I’ve started to make a sort of index of the board meeting minutes, so that we have a vague idea of what was discussed where. It’s a bit, well, ‘surprising’, so far.
From 2011-2015
GIDS is hardly mentioned at all, beyond the data for stuff like budget, staff levels and ‘Did Not Attend’ for appointments numbers. I will revisit these early ones after I’ve completed the ones with more substantial mentions.
If the month isn’t listed below it’s either because there was no meeting that month or the meeting barely mentioned GIDs.
2015
June: Big section on GIDs, including a list of staff, discussed here already
July: two teens on blockers speak to the board.
October: Leeds has 8 staff and 379 patients, bigger premises have been found
November: recruiting more GIDs staff - underspent the staff training budget
2016
January: GIDS had been understaffed, but was now fully staffed and using additional sessions to catch up on demand
February: ‘The Trust has made it mandatory for all clinical staff from Child and Adolescent Mental Health Services, GIDS, Portman Child and Adolescent Service and the Adolescent and Young Adult Directorate to be trained in Safeguarding of Children Level 3, where staff are required to attend Level 3 training every 3 years. (In addition, all other Trust staff regularly attend Safeguarding of Children Training, including Level 1 and 2 training.)’
March: ‘Much of the work which the Trust is engaged in has a strong ethical focus including areas of cutting edge practice such as GIDS. Clinical ethics in the field of mental health is less well developed than other areas of clinical practice and there is the opportunity for the Trust to establish a reputation in this area.’
‘The Gender Identity Development service for under-18s, commissioned nationally, has recently moved its Leeds base to larger premises. Overall activity has to be managed at the present contract level, which allows for the rapid growth in access in recent years but not for further growth. The contract is under review, as the only GIDS in the country, demand has been outstripping capacity for the last six months. The service model is under review, partly owing to demand, and partly owing to the changes in specification’
April: Lots of tables about waiting times and patient ages etc (for all of T&Ps services). I think they meet the 18 week target on most services except GIDS (although I can’t really see the tables on my device)
May: ‘For the coming year the funding for GIDS was £1M above budget, and though there would be additional costs this was significant. Other contracts had turned out at least as well as expected, but there was uncertainty over a couple, for example Barnet YPDAS was going out to tender. A re-evaluation of the Trust’s assets would lead to an increase in the dividend the Trust had to pay, and this had only been partially accounted for in the budget.’
‘More good news was that all contracts for the year had now been signed, and there had been a significant uplift for GIDS, which would allow them to increase staffing to address the demand and waiting list. GIDS was now the 3rd largest service in the Trust, and to ensure they supported it properly a task and finish group would be formed to draw key stakeholders together.’
‘Chief Executive’s Report
- Raising our profile
1.1 We held an event with staff on 4th May to consider issues around how we can best work together to raise the profile of the Trust and of our contribution to public debate.
1.2 On 13th May the Today Programme included a substantial feature on our GIDS service including excellent interviews with a service user and parent from the service and Bernadette Wren, the Trust’s Head of Psychology. We had also been successful, earlier in the work, in securing a substantial feature on the service in the Evening Standard.
1.3 Both features provided the opportunity to set out an informed and positive view of the issue of gender dysphoria and the work of the GIDS service.’
June: ‘Chief Executive’s Report. Mr Jenkins introduced his report by noting the powerful coverage of GIDS on the Today programme, which was a good example of the profile raising work the Trust needed to be doing more of. Mr Holt asked whether it was possible to put the programme on the website, and Mr Jenkins confirmed that this was possible with the new website.’
Lots of talk about IT system case notes, which I believe generates the graphs we now see on GIDs foi requests.
July: ‘GIDS Named Patient Agreements (NPA’s) and the Day Unit over-performing against targets.’
[the waiting list for]‘GIDS has increased from 250 patients waiting in Q4 to 427 in Q1.’
September:GIDs to pilot Skype appointments ‘in Spring’
‘During the summer we have had to make a number of accommodate changes to find space for the significant number of new staff we have recruited for the GID service.’
‘Century Films
8.1 The project, working with Century Films, to produce a series of three documentaries for Channel 4 about the work of the Trust is approaching completion. We currently anticipate the programmes to be broadcast in November.
8.2 The programmes cover three aspects of our work with young people. This includes our school Gloucester House, our GIDS service and our community based CAMHS service.
8.3 We have seen some of the material and have been assured that Century Films have succeeded in making sensitive and high quality documentaries which will both showcase the work of the Trust and make a contribution to breaking down the stigma for young people experiencing mental health problems.
8.4 We have developed a plan for how we can build on the publicity which the documentaries will create to promote the work of the Trust.
8.5 We have also learnt that the Radio 4 documentary “Mending Young Minds” which featured the work of the Trust and which was broadcast in August/September 2015 has been shortlisted for the 2016 Mind Media Awards.’
October:
‘We have now seen the second film produced by Century Films, on this occasion about our GIDS service. This was again of a high quality and covered the issues involved with great sensitivity.
3.2 We are still expecting the films to be screened at the beginning of November. We have developed a plan for how we can build on the publicity which the documentaries will create to promote the work of the Trust.
3.3 The radio documentary “Mending Young Minds” produced last summer about the work of the Trust has been shortlisted for the 2016 Mind Media Awards.
‘Waiting time breaches within Adolescent and Young Adults and Camden CAMHS Services are reducing. The trajectory for other CAMHS, GIDs and Westminster services continues to increase.’
‘The GIDs service has an 18-week waiting list target which continues to be breached by ~66%. Referrals increased by 100% last year and are up by about 23% for the first 6 months this year. GIDs have a detailed action plan which includes significant administrative and clinical recruitment which continues. Until September the existing staff were managing referrals with no extra clinical resource. This is because the recruitment process takes time. The administration team is also working on innovative ways of managing the waiting list. Over 17 year olds present a particular challenge due to the long waiting list in adult services which also differ in their protocols. The Leeds base have piloted a group first appointment for over 17 year olds with excellent feedback. This will be rolled out in London.’
November:M‘Prof Bhugra had visited Abu Dhabi on mental health day, and seen the services that SLAM had set up there, which should be an inspiration for our own international ambitions. He noted that Prof Lamb from Hong Kong university, who was setting up a gender service there, would be visiting GIDS in January, and there were opportunities both in Hong Kong and on the mainland.’
‘Prof Bhugra commented that he had reviewed the Trust’s complaints, and 2 out of 3 were concerned with GIDS waiting times, all of which had been handled very well. Dr McPherson commented that waiting times were likely to be increasingly used as a tool for judging performance in the future. Mr Jenkins noted that the increase in activity shown in the first table, and commented that this created an increasing pressure on waiting times, which did seem to be getting worse. GIDS should improve with the increase in staffing, but overall there was best practice to be shared over practical measures that could be taken to see patients as soon as possible and support them during their wait. It was agreed that a report on waiting times, including both trajectories and granularity, should come to the next board.’
Stuff about 17+ pilot on page 151
(I’m going to put up the Christmas tree now but will do 2017-2020 in batches when I have time and brain space)
tavistockandportman.nhs.uk/about-us/governance/board-of-directors/meetings/