The panel asked a range of questions to the representatives from Devon Partnership NHS Trust (DPT) and the key points that came out of the questioning were:

·         Devon Partnership Trust (DPT) is a mental health and learning disability trust providing a wide range of NHS services to people with mental health and learning disability needs - in Devon, the wider South West region and nationally. The Trust also commissions regional secure services as lead provider within the South West Provider Collaborative.

·         DPT employs around 4,000 full time equivalent staff. The vision of the organisation is to build an inclusive society where the importance of mental health and wellbeing is universally understood and valued.

·         The DPT board has recently approved a new Trust Strategy for the next three years, of which one of the key objectives is to promote social justice and inclusion in the widest sense for all communities served by DPT, including Torbay and to tackle discrimination. The aim is to foster a culture where patients and staff feel able to be themselves and bring their whole selves to their care, treatment and employment.

·         DPT make it clear that they value diversity of experience as well as background which helps to make an impact upon the mental health and well-being of their patients but also their staff and wider society. They are clear they have more to do to ensure staff and patients get the support and services they need in a holistic and personalised way but summarised how huge progress is already being made.

·         The Director of Corporate Affairs for DPT provides executive leadership on equality, diversity and inclusion. Part of that role is to ensure all organisational policies, procedures and strategies maintain a focus on all aspects of equality and inclusion and how those aspects are potentially impacted.

·         A higher than average proportion of the Devon population of senior doctors from Black or Asian or Minority Ethnic groups (BAME) are employed at DPT but not in other senior roles. This is being addressed by looking at how support can be given to make sure BAME employees have equal opportunities to progress through career pathways and wider targeted recruitment at people from diverse ethnic backgrounds.

·         The Trust uses a combination of locally collected and wider Devon census data to ascertain the representation of their service users. They stated they don’t appear to have to have an overrepresentation of people from BAME groups using their services, but numbers are very small and need to be considered carefully. In partnership with Public Health and other organisations, DPT is making sure people can access their services and are working with different community groups and networks to help them find the best ways to reach people.

·         DPT works to ensure people feel that they are being seen and treated as an individual and that their cultural needs are recognised through all aspects of care and treatment.

·         DPT has set up and is running a range of staff networks, one of which is for BAME staff, so there is a place where they can come together and discuss experiences and provide peer support to each other. This is also a forum for the network to invite senior leaders to discussions about what else could be done within the organisation, what would make a difference, what's not going well and how any issues can be resolved.

·         DPT has done work with its Secure Services around Black men’s mental health, and is working in partnership with Black men who use their services or have used similar services elsewhere to help design them. This is to ensure their voices are heard and understood in how services are designed and delivered. DPT’s Secure Services were part of a national pilot addressing health inequalities for Black men in care services across the country.

·         The Chaplaincy Service at DPT has been reviewed to ensure there is a range of support and opportunities for people to talk about differing faiths and cultures with someone who understands the culture that person is part of or can connect people to community groups for support.

·         DPT recognises that across the NHS there are occasions where people from BAME communities are not treated properly or fairly, and their representatives were clear that even one occasion is too many. DPT is very clear that this not acceptable and that discrimination and unacceptable behaviour will be addressed. The organisation works to support its staff networks so there is a place for staff to speak up. There are also peer support workers – people with lived experience who now work on wards and in other community services to help others have a voice. DPT also works with various advocacy groups from different communities to support patients.

·         Part of the equality, diversity and inclusion development and training for staff at DPT helps staff members to understand the impact of unacceptable behaviour. DPT is currently developing an inclusive leadership and behaviours programme and cultural competence training. A number of staff meetings have been held where expectations around language, being part of a team, respect and inclusivity are discussed.

·         DPT has commissioned services from an Independent Guardian Service to support staff to speak freely if they need to raise something that they feel they couldn't do through normal organisational channels. DPT is proud of that arrangement and is moving to increase the different avenues for staff to voice their concerns so they can be listened to and learned from. The Guardian has direct access to the CEO and Chair and the CEO meets with the guardian every six months to discuss any issues or themes that need to be addressed.

·         Where incidents have been raised with its Freedom to Speak Up Service, DPT employs appropriate responses to address and resolve issues. This may be; focused work with the relevant team to discuss the impact, reviewing the development programme to understand and reflect on the impact, reviewing processes to reduce the negative impact on service users, taking action with individual members of staff but, overall, always learning from the experience to improve and adapt systems and policies.

·         DPT works closely with the voluntary sector, faith communities and other community groups to make sure people who require access to additional help and support, can be offered services in different ways and environments which suit them. DPT’s range of services work together to improve access, experiences and outcomes for people who need its services before people need urgent or crisis services.  However, the Trust recognises more needs to be done to ensure that people who might be reluctant to engage with its services, perhaps due to stigma, have a variety of opportunities to access services in a range of ways.

·         DPT considers that its strengths in relation to equality and diversity are knowing and understanding the statistics around service users, which has driven a lot of positive work across the organisation as well as its ability to look for innovation or creativity from other areas and work with partners in the Integrated Care Organisation – which provides opportunities for local engagement and to drive local change. Another strength is the passion and commitment of DPT staff in the ways that they work to provide services for individuals at a local level.

·         Regarding the disproportionate impact of COVID-19 on people from BAME groups, DPT tackled this early on by asking all teams to review their patient lists and have discussions with all members of staff, prioritising those from BAME communities to ensure that they had a proper risk assessment, that they received whatever protection and support they needed, and that they were prioritised for vaccination. DPT also worked closely with local communities and colleagues within the Integrated Care Organisation to provide additional support to service users.

·         DPT had two complaints from people who identified as BAME in the last three years in relation to services they received. DPT will always meet with a complainant to discuss concerns, hear what they have to say, agree a complaints resolution plan with the complainant, learn from the findings and apologise when they get it wrong.

·         DPT is part of a number of different networks including some relating to equality and diversity e.g. the Positive Practice Network. DPT’s Learning from Experience work looks at cascades of information from other areas and has led to collaborative programmes around the overrepresentation of Black men using services, the use of restraint, health inequalities, supporting staff from different communities to have better development opportunities and reverse mentoring.

·         In response to a question from a member of the public, DPT made assurances that there are robust referral and assessment systems and procedures in place to ensure people only receive the services they need. If service users present as a result of mental health trauma, due to incidents of racism, DPT could raise that issue with Devon and Cornwall Police.

·         There is evidence nationally of an overrepresentation of young Black Afro-Caribbean men in mental health services and that systematic and constant racism in our society is a pressure which can contribute to mental health problems. DPT’s TALKWORKS service is aimed at improving access to psychological therapy. The service has worked with the lesbian, gay, bisexual, transgender, intersex plus community and now they're doing targeted work with BAME communities around the impact of discrimination on people's mental wellbeing.

·         In response to a question from a member of the public DPT recommended that, to ensure reports on the issue of racism are acted on, there needs to be proper training in place across the workforce and people need to be supported and prepared to address these issues.

·         DPT is keen to develop wider engagement forums so service users from all protected groups, backgrounds and communities can comfortably and confidently feedback about their services and issues can be discussed, addressed and action taken as early as possible.

·         DPT works closely with the police and a range of wider partner organisations to respond to people in mental health crisis. Important developmental work in recent years has seen these services evolve to include Street Triage, the Liaison and Diversion Service and the Joint Response Unit so there are practitioners working alongside the police to respond to people in mental health crisis. If there was a concern that anyone had acted in a discriminatory way, it would be raised with the police and the expectation is that the police would do the same.

·         DPT is on a journey to improve support to its staff and people who use its services who are from the BAME community. Much of the work they described in the meeting is about making sure people’s understanding and awareness, particularly in relation to cultural competence, is being developed. An inclusive recruitment processes is being further enhanced and making sure people have equal opportunities, ensuring clarity about DPT’s zero tolerance of racism and discrimination, maintaining a strategic focus and priority of promoting social justice and making sure there are opportunities for people to speak up about issues and feel assured that those issues will be addressed.

·         DPT emphasised the importance of reviews such as the Torbay Racism Review and talking to and learning from other organisations about what the issues are – and to share that learning. DPT would like to work with Torbay Council to engage with community groups.

·         DPT stated that they are well prepared for another wave of COVID-19, from an infection control point of view, but there are concerns about capacity within services because of the evidenced impact of the pandemic on people's mental health, particularly with young people from BAME groups.

·         Melanie Walker paid tribute to DPT staff, who perhaps don't get the same recognition as some other NHS staff do. It is a challenging job to work in mental health services, and it's been particularly so during the pandemic.