Annual Report 2006 / 2007 - South West London and St George's ...

South West London and St George’s
Mental Health NHS Trust
Making life better
Annual Report 2006/07

contents
4 Chairman’s welcome
5 Chief Executive’s introduction
6 About us
7 Our vision
8 Our work
32 Statutory information
42 Remuneration
44 Financial review
50 Our board
51 Map and contact numbers
FRONT COVER PHOTO: Ward Manager Collen Baffana (left) with Anthony
LEFT: Clinical Specialist Occupational Therapist Mandy Billingham (right) with Jenni
3

Welcome to this year’s annual report which reviews
2006/07 and looks ahead to the future.
Like many other mental health trusts we have faced many
challenges in the last 12 months. We have responded to
these positively. We have much to celebrate and many
improvements have been made. You can read about them
in this report.
The Trust covers a huge area and I would like to pay
tribute to the many staff we have providing valuable
services in Kingston, Merton, Richmond, Sutton and
Wandsworth. Anyone who has visited Springfield Hospital
in Tooting over the past few months cannot fail to have
noticed the building work taking place on site. Work is well
underway for the new Wandsworth Acute Unit which marks
the first phase in our exciting plans for the Springfield
Regeneration Programme.
The past year has seen some changes to the membership of
the Trust Board. In October 2006 we welcomed Dr Diana
Rose as an Associate Non-Executive Director to strengthen
the voice of the service user on the Board, which I believe is
imperative to ensuring our services meet the needs of those
who we serve.
The decision to appoint full-time medical and nursing
directors has resulted in us saying goodbye to Medical
Director Dr Deji Oyebode and Chief Nurse Professor Mary
Chambers. I would like to thank them both for their
dedication and commitment to the Trust and wish them
well in their new roles.
Finally I would like to acknowledge the leadership of Peter
Houghton who with the Trust Management Team is driving
the Trust forward. I would also like to thank my colleagues
on the Board and every member of staff for their continued
hard work and commitment during the last year.
John Rafferty
Chairman
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Introduction by
the Chief Executive
This is my first annual report as Chief Executive. Over the
Managers and staff have responded well to the challenges
Third, in all that we do, we
past year I have been struck by the quality of many of the
and the lessons presented by the Independent Inquiry
will treat people with dignity
Trust’s services and by the skill and commitment of many
into the Care and Treatment of John Barrett and to the
and respect, give them the
of our staff. This is a Trust with huge potential to help
development of a new business model for the Henderson
information they need and
those whom we are here to serve. I am proud to be its
Hospital. As a result of their work, I am confident that
want, and involve them in all
Chief Executive.
we will soon be providing forensic services and a range
decisions that affect them.
The past year has been one of real progress. Improvements
have been made in many areas, in particular in the quality
of the environment for many of our services and also in
some areas of our patient survey results, which to me is the
most important indicator of how well we are doing.
That’s why we have chosen to use our annual report this
year to provide a snapshot of the work that goes on in the
organisation and to ask those whose lives have been
affected by mental illness and our partners to talk about
their experience of Trust services. We hope that their
testimonies will go some way towards challenging the
stigma of mental illness and demonstrate both how much
our staff are valued and how with the right support it is
possible for people to recover.
During 2006/07 we have won a number of tenders set by
our local primary care trusts. We are now managing all
aspects of the substance misuse and mental health service
in Wandsworth Prison and have also won a contract
to provide eating disorder services to the local community
for the next three years.
of personality disorder services which are among the
best in the country.
In the months and years ahead, we intend to develop
mental health services which are special to those who use
them and to the staff who work in them. Our vision is a
future in which people with mental health problems have
the same opportunity as other citizens to participate in and
contribute to our communities.
First, all our clinical services will be compliant with best
practice guidelines and deliver safe and effective treatment
and care.
Second, we will work with our partners in local government,
the voluntary and private sectors and hard-to-reach groups
to ensure that all those who use our services enjoy the
same opportunities as everyone else. This means, in
particular, that they have the support they need to maintain
hopeful relationships and friendships; have something
meaningful to do, whether education, work or recreation;
and, where required, to be helped with safe and appropriate
living arrangements.
We want those who use our
services and the people who
care for them to experience excellent service as a reality and
to work with us to continually improve the quality and
responsiveness of our services.
Finally, we need to renew our organisation in order to
deliver these important things. Much has been done in the
past year to improve our management capacity and
capability. We will build on this in the coming months as we
prepare to become a Foundation Trust later in 2008. This
will enable the 18,000 long-term users of our service, our
staff, our partners, and members of the local community to
have a real stake in the direction and governance of the
organisation. It will equip us with greater financial and
business flexibility to ensure that together we can provide
services which are special and highly valued by the people
we are here to serve.
Peter Houghton
Chief Executive
South West London and St George’s Mental Health NHS Trust Annual Report 2006/07
5

about us
South West London and St George’s Mental Health NHS
Trust was formed in 1994 but its history goes back a lot
further. The headquarters at Springfield University Hospital
in Tooting has been providing mental health services for
more than 160 years, since the ‘asylum’ was first built there
in 1841.
Today the Trust serves a population of about one million
people across the five London boroughs of Kingston,
Merton, Richmond, Sutton and Wandsworth. We provide
the full range of secondary mental health services to the
local population as well as some learning disability services
and a number of specialist services nationwide.
The Trust is contracted to provide some primary care services
within GP practices and also provides education, training
and research, in partnership with four academic institutions.
We operate from 100 sites including:
• Springfield University Hospital, Tooting
(our headquarters)
• Barnes Hospital
• Richmond Royal Hospital
• Tolworth Hospital
• Queen Mary’s Hospital, Roehampton
• Henderson Hospital, Sutton
• Nelson Hospital, Raynes Park
• St George’s Hospital, Tooting
• Sutton Hospital
• St Helier Hospital, Carshalton
• Wilson Hospital, Mitcham
Did you know?
• 18,000 service users are currently receiving treatment
• We had 3,831 inpatient admissions in 2006/07
• We employ 2,696 staff
• We have 750 inpatient beds
• Our annual budget is £170 million
ABOVE: Springfield Hospital, Tooting (top); Queen Mary’s
Hospital, Roehampton
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our vision
A future in which people with mental health problems
have the same opportunity as other citizens to participate
in and contribute to our communities.
Our values
The most important people in our services are those who
use them and their relatives, friends and carers. The most
important resources that we have are the staff that provide
their care and support.
In all our actions we will recognise and value the diversity
that exists in our services and our local community and
strive to ensure equality of access, experience and outcome
irrespective of race or ethnicity, disability, age, gender,
sexuality or religious belief, or place of residence.
We will treat everyone with dignity and respect, involve
them in decisions that affect them and provide them with
whatever information they feel will help them.
In all that we do we strive for excellence, equity and the
efficient use of resources.
Our purpose
The Trust recognises that everyone with mental health
problems faces the challenge of retaining or recovering a
life that is as meaningful, satisfying and valued as possible.
The purpose of the Trust is to help people with mental
health problems to do the things they want to do, live the
lives they want to live and access those opportunities that
all citizens should take for granted.
To achieve this purpose we will work in partnership with
those who use our services, their relatives, carers and
friends, and other stakeholders to:
• foster hope in those whom we serve and do our best
to ensure that everyone’s experience of using our
services is a positive one
• provide effective treatment and help people to take
back control over their problems and their lives and the
help they receive
• improve people’s life chances by promoting their
health, safety and wellbeing and assisting them to
access the opportunities that they value: homes, jobs,
friends, relationships, education, social pursuits, leisure
activities, spiritual possibilities
• undertake teaching, clinical audit and research, to enable
us to continue to do this work for those who will use our
services in the future
• cultivate a workforce that is committed to pursuing
our vision and purpose and ensure they have the
support and development opportunities they need to
do so.
South West London and St George’s Mental Health NHS Trust Annual Report 2006/07
7

Key achievements 2006/07
• Eight out of 10 respondents in the
2007 National Service User Survey
rated their care at the Trust as ‘good’,
‘very good’ or ‘excellent’
• We obtained funding from the
National Specialist Commissioning
Advisory Group (NSCAG) for our
national obsessive compulsive disorder
(OCD) service and our enhanced
community treatment for OCD was
singled out by the National Institute
for Health and Clinical Excellence as
a model for other services nationwide
to follow
• We have taken over the management
of the substance misuse and mental
health service in Wandsworth Prison
• We won a contract to provide eating
disorder services to the local
community for the next three years
• Building work got underway for the
new Wandsworth Acute Unit, at
Springfield Hospital, due to open in
January 2009
• In July 2006 Richmond became the
first London borough to use RiO, the
new electronic patient record system
• Service users have faster access to
medication now that we have six
qualified supplementary prescribers
at the Trust. This enables them to
prescribe medicines within the scope
of the patient’s clinical management
plan agreed with a doctor.
our work
Scott Bradley
Health Care Assistant
“I’ve worked in the Eating Disorders Day Hospital since it
opened two years ago. All patients have to commit to
attending the day hospital between 8am and 4pm on
weekdays and the treatment programme lasts around 30
weeks. It’s an innovative way of working which achieves
the same results as an inpatient service, but means that at
the end of treatment patients don’t need help with
reintegrating into home life.
“My role involves providing help and guidance for patients,
for example sitting in on mealtimes to provide therapeutic
support, doing home visits to assess a person’s living
arrangements, accompanying patients to buy food for the
weekends and being a friendly ear when they need it. A lot
of the work is about building people’s self-esteem, selfworth
and confidence in how they live their lives. Because
patients are so ill when they first come in, they have to
re-skill themselves about how to lead a life again.
“It’s a rewarding job – there’s nothing like seeing people
come in who are obviously damaged and seeing them go
out fixed. I’m here to help patients but also learn so much
from them – it’s a two-way street.”
Holly
eating
disorders
“I’ve suffered from an eating disorder since I was about 13
years old. When it was suggested to me that I come into
the day hospital, my stomach sank with relief. At the time
I think I was still very much in denial about how serious my
eating disorder was and how I wasn’t coping.
“The way the day hospital works is quite challenging but in
a gentle way. Every week staff reassessed what I needed
and because treatment was based on me as an individual,
I felt respected as a person and that staff accepted me no
matter what. As a day patient, I also had the chance to go
home and take responsibility for food and know that I
could cope on my own.
“Even though I still struggle and don’t feel 100 per cent
satisfied with my body, I’m more confident than I’ve ever
been simply because I felt staff respected me and gave me
permission to just be me. I found the art therapy to be a
really powerful way to express myself and am now doing
art at college. I’m also going abroad twice this year and feel
like the whole world has opened up to me. The hospital
saved my life and totally changed it.”
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RIGHT: Holly with Health Care Assistant Scott
Bradley in the Eating Disorders Day Hospital

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South West London and St George’s Mental Health NHS Trust Annual Report 2006/07

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South West London and St George’s Mental Health NHS Trust Annual Report 2006/07

occupational therapy
Carol Farrell
Associate Director of Therapies, Sutton
“As an occupational therapist, I see my role as helping
people to live the kind of life that they want to live.
Occupational therapists are not so concerned about what
a person’s diagnosis is, but try to use that person’s
strengths to help them develop and gain confidence. I look
at how they manage in their home or at work, or look at
ways to assist them into work or leisure activities. We use
occupation as our medium to help people – everybody
needs to be able to spend their time doing things that are
important and meaningful to them.
“It’s a very varied role as it depends on each individual as
to what they want and how best we can help them. It’s
about looking at the whole person and trying to consider
all their needs. It may be that they need help to access
training or education or help improving their cooking skills.
The thing I love about occupational therapy is that it’s
about helping people to help themselves and achieve what
they want to achieve. It’s very much about empowerment
and it’s very satisfying to give people hope and a feeling
that they can be full members of society in some way
whatever they do.”
Lea
“I became ill with depression in 1991 and this meant I was
not looking after myself or my flat and had problems
relating to my family. I had no self-confidence – I had
reached the bottom and couldn’t go any further.
“Carol started to see me on a regular basis at my home –
she helped me to clear out my flat and to do the day-today
things I was struggling with. We talked through the
problems I was having with my family and this helped me
to make a better attempt at talking to them. Carol helped
me to build my self-confidence. She encouraged me to
complete some courses on volunteering in the community
at college and also I started to do some voluntary work.
“In March I started a job with Sutton Advocacy for Mental
Health. I’m a community advocate and help support people
with mental health problems with any problems they may
be having and to speak up on their behalf. I love it – I get
a buzz knowing that I’m doing something that helps
people to progress rather than being stuck with their
problems. I never loved my life like I’m loving it now – my
life has totally transformed.”
A meaningful day
People who are admitted to an
inpatient unit often complain of
boredom and this can have a negative
impact on their wellbeing and recovery.
The Meaningful Day project has been
launched to improve the relevance,
accessibility and therapeutic
effectiveness of activities on offer
to enhance the quality of life on the
wards and the health, wellbeing and
community reintegration of inpatients.
Several wards are piloting the project,
adopting the following principles:
• a coordinated approach involving a
wide variety of staff, volunteers and
community agencies
• strong user involvement
• activities focused on retaining
and/or developing strong links with
the community
• daily activities including evenings
and weekends.
This year another exciting project has
seen the introduction of internet access
and other computing facilities for
service users. Following a successful
pilot, many wards at the Trust now
have a computer that service users can
access. We believe there are many
potential benefits, for example, service
users will be able to develop their
skills as well as having better access
to information, education and
employment opportunities.
LEFT: Lea (left) with Sutton’s Associate Director of Therapies
Carol Farrell in the garden at Sutton Hospital
11

OCD services
Moving towards
Foundation Trust status
We’re aiming to become a Foundation
Trust by October 2008. As well as
ensuring that local people have a real
stake in our services, in particular those
who use our services and the people
who care for them, staff and our
partners, this will give us greater
autonomy and financial flexibility. In
November 2006, the Trust undertook
the Foundation Trust diagnostic with
NHS London and Monitor, the
Foundation Trust regulator. This looked
at our systems and processes and
identified those areas that we need
to focus on further before we formally
apply to become a Foundation Trust,
such as ensuring we have a clear estates
strategy and that we understand our
position in the market. We’ve recently
appointed a Foundation Trust lead to
take forward our application.
Lynne Drummond
Consultant Psychiatrist
“I’ve been the consultant in charge of the Behavioural
Cognitive Psychotherapy Unit, which deals with severe,
complex, resistant obsessive compulsive disorder (OCD), for
nearly 22 years. I have a fantastic team, some of whom
have worked with me for 20 years, which sees around 200
people a year.
“OCD may appear in various forms, including fear of
contamination by dirt and germs and repeated handwashing,
and the mainstay of treatment is to encourage people in
a consistent, regular and graded way to face up to their
worst fear.
“This year we obtained central funding from the
Department of Health for our national service, which
includes the only fully staffed inpatient unit for OCD in the
NHS and an outpatient community facility. This has not
only secured the future of the service but will allow
research projects to continue into the causes and best
practice for dealing with the disorder.
“Our enhanced community service which provides local
services for people in the five boroughs we serve was also
singled out by the National Institute for Health and Clinical
Excellence earlier in the year as a model for other services
nationwide to follow.
“I really enjoy the variety of my job and love seeing patients
get better.”
Jayne
“I have obsessive compulsive disorder which means I have
a fear of contamination so repeatedly wash my hands. Last
summer it got particularly bad and I was finding it disabling
so that’s when I was prompted to ask if there was a
residential centre where I could go. I couldn’t pick things
up from the floor or touch door handles and would take
hours to cook something because of the constant
handwashing. I have two young children and while I was
still able to take care of them, I felt guilty about not
spending enough time with them.
“At first I was scared about being an inpatient – being
away from home and the thought of coming to a
psychiatric hospital was a bit frightening. But everyone was
very friendly and welcoming when I arrived and within no
time at all I had settled in.
“I’ve now been here for about 10 weeks and it’s meant I
can fully concentrate on myself and getting better. I’ve
undergone exposure therapy which makes you do the
things that you fear and cause you anxiety, such as
touching door handles. I’ve definitely improved and notice
when I go home at weekends that I’m much happier and
have more time to do the things that I want to do.”
12
RIGHT: Jayne (left) with Consultant
Psychiatrist Lynne Drummond

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South West London and St George’s Mental Health NHS Trust Annual Report 2006/07

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South West London and St George’s Mental Health NHS Trust Annual Report 2006/07

addictions
Collen Baffana
Ward Manager
“Patients are referred to Heather Ward for assessment
and treatment for addictions and related physical illnesses.
Their primary diagnosis is alcohol dependence. My role
is to coordinate the care of patients based on a supportive
therapeutic relationship, and adequate support for
families and carers. The patients are admitted via the
Community Alcohol Team and boroughs of Kingston
and Richmond.
“The challenges that we face as a team are centred around
severe dependence and high risk of severe withdrawals if
not properly monitored. The key to successful treatment
plans is to have an intensive ward routine that is based on
being alert, flexible and client-centred.
“Running a ward successfully is challenging and a lot of
hard work. Patients are involved in decision-making so we
have community meetings twice weekly and also meet
with their patient representative once weekly to discuss any
issues affecting their day-to-day care. Each day is totally
different to the next which keeps you on your toes. But the
benefits outweigh the challenges because you can
compare their presentation on admission and when they
get discharged – physically they are 80 to 90 per cent
better and emotionally stronger. I’ve been with the team
for about five years but it feels as though it’s only been
a month!”
Anthony
“I’ve had a drinking problem since I was about 27 and first
went into detox when I was 31. My latest relapse happened
after some personal problems which pushed me over the
edge and I started drinking again. Before I knew it a lot of
my old behaviours returned – I was short of money and
was going to any measure just to get a drink.
“I completed a detox programme at Queen Mary’s Hospital
and decided I wanted to go into rehab and was admitted
to Heather Ward at Springfield Hospital. I needed to build
my mental strength again in a structured and safe
environment – I wanted to get my confidence back.
“I’ve now been discharged back into a treatment centre
and want to get my life back. I know that’s only going to
happen if I take the help I’ve been offered and stick to it. I
need to take one day at a time. I turn 40 this year – they
say life begins at 40 so I hope it’s true in my case.”
Listening to service users
Understanding what people who use
our services think about the treatment
and support they receive is crucial to
improving the quality of the services
we provide.
In the Healthcare Commission’s 2007
National Service User Survey, eight out
of 10 respondents rated their care at
the Trust as ‘good’, ‘very good’ or
‘excellent’. Areas in which we appear
to have performed better than other
mental health trusts include:
• ensuring people have a say in
medication they take
• having a number to call out of
office hours
• explaining a person’s rights when
being sectioned
• not having appointments changed
or cancelled and ensuring people
see the same psychiatrist on
different occasions.
However, the survey also highlighted
several areas needing improvement
which will be addressed in an action
plan, including:
• ensuring people can contact their
care coordinator if they have
a problem
• involving people in deciding what is
in their care plan and ensuring they
understand their care plan
• ensuring carers receive enough
information and support from health
and social services.
The Trust has also introduced a series
of local surveys of both inpatient and
community care to help improve the
service that individual teams provide.
LEFT: Ward Manager Collen Baffana (left) and
Anthony in the gardens at Springfield Hospital
15

Hume wins National
Clean Air Award
Hume Ward became the first mental
health unit in the UK to be presented
with the National Clean Air Award, an
initiative by the Roy Castle Lung Cancer
Foundation, for its no smoking policy
in September 2006. Hume, like the rest
of the Trust, became officially smokefree
on 1 January 2006 in response to
growing concerns over the effects of
secondhand smoke.
Sharon Spain
Deputy Ward Manager/Wellbeing Nurse Advisor,
Wandsworth
wellbeing service
Taukeer
Now the secure psychiatric ward at
Springfield Hospital is completely free
from smoking, which is only allowed in
an outdoor courtyard at certain times
of the day.
Smoking rates are at least twice as high
among mental health patients compared
to the general population. The ‘Smoke
Free Minds’ programme running within
the Trust is aimed specifically at helping
mental health service users to give up
smoking. To date, more than 200 staff
have been trained to offer stop-smoking
support and more than 50 have trained
to become NHS Stop Smoking Advisors.
“The wellbeing service was launched in September 2006
for patients with severe mental illness because research
shows that their physical health is often neglected and they
are at a higher risk of developing problems such as
diabetes, coronary heart disease and hypertension.
“I work with the seven community teams in the borough
and my role is to engage with service users who may be
reluctant or feel unable to see their GP. We run eight-week
healthy living groups to educate patients about areas such
as stress management, healthy eating, reading food labels
and how to increase their physical activity. We also have
one-to-one meetings with service users and are in the
process of identifying physical health champions on the
wards who will run healthy living groups for inpatients.
“It’s been really successful with the clients and with some
their weight and blood pressure has been gradually coming
down. Carers have also given positive feedback and are
pleased there’s someone else checking out physical health.
There have been a few people who have slipped through
the net and haven’t been to their GP so I hope we’ve
caught them in time and helped prevent them from
developing a physical illness.”
“I first heard about the wellbeing service from my consultant
psychiatrist so I thought I’d go along and see what it was
about. I found the sessions very easy-going and would
recommend them to others. The staff are friendly and you
can ask them any questions you may have. There is also no
pressure on you to immediately change your life style.
“In the sessions I learnt about nutrition and the importance
of cutting down on sugars, fats and salts. Since then I’ve
completely stopped eating sweets and putting sugar in
coffee and tea. I’m also drinking fruit juices rather than
fizzy drinks.
“We also learnt about exercise and how you can easily
burn more calories by using the stairs or going for walks.
I work in a post room and have been using a pedometer
recently which has shown that I walk half a mile while at
work. Stress management is another big area we’ve discussed
and ways to help cope with stress and feel more relaxed.
“I now see Sharon, my wellbeing nurse advisor, on a oneto-one
basis in clinic about every six weeks to monitor my
physical health. I only started the programme a few weeks
ago but have already lost a few pounds.”
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RIGHT: Wellbeing Nurse Advisor Sharon
Spain checks Taukeer’s blood pressure

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South West London and St George’s Mental Health NHS Trust Annual Report 2006/07

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South West London and St George’s Mental Health NHS Trust Annual Report 2006/07

youth club
Mandy Billingham
Clinical Specialist Occupational Therapist
“We set up the Springfield Hospital Youth Club two years
ago to provide a non-ward-based social setting for young
people under the care of mental health services. We found
that for many of these young people going out to a
community youth club was a big step so we wanted to
give them a stepping stone in between. We worked with
Wandsworth local education authority teachers who
work on Aquarius Ward, Wandsworth Youth Service and
the young people themselves to develop a proposal
which then won a grant to help set it up.
“The youth club is available for 11 to 18-year-olds from
the deaf child and family inpatient unit, our adolescent
and eating disorders inpatient wards and those receiving
care in the community. We run the youth club every
Thursday night, providing a range of activities including
sports, music, arts and cookery, and in the school holidays
we organise day trips every week.
“It’s very user-led with the young people deciding what
they want to do. The club has been great for the
interaction between deaf and hearing young people and
has helped them to gain an understanding of each other’s
needs. Seeing the young people develop is fantastic – they
have improved confidence, better social interaction and
greater self-esteem.”
Jenni
“I started going to the Springfield Youth Club when it
first opened in 2005. At the time I was an inpatient on
Aquarius Ward and I enjoyed being able to leave the ward.
You can’t choose who you are in hospital with, so it was
also good to be able to meet people and staff from other
units. I made some friends who I’m still in touch with.
“I was a member for about nine months and enjoyed
activities like Playstation, playing the drums and guitar,
using the decks, and playing pool, snooker and badminton.
We also went bowling and ice-skating. We also started
learning sign language from the deaf staff and members
and I now want to learn it properly so have signed up to do
a British Sign Language course.
“Being in hospital isn’t easy and so it was good to have
somewhere you could go and be normal and do normal
things that weren’t hospital-related. I’m now hoping to
go back and work as a volunteer at the youth club. I got
a lot out of the youth club – seeing it when it first started
and helping to set it up – so I’d like to be able to give
something back.”
Wandsworth Acute Unit
The Springfield Hospital site had its
largest upheaval to date when ground
works to install infrastructure and
services for the new Wandsworth
Acute Unit started in December 2006.
Foundations for the building are now
underway and the unit is scheduled to
open in the early part of 2009. It will
replace the facilities currently housed
in John Meyer and Bluebell Wards to
create a modern psychiatric intensive
care unit and a Section 136 suite, plus
an adult acute inpatient ward and
spacious community mental health
team (CMHT) offices.
The innovative design means that
security will be designed into the
boundaries of the building. Inpatient
areas will be on the first floor while
offices will be on the ground floor.
The themes of wellbeing and nature
will guide the interior design of the
building, with plenty of natural light
flooding in and through the use of
natural materials.
At a cost of £22.9 million, the
Wandsworth Acute Unit is the largest
building project ever undertaken by
the Trust. The cost of the building is
being met by a capital allocation from
the Strategic Health Authority (before
it became NHS London) that was
granted to help replace some of our
most outdated facilities.
LEFT: Clinical Specialist Occupational Therapist Mandy Billingham
(left) and Jenni at the Springfield Hospital Youth Club
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partnership working
Springfield regeneration plan
The Wandsworth Acute Unit represents
the first phase of the Springfield
Regeneration Programme. This is a
programme of replacing the outdated
mental health facilities on the
Springfield Hospital site at the same
time as integrating a new sustainable,
healthy community.
In April 2007, the Trust announced
that it had started a partnership with
urban planning and design consultants
Montagu Evans – Urban Strategies after
a six-month competitive tendering
process. The partnership will work
on producing an outline planning
permission application to the local
council and the Mayor of London’s
office for a major regeneration project
incorporating a mix of new uses
including housing, shops and leisure
facilities set among 21st century health
care accommodation – to be called
Springfield Garden Village.
Richard Hance
Head Gardener
“I’ve worked in the gardens at Springfield Hospital for 17
years. We have a team of three full-time and one part-time
gardeners who work here and we’re responsible for
maintaining all the land at the hospital plus the gardens at
three local hostels.
“Our job is to keep the place looking tidy and colourful.
We not only do the traditional tasks like planting, weeding
the beds and pruning but are also in charge of cleaning the
roads, installing fencing and paths and go round picking up
the litter twice a day.
“We work with SHARE Community, an organisation that
provides training and educational opportunities for
disabled people and those facing health-related barriers
to employment. SHARE grows many of the plants we use
at Springfield.
“I love being out in the fresh air and enjoy making the
gardens look attractive for patients, staff and visitors. It’s
great when you’ve planted something and then see the
outcome – it makes you think you’ve done a good job and
people appreciate it. When people say the gardens look
nice, clean and tidy, it makes the job worthwhile.”
Alex
“I’ve been working in the gardens at Springfield Hospital
for nearly two years as a work placement to gain
experience and improve my skills. I work here once a week
through SHARE Community and have completed an
NVQ level 1 in horticulture and am now working towards
my level 2.
“I enjoy being part of the gardening team and being able
to use the machinery, drive the vehicles and use the
equipment to gain the practical experience I need. Because
the gardens are so big, you get lots of practice whether
it’s weeding, mulching, pruning or looking after the paths.
I’d never worked as a gardener before I came here and
now I know I can do it – it’s done my confidence no end
of good.
“I’m hoping to complete my NVQ level 2 by September and
then I’ll start looking for a job. I’ll have the qualifications
and also the practical knowledge and experience so it
should help me to get a good gardening job.
“Nothing compares to being out in the garden – it’s new
every morning. You see flowers beginning to bud and
something you planted maybe six months ago starting to
grow. You feel closer to nature here.”
20
RIGHT: Head Gardener Richard Hance (left) and
Alex in the SHARE garden at Springfield Hospital

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South West London and St George’s Mental Health NHS Trust Annual Report 2006/07

22
South West London and St George’s Mental Health NHS Trust Annual Report 2006/07

in the community
Joyce Mutabeni
Christine
Community Psychiatric Nurse
Text messaging
Missed appointments cost the NHS
money. In community teams, ‘Did Not
Attend’ (DNA) rates are as high as 25
per cent for first appointments, making
it very difficult to balance capacity with
demand in these services.
Work started this year on a six-month
pilot using mobile phone technology
to remind service users when they have
an appointment at the Trust.
“I work as part of a multidisciplinary community mental
health team and manage a caseload of clients with a
variety of conditions such as schizophrenia, bipolar
disorder and depression, who I see regularly in the
community. My role is as an independent care coordinator
providing holistic care for my clients – whether that be
helping them with their mental health problems or any
social or financial issues.
“It’s important to help clients understand their illness and
how to deal with relapses or relationships with their family
so they become independent and can help themselves.
I carry out assessments of people referred by their GP, help
clients with their medication and provide support and
education for their carers, as it can be stressful for them
too. My role also involves supervising student nurses on
placement at the Trust to help with their learning.
“I enjoy the independence of my job and the fact that I get
to know clients and their families well so build therapeutic
relationships with them. One of the best things is that you
feel you’ve achieved something big when you change
someone’s life for the better and people appreciate what
you do. I have great support from the team and have learnt
not only from colleagues but from clients as well and this
has helped me to grow personally and professionally.”
“When you are ill, you need support and someone
professional who knows what they are talking about and
who can give you help. I started seeing Joyce, my
community psychiatric nurse, around five years ago and
have not been back in hospital since then. Developing a
relationship with Joyce has been very helpful – I know she’s
at the end of the phone if I need to speak to her and that
she’s going to visit every fortnight.
“We spend time talking about how I’m feeling, whether
I’m sleeping properly and any other problems I may be
having. Joyce has also taught me about relapse signs and
what to look out for. Joyce will spend as much time with
me as I need and always gives me her full attention.
“I’m now doing a course on counselling, which is
something I never would have done a few years ago. I’m
also working as a volunteer kitchen assistant, which
motivates me. When you are experiencing depression
you’re not able to get out of bed but this gives me a focus.
“Joyce is always a positive influence on my life and has
helped to build my self-esteem. She’s helped me to see
there is hope and that you can recover.”
The pilot was launched in May 2007
in the Early Intervention Service with
a system that automatically sends text
message reminders to service users
at a predetermined time before their
appointment. If the recipient wishes
to cancel the appointment, they can
respond to the text message and let
the service know.
It is hoped the system will deliver
other benefits including a reduction
in the amount of time staff spend
making reminder calls and a handy
way for service users to rearrange the
appointment if it is not convenient.
Later this summer, the pilot is being
extended to the Balham and Tooting
and the New Malden Community
Mental Health Teams.
LEFT: Community Psychiatric Nurse Joyce
Mutabeni (left) and Christine in the art room
23

working with carers
Wandsworth Prison tender
Since 1 June 2007 the Trust has taken
over the management of all aspects
of the substance misuse and mental
health service in Wandsworth Prison.
This followed a successful bid by the
Secure Healthcare consortium, of which
the Trust is part, to provide health care
to the prison. This will allow us to build
on the excellent work already being
undertaken by the inreach team to
provide a fully integrated service across
the prison wings, the mental health
inpatient unit and the day service.
It also provides an excellent opportunity
for staff to rotate between the forensic
service and the prison and to build
better links between the Trust service
and the criminal justice service.
Kris Chokupermal
Manager, Maddison Centre
“I oversee the services based at the Maddison Centre
which includes the Hampton Community Mental Health
Team, the Crisis and Home Treatment Team and the
Maddison Day Hospital. We offer a holistic package of care
with all services based on one site.
“I also run the carers’ group here which has been going
for 15 years. My role with the group is to make people
aware of the signs and symptoms of illnesses, the different
types of illnesses, how they manifest themselves and how
a person’s needs can best be met.
“For some people, a family member being ill can lead to
the breakdown of the relationship but often this can be
prevented if they know what kind of support is available
for their family members, for themselves and for their
relative who is mentally ill. The carers’ group is educational
as well as a support group and I think it’s been sustained
because people feel they get something out of attending it.
“I really enjoy the contact that I have with clients and
carers. The greatest pleasure I get is when I see someone
who is very unwell and then see them moving forward and
getting on with their life. That’s the greatest achievement.”
Dilys
“I came into contact with Kris and the Maddison Centre
through my son’s illness. I hadn’t had any experience of
mental illness before and the symptoms can be extreme so
the carers’ meetings were very useful. It was good to see
that there were other people experiencing the same thing
and to understand that these are symptoms of an illness
and not of a chaotic family or a bad upbringing or any of
the other things that people generally think they are.
“The carers’ group meets monthly and each person
talks about what has happened in the past month with
the person they care for – because some of us have
been meeting over several years we often see great
improvements, as with my own son.
“We have also had meetings where an expert has come in
to discuss a specific topic, such as a particular illness, new
medications and counselling and cognitive behavioural
therapy. Kris’s role in the carers’ group is crucial because
it means that carers can ask specific questions related
to medication or day-to-day care and he can give
authoritative answers.
“Our involvement in the carers’ group has given us a
deeper understanding of our son’s illness and the likely
outcomes, which has given us strength to go forward.”
24
RIGHT: Manager Kris Chokupermal
with Dilys at the Maddison Centre

25
South West London and St George’s Mental Health NHS Trust Annual Report 2006/07

26
South West London and St George’s Mental Health NHS Trust Annual Report 2006/07

social work
John Leavy
Senior Approved Social Worker
“I work in a multidisciplinary team and with my colleagues
help support vulnerable adults in the community with
severe and enduring mental health problems, such as
psychotic illnesses and major mood disorders.
“My role is to look at a person’s social circumstances but I
also work very closely with health colleagues. This involves
working with the individual to assess their needs and then
helping the person to help themselves. For example, it
might be ensuring they are getting the benefits they are
entitled to, issues around housing or identifying funds and
alternative sources of support that might better meet their
needs. It’s helpful to establish a good working relationship
with clients as this enables a more constructive partnership.
“As an approved social worker, I also assess people who it
may be necessary to detain under the Mental Health Act
1983 for their own health and safety. This is a decision that
is taken when all other options have been exhausted.
Whilst I can find this a difficult process, I also see the
benefits that treatment can bring in improving the quality
of life of clients.
“Mental health is very holistic and you get to know
clients which I see as a privilege. It’s very rewarding to
help individuals make positive changes to their life,
however small.”
Stafford
“I started seeing John, my social worker, around nine
months ago having been put in touch with him through
Twickenham Community Mental Health Team.
“I now see John once a fortnight and we have discussed
everything from family life and life management to
motivation and my recovery and how I move forward. John
has put me in touch with a resource centre which helps
people get back to work and I’m currently looking to do
some voluntary work.
“Being involved with John and the team at Richmond
Royal has improved my quality of life and my overall
independence. The team is very professional and skilled
at identifying problems and then working through them
with you.
“I’ve been given help with practical aspects such as getting
benefits and the resources I need to find a home. I was
living with family before and John and I discussed various
options that were open to me. A room in a supported
house became available and I’ve now been living here
for a month. It’s been good for my mental health and
has given me independence from my family. I’m more
relaxed and feel able to progress with my life in a
constructive way.”
Setting new records with RiO
In July 2006 Richmond became the first
London borough to start using RiO, the
new electronic patient record system.
RiO is replacing the three main clinical
systems in use at the Trust with one
system to plan, schedule and record
patient care and since July 2007, all five
of the Trust’s boroughs have been
using RiO.
On time and on budget, the complex
project has huge benefits for the Trust
and will improve information sharing
and communication across our many
sites. Data has to be recorded within
24 hours, which means that whenever
a patient is seen at the Trust, clinicians
can access the most up-to-date
information at the touch of a button.
As the first mental health trust out of
six in London to go live with RiO, it
was inevitable that we would face
some teething problems. The staggered
launch has taken a huge amount of
preparation. In the year ahead, more
support will be given to staff using
RiO and further preparations will be
made to upgrade the system.
LEFT: Senior Approved Social Worker John Leavy
(left) with Stafford outside his new home
27

Henderson Hospital
In February 2007 a new business case
was agreed for the internationally
renowned therapeutic community,
Henderson Hospital, which treats adults
with severe personality disorders. The
hospital, based in Sutton, is run as a
democratic community and residents,
who live there on a voluntary basis, are
very much involved in the day-to-day
running of the community. Treatment is
based on group psychotherapy and
sociotherapy and no medication is used.
In response to requests from
commissioners for more choice and
flexibility, the new model agreed
includes shorter lengths of inpatient
stays of six, nine and 12 months,
governed by clinical need and patient
choice. We will also be making further
changes to Trust-wide personality
disorder services with the development
of a two-day a week programme for
local people with personality disorder.
personality disorders
Jane Fisher-Norton
Principal Adult Psychotherapist
“I’m based at the Henderson Outreach Service where part
of my role is to assess and prepare people to be admitted
to the Henderson Hospital. This usually involves providing
them with more information and offering a space for them
to explore what committing to intensive therapy means for
them, emotionally and practically.
“Residents stay at the Henderson for up to 12 months and
so can need help to adjust when they leave. Many people
have never felt like they belong anywhere before and so
leaving can be a painful process. We run a weekly leavers’
transition group to talk about these issues and to help
people find a way of moving on from them.
“Another large part of my job is training other
professionals on personality disorder. We have a small
group of ex-residents who help co-deliver the training and
we also give joint presentations on the Henderson to
referrers and commissioners. It’s very satisfying helping
people to set up new services for personality disorder and
so ensuring the client group is better served.
“I enjoy the variety of my role but the best thing is seeing
people change so they are able to manage their difficulties
in a less destructive and more creative way.”
Kath
“I was discharged from the Henderson Hospital in
September 2004 after completing the one-year programme.
Before I went to the Henderson my life was very chaotic
and I spent a lot of time in psychiatric units for a variety of
things, including self-harm.
“My time at the Henderson was hard work but at the same
time it was beneficial in helping me come to terms with my
difficulties. For me, the non-structured time was most
valuable as it gave you the chance to live with people and
repair your social skills. I also found the supportive nature
of the community very helpful, especially from my peers.
“Since leaving the Henderson I have not self-harmed or
been in an acute ward. It doesn’t mean all your problems
will go away but you are armed with better skills to deal
with difficult issues. I believe that if I hadn’t gone to the
Henderson I would now either be in prison or maybe not
be alive – it was a life-changing experience for me.
“I now work with Jane and the Henderson Outreach Team,
giving workshops and training to inform people about
personality disorder from a service user perspective. I really
enjoy it because I feel I’m putting something back into the
system that has helped me enormously.”
28
RIGHT: Principal Adult Psychotherapist Jane
Fisher-Norton (left) and Kath co-deliver training

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South West London and St George’s Mental Health NHS Trust Annual Report 2006/07

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South West London and St George’s Mental Health NHS Trust Annual Report 2006/07

employment support
Edmund Glynn
Lead Employment Specialist
“I work in Kingston and manage the Employment Support
Services. Our work demonstrates that the Trust can
promote people’s recovery and social inclusion by
supporting them to succeed in their careers.
“Our approach focuses on meeting individuals’ unique
needs. We support clients to identify their strengths and
skills and find out what job they want to do. We then help
provide the support the person needs to achieve their goal.
“This involves helping people with CV-writing and their job
search, overcoming benefits’ traps and providing ongoing
support with any problems that may arise. Our work with
employers ensures they make the most of the employee’s
particular skill set.
“We have supported people to gain work in a wide variety
of roles including IT, sales and marketing, teaching, retail
management, accountancy and in the media.
“What works really well in Kingston is that the
employment specialists are fully integrated with the clinical
teams and it is now recognised that it is part of every
professional’s job to support people towards their career
goals. It is great to see people succeeding in what are often
highly skilled jobs, surpassing their own and others’
expectations, and enjoying the personal, social and
financial benefits that paid work brings.”
Chris
“I was put in touch with the Employment Support Service
around two years ago through the Kingston Assertive
Outreach Team.
“I studied horticulture at college and had previously
worked as a landscape gardener. Running my own
gardening business was something that I had always
wanted to do and Edmund helped me to achieve this goal.
“We worked together to draw up my CV and then I came
up with the name for the business, Flower Pot Men, and
developed a logo. I put an advert in the local shop window
about the business and started to get regular customers.
“I have now recruited another member of staff and we
have around seven regular customers. Edmund and I still
meet up for a chat every now and again to discuss how
things are going and any problems I may be facing. For
example, when I first started out I had no transport so had
to take all my tools on foot but I now have bought a car so
am able to get jobs further afield.
“We do everything from planting to mowing the lawns,
weeding to garden clearance – whatever the customer asks
us to do. I love working outside and getting a result from
what you do.”
Supporting people back
to work
This year we’ve introduced employment
support workers into the Community
Mental Health Teams in Wandsworth
following their success in Kingston
and Merton in helping service users
gain and retain open employment,
mainstream education/training and
voluntary work.
In Richmond we have worked in
partnership with a voluntary sector
agency to provide employment
specialists to work within its CMHTs.
We have also worked in partnership
with Kingston Council to provide
employment specialists in primary care
and this is being expanded to Merton
during 2007/08.
We’ve teamed up with the Fredericks
Foundation to support its Enterprising
Minds project which helps people with
mental health problems become self
employed. So far 28 per cent of our
service users who have used the service
have become self employed and a
further 32 per cent are working
towards self-employment.
In September 2006, our Vocational
Services were cited as a model of good
practice in the Department of Health’s
commissioning guidance on vocational
services for people with severe mental
health problems and within the Cabinet
Office’s White Paper Reaching Out.
LEFT: Chris (left) has received support from Lead
Employment Specialist Edmund Glynn to set up his
own business
31

Our performance
We have reviewed our performance against the key
objectives identified for 2006/07:
• Progress towards Foundation Trust status
We have completed the Foundation Trust diagnostic,
which assessed whether our clinical and management
systems meet the basic standards needed to become
a Foundation Trust. The Trust has now been allowed
to proceed to apply for full status, which we will pursue
over the next 18 months.
• Service redesign
Our performance against several key indicators has
improved over the past year, including seeing people
within seven days of discharge, reducing the number
of occupied bed days, reducing the number of people
whose discharge is delayed, increasing the number
of people seen by early intervention services and the
proportion of carers who have received an assessment.
• Patient experience
We have seen a significant improvement in the Trust’s
results in the annual national patient survey and local
service user experience audits are now regularly carried
out to demonstrate differences in satisfaction between
teams and over time.
• Learning from critical incidents
We introduced a programme of ‘being open’ training to
educate staff on what to do after a critical incident and
trained more staff in root cause analysis to ensure lessons
are learnt.
• Achieving financial balance
We achieved financial balance in 2006/07 and made
the surplus required to progress the Foundation
Trust application.
• Implementing RiO
We implemented RiO, the new clinical information
system, in three of our five boroughs. Rollout
continues to proceed on time and on budget.
We have introduced a set of key performance indicators
(KPIs) that monitor national targets and local strategic
priorities. The structures for data collection have been
embedded during the year and reviewed in the light of The
Intelligent Mental Health Board, Dr Foster, May 2007. As a
result of this review, nine new KPIs have been identified to
be reported regularly to the Board.
There are currently 34 KPIs that are reported to the Board
quarterly and can be found on the Trust website. The Board
report includes the definition, the purpose, the source of
the data and commentaries on each indicator.
Local Implementation Teams, made up from stakeholders in
each borough, assess the provision of mental health services
each year against 42 indicators. This year, the services
increased the number of indicators that were rated ‘green’
across the boroughs to a current average of 63 per cent.
Each borough produces a quarterly service level agreement
(SLA) monitoring report which goes into greater detail.
These are shared with commissioners and used as the basis
for performance monitoring.
The Trust still does not meet the critical targets for the
introduction of crisis resolution/home treatment and early
intervention teams. Our adult services are currently being
reviewed with partners including local authorities, PCTs and
GPs to ensure they can meet the needs of the most
vulnerable people in the future.
32

Annual health check
This year, the Healthcare Commission introduced its new
system for assessing and rating the performance of all NHS
health care organisations in England – the annual health
check. This has replaced the star ratings and is designed
to provide a fuller picture of a Trust’s performance. Under
the new system, all NHS organisations receive a two-part
scoring – the first part looks at the quality of its services
and the second part looks at how well an organisation uses
its resources.
For the period 2005/06, the Trust received a ‘fair’ rating for
quality of services and for its use of resources – in line with
most mental health trusts. Nationally 9.8 per cent of trusts
providing mental health services were rated as excellent,
29.5 per cent as good, 55.7 per cent as fair and 4.9 per cent
as weak for the quality of services. For use of resources, 1.6
per cent were rated as excellent, 9.8 per cent good, 73.8 per
cent fair and 14.8 per cent weak.
A number of Trust-wide initiatives have been introduced to
help improve our score for 2006/07, including:
• quarterly expert seminars aimed at senior clinical staff on
topics such as feedback from the patient survey, healthy
eating, physical health care and the experience of black
and minority ethnic groups
• production of ward information booklets and CMHT
information booklets, plus a Trust-wide information
group reviewing all literature
• annual quality awards ceremony and good practice
market place to acknowledge outstanding contributions
and share ideas and best practice
• leadership and development programmes for nurses led
by the Nursing Directorate
• risk training for all qualified staff covering adult, child
and public protection
• implementation of RiO to improve clinical information
and enhance decision-making and communication
• introduction of ‘being open’ training for all senior
managers and clinicians to enable staff to feel more
confident when communicating with distressed service
users and carers following any serious incident.
In April 2007, the Trust submitted its final declaration
against the 24 core national standards for the period
2006/07 to the Healthcare Commission. We believe good
progress has been made against a number of core standards
since last year, including ensuring all service users have the
information they need about their rights and the
treatments on offer.
However there is still more that needs to be done before
we are compliant with all the core standards. For example
some of our buildings do not meet the Healthcare
Commission’s criteria and we need to do more to meet recent
changes in statutory waste management requirements.
South West London and St George’s Mental Health NHS Trust Annual Report 2006/07
33

Our objectives
The Trust’s strategic objectives for the next three to five
years are to:
• provide clinical services that are demonstrably effective
and safe
• implement a recovery and social inclusion approach
across the organisation
• ensure the sustainability of services
• optimise the value of the estate
• create a workforce that is fit for purpose
• maintain financial balance.
To achieve these objectives, we will be concentrating
on the following key areas during 2007/08:
1. Complete the adult services review
We want to ensure that people with severe and enduring
mental illnesses receive services that are more responsive
to their needs. We will continue to work with local primary
care trusts and GPs to complete the review of community
services to introduce in 2008 the national best practice
models for crisis resolution, early intervention and assertive
outreach teams.
2. Undertake an audit of clinical services
We plan to undertake a careful and comprehensive audit
of the type of treatment and care offered to our
patients/clients, set against the explicit standards of care
determined by the National Institute for Health and
Clinical Excellence (NICE). The results of this will inform
and shape a comprehensive programme of improvement
in clinical services to ensure that, as a Foundation Trust,
our clients receive a quality of care that maximises their
chances of remission and recovery.
3. Complete the roll-out of the new patient
record system
RiO, the new patient record system, was implemented
in three of our five boroughs during 2006/07. Over
the next year we will complete the roll-out, which
will not only improve access to patient information but will
also create a source of quality information to assess the
effectiveness of services, especially in our Child and
Adolescent Mental Health Services (CAMHS). When
completed the Trust will have invested more than
£2 million in the roll-out of the RiO system and
further investment is planned for the upgrade to later
versions of RiO which have increased functionality.
4. Introduce a recovery approach across
the organisation
Mental health problems, and all the prejudice and
discrimination that surround them, can have a
devastating effect on people’s lives. Too often people lose
the things that they value – like jobs, homes and friends –
and are left feeling hopeless, isolated and alone. Our
job as a Trust is to restore hope and help people to
find a new sense of meaning and purpose in life. Help them
to hang on to the things they value, work out
ways of overcoming the difficulties they face, and make
the most of their lives. The national trend and a local
strategic priority is the implementation of a recovery
approach. During 2006 we worked on developing a
Strategy for Promoting Recovery and Facilitating Social
Inclusion to provide a framework for guiding these
endeavours. Over the coming year we will begin a
comprehensive training programme for our staff in
the recovery approach and introduce up to 60 recovery
support workers. This will help the Trust and local
commissioners to meet the national target for support
time and recovery workers. We will also work with
service users and partner organisations to develop local
plans for translating our ambition into reality in each
borough and service.
5. Focus on Foundation Trust status
We will continue to progress our application to become a
Foundation Trust during 2007 and aim to achieve this
status in October 2008.
6. Continue the estates renewal programme
The Trust has a large and old estate, which currently
is a financial burden due to the capital charges
and backlog maintenance costs. A renewal programme
has started with the development of the Wandsworth
Acute Unit at Springfield Hospital which will open
its doors to service users in 2009. The Trust spent
£10 million on capital investment last year and is planning
increased investment of £16 million in 2007/08. This will
include £9 million for the first stage of the Wandsworth
Acute Unit and £1 million on the Shaftesbury Clinic.
34

7. Implement the workforce strategy
To provide modern services the Trust needs to modernise
the workforce, ensure that there is strong leadership
at all levels and that staff are adequately trained and
supported to perform their duties. The Trust has already
reorganised senior management to be more locally
focused and has provided several leadership development
opportunities for team leaders and service managers
and these will be further developed over the
coming year. A workforce strategy in spring
2007 outlined the need for a development centre to
identify training needs in key staff grades and
the longer term staffing requirements and skill mix.
These will be supported by the introduction of the
Electronic Staff Record (ESR) and underpinned by the full
roll-out of the Knowledge and Skills Framework (KSF)
during 2007.
8. Maintain financial balance
The Trust has a good record of delivering financial
balance and this will be built upon to support our
Foundation Trust application and Healthcare Commission
reviews. In order to maintain a sound financial position,
the Trust has identified and reviewed the risks
to 2007/08 and beyond. These include the potential
loss of income from commissioners due to changed
commissioning intentions and the financial
circumstances of individual primary care trusts (PCTs),
the risks around service reconfiguration in the Henderson
Hospital and eating disorder services, and the need to
maintain good budgetary control over unit budgets
and savings plans. The Trust will continue to monitor
PCTs’ plans, any services at risk from changes
in demand and any opportunities for the development
of services.
Forensic service
In November 2006, the findings of the Independent
Inquiry into the Care and Treatment of John Barrett
was published. The event which gave rise to the inquiry
was the death of Denis Finnegan who was attacked
without warning by one of the Trust’s patients in
Richmond Park in September 2004. To make the report’s
findings as accessible as possible, a booklet reproducing
the report’s recommendations was distributed to staff
in January. The booklet contained key learning points for
the whole organisation.
A task force worked with the Trust’s forensic service
from October 2006 to April 2007. Its remit was to examine
the performance of the forensic service, and the
relationship between the forensic service, psychiatric
intensive care units (PICUs) and challenging behaviour
rehabilitation services within the Trust. This remit was
widened following publication of the John Barrett report in
November and again following a serious breach of
security in December 2006 which led to a temporary
closure of the unit to admissions.
The task force produced a report containing recommendations
for the forensic service aimed at improving
multidisciplinary working, standardisation of practice
across teams and a greater integration of the forensic
service with other Trust services. This was approved
by the Trust Board in April 2007 and a timetable agreed for
the recommendations to be carried out.
South West London and St George’s Mental Health NHS Trust Annual Report 2006/07
35

Our child and adolescent
mental health services
Our child and adolescent mental health services (CAMHS)
work Trust-wide to deliver accessible, responsive and
appropriate care to service users and carers. We work
within primary care, youth offending and behaviour
support services across the five boroughs to provide a
comprehensive service for all client groups.
We also offer a range of specialist services including a
generic inpatient adolescent service, an adolescent
assertive outreach team and children’s assertive outreach,
plus a specialist learning disability, child and adolescent
inpatient eating disorder service and a targeted
outpatient and national deaf service for children.
CAMHS provides proven high quality services and highly
skilled and qualified child and adolescent mental health
professionals. The Trust has a clinical lead for CAMHS as well
as a governance manager to ensure the highest quality
of services continue to be delivered to children,
adolescents and their carers. Each borough works closely
with its stakeholders, including users, carers and
commissioners. Services within each borough are planned
in partnership with the PCT and local authority and
delivered through the multi-agency children and
young people’s plans.
Meeting the needs of our
diverse population
The Trust is committed to ensuring our services are fully
accessible to the diverse population which we serve. Each
borough has a Race Equality Lead, while a Black and
Minority Ethnic User and Carer group ensures input from
those who use our services.
A diversity consultant, Cary Rajinder Sawhney, joined the
Merton team in January 2007 to create better links with the
borough’s black and minority ethnic (BME) communities
and ensure information about mental health services is
readily available to them. Two community development
workers have been employed in Wandsworth to help reach
out to the BME communities in the borough. In Sutton, a
monthly Culture Club has been launched to which people
from BME groups are invited to share their experiences of
using our services and to explore ways for them and their
families to seek help and improve their care. The aim is to
learn from their experiences and to develop services in
Sutton to further meet the needs of BME communities. A
handbook of cultural, spiritual and religious beliefs has
been developed in Richmond to raise awareness among
staff of the different needs of all patients. This has proved
so popular that staff in other boroughs are looking at
introducing the handbook. In Kingston, a designated
Korean interest group has been established with
representatives from the Korean Community Association.
A special event was held to celebrate Korean culture
and an information booklet translated into Korean has
been produced.
This year we’ve obtained patient information leaflets
on 32 drugs used to treat mental illness and their side
effects in 13 languages and translated our Community
Mental Health Team booklet into the 10 most commonly
requested languages at the Trust.
36

Promoting equality
Valuing our staff
The Trust is an equal opportunities employer and
equality of opportunity for disabled people is reflected in its
The fourth national staff survey, managed by the
welcomes job applications from people who have
use of the Disability Symbol (formerly called The Two Ticks
Healthcare Commission, was sent to a random sample of
experienced mental health problems.
scheme). Work has started to make the physical
our staff in autumn 2006 and focused on 28 key areas. Our
Our User Employment Programme was established in
1995. This pioneering programme facilitates access to
employment within the organisation for people who have
themselves experienced mental health problems. It has
supported more than 150 employees with mental health
problems in the Trust and has ensured that since 1999
at least 15 per cent of our employees have had personal
experience of mental health problems. By the first quarter
of 2006/07 this figure had risen to 20 per cent. People
with mental health problems have been employed at
all levels of the organisation and within all the mental
health professions.
Over the past year we have continued to make progress in
implementing our Race Equality Scheme and, while we still
have more to do, have seen an increase in the proportion of
Black and Asian staff among the Trust’s senior management
and the higher grades of the nursing workforce.
The Trust’s first Disability Equality Scheme was published in
December 2006 and included an action plan directed at
promoting disability equality in both employment and the
services we provide. The Trust’s commitment to promoting
environment more accessible and each borough is
addressing ways in which it can further meet the needs of
people with mobility and sensory impairments and longterm
health conditions.
A gender equality and women’s services steering group was
established in 2006 to work on our first Gender Equality
Scheme. This was published in April 2007 and priorities
include increasing the gender sensitivity of our services,
ensuring better provision of single-sex accommodation and
a care coordinator or therapist of the same sex should the
person so wish. For our staff, our priorities include
increasing access to flexible working for those with caring
responsibilities and improving the representation of women
in higher grade positions within the organisation.
We have established groups to address ways in which we
can promote age equality and equality for lesbian, gay and
bisexual staff and service users.
results showed a significant improvement in eight areas,
including staff reporting that they feel more positive about
working in the Trust, that they have greater job satisfaction
and the design of their jobs is better. However we still do
not compare well against other trusts on a number of the
indicators and need to do more to reduce the number of
staff who work extra hours due to the pressure and
demands of their job and the numbers who say they
experience work-related stress. We also need to support our
employees in achieving a better work-life balance.
The training and development of staff at all levels is
fundamental to the work of the Trust. Recent
initiatives include:
• a new management development programme, which
was piloted in March 2007, aimed at newly promoted or
recruited managers and those wishing to develop their
management skills. Feedback from the pilot has been
incorporated into the programme to ensure we meet
staff needs and is due to be rolled out across the Trust
later in 2007.
• a new-look induction was launched in July to make sure
we are addressing the needs of new starters.
South West London and St George’s Mental Health NHS Trust Annual Report 2006/07
37

• work on drafting competency outlines for all of our jobs
under the NHS Knowledge and Skills Framework has
continued this year.
• a high level of collaborative working between the
human resources, finance and IT departments means
we successfully completed the first four stages towards
implementing the Electronic Staff Record (ESR) and
began using the new system in June 2007. The ESR is the
national, integrated human resources and payroll system
which is being rolled out across all NHS organisations in
England and Wales. It will make it easier to calculate
and forecast useful trends and statistics on workforce,
training and finance.
• a number of key policies have been updated this year
including a new capability procedure, a grievance
procedure and a disciplinary procedure with guidance
for staff and managers. We have also introduced a new
retirement policy and updated our maternity leave policy
in response to the Age Discrimination Act and Work and
Families Act.
None of these developments would be possible without
the ongoing positive partnership arrangements we have
with our staff representatives. Union representatives
continue to work alongside Trust management to achieve
improvements and changes to the service. During the
forthcoming year we aim to develop further our methods
of informing and involving staff at all levels of the
organisation about issues that affect their employment
and the strategy and business of the Trust.
Communicating with staff
We have many different methods of keeping in touch
with our staff including a quarterly newsletter, a monthly
team briefing and monthly site briefings. Our new intranet,
Quick, was launched in July 2006 and is providing a vital
communication tool for staff to share information, keep in
touch with news and download policies and procedures,
wherever they are based on our 100 sites. The site is
constantly evolving, often in response to feedback from
staff. This year, we’ve also introduced a new weekly
briefing which is emailed to all staff every Monday and
includes announcements, Trust news and internal and
external events. An internal communications survey has
recently been carried out with staff to identify how
we can further meet their communication needs.
Working with our partners
The Trust has a long history of involving those who use
our services and their relatives, friends and carers. We aim
to include our service users in all aspects of our
operation and development, from the Trust Board to
individual teams and projects.
We believe we provide better care through working in
partnership with a range of other organisations both
from the public and independent sectors, although this
does mean that the system is more complex and difficult
to manage.
A major partnership is with social services in Kingston,
Merton, Richmond, Sutton and Wandsworth and we strive
to ensure that health and social care are provided
through integrated, coherent teams. These teams help
to minimise the difficulties for those experiencing mental
health problems by ensuring that statutory sector resources
can be accessed in one place. These arrangements are
governed by agreements under section 31 of the Health
Act, which includes a managed budget in Wandsworth.
The four primary care trusts (PCTs) covering the five
boroughs provide the majority of mental health care,
especially for common mental health problems, through GP
surgeries. They also commission secondary services for their
populations from the Trust. This dual relationship means the
Trust is very closely linked with the PCTs. This year we have
seen further engagement in partnerships at all levels as
some local PCTs struggle with financial deficits and the Trust
considers appropriate levels of care for the most vulnerable
service users. The Trust has service level agreements with all
local PCTs to cover the provision of generic services and
agreements with PCTs throughout London and nationally
for the provision of specialist mental health services.
Some areas of support for people experiencing mental
health problems are better catered for by the voluntary and
independent sectors. The Trust has active partnerships with
several agencies, particularly around vocational and
advocacy services, including Rethink, Sound Minds and
MIND. Some services provided by independent agencies and
the Trust are currently being tendered by the PCTs and the
Trust hopes to maintain strong relationships with future
providers to ensure seamless care for our service users.
We work closely with the police and acute hospitals, as well
as local academic organisations, which help meet the
education and training requirements of our staff as well as
providing support for research and development.
38

Improving the
hospital environment
Information Management
and Technology (IM&T)
Providing a safe, clean and modern environment for our
inpatient facilities is important to recovery for some service
users. Developments over the past year include:
consequence of changes in public sector policy. In
preparation for this, we have identified the services most
likely to face competition and analysed the costs of each
The main focus of the IM&T department this year has
been the implementation of RiO, the new electronic
patient record system, but there have been a number of
• enhancements to the physical environment of a number
of wards including Jasper Ward at Sutton Hospital and
Crocus Ward at Springfield Hospital
service. The Trust expects to respond to tenders for
local and broader services during the year and has
introduced a system to ensure there can be a rapid
turnaround of tenders when required. Decisions will be
other key developments including:
• a new stock control and dispensing system for the
pharmacy department
• the move of our learning disability ward from Orchard
Hill in Sutton to a new 10-bed ward with a kitchen,
computer room, a multi-sensory room and games room
at Tolworth Hospital
• improvements to reception facilities at Springfield and
Sutton Hospitals.
An estates strategy has been developed this year to help
achieve our aim that all our buildings should be to a
recognised acceptable standard by 2017.
Marketing our services
The current trend in health services is for provision to
be subject to greater levels of competitive testing. Over
the past year, the Trust in partnership with a range of
agencies has won tenders to provide eating disorder
services to the local population, substance misuse and
mental health services in Wandsworth Prison and services
for adults facing chronic exclusion in Merton.
The Trust feels that it is likely to be subject to greater
degrees of competition in the coming years as a
made strategically on the tenders which the Trust will
pursue and aim to develop.
WATTs on?
In December 2006, the Trust launched its first ‘WATTs
On?’ Energy Week to help raise awareness of energy
issues across the organisation. With such emphasis on the
current climate and fluctuating utility costs, the Trust
engaged the assistance of the Carbon Trust to advise
us on saving energy and reducing carbon emissions.
The Carbon Trust reported that one of the causes
of energy wastage in the Trust is bad energy habits
such as leaving computers on or on standby all night,
leaving windows open during the cold, and not switching
off lights when leaving a room. Using promotional material
and the intranet, the ‘WATTS On?’ Energy Week
emphasised that energy efficiency is the responsibility of
everyone in the Trust. Taking small actions such as turning
off lights and reporting faults to the maintenance
department can make a huge reduction in the amount of
energy wasted in the Trust.
• a new ‘data warehouse’ for service managers and
clinicians that holds financial, workforce and clinical
information in one place
• ‘n3’ connections for every Trust site, giving access to the
new national NHS broadband network
• a new telecommunications system that will save the Trust
money by using the existing network to make internal
calls.
The Trust has also produced a plan to implement the
National Programme for IT, which includes the introduction
of smartcards for staff to use when accessing computers
and national systems such as RiO. In 2007/08 a number of
other projects will continue. One is to implement the
second phase of the best practice standard for IT (known as
ITIL). Another is to continue installing more computers
around the Trust for use by service users, especially in
inpatient services.
South West London and St George’s Mental Health NHS Trust Annual Report 2006/07
39

Research and development
The Trust’s long-standing reputation as a centre
of research excellence is well deserved, particularly as it
continues to respond to both the changing needs of the
local population and the demands of the national
research framework. The Department of Health has
recognised and praised the consistently high standards
attained by the Trust’s programme of research; in
particular, the addiction research programme has gone
from strength to strength over the past year, culminating
in a successful £3.2 million Department of Health
programme grant application, ‘Alcohol screening and
brief intervention’, which was the largest grant ever
awarded in the Trust’s history. The Department of Health’s
overall feedback to the five research programmes in
our last annual report was also very positive.
We are keen to maintain our competitive edge and
following the initial implementation phase of the
Department of Health’s national health research strategy,
‘Best Research for Best Health’, have introduced eligibility
criteria to ensure that all research meets national and
Trust priorities. The Trust has also joined the south
London Comprehensive Local Research Network under
the new national R&D strategy, which will secure support
within the Trust for both the infrastructure and for future
applied research.
Our PALS
The Trust’s Patient Advice and Liaison Service (PALS)
seeks to resolve concerns before they escalate into major
problems by providing information, advice and support
for those who use our services, their families and carers.
PALS has achieved staggering growth between January
and December 2006. Enquiries have almost tripled from 260
in 2005 to more than 635 in 2006.
You can contact PALS by phone on 020 8682 5915 or by
email at pals@swlstg-tr.nhs.uk.
Complaints
The Trust welcomes all comments from patients and
sees complaints as an important source of information
about how we can do things better. Many improvements
have been made as a result of complaints, including:
• the introduction of customer service training to tackle
concerns over the attitude of some staff
• the appointment of a patient information officer
as a result of concerns over a lack of information
given to patient/carers upon first admission to mental
health services.
In 2006/07 we received 182 complaints and answered
78 per cent within the national target of 20 working days.
We continue to filter complaints that can be responded
to sooner than the 25 working day guideline by sending
them to the relevant service for direct action.
Mandatory training on complaints handling is being
introduced in summer 2007 for all staff involved in
investigating complaints, including frontline staff and
performance and service managers.
The Independent Complaints Advocacy Service (ICAS) has
welcomed active involvement from the Trust in respect
of meeting with complainants at local resolution stage
and following a formal response, if the concerns
remain unanswered.
Risk training
In response to critical incidents that the Trust has faced over
the past four years, a programme of risk training has been
introduced for all clinical staff. The programme has been
running since January 2007, initially through ‘training the
trainer’ schemes, and has now moved to a central Trustwide
provision. Some services have made substantial
inroads to training all their clinical staff and the programme
will be completed during 2007/08.
Risk management
Risk is the threat that an event or action will adversely
affect the Trust’s ability to achieve its objectives and to
successfully execute its strategies. Risk management is the
process of systematically identifying risks, analysing the
likelihood and impact of their occurrence, and then
deciding what action to take to prevent, minimise, accept or
transfer these risks in a way that will enable the Trust to
minimise losses and maximise opportunities.
40

Emergency planning
All NHS trusts are required to:
• regularly assess the risks to which the Trust is exposed
taking positive action to manage risks of all kinds and
providing staff with a clear framework and associated
processes for managing risks.
The Trust’s Emergency Planning committee, which has
Board representation, has this year reviewed and updated
its major incident plan so it is fully compliant with the
• report that the Trust is taking all reasonable steps to
manage risks of all kinds
• provide an assurance to key stakeholders that an
effective system of risk management is in place.
The management of risks of all kinds is an essential
element in improving clinical and non-clinical services. It
directly benefits the standard of patient care and staff
satisfaction, and reduces costs. The Trust has recently
purchased software and will employ a project manager
to implement a system of assessing and ensuring that
all risks identified on the risk register and assurance
framework are robustly managed.
The importance to the NHS of learning from previous
mistakes and actively seeking to prevent recurrence is
described in Organisation with a memory. All our staff have
a responsibility appropriate to their role for the
identification, assessment and elimination or reduction of
risk and ensuring that there are mechanisms in place
to actively manage the financial and other consequences
of remaining risks.
The Trust Risk Strategy (available on the Trust website) is
revised annually and sets out how we aim:
1.1 To minimise risks to the quality and delivery of patient
care through creating awareness throughout the
organisation about the importance of recognising and
1.2 To continue to innovate and pioneer service
developments within a framework of risk management.
1.3 To protect the services, reputation, and finances
of the organisation through a process of risk
identification, assessment, prevention, reduction,
elimination and transfer.
Despite our best efforts mistakes are sometimes made or
our service users have cause to complain. During 2006/07
we have concentrated on training staff to be open when
things go wrong. Our ‘being open’ policy supports staff to:
• acknowledge, apologise and explain when things
go wrong
• conduct a thorough investigation into the incident and
reassure patients and/or their carers that lessons learned
will help prevent the incident recurring
• provide support to cope with the physical and
psychological consequences of what happened.
Taking this approach is not always easy but we believe it
is fundamental to the partnership between patients and
those who provide their care.
NHS Emergency Planning Guidance 2005 and the
Department of Health’s document Mass casualty incidents:
A framework for planning. We liaise closely with other
trusts, PCTs and local authorities within southwest
London through membership on Emergency Planning
committees. A Trust-wide command and control
exercise was held in January 2007 which involved all
on-call directors and tested our emergency response
in the event of a major incident, including our business
continuity plans.
South West London and St George’s Mental Health NHS Trust Annual Report 2006/07
41

emuneration report
Remuneration
and Terms
of Service
Committee
The committee is chaired by the Chairman and the
membership comprises all the Non-Executive Directors. The
committee is considered quorate if it has a minimum of
three Non-Executive Directors present.
The Chief Executive attends all meetings of the committee
but is not present for discussions about his/her own
remuneration. The Director of Human Resources acts as
Secretary to the Committee but is not present for
discussions about his/her own remuneration.
The committee:
determines the remuneration and terms of service of the
Chief Executive and those Directors that report directly to
the Chief Executive (all other senior managers are
covered by Agenda for Change);
reviews the performance of those Directors who
report directly to the Chief Executive, through reports
submitted by the Chief Executive, no later than May
each year. The Chair will similarly report on the
performance of the Chief Executive;
42
Salaries &
Allowances
Note 1:
Interim Chief
Executive from
19 December 05
to 24 July 06
Name Title 2006/07 2005/06
Salary Other Salary Other
(bands of £5,000) Remuneration (bands of £5,000) Remuneration
(bands of £5,000) (bands of £5,000)
£’000 £’000 £’000 £’000
Mr John Rafferty Chair 20-25 0 20-25 0
Mrs Charlotte Barney Non-Executive Director (to 29/7/05) N/a N/a 0-5 0
Ms Judith Chegwidden Non-Executive Director 5-10 0 5-10 0
Mr Arthur de Frisching Non-Executive Director 5-10 0 5-10 0
Mr Emir Feisal Non-Executive Director 5-10 0 0-5 0
Prof Roger Horton Non-Executive Director 5-10 0 5-10 0
Ms Elizabeth Owen Non-Executive Director (from 1/5/06) 5-10 0 N/a N/a
Dr Diana Rose Associate Non-Executive Director (from 1/10/06) 0-5 0 N/a N/a
Mr Raficq Abdulla Associate Non-Executive Director 5-10 0 5-10 0
Mr Peter Houghton Chief Executive (from 10/7/06) 105-110 0 N/a N/a
Mrs Christine Carter Interim Chief Executive (from 19/12/05) 35-40 0 30-35 0
Dr Nigel Fisher Chief Executive (to 16/12/05) N/a N/a 90-95 0
Mr Peter Cardell Director of Finance & IT 95-100 0 90-95 0
Prof Mary Chambers Chief Nurse & Professor of Nursing (to 31/3/07) 55-60 40-45 50-55 0
Ms Maresa Ness Chief Operating Officer (from 1/11/04) 90-95 0 85-90 0
Dr Deji Oyebode Medical Director (to 30/4/07) 85-90 115-120 85-90 75-80
Ms Sandy Gillett Director of Human Resources (from 1/8/05) 75-80 0 45-50 0
Ms Kim Goddard Director of Corporate Affairs (from 1/10/06) 35-40 0 N/a N/a
Mr Andrew Simpson Director of Planning 75-80 0 75-80 0

Performance arrangements
periodically reviews pay data from similar organisations
in order to ensure that appropriate arrangements have
been made for the salaries of these Directors.
oversees appropriate contractual arrangements for
such staff, including the proper calculation and scrutiny
of termination payments, for these and other senior
staff, taking account of such national guidance as
is appropriate;
meets annually as a minimum, but may meet on other
occasions as may be required from time to time.
Pension Benefits
The Trust does not operate any system of performance
related pay. The performance of executive directors is
assessed by the Chief Executive on an annual basis. The
performance of Non-Executive Directors and the Chief
Executive is appraised by the Chair.
Most senior managers have a basic salary which is based on
national Agenda for Change pay and remuneration
guidelines. Executive Directors remain on local Trust
conditions of service, and their salaries are reviewed
annually by the Remuneration Committee. Executive
directors received cost of living increases in line with the
Very Senior Managers’ Pay Framework, and the
Remuneration Committee awarded differential pay
increases, based on achievements against objectives (as
assessed by the Interim Chief Executive) and market rates.
Senior managers contracts which fall within this remit are
all substantive and permanent. The Medical Director was on
the new national consultant contract. Over and above this
he received an additional payment for management
responsibilities in recognition of his role as Medical Director
(which was a rolling contract). The Interim Chief Executive
was on a fixed term contract, which expired when the new
Chief Executive took up post. Notice periods are in line with
employment law.
Payments to past senior managers
The Trust Board decided that, in order to achieve one of its
key priorities, clinical safety and excellence, the Trust would
need full time Medical and Nursing Directors. As a result,
the Remuneration Committee agreed compensation
payments to the two former post holders.
Name Real increase in Lump sum at Total accrued Lump sum at Cash Equivalent Cash Equivalent Real increase in Employer’s
pension at age 60 age 60 related pension at age 60 related Transfer Value at Transfer Value at Cash Equivalent contribution to
(bands of £2,500) to real increase age 60 at 31 to accrued 31 March 2007 31 March 2006 Transfer Value stakeholder pension
in pension March 2007 pension at 31
(bands of £2,500) (bands of £5,000) March 2007
(bands of £5,000)
£’000 £’000 £’000 £’000 £’000 £’000 £’000 £’000
Mr Peter Houghton 0-2.5 2.5-5.0 45-50 135-140 651 626 5 0
Mr Peter Cardell 0-2.5 2.5-5.0 10-15 30-35 199 166 20 0
Prof Mary Chambers 0-2.5 2.5-5.0 0-5 10-15 N/a N/a N/a 0
Ms Maresa Ness 0-2.5 2.5-5.0 30-35 90-95 529 475 29 0
Dr Deji Oyebode 0-2.5 2.5-5.0 30-35 90-95 504 464 20 0
Ms Sandy Gillett 2.5-5.0 12.5-15.0 20-25 65-70 416 323 60 0
Ms Kim Goddard 0-2.5 0-2.5 15-20 50-55 262 229 9 0
Mr Andrew Simpson 0-2.5 2.5-5.0 10-15 30-35 135 116 11 0
As Non-Executive members do not receive pensionable remuneration, there will be no entries in respect of pensions for Non-Executive members.
South West London and St George’s Mental Health NHS Trust Annual Report 2006/07
43

financial review
Surplus for the Year
For the year ended 31 March 2007 the Trust reported
surplus income over expenditure of £2.7m. The surplus for
the year included £0.5m of interest receivable and £0.1m
profit on a property disposal.
The Trust successfully achieved the target surplus of £2.65m
agreed with NHS London, and has achieved a surplus each
year since the Trust was formed. Patients will benefit from
the surpluses created in 2005/06 and 2006/07 as in 2007/08
the Trust will be repaid these surpluses, and the budget has
been set accordingly.
Financial Results – 3 Year Summary
2006/07 2005/06 2004/05
£000 £000 £000
Income £168,595 £153,480 £155,017
Retained surplus for year £2,670 £1,532 £114
Operating Income for 2006/07
The majority of the Trust’s income comes from agreements
with primary care trusts to provide healthcare for people
living within their catchment area, including £127.9m from
the Trust’s four local PCTs, as set out in the table right.
Whilst the level income reported in the Accounts has
increased by £15.1m, the most significant factor is the
inclusion of £7.7m relating to the social care budget in
Wandsworth, managed by the Trust.
Other change in Trust income compared with 2005/06 reflect:
inflation on 2005/06 agreements; and
new funding from two local primary care trusts to cover
the costs of the three wards in the new hospital at Queen
Mary’s, Roehampton, which opened just prior to the start
of the financial year.
Operating Income (£ millions)
0 50 100m
Wandsworth Primary Care Trust
£44.6m
Sutton & Merton Primary Care Trust
£37.6m
Richmond & Twickenham Primary Care Trust £24.3m
Kingston Primary Care Trust
£21.4m
Other income from activities
£30.6m
Education, training and research
£8.8m
Other non-patient related income
£1.3m
Total
£168.6m
Operating Expenditure for 2006/07
Expenditure for the year totalled £166.5m. Again, £7.7m of
the increase since 2005/06, relates to the inclusion of the
Wandsworth social care budget.
67% of our expenditure is on staff costs, £113.4m (£109.0m
in 2005/06), of which £91.3m or 81% related to staff
directly involved in patient care. The proportion of staff
expenditure relating to staff directly involved in patient
care has remained between 81% and 82% since 2001/02.
Past and present staff are covered by the provisions of
the NHS Pensions Scheme. Employers’ pension cost
contributions are charged to Operating Expenses as and
when they become due, and there are no pensions liabilities
within the accounts.
Operating Expenditure (£ millions)
0 50 100m
Clinical Services staffing
£91.3m
Non Clinical staffing
£22.1m
Non pay
£39.4m
Depreciation, dividends and interest £13.7m
Total Expenditure
£166.5m
44

Liquidity/External Financing Limit
Capital Expenditure
The major capital projects during
the year were as follows:
The Trust is required to remain within the prescribed
external financing limit (EFL).
The Trust maintained a positive bank balance throughout
the year. The cash/bank position at 31st March 2007 was
£0.5m, within the allowed limit of 0.3% of turnover.
The Department of Health set the Trust an External
Financing Limit of £3,803k. The Trust marginally under
spent against this limit by £26k, which is within the
permitted tolerance levels.
Capital Resources
(Capital Cost Absorption Rate)
The Trust is required to absorb its cost of capital at a rate of
3.5%. This is calculated by comparing the dividend paid on
Public Dividend Capital with Average Net Relevant Assets.
The Trust achieved a rate of return of 3.41%, against the
target of +/- 0.5 of 3.5%.
The Trust is allocated specific funding for capital
expenditure, and is required to remain within this
prescribed capital resource limit (CRL).
The Trust was set a CRL of £8.9m for 2006/07. The Trust
incurred capital expenditure of £8.6m, an allowed under
spend of £0.3m.
During the year the Trust disposed of a property surplus to
requirements. This increased the capital expenditure
available for re-investment by £1.1m.
£m
New Wandsworth Acute Unit 2.5
Design costs and enabling works
Jasper Ward (refurbishment) 0.8
To be completed in 2007/08
Information Technology 0.8
Various schemes & equipment
Crocus Ward (refurbishment) 0.7
To be completed in 2007/08
Springfield Regeneration Scheme 0.4
Enabling works
Learning Disability move to Tolworth 0.4
To be completed in 2007/08
Hebdon Lodge (refurbishment) 0.4
Springfield Fire Alarm system 0.3
To be completed in 2007/08
Yew Ward (refurbishment) 0.2
Other schemes 3.2
Gross Capital Expenditure 9.7
Less: book value of disposal (1.1)
Net Capital Expenditure 8.6
South West London and St George’s Mental Health NHS Trust Annual Report 2006/07
45

Public Sector Payment Policy
Measure of Compliance
In addition to the four key financial duties, the NHS
Executive requires that Trusts pay their non-NHS trade
creditors in accordance with the CBI prompt payment code
and Government Accounting rules. The target is to pay non-
NHS trade creditors within 30 days of receipt of goods or a
valid invoice (whichever is the later) unless other payment
terms have been agreed with the supplier.
2006/07 2005/06
number £m £m
Total bills paid 51,876 37.1 37.6
Total bills paid
within target 48,698 34.5 35.6
Percentage of bills paid
within target 93.9% 93.2 94.70%
Management Costs
2006/07 2005/06
£m £m
Management costs 8.3 7.1
Audit Arrangements
The Trust’s external auditors for 2006/07 were the Audit
Commission, who first undertook the audit of the Final
Accounts in 2002/03.
The audit fee for the statutory audit and services carried
out in relation to the statutory audit for 2006/07 was
£146,000 (£172,000 including VAT). In addition to the
statutory audit, the Commission under took a “Board to
Board” review of the Trust’s Foundation Trust diagnostic
application, at a cost of £12,000, in preparation for the
meeting with the Strategic Health Authority and Monitor.
This was undertaken by a different team to that who
undertook the audit of the Accounts, and neither
the Commission nor the Trust regarded this a potential
conflict of interest.
As part of the Final Accounts exercise, each director of
the Trust has made a declaration that, as far as s/he is
aware, there is no relevant audit information of which
the NHS body’s auditors are unaware, and s/he has taken
all the steps that s/he ought to have taken as a director
in order to make him/herself aware of any relevant
audit information.
The Accounts
Summary Financial Statements
The following statements represent a summary of financial
information about the Trust. The full accounts are available
on request from:
Director of Finance,
South West London and
St George’s Mental Health
NHS Trust
Springfield University Hospital,
61 Glenburnie Road,
London SW17 7DJ.
Telephone 020 8682 6000.
Signed on behalf of the Board
Peter Houghton
Peter Cardell
Chief Executive
Director of Finance
A summary of the Trust accounts is shown on pages 47 to 48.
Relevant income 168.6 153.5
Percentage of relevant income 4.90% 4.63%
Salary and pension entitlements of
senior managers
Full details of senior managers’ remuneration are provided
in the Remuneration Report on pages 42 to 43.
46

INCOME & EXPENDITURE ACCOUNT
Figures in £000s
For the year ended 31 March 2007
2006/2007 2005/2006
Income from activities: Continuing operations 155,449 139,188
Other operating income 13,146 14,292
Operating expenses: Continuing operations (157,989) (144,351)
Operating surplus: Continuing operations 10,606 9,129
Profit (loss) on disposal of fixed assets 132 311
Surplus (deficit) before interest 10,738 9,440
Interest receivable 464 307
Interest payable 0 0
Surplus (deficit) for the financial year 11,202 9,747
Public Dividend Capital dividends payable (8,532) (8,215)
Retained surplus (deficit) for the year * 2,670 1,532
Financial target performance 3.4% 3.5%
* No financial support is included in the retained surplus for the year.
BALANCE SHEET
Figures in £000s
As at 31 March 2007
31/03/07 31/03/06
Fixed assets
Intangible assets 112 70
Tangible assets 263,954 243,724
264,066 243,794
Current assets
Stocks and work in progress 176 155
Debtors:Amounts falling due:
after one year 0 0
within one year 11,787 7,712
Investments 0 0
Cash at bank and in hand 484 458
12,447 8,325
Creditors: Amounts falling due
within one year (11,704) (10,073)
Net current assets (liabilities) 743 (1,748)
Total assets less current liabilities 264,809 242,046
Creditors: Amounts falling due
after more than one year 0 0
Provisions for liabilities and charges (116) (635)
Total assets employed 264,693 241,411
Financed by: Capital and reserves
Public Dividend Capital 111,987 108,184
Revaluation reserve 144,033 127,447
Donated asset reserve 3,081 2,912
Other reserves 750 750
Income and expenditure reserve 4,842 2,118
Total capital and reserves 264,693 241,411
South West London and St George’s Mental Health NHS Trust Annual Report 2006/07
47

STATEMENT OF TOTAL RECOGNISED
GAINS AND LOSSES
For the year ended 31 March 2007
Figures in £000s
2006/07 2005/06
Surplus (deficit) for the
financial year before
dividend payments 11,202 9,747
Fixed asset impairment losses 0 0
Unrealised surplus
(deficit) on fixed asset
revaluations/indexation 16,874 8,037
Increases in the donated
asset & government grant
reserve due to receipt of
donated & government
grant financed assets 0 0
Additions/(reductions) in
‘other reserves’ 0 0
Total recognised gains
and losses for the
financial year 28,076 17,784
Prior period adjustment 0 0
Total gains and losses
recognised in the
financial year 28,076 17,784
CASH FLOW STATEMENT
Figures in £000s
For the year ended 31 March 2007
2006/2007 2005/2006
Operating activities
Net cash inflow from operating activities 11,900 17,864
Returns on investments and servicing of finance
Interest received 464 307
Interest paid 0 0
Interest element of finance leases 0 0
Net cash inflow/(outflow) from returns on investment
and servicing of finance 464 307
Capital expenditure
Payments to acquire tangible fixed assets (8,708) (6,718)
Receipts from sale of tangible fixed assets 1,197 1,525
(Payments to acquire)/ receipts from sale of intangible assets (98) 0
Net cash inflow (outflow) from capital expenditure (7,609) (5,193)
Dividends paid (8,532) (8,215)
Net cash inflow/(outflow) before management
of liquid resources and financing (3,777) 4,763
Management of liquid resources
Purchase of investments 0 0
Sale of investments 0 0
Net cash inflow/(outflow) from Management of liquid resources 0 0
Net cash inflow/(outflow) before financing (3,777) 4,763
Financing
Public dividend capital received 3,803 0
Public dividend capital repaid (not previously accrued) 0 (3,372)
Public dividend capital repaid (accrued in prior period) 0 0
Loans received 0 0
Loans repaid 0 0
Other capital receipts 0 0
Cash transferred from/to other NHS bodies 0 0
Capital element of finance lease rental payments 0 0
Net cash inflow/(outflow) from financing 3,803 (3,372)
Increase/(decrease) in cash 26 1,391
48

Independent auditor’s report to the
Directors of the Board of South West
London and St. George’s Mental
Health NHS Trust on the Summary
Financial Statements
I have examined the summary financial statements set out
on pages 47 to 48.
This report is made solely to the Board of South West
London and St George’s Mental Health NHS Trust in
accordance with Part II of the Audit Commission Act 1998
and for no other purpose, as set out in paragraph 36 of the
Statement of Responsibilities of Auditors and of Audited
Bodies, prepared by the Audit Commission.
Respective responsibilities
of directors and auditors
The directors are responsible for preparing the Annual
Report. My responsibility is to report to you my opinion
on the consistency of the summary financial statements
with the statutory financial statements. I also read the
other information contained in the Annual Report and
consider the implications for my report if I become aware
of any misstatements or material inconsistencies with the
summary financial statements.
Basis of opinion
I conducted my work in accordance with Bulletin 1999/6
‘The auditor’s statement on the summary financial
statements’ issued by the Auditing Practices Board. My
report on the statutory financial statement s describes the
basis of our audit opinion on these financial statements.
Opinion
In my opinion the summary financial statements are
consistent with the statutory financial statements of the
Trust for the year ended 31 March 2007 on which I have
issued an unqualified opinion.
Kash Pandya
Audit Commission
1st Floor Millbank Tower
Millbank
London
SW1P 4QH
21st June 2007
South West London and St George’s Mental Health NHS Trust Annual Report 2006/07
49

Our board
John Rafferty,
Chairman
Judith Chegwidden,
Vice Chairman
Emir Feisal JP,
Non-Executive Director
Arthur de Frisching,
Non-Executive Director
Roger Horton,
Non-Executive Director
Appointed
December 2004.
Appointed June
1998; reappointed
January 2006. Chair
of Audit Committee.
• Managing Director
of Roskill Information
Services Ltd and of
Roskill Consultants
Group Ltd
Appointed January 2006.
Member of Audit Committee.
• Associate Managing
Editor, The Sunday Times
• Member, Ministerial
Advisory Board,
The Royal Parks Agency
• Magistrate,
Westminster Bench
• Trustee, Vitalise
Appointed June 2002;
reappointed June
2006. Member of
Audit Committee.
Appointed December
2003. Member of
Audit Committee.
• Vice-Principal of St
George’s University
of London
Elizabeth Owen,
Non-Executive Director
Appointed
May 2006.
Raficq Abdulla,
Associate Non-Executive Director
(non-voting)
Appointed
September 2006.
Diana Rose,
Associate Non-Executive Director
(non-voting)
Appointed
October 2006.
Peter Houghton,
Chief Executive
Appointed
July 2006.
Maresa Ness,
Chief Operating Officer and
Deputy Chief Executive
Appointed
November 2004.
• Trustee,
Mosaic Clubhouse
• Husband is an
employee of South
London and the
Maudsley NHS
Foundation Trust
Peter Cardell,
Director of Finance
Appointed
May 1998.
• External member
of the University
Audit Committee,
Kingston University
Mary Chambers,
Chief Nurse and Professor
of Mental Health Nursing
Appointed
February 2004,
left April 2007
Sandy Gillett,
Director of Human Resources
(non-voting)
Appointed
August 2005.
Kim Goddard,
Director of Nursing
Appointed 6 June
2007. Appointed
Acting Director of
Corporate Affairs
(non-voting) in
September 2006
and Interim Director
of Nursing and
Governance on
1 April 2007.
Deji Oyebode,
Medical Director
Appointed
July 2002,
left 1 May 2007
Non-Executive Directors
Andrew Simpson,
Director of Estates and
Regeneration (non-voting)
Appointed
January 2003.
Debbie Stinson,
Joint Interim Medical Director
Appointed
1 May 2007.
Jim Bolton,
Joint Interim Medical Director
Appointed
1 May 2007.
50
Executive Directors

Main Trust locations
Acre Road
Barnes Hospital
Cheam Resource Centre
Franklin House
Guildhall
Haydon House
Henderson Hospital
Henderson Outreach
Maddison Clinic
Mapleton Centre
Mitcham Polyclinic
Nelson Hospital
Norfolk Lodge
Old Church
Orchard Hill
Queen Mary’s Hospital
Richmond Royal Hospital
Rose Lodge
Roselands
South Bank House
South Place Day Centre
Springfield University Hospital
St George’s Hospital
St Helier Hospital
St John’s Hospital and Amyand House
St John’s Therapy Centre
Sutton Hospital
Thrale Road
Tolworth Hospital
Wallington Resource Centre
Westmoor House
William Harvey Clinic
Wilson Hospital
York Road
32
3
26
22
33
8
25
11
34
7
18
19
15
14
20
4
2
31
30
29
28
12
16
21
1
10
24
13
27
23
6
5
17
9
M3
TEDDINGTON
HAMPTON
TWICKENHAM
34
HAMPTON PARK
HAMPTON COURT
PARK
M4
KEW
GARDENS
2
3
1 4 5
7
6 WANDSWORTH
33
KEW
RICHMOND
RICHMOND
32
RICHMOND
PARK
KINGSTON
UPON-THAMES
27
31
30
29 28
KINGSTON
SURBITON
HOOK
CHESSINGTON
NEW MALDEN
WORCHESTER
PARK
BARNES
BARNES
COMMON
ROEHAMPTON
WIMBLEDON
COMMON
PUTNEY
WIMBLEDON
RAYNES
PARK
SOUTHFIELDS
26
MORDEN
PARK
WIMBLEDON
PARK
MERTON
MORDEN
CHEAM
9
10 8
16
MERTON
19
25
24
EARLSFIELD
COLLIERS
WOOD
21
SUTTON
12 13 14
15
20
BATTERSEA
PARK
BATTERSEA
CLAPHAM
JUNCTION
CLAPHAM
COMMON
WANDSWORTH
COMMON
SUTTON
BALHAM
TOOTING
17
18
CARSHALTON
TOOTING
COMMON
MITCHAM
MITCHAM
COMMON
BEDDINGTON
PARK
23
22
11
WALLINGTON
Useful contact numbers:
• Barnes Hospital
020 8878 4981
• Henderson Hospital, Sutton
020 8661 1611
• Nelson Hospital, Raynes Park
020 8251 1111
• Queen Mary’s Hospital, Roehampton
020 8487 6000
• Richmond Royal Hospital
020 8940 3331
• Springfield University Hospital, Tooting
(Trust headquarters)
020 8682 6000
• Sutton Hospital
020 8296 2000
• Tolworth Hospital
020 8390 0102
Website: www.swlstg-tr.nhs.uk
South West London and St George’s Mental Health NHS Trust Annual Report 2006/07
51

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