the 64% of staff who responded to the survey still rate the Trust as a good place to work and receive treatment. This places the Trust amongst the best mental health trusts nationally for staff feedback.

The Trust, alongside partners in health and care launched the county’s new Staff Wellbeing Hub. LPFT is the lead coordinator for the county’s staff wellbeing offer, supporting NHS and care colleagues with the wellbeing impact of the ongoing pandemic. 

As part of our continued work to support our staff, the Trust extended their staff support networks to include specific forums for men and women in the organisation. These forums join the already existing staff networks for lesbian, gay, bisexual and transgender (LGBT+), Black, Asian and Minority Ethnic (BAME) and lived experience of mental and physical long-term health conditions and/or disabilities.

The first cohort of international recruits joined the Trust this year as part of an ongoing recruitment programme. The Trust has recruited 10 nurses initially from areas such as Kenya, Ghana and Trinidad and Tobago and are supporting them to take the examinations required to be able to practice mental health nursing in the UK.

The Trust appointed a new lead for Advance Clinical Practice (ACP) to strengthen our leadership in this area and further develop how ACP practitioners can support different ways of working in our services.

The Trust, in association with the Lincolnshire Talent Academy and Lincolnshire County Council Adult Services, launched a new internship and work experience programme for young people with Education Health Care Plans. This supports young people between the ages of 17 and 24, with special educational needs to gain meaningful work experience.

Service developments and improvements

In an exciting development for the county, work began on two new purpose built adult acute wards in Lincoln, on the Peter Hodgkinson Centre site. The brand new wards will provide a much improved environment for patients, including individual en-suite rooms. They will replace the existing wards at Peter Hodgkinson Centre which currently have dormitory style accommodation and do not meet the modern standards of mental health hospital care. Work continues in reviewing options for the Boston development to replace Ward 12.

An extra £2.4million in funding over three years was secured through a joint bid with Lincolnshire County Council, NHS Lincolnshire Clinical Commissioning Group and LPFT to create a new countywide children and young people complex needs service. The service offers improved care for young people with complex health or care needs who have also been part of the care setting or adopted.

Children and young people’s mental health services were also bolstered by a number of new investments over the year to expand their workforce to meet demand. Particularly in their crisis and home treatment services and eating disorders team.

The Mental Health Support Teams into schools was also extended to further schools in the county and now include Boston, Skegness, Lincoln and Gainsborough.

The Tier 2 Mental Health Helpline for professionals was relaunched as the Lincolnshire Mental Health Adviser helpline. A helpline for professionals or community groups who support people with mental health needs.

Lincolnshire successfully became one of 26 national Maternal Mental Health Hubs, bringing together maternity services, reproductive health, and psychological therapy under one roof. Part of the county’s Better Births programme, Lincolnshire Partnership NHS Foundation Trust (LPFT) in partnership with United Lincolnshire Hospitals NHS Trust (ULHT), introduced new countywide support for women who have experienced birth trauma or loss, as well as expectant mothers who have a fear of labour.

In January 2022, the Trust launched a new Mental Health Urgent Assessment Centre on the Lincoln County Hospital site. Piloting a new therapeutic environment for people in mental health crisis to receive additional assessment of their needs. Initially the service is taking direct transfers from East Midlands Ambulance Service and United Lincolnshire Hospitals NHS Trust to reduce demand in emergency departments. However, once developed the service will also accept walk-ins from the local community.

In addition to the expansion of the crisis assessment services, funding was also made available to extend the well-received Night Light Crisis Cafés to other areas of the county. Night Life Cafés are safe spaces that offer an out-of-hours, non-clinical support service for anyone struggling and at risk of experiencing a mental health crisis. They are staffed by teams of trained volunteers and are located in Lincoln, Gainsborough, Grantham, Spalding, Bourne, Long Sutton and Stamford. Further locations are set to open on the East Coast.

As part of continued work to transform mental health rehabilitation services in the county, the Wolds at Discovery House in Lincoln is now a fully functioning mixed sex re-ablement ward. It supports people who have had an acute mental health admission to reintegrate into their community.

Adult Eating Disorder services received additional investment to expand the team to meet increasing demand. The eating disorder pathway is also part of the on-going community transformation work.

There continues to be a focus on bringing care closer to home and the Trust successfully achieved zero out of area placements for acute patients during the last year. This was helped significantly by the opening of the female acute treatment ward at Ash Villa and continued success of the Psychiatric Clinical Decisions Unit.

The memory assessment and management service has introduced a new digital pathway, significantly reducing waiting times for assessment, diagnosis and early interventions for people with suspected, and/or mild to moderate dementia.

Whilst the dementia ward at Manthorpe Centre in Grantham continues to be temporarily closed as part of the Trust’s pandemic response. The pilot Dementia Home Treatment Service has continued to support people with dementia and their carers and families in their home environment, therefore significantly reducing the need for hospital admission.

The older people and adult acute wards now have dedicated Carer Leads.

Talking therapy services through steps2change were expanded with over £380,000 additional funding to recruit additional practitioners and improve access.

The Lincoln Mental Health Liaison Team have now moved to a 24 hour service on the Lincoln County Hospital site, similar to the team already in place at Boston Pilgrim Hospital. The team has also introduced a new peer support worker role which will be invaluable in supporting patients who are acutely distressed and require additional support whilst attending A&E departments.

Awards

For the second consecutive year, LPFT was shortlisted for Mental Health Trust of the Year at the 2021 Health Service Journal (HSJ) Awards. This national recognition commends the ongoing work of our Trust to transform mental health and learning disability services for vulnerable communities across Lincolnshire. This enables them to access excellent care as close to home as possible, in the least restrictive environment.

Selina Adda-Dixon, Nursing Associate, was shortlisted for the Nursing Associate Trainee of the Year at the Student Nursing Times Awards 2021. Her dedication, involvement in quality improvement projects and role as link nurse for physical health, have made her a valuable asset to the Trust.

Patients and their creative projects at Francis Willis Unit in Lincoln were recognised at the National Service User Awards 2021 where they won awards in two of the five categories they were nominated in. The team won the Recovery and the Arts’ category for their ‘Smart Phone Movie Making’ project, and the award for ‘Health and Wellbeing’ for their work on the ward’s ‘Monthly Health Challenges’.

The Children and Young People’s Support Team were shortlisted in the peer support category at the Positive Practice Mental Health Awards 2021. Recognising the valuable role peer support workers play in supporting young people and parent/carers accessing mental health services.

Lincolnshire’s Children and Young People Complex Needs Service (formerly known as the Future4Me Health Team) won the ‘Mental Health and Wellbeing’ award at the Children and Young People Now Awards 2021. The service works as an integrated partnership between LPFT, Lincolnshire County Council and other partner agencies such as education and the criminal justice system, providing holistic support to young people who are at risk of homelessness, criminalisation, or exploitation.

The Trust’s Research Team was a finalist for ‘Outstanding Achievement by a Team’ at the CRN East Midlands Research Awards 2021. Recognising the outstanding achievements of research teams in the East Midlands, and awards teams that have gone above and beyond what would normally be expected to achieve outstanding results.

Lincoln Core CAMHS (children and adolescent mental health service) were one of three teams to be shortlisted for the Team of the Year Award in Lincs FM Community Awards. The panel were impressed with how the team have continued to provide support to young people throughout the pandemic, both digitally and face-to-face.

One of the Trust’s Clinical Research Practitioners, Tracey Collishaw, won the Academy for Healthcare Science Award for ‘Outstanding Achievement by a Clinical Research Practitioner’ in the Advancing Healthcare Awards 2021.Tracey won the award as a result of the hard work and dedication shown by both her and the research team in promoting ENRICH (enabling research in care homes) and JDR (Join Dementia Research).

Jodie Gunson was shortlisted for Nursing Associate Trainee of the Year at the 2022 Student Nursing Times Award. Jodie commenced her nursing associate training in October 2020 and is due to register as a nursing associate in October 2022. The winner will be announced at the awards ceremony on 27 May 2022.

Accreditations

Lincoln’s Electroconvulsive therapy (ECT) team achieved Electroconvulsive Therapy Accreditation (ECTAS) which included a included a Commendation in Monitoring and Follow-up.

Several teams across the Trust achieved re-accreditation by Lincolnshire Carers Quality Award, recognising services hard work and dedication to carers. This included all age inpatient wards, crisis and home treatment services and the veteran’s mental health team.

Grantham Crisis Resolution and Home Treatment Team (CRHT) received their HTAS (Home Treatment Accreditation Scheme).

Ward 12 in Boston also achieved the standards in the Quality Network for Inpatient Working Age Mental Health Services (QNWA) through a comprehensive process of self and peer review.

A number of the Trust’s community teams undertook their reaccreditation for ACOMHS the Royal College of Psychiatrists standards for community mental health services and maintained their accreditation.

The Individual Placement and Support Employment Service maintained their “Good Fidelity” status as a result of their external Fidelity review.

Grantham Crisis Resolution and Home Treatment Team received reaccreditations for their HTAS (Home Treatment Accreditation Scheme) and Ward 12 for QNWA (Quality Network for Inpatient Working Age Mental Health Services).

The Trust received a Stonewall Gold Award for commitment to LGBTQ+ inclusion at work.