The Blog: 8 May 2024

You may be aware I’m retiring as Chief Executive Officer of Mersey Care on 31 October 2024. It’s been a whirlwind 12 years since my first day at the Trust, but helping the organisation evolve, with the hard work of many others, into the organisation it is today has been one of the main highlights of my career.

I'll reflect on my time at Mersey Care before I leave, but I must pay tribute to everyone I’ve worked alongside over the years. The dedication and innovation of our workforce remains a key part of Mersey Care’s DNA and it’s the hard work of our staff that has helped establish the organisation as one of the largest mental and community health trusts in the country.

For now, I’d like to focus on a selection of our innovative services. Like all major organisations we’re constantly looking ahead to explore and nurture ideas to improve our services and provide better treatment and care for our population.

A key theme of this blog is the importance of Mersey Care and the ability to adapt to the renewed focus on integration, both now and in the future. Integration remains a massively overused word, but I’d argue that it’s an obvious route for the NHS and organisations should be working more closely together to help put patients front and centre with more focus on preventative treatment and avoidable hospital admissions.

One great example of true partnership working is our addictions team. They should be given enormous credit for their success and we recently featured them on our website to highlight their achievement in removing Hepatitis C from among our service users for more than six months. I’m delighted to confirm they have continued this great work and have extended the Hepatitis C free period to 10 months, becoming the first team in the country to do so.

Pictured above: Staff from Mersey Care’s addictions service at Brook Place

Our addictions team have adapted the service to meet the needs of our communities. Through engagement and listening to our service users we know people with addictions often feel discriminated against when they enter a hospital setting, so we approached other services generally delivered at the Liverpool University Hospitals to explore how we can work more closely together and remove any barriers.

As part of the service offer and our ethos to provide whole person care, we now offer onsite sessions with Smokefree Liverpool and sexual health. We also host a spirometry clinic which offers breathing tests, diagnosis and monitoring of certain lung conditions by measuring how much air you can breathe. To put the success of this initiative into context, only around two percent on patients on the team’s caseload previously required a spirometry test but since these clinics were introduced that has increased to 69 percent of patients.

The addictions team has also forged links with the Integrated Mersey Palliative Care Team (IMPaCT) who work closely with the Marie Curie Hospice to support end of life patients and are also setting up a wound care service.  This is not a big shift in the way we work with other organisations or agencies, but the positive outcomes indicate that when we do work differently we start to see a real patient benefits and improvements to overall experiences.

For integration to become the norm within the NHS, though, organisations may need encouragement to seek out partnership working. According to NHS Confederation’s report into ‘Unlocking reform and financial sustainability’, ‘Currently, financial flows within the NHS are fragmented and work against integration. The different parts of the NHS – primary care, community care and hospital care – are not financially incentivised to work better together.”

Effective integration has many benefits, including allowing organisations to respond and coordinate care quicker, supporting people to stay well and remain independent, care for people with multiple needs as populations age and, most importantly, using our collective resources as effectively as possible and relies on professional relationships between services as well as formal structures and policies.

The biggest obstacle in integration is the inequalities in demand that Integrated Care Systems and Boards may face. Different areas will face varying pressures, complexities and demands, for instance areas with high numbers of young working professionals have different demands to areas with high unemployment. There is a concern that ICSs in areas with populations with more health problems will be under more strain than those with healthier populations, and these areas will need additional funding to tackle health inequalities.

Last year, the Institute of Health Equality published a report called ‘All Together Fairer; Health Equity And The Social Determinants Of Health In Cheshire And Merseyside,’  it’s a lengthy title but offers a comprehensive review of health inequalities across our geography. It states ‘Overall a third (33 percent) of the Cheshire and Merseyside population live in the most deprived 20 percent of neighbourhoods in England, with significant negative implications for health,’ which is illustrated in the table below taken from the report.

Unless this Government or the next releases additional finances to address those inequalities, Mersey Care and the city region will need to find more creative ways of working together better to help care for our communities. I’ve already highlighted addictions but I’ve also picked out several other services that are both engaging Mersey Care in the next year or so, and also represent a new way of working.

I’m delighted Aspen Wood, our purpose built low secure facility based at Maghull Health Park for service users with learning disabilities and/or autism is now fully operational. You can see around it in the video below.

It’s a big leap forward and a new model of delivering complex care and we’ll guarantee multi-disciplinary care tailored around each service user and their individual needs at a time when they need intense care and support, with a team of psychiatrists, psychologists, speech and language therapists, pharmacists and occupational therapists on site. This approach aims to reduce the length of stay and where possible, support discharge for our service users back into a community setting in a timely way.

Maghull Health Park’s reputation will be further enhanced if we secure funding for a new Mental Health Digital Research Centre. This will based on the former HMP Kennet site, and is one of 21 projects seeking funds from the  Liverpool City Region’s Investment Zone and plans to supercharge health and life sciences within the region.

The centre aims to create an environment for innovators to develop new treatments to support improved mental health care and act as a gateway for investors and innovators to transform and accelerate product development.

I’d also like to single out a couple of more services that are great examples of partnership working. They are by no means the only ones to excel in working differently with other agencies, but they are great examples of how partnerships can allow services to grow.

Our mental health triage services go from strength to strength and we now have five in operation partnered with Merseyside Police, Chesire Police and British Transport Police (BTP). The cars cover Liverpool, Sefton, St Helens, Knowsley, Halton and Warrington with each car operated by a registered Mental Health Practitioner from Mersey Care and a police officer.

We also have a Mental Health Response Vehicle (MHRV) in operation, which operates with a registered Mental Health Practitioner from Mersey Care and an Ambulance Technician (EMT) from North West Ambulance Service (NWAS) covering Sefton and Liverpool. In line with the NHS long term plan, we’re ready to launch an additional MHRV later this month which will cover Warrington, Halton, Knowsley and St Helens. The services have significantly evolved over the last 12 months and work proactively to support some of our more vulnerable service users.  

Our service users benefit from a collaborative multi-agency approach which supports a reduction in restrictive practices and ensures Service Users access support for their needs in a timely way.

The Triage service also alleviates pressure on our Emergency Service colleagues:

• Between April 2022 and September 2023 there have been 7,072 assessments completed by the cars – saving time and money for Merseyside Police, NWAS and BTP – including 8,895 contacts and 3,972 individual service users being supported
• The Emergency Services Business Line, used by Merseyside Police, the triage cars, NWAS and BTP, received 4,078 calls between 1 June 2023 and 31 March 2024, helping to reduce the use of section 136
• We average around 12,000 incoming and outgoing calls to crisis lines each month which allow direct and other parties to access urgent support and advice, including around 240 urgent assessments undertaken rather than divert to A&E Departments.

Finally, I also want to focus on an inspirational service we provide for the majority of Merseyside called Building Attachment and Bonds Service (BABS). This service is an outstanding example of making a real and lasting difference, they have helped around 250 families over the last year, and offer specialist, therapeutic parent infant mental health support during pregnancy and in the postnatal period. The infographic below gives an indication of how popular the service has become and the support it has provided.

It’s also an example of a trailblazing partnership with GPs, social services, early help, midwives, health visitors, local authorities and wellbeing hubs. Like any service, we ask those who use it for feedback so we can improve and I urge you to read this recent piece from the magazine or watch the video below to understand what this service means to those it has helped.

Once again, thanks to health and social care staff across all sectors for the support you provide for the people we serve

Prof Joe Rafferty CBE

Chief Executive Officer