A city of surprises, Liverpool has had its fair share of notoriety. It gave us the Beatles and Trotskyite Militants, then morphed into a European capital of culture in 2008. Despite having a population of less than half a million, it is – according to VisitEngland.com – now second only to London in the UK for the number of museums and art galleries.
Now it has another claim to fame – its mental health services have been judged to be among the best in England. The Mersey Care NHS foundation trust that covers the city and a large area of the north-west, including 22 miles of coastline, is one of only a third of mental health trusts in England to be rated as “good” overall – and “outstanding” in some categories – by the Care Quality Commission.
It is one of the NHS’s seven global digital exemplars for the use of new technology to support patients and is leading the way with its “zero suicide” approach to identifying and supporting those at risk.
It is also one of the few mental health trusts to be financially stable at a time of funding cuts. Though the city has been transformed over the last two decades – with the Liverpool One shopping and entertainment complex offering more than 150 stores and its famous waterfront becoming a Unesco world heritage site – Merseyside still has pockets of deprivation and a large call on its medical services.
So how has Mersey Care succeeded in what is generally acknowledged to be a difficult time for mental health services?
“We want to help to create the best future medical leaders,” he says. “In fact, we encourage our doctors to develop special interests, and to contribute towards the successful growth of the trust. We want them to be a part of our long-term plan.”
Consultant psychiatrist and director of education, Dr Indira Vinjamuri, says the medical director is “absolutely inspirational” in his support for staff who want to continue with their research and innovate to improve patient care.
She is a consultant at one of Liverpool’s acute in-patient units on top of her duties supervising medical students and researchers, and says she values her close links with the medical school at the University of Liverpool.
Dr Simon Graham, the consultant psychiatrist who leads the psychotherapy service, says the trust has backed three of his innovations. The latest is a personality disorder hub that will provide a drop-in centre and care for patients with complex personality disorders. He says it will save sending complex cases out of the area, at a cost of £200,000 per patient per year.
“Our trust is pretty stable financially even though pressures are there chronically. So that makes it a good place to work because it is not as deprived as some of the other trusts,” he says. “I have been a big innovator in developing new services and the trust has always backed me,” he adds.
Support for staff to take on external posts is important to Dr Kuben Naidoo, a consultant psychiatrist specialising in adult attention deficit hyperactivity disorder (ADHD). He is the chairman of the board of trustees for the ADHD Foundation and an examiner for the Royal College of Psychiatrists. He is particularly proud of the trust’s Centre for Perfect Care, an evidence base that collates research, innovations and experience from across the world.
Losing touch with reality is not as rare as you might think and it’s most common between the ages of 14 and 35, says Dr John Stevens, a consultant psychiatrist with the trust’s early intervention service.
“People experience psychotic incidents for many reasons,” he says, “and it could happen to any one of us in a certain set of circumstances. With support, many people can, and do, recover and the trust sees early intervention as key because the evidence shows it improves the prognosis.”
The trust is fortunate in having a stable staff and that could be to do with the wide choice of areas to live in, from the city of Liverpool to coastal towns and picturesque rural villages.
Parks and river pathways are an attraction for Stevens, a keen runner, who lives in the St Michael’s area of Liverpool. Graham says it’s the proximity of so many outstanding national parks – the Lake District, Snowdonia in Wales and the Peak District – that helps keep him in the area.
Vinjamuri lives in St Helens, a 20-minute commute from her work. “It’s a lovely place to bring up a family – house prices are very reasonable, there’s a big choice of good state and independent schools, and childcare is much easier to arrange than it would be in London and the south-east,” she says.
But they all agree that at least part of the reason for the trust’s good record are its patients. Liverpool has gone through many changes but the friendliness of its people and the Scouse sense of humour both remain undimmed.
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