Norfolk and Suffolk: Improvement at mental health trust once named 'worst' in country

A mental health trust previously named the worst in the country has significantly improved, inspectors say.

Norfolk and Suffolk NHS Foundation Trust (NSFT) was served a warning notice in 2021 after a report found patients were exposed to risks of harm.

On Friday, the Care Quality Commission (CQC) said young people's wards and crisis services had improved.

Norwich South MP Clive Lewis said an inquiry into "institutional failings" at the trust was still needed.

The NSFT provides mental health support and care for people with learning difficulties across Norfolk and Suffolk.

In 2021, the NSFT was rated inadequate, placed in special measures and was the only mental health trust within the NHS's improvement regime for not meeting standards.

The CQC upgraded the trust rating from "inadequate" to "requires improvement", following an inspection undertaken between September and November 2022.

The report, released on Friday, rated the trust as "good" for being caring, and "requires improvement" in its responsiveness to people's needs.

However, inspectors did find "a small number of areas where there has been a deterioration in the quality and safety of care provided to people".

Jane Ray, CQC deputy director of operations, said: "While the trust has more to do to consistently provide high standards of care and treatment that people have a right to expect, it's made welcome progress - even at what continues to be a difficult time for the NHS.

"The trust must now ensure the progress it has made does not slip and it must apply its commitment to improvement to areas that still don't meet standards people have a right to expect."

Stuart Richardson, NSFT chief executive, said he welcomed the report adding it "serves as a stepping-stone to get to where we want to be as an organisation - consistently delivering excellent care".

"We are not complacent and must continue to make improvements at pace so that we can consistently deliver high quality care," he said.

Zoë Billingham, who chairs the trust's board, said the organisation would "focus on improving quality, safety and the experiences of the people who use our services and our staff."

Sally Harris, whose son Eliot, 48, died at Great Yarmouth's Northgate Hospital in April 2020, called on the trust to prove it had made changes.

Mr Harris, who had schizophrenia and was admitted for not taking his medication, was found unresponsive in a private ward and died half an hour later.

Three members of staff were subsequently sacked after falsifying observation records on the night he died, an inquest into his death revealed.

Mrs Harris told the BBC she was "absolutely appalled" at how "robotic and uncaring" staff had been towards her son.

She said Eliot was "clever and artistic, but needed a bit of extra care".

"I hoped they'd get him back on his medication and start functioning again," she said.

"I'm horrified to think that anyone could be so dishonest. They were falsifying the records, signing, not checking people. Or getting other people to sign when they hadn't even checked. It was pretty horrendous."

A review of deaths at the trust is due to be published in the next month.

An NHS East of England spokesperson said the progress at NSFT was "encouraging", adding: "There's more to do and the trust will continue to receive intensive and targeted help as part of the recovery support programme to make sure improvement is sustained and developed further."

It is positive that significant improvements have been made in the children and adolescent units and with services for people in a mental health crisis. For eight years the trust has not provided the level of care that patients in the area need.

Millions of pounds is being spent on the eating disorder service and third sector providers are being brought in to run new initiatives like crisis cafes.

However, safety issues need to be addressed in some wards. It's been almost three years since the death of Elliot Harris who had his observation checks forged by staff 23 times. There has also been a warning from the Senior Norfolk Coroner Jaqueline Lake that observations aren't being conducted properly, yet inspectors still found occasions when seriously ill patients weren't being checked regularly enough.

Staffing also remains an issue with 41% leaving within two years of joining. Even at the adolescent unit in Lowestoft where the rating has improved, at the time of the inspection, four out of 10 beds were empty because they didn't have a substantive consultant psychiatrist and senior psychologist.

Bereaved relatives are hoping this isn't a false dawn and the changes are sustained into the next inspection. That's why they have recommended they stay in the recovery support programme.

In August 2022, 140 doctors wrote a letter of no confidence to the trust's senior leadership, telling Ms Billingham that "endemic issues show little sign of resolving".

Labour MP for Norwich South, Clive Lewis, said he welcomed the improvements outlined by the CQC but described the trust as "institutionally failing".

"The problem is we've been here before, it's a bit of a yo-yo effect," he said.

"People want to see real results when it comes to turning around our mental health services across the region."

He said he believed the NSFT was "not fit-for-purpose" and called for a public inquiry into its failings.

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