Mental health has a hell of a lot to teach the acute sector,” says Bev Humphrey, the outgoing chief executive of the Greater Manchester mental health NHS foundation trust. “It needs to sit up and listen.”
Humphrey believes that truly integrated mental health teams – involving psychiatrists, psychologists, mental health nurses, social workers, speech therapists, occupational therapists and dietitians – that provide services around the clock are the way forward across the NHS. “We have crisis intervention teams working 24/7, helping to reduce the pressure on inpatient beds. If you had that for older people, you would have fewer emergency admissions to hospital.”
Although Humphrey wants more integration on the frontline, she does not think that health and social care organisations should merge. “What makes me incredibly nervous is any talk about integrating commissioning and funding of services,” she says. “If the funding is shared between clinical commissioning groups and local authorities – when I see that those same local authorities have had to decimate their adult and children’s social care services due to cuts – why would I want to merge? It would be like getting into bed with a bankrupt brother.”
Humphrey is particularly scathing about how council cuts are impacting on substance misuse services. “In the north-west, alone, we have seen cuts of 30%-40% to addiction services in the last five years,” she says. “Services are tendered every three years on a hamster-wheel basis. Treating addiction is very complex – it relies on good relationships with health, prisons, the police, housing, social services, the voluntary sector and schools. They take time to build up. When services are re-tendered it can smash those relationships.”
Humphrey also worries about the state of mental health services in prisons. “The way they have been procured by NHS England is woeful,” she says. “They need to be much more strategically planned. But there is no joined-up strategy across the NHS and the criminal justice sector. Prison health services need to be intelligently commissioned and not procured in the same way as the NHS buys office pens. And commissioners need to stop taking money out of these services.”
Much of the pressure on mental health services is exacerbated by charities going under, says Humphrey. “An awful lot of voluntary organisations locally have gone to the wire or had their grants cut.” So, GMMH has introduced a wellbeing fund, which gives £500,000 a year to community groups to run local mental health and substance misuse projects in Manchester.
Humphrey leaves GMMH after steering its creation in January 2017, when Greater Manchester West mental health NHS foundation trust, where she was chief executive, took over Manchester mental health and social care trust, which had provided community and inpatient services in the city centre. Her responsibilities and budget almost doubled to nearly 5,000 staff and an income of £300m. Earlier this year, the new trust’s leadership was rated “outstanding”, along with its substance misuse services, by inspectors for the Care Quality Commission. Overall, it rated GMMH as “good” overall, with substance misuse services and the trust’s leadership deemed “outstanding”. And t. Three-quarters of patients with a first episode of psychosis begin treatment within two weeks, well above the target of 50%. Waiting times from referral to treatment are coming down, although they are some way off hitting national targets. There have also been financial improvements. “We have saved £3.2m in management and corporate function costs in one year, and these savings are being directly reinvested in frontline staff such as community psychiatric nurses, psychologists and social workers,” she says.
Humphrey, 57, has enjoyed a 35‑year career in the NHS after developing a keen interest as a teenager when she spent a lot of time doing her homework in hospital corridors while her mother was ill. She got a place on the NHS graduate training scheme and never looked back. “I did everything from working in the hospital laundry to assisting with hip replacements in theatres. It teaches you how complex the NHS is and how interdependent everything is. I was hooked.”
Humphrey believes the health service is now close to breaking point and that government policy is to blame. “The chronic underfunding of the NHS is almost conspiratorial,” she says. “The way it has been starved of money for the last seven years is scandalous. We haven’t got to this decade to find everyone is suddenly iller. I fear the government will turn around in a few years and say, ‘Look, we have given you money and it hasn’t worked – we need a new system.’ I am concerned this would lead to a compulsory insurance model.” It would create a two-tier system, she feels. “The NHS is not only a very efficient service, it’s also clinically excellent. If we move away from that [a service that is free at the point of need] there’s no going back. What you would end up with is very poor quality services for the poorest and those who need it most.”
Humphrey is clear that improving recruitment and retention of employees is critical to GMMH’s success. She has voluntarily introduced the living wage, the first NHS organisation in the north-west to do so. All staff earn at least £8.75 an hour. The move has seen pay rises for 522 staff, including the trust’s nursing assistants, healthcare support workers, porters, receptionists, drivers and administrative staff. “It was a no-brainer,” says Humphrey. Introducing the living wage cost around £2m. “I took quite a lot of flak for that, but we had healthcare assistants in secure mental health units being paid less than they could earn at Tesco. I was clear – how could we afford not to do it? Not paying the living wage would have been unethical.”
Curriculum vitae
Age: 57.
Family: Married, with one daughter from a previous marriage and two stepdaughters.
Lives: Barrowford, Lancashire.
Education: Holly Lodge comprehensive school, Liverpool; University of Liverpool (BA literature and language); University of Manchester (MA economics).
Career: 2017-18: chief executive, Greater Manchester mental health NHS foundation trust; 2006-17: chief executive, Greater Manchester West mental health NHS foundation trust; 2004-06: chief executive, the Walton Centre NHS trust for neurosciences; 2002-04: director of performance, Cumbria and Lancashire strategic health authority; 2000-02: director of specialist services commissioning, Lancashire and South Cumbria; 1995-2000: director of strategic planning and commissioning, East Lancashire health authority; 1992-95: director of planning and contracting, East Lancashire health authority; 1991-92: children’s services manager, Burnley health care NHS trust; 1988-91: district services manager, Burnley, Pendle and Rossendale health authority; 1985-88: deputy hospital manager, St John’s hospital, Chelmsford; 1983-85: national management trainee, Mersey regional health authority.
Interests: Mountaineering, fell-walking, photography, swimming, poetry.
