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					                               Evaluation of the ‘Leading by Example’ Project




                                         EVALUATION:

                         ‘LEADING BY EXAMPLE’
                                      PROJECT

                                                Author: T.R. Coldham

                              Independent Mental Health User Consultant




                                                 Date: 20th July, 2006




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                                                     Evaluation of the ‘Leading by Example’ Project


LIST OF CONTENTS


EXECUTIVE SUMMARY ............................................................................................ 3

INTRODUCTION ........................................................................................................ 5

METHODOLOGY ....................................................................................................... 7

FINDINGS .................................................................................................................. 9

   Surrey and Borders NHS Trust ............................................................................... 9

   Sussex Partnership NHS Trust ............................................................................. 12

   Hampshire Partnership NHS Trust ....................................................................... 16

   Portsmouth City Teaching Primary Care NHS Trust ............................................. 23

CONCLUSIONS ....................................................................................................... 28

      WHERE ARE WE WITH LEADING BY EXAMPLE IN THE FOUR TRUSTS? .. 28

      CROSS-CUTTING THEMES - A DISCUSSION.............................................. 31

Appendices .............................................................................................................. 37

      A: Questionnaire 1 – Operational Level (aimed at Project leads, managers &

      Occupational Health)......................................................................................... 38

      B: Questionnaire 2 – Individual level (aimed at Frontline Staff) ........................ 40

      C: Questionnaire 3 – Individual Level (aimed at Mental health Service Users) 42

      D: Telephone Interview sheet – aimed at Lead / Strategic level (CEO or senior

      managers) ......................................................................................................... 44

      Appendix E: Evaluation Sources and Respondents ......................................... 45




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                                      Evaluation of the ‘Leading by Example’ Project




EXECUTIVE SUMMARY



“This is new territory for everyone so therefore no one knew how
it was going to work.”
                                                        A comment by a Service User




What Happened?

    Three of the four pilot trusts (Hampshire, Sussex and Portsmouth) engaged
       with Leading by Example in a significant way.
    One trust (Surrey) in effect mislaid the pilot during organisational changes.
    Only one trust (Hampshire) funded and appointed a full-time Employment
       Service Co-ordinator, who remains in post permanently.
    Sussex used Leading by Example to enhance its own existing and ongoing
       supported employment programme.
    Portsmouth did not implement a supported employment programme but did
       recruit a part-time development worker to pursue a policy and training agenda
       prompted by the pilot.
    Surrey has plans to fund a post to co-ordinate a supported employment
       programme during 2006/07.




What Worked?


    Support from the Sainsbury Centre for Mental Health (but not in every
       instance).
    Additional resources and posts (where funded).
    Impetus to review, renew and generate new policies.
    Delivery of new training initiatives in three of the four pilots.



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                                       Evaluation of the ‘Leading by Example’ Project




What Did Not Work?


    Support and monitoring from South East Development Centre and Mentality.
    Anything other than the complete support of senior managers and the HR
       Departments of trusts.
    One year was too short a timescale to run the pilots.




What Lessons Emerged?


    The complexity of the various paths back to work.
    Highlighting of the barriers to getting back to work.
    What difference a few committed people can make to attitudes and policies.
    Trusts do not accord Mental Health issues amongst staff high priority.
    Pilots require close support and supervision.
    Each trust interpreted the pilot as it pleased (one trust did not actually
       participate meaningfully at all).
    Leading by Example needs the commitment of everybody in the NHS, not just
       a few voices in the wilderness.
    The resources allocated to the pilots (even in Hampshire where the trust is
       plainly committed to Leading by Example, and enjoys the Chief Executive‟s
       hands on support) was minimal in the context of the issues being addressed.
    Leading by Example caught the imagination and excited many of the people
       working on the programme.
    Leading by Example is a big mountain to climb, and a slow process.




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                                               Evaluation of the ‘Leading by Example’ Project



INTRODUCTION

The Leading by Example programme was initiated in 2003 when the South East
Development Centre (SEDC),1 now part of the Care Services Improvement
Partnership (CSIP), contracted with the Sainsbury Centre for Mental Health (SCMH)
including Mentality, to assist a number of NHS Trusts in the region in the
development of their own user employment / exemplar employer programmes.


Leading by Example promotes supported user employment schemes, the
recruitment into the NHS of people who use, or have used mental health services,
the retention, and the mental wellbeing of all staff in an organisation. An exemplar
employer will therefore, not only institute changes in their employment procedures
and policies, but they will:


     Actively promote cultural change throughout the organisation in the
        recruitment, retention and development of mental health service users past
        and present.
     Actively promote mental health wellbeing across the whole organisation.
     Develop a mentally healthy working environment.


In this evaluation I have been asked to look at the pilot roll out of Leading by
Example in four NHS Trusts in the south east.


     Surrey Hampshire Borders NHS Trust (now Surrey and Borders NHS Trust)
     West Sussex Health and Social Care Trust (now Sussex Partnership NHS
        Trust)
     Hampshire Partnership NHS Trust
     Portsmouth City Teaching Primary Care NHS Trust


SEDC invited the four trusts to commit to Leading by Example in 2004, with the
broadly stated objectives of promoting the employment of mental health service

1
 At that time the South East Development Centre [of] the National Institute for Mental Health in England
(NIMHE).


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                                                Evaluation of the ‘Leading by Example’ Project


users through supported employment programmes, and the development and
implementation of policies and practices to improve the mental health of their whole
workforce.


Leading by Example was to be planned and implemented in the four trusts during
2004/05, and operated from 2005/06. It was hoped recruitment would commence
early in 2005.       Within this framework each trust might have had their own Leading
by Example programme in place for at least a year by now.


However, in two of the trusts major re-organisations have taken place in the period
2004/05 to 2005/006, in addition to the raft of other ongoing NHS changes.
Recognising the challenges faced by all NHS trusts, this author was given a remit to
address the following issues:


     What actually happened in each trust
     What worked
     What did not work
     What lessons emerge from the experiences of the trusts involved


Throughout this report the author has adopted the convention of – wherever possible
– using the words of people who were actually involved in Leading by Example. No
apology will be made for accurately and frankly reporting what was said.2


Finally, a short note about the Author.                 I am a Mental Health User Consultant,
Researcher and Trainer of many years experience. I have been a long-term user of
mental health services. I have a broad and in-depth experience of mental health
services and the user environment, and have worked for many major organisations
in the field.




2
 As not all respondents would necessarily expect, or wish, any or all of their comments to be quoted verbatim
or otherwise, no specific attributions will be listed in this document.


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METHODOLOGY

The evaluation exercise was carried out in the period May-July 2006. This relatively
brief timescale meant that of necessity the evaluation was focussed directly on the
four issues listed in the previous section: what happened, what worked, what did not
work, and what lessons emerged.


To directly address these issues a dual track questionnaire / interview approach was
employed.


Interviews – mostly conducted by telephone due to the availability of interviewees –
of key players in each trust3.


Questionnaires directed at three different target groups:


     Operational level – Project Leads, Managers, Occupational Health4
     Individual level – Frontline Staff5
     Individual level – Mental health Service users6


Followed up by telephone interviews where appropriate.7


In practice a number of the people contacted either did not respond, or were
otherwise unavailable. A significant number of individuals had for example, moved
on, either leaving the NHS or transferring away due to trust reorganisations. Other
staff did not actively engage with the evaluation, possibly because they had already
fully engaged with the evaluation carried out by the Sainsbury Centre for Mental
Health, which is awaiting imminent publication.


3
  See Appendix E: Evaluation Sources and Respondents
4
  See Appendix A: Questionnaire 1 – Operational Level (aimed at Project Leads, Managers & Occupational
Health)
5
  See Appendix B: Questionnaire 2 – Individual Level (aimed at Frontline Staff)
6
  See Appendix C: Questionnaire 3 – Individual Level (aimed at Mental health Service Users)
7
  Responders were given the option of being contacted / or not and the author respected this in every instance.


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Recognising that the time of NHS staff is a precious resource the view was taken
that if a contact did not respond to two approaches, no further attempt would be
made to engage them in the process.


Notwithstanding, selective interviews were conducted across a representative
sample of people involved in Leading by Example work in the trusts, and a number
of interesting and informative questionnaire responses were received.


Another source of evidence was informal and anecdotal information available to me
in my general work in the field,8 and many years experience working as an
independent mental health user consultant.


My original intention was to have held face to face interviews, if at all possible, and,
or to have organised focus groups. However, during the course of the evaluation
this proved impractical for a number of reasons:


       The timescale of the evaluation.
       The slow engagement and non-availability of trust staff (due in part to leave,
           people moving on, trust reorganisation).
       The ways in which trusts responded to this project.


Nonetheless, viewed as a whole, in my view the evidence gathered allows a
relatively comprehensive overall picture to be drawn, supported by the stories of
each of the trusts involved.




8
    For example, in my work for the Healthcare Commission.


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FINDINGS



Surrey and Borders NHS Trust9

“Leading by Example got lost in the changes…”


1. What actually happened


For a variety of reasons Leading by Example did not happen in the then Surrey
Hampshire Borders NHS Trust.


Part of the problem was that the trust which had signed up to the program was, on
1st April 2005, merged with two other trusts (Surrey Oaklands NHS Trust, and the
North West Surrey Partnership NHS Trust) to form the current Surrey and Borders
NHS Trust.


Leaving aside the issue of whether the merger ought to have impacted on the
commitment to Leading by Example, the result of the merger was that the „co-
ordinator‟ post for the project was never filled. Without a champion or a driver to
implement the program, in effect, no concrete action to implement the project after
1st April 2005 has occurred.


This is not to say that the trust has done nothing. Prior to the merger the original
trust had begun to plan for Leading by Example taking the South West London and
St. George‟s Mental Health NHS Trust example as its model. Although Leading by
Example seems to have got lost in the merger, it is in the process of being revived.


     The trust has made the employment of people with mental health problems a
        priority.


9
 At the time the trust bid to be a Leading by Example pilot it was the Surrey Hampshire Borders NHS Trust,
which has since been subsumed into the new trust.


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    It is looking to create a post in the Human Resources (HR) Department to
       support people /staff with mental health problems.
    It is looking to raise the profile of employment issues in its various mental
       health teams.
    Database products are being developed and rolled out to monitor mental
       health service users engagement with employment and their vocational issues
       (primarily, to identify how many people are being helped).
    A charter is being developed to include the culture of Leading by Example.
    There are plans to fund and employ a Leading by Example co-ordinator –
       timescale for this is within the next 18 months.
    Prior to the merger of the three trusts a job specification had been drawn up
       for an Employment Co-ordinator.




2. What worked


This question does not really apply to this trust. Leading by Example has still not got
off the ground in the Surrey Hampshire Borders NHS Trust, staff are still not in post
and a timescale of 18 months hence may be viewed as aspirational, rather than set
in stone at this time.


However, the existence of, and the inherited commitment to, Leading by Example
does mean that it remains on the trust‟s agenda and that the issues surrounding it
probably have a priority that otherwise, might have to be fought for all over again.




3. What did not work


Leading by Example got „lost in the changes‟ when the trust merged in 2005. While
managers might now view reviving it as a priority not much has happened on the
ground since April 2005.




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While mental health service users might welcome planned or intended policy and, or
cultural changes at some future date, they will have seen little or no change on the
ground in this trust.


4. What lessons emerged


In the absence of a powerful champion, a „driver‟ willing and able to fight for the
programme, Leading by Example was sidelined when the old trust merged to form
part of the larger Surrey-wide trust.


The fact that in this trust Leading by Example was sidelined in this way speaks
eloquently of the priority given to it, and its objectives, by Managers.


The trust is looking for external funding (from Surrey County Council) to fund the
proposed post in the HR Department tasked with supporting people with mental
health problems.


While it is a good sign that the trust currently plans to go forward with Leading by
Example, and is taking active steps to implement new procedures, develop new
policies and recruit, at some stage in the future a member of staff to co-ordinate or
support a supported employment programme for mental health service users is a
sign of hope, it is hardly evidence of deep-seated, long-term commitment to the
ideals of Leading by Example.




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Sussex Partnership NHS Trust10

“Everyone has been very supportive indeed. Helping me to achieve my goals.”


1. What actually happened


This trust actually had its own supported employment scheme operating some 18
months prior to Leading by Example.


From our perspective this has two knock on effects:


        Leading by Example did not get lost in the changes of the subsequent merger
           of local trusts because it already existed in one form.
        It makes it difficult – perhaps impossible – to unpick the impacts of Leading by
           Example from those of the original, inherited project.


To date 9 people have been employed by the trust via either the original programme
or the later Leading by Example project.


Throughout the project a member of staff has been in post co-ordinating the project,
keeping in touch with service users and monitoring outcomes.                   Largely due to
Leading by Example funding for this post has now become mainstream and long-
term.


The importance of training in shifting cultural values was highlighted. Interestingly,
people‟s attitudes in corporate (that‟s is, non frontline areas) of the organisation tend
to be more prejudicial to service users. The trust is actively targeting this through
awareness training.


There has been a continuity of commitment to the programme, a conscious effort to
shift cultural values within the organisation, and clear evidence that the trust has


10
     Formerly West Sussex Health and Social care NHS Trust.


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                                      Evaluation of the ‘Leading by Example’ Project


made, and continues to make, real efforts to learn from their experience running the
programme.


It is unclear whether the trust has embraced the whole ethos of Leading by Example
in respect of the mental health wellbeing of all staff. However, the programme has
had a direct input into the revision of recruitment and retention policies.


In response to the evaluation exercise the trust informally reviewed the programme –
the results of that review have been fed into this report.




2. What worked


Leading by Example enhanced the effectiveness of the existing programme and:


    Made accessible advice and support from the Sainsbury Centre for Mental
       Health (particularly from Bob Grove of SCMH and Elizabeth Gale of Mentality)
       which greatly helped the staff on the ground.
    Improved the funding scenario – the original funding was time-limited, now the
       programme is funded longer term.


A Sussex Steering Group was set up in lieu of the national Steering Group – this
produced improved continuity.


Although it is hard to quantify, the feeling is that Leading by Example has promoted a
significant „culture shift‟.


The trust has embarked on a „Removing the Stigma of Mental Health Campaign‟,
instigated by service users. Related logos – designed by users - now go out on all
recruitment packs. Staff handbooks have been updated. The trust now produces a
Mental Health Service User Handbook.


Other positives that have come out of Leading by Example include:



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    The facilitation of networking opportunities and talking to other professionals
       about how their projects work.
    Exposure to the lessons learned in the South West London and St George‟s
       Mental Health NHS Trust programme.
    General raising of the profile of mental health service users issues and
       moving cultural changes up the agenda.




3. What did not work


While staff were happy with the level of support from SCMH, they were not
impressed by that from SEDC. This latter was described as minimal.


By and large the impacts seem to have been positive in this trust.




4. What lessons emerged


There are a host of issues around what is an appropriate level of support and, or
involvement by HR, and or, the Service User Employment Project worker:


    The trust wants to be non-discriminatory and treat everybody equally but
       service users do not all want to be treated the same way.
    Some service users want more support, others less.
    The balance to be struck in mediating with Managers, disclosure issues and
       ongoing support issues is a very delicate one, which is always developing.
    It is very important to have committed support staff in post.


Balancing this is the following comment:      “I think sometimes staff can be over
protective towards you.”




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                                         Evaluation of the ‘Leading by Example’ Project


A service user has said of the recruitment process itself:              „This process was
excellent…everyone has been very supportive.‟


Tackling barriers is a many facetted challenge:


     The trust has had to review its induction procedures.
     Support issues for managers arise because a service users history is not
         disclosed to managers.
     Monitoring staff‟s progress and mediating with managers very important.
     Dealing with situations when a user‟s history becomes known indirectly –
         other staff can be „a little apprehensive to being with.‟
     Attitudes of staff, while „positive on the whole‟, are often problematic because
         the attitudes of a small minority. For example, staff can say (even think) they
         support Leading by Example and yet still come out with remarks like you
         „have to be careful what you say.‟


The programme has direct inputs into the trust‟s recruitment and retention policy.


Attitudes of managers and trust policies do not of themselves translate into shifts in
the culture of an organisation.


Sometimes the worst barriers and the greatest misgivings are nothing to do with the
organisation but are the perceptions of the service user – which is why support from
the trust is vital.


Lastly, one respondent from this trust makes a very valid point. We are still in the
early stages of developing Leading by Example, so it is hardly surprising that both
staff and service users are sharing a steep learning curve.


“This is new territory for everyone so therefore no one knew how it was going to
work.”




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Hampshire Partnership NHS Trust

“There are lots and lots of things you would want to make better but…what we’ve
done so far, it’s been tremendously successful.”


1. What actually happened


For a number of reasons the trust embraced Leading by Example and ran with it:


     It was supported from the top – the Chief Executive, Martin Barkley was
         already committed to the user-involvement agenda before the advent of
         Leading by Example (he had brought the South West London and St
         George‟s Mental Health NHS Trust Charter with him to Hampshire).
     There were recruitment and retention problems in the trust, which the
         programme implicitly addressed.
     Staff already in post to „drive‟ the project, including a staff member who is an
         „Out‟ mental health service user.
     A committed and expert steering group from the outset of the programme.


With the active support of the Chief Executive (who funded the post out of his „Chief
Executive‟s‟ Budget), an Employment Co-ordinator post was designed and recruited,
and a steering group formed at an early stage.


Not everything went smoothly. Although an Employment Co-ordinator was in post,
the role was not a strategic one, and reported to the Social Inclusion lead, a role not
filled until recently.


Notwithstanding, Leading by Example was initially rolled out in the Winchester area.
The supported employment element of Leading by Example has been operating ever
since.


The Employment Co-ordinator‟s brief is:




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     To provide support to people applying for jobs in the trust who may have
        additional needs.
     Provide support around retention issues.
     Input to training needs.


Initially, the Co-ordinator takes people onto her caseload for a period of 8 weeks –
the idea is to move people forward all the time. Experience to date is that the
majority of people referred do not want paid employment. A lot of people have
however, progressed to the interview stage, albeit with little success so far.


An ongoing problem is the difficulty getting feedback on the reasons why people are
rejected at the interview stage.


Leading by Example has given impetus to the development of trust policy on the
mental health wellbeing of its staff, their recruitment and retention (for example the
„Mental health at Work‟ policy document).


In a strange way Leading by Example in the Hampshire Partnership NHS Trust tends
to highlight both the good and the not so good side of this, and similar programmes
running within large, complex organisations. Without in any way „doing down‟ the
people on the ground in Hampshire we can probably learn more from the successes
and failures of the programme in this trust than in any of the others. If only because
Leading by Example – as a project - has been operating in this environment longer
than anywhere else.


The trust‟s internal survey of the first year of Leading by Example has identified:


    The need to break down barriers.
    The need to promote and market the role of the ES Co-ordinator across the
       whole trust.
    That there is a lot of work still to do to tackle the stigma attached to mental
       health.
    That within the trust a lot of people are committed to the programme.



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Following the survey the trust is addressing cultural issues:


    A new staff wellbeing policy is in place as a result of Leading by Example.
    Every job application pack contains information about the programme.


A general point worth making is that as Hampshire is the only trust that has
deliberately and specifically gone down the Leading by Example route its successes
and failures are by definition, more tangible.     This should not detract from the
excellent work that has gone on to get the programme up and running. Not should
we forget that we are only now, entering the second year of that programme. These
are, therefore, early days still.


2. What worked


Leading by Example was up and running in the trust so early because there was top
down commitment to it. The programme had „champions‟ and „drivers‟ at each level.


Support from the Sainsbury Centre for Mental Health (SCMH) was very well received
in the initial phase; however, this support seems to have ceased when the Co-
ordinator took up post. Support from the South East Development Centre (SEDC)
was described as „underwhelming.‟


Of SCMH it was clear that the inputs of Bob Grove and Patience Seebohm was
regarded as instrumental in getting the project off the ground. Support from SCMH
was „vastly more important in quantity and quality than that from SEDC.‟


The project has a tangible product: the Employment Co-ordinator post which assists
people who want to come into the trust. As the Co-ordinator herself says, proudly:
“We‟ve got a program running.” Which is no mean feat, in itself.


The Co-ordinator has been in post over a year now. She is currently supporting 53
people. Although to date, only 2 people have been employed in paid work by the
trust, 4 others are in work placements / experience positions, and the plan is to



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arrange between 10 and 15 placements at any one time.            Referrals to these
placements have come from both social workers and CPNs.


The Co-ordinator is very optimistic about the future. “Things are moving forward”,
managers and staff are generally supportive and she knows she has the full backing
of the Chief Executive. Her local steering group is proactive and supportive. Despite
her heavy workload she is planning ways to continue to break down barriers looking
to arrange further awareness training later this year.


Her role is clear cut – covering the employment side, although in practice her work
touches on many aspects of the Leading by Example philosophy:


    She supports the recruitment of people to the trust
    She is involved in the retention of staff
    Arranges work experience placements
    Arranges volunteering placements


The latter roles both operate as a mechanism to ease people back into the
workplace.


Leading by Example raised expectations of changes in the working environment (the
reverse of this is that these expectations may have been disappointed in some
respects).




3. What did not work


One remark sticks in the mind: „[Leading by Example] has become very much about
the employment project.‟


On the same theme the steering group is seen as supporting the employment project
rather than the broader aims of Leading by Example.




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It is not really a question of identifying failures, mistakes or things that went wrong as
opportunities missed, things not being addressed. It may be that the success of the
employment project has drawn the focus away from working for a radical cultural
change.


Leading by Example is to a degree, swimming against the tide. There are many
barriers to be surmounted, and relatively few champions. Even in an environment
like the one in Hampshire where there is unambiguous support from senior
management, to be successful and to develop the programme needs to be „driven‟.


Although the trust clearly benefited from SCMH‟s support in the setting up process,
thereafter, „SCMH were very unhelpful‟ and „seemed to have a separate agenda.‟


Practically, the trust received little or no support from SEDC, and since the
Employment Co-ordinator took up post she has been badly let down on at least two
occasions by Mentality, who are part of SCMH (failing to deliver awareness training
with minimal warning). „Mentality let us down big time,‟ says one respondent.




4. What lessons emerged


One employment co-ordinator for a big trust is not enough for Leading by Example to
be „the change agent it could be‟. To repeat one view to make things happen trusts
need somebody „in their face‟ all the time and while so few people are directly
engaged in the programme this is unlikely to happen.


The trust has an „exemplar‟ committed Employment Service Co-ordinator in post,
who despite the support of managers – all the way up to and including the trust‟s
Chief Executive – is probably overloaded.        The Co-ordinator‟s own, remarkably
uncomplaining analysis of where the trust needs to go with Leading by Example, is
cogent and to the point: “Ultimately, it needs to be a whole team.”




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The trust has made a good start, laid foundations but without devoting more
resources to Leading by Example it will fall short of the high standards it has set
itself.


The Hampshire story is one of limited – but not to be in any way belittled – success.
However, a lot of referrals to the employment project are of people who are „not work
ready‟, and the majority of referrals are generated internally. Inevitably, this means
that the programme is trust centred, rather than mainstream. If most referrals come
from service users who are already in the system, those outside it are probably being
neglected. Leading by Example is about exemplar practice, and the above is a
criticism of the trust only in the sense that it is not striving for the very best practice.


Hence the comment: „I don‟t feel like we‟re being very radical‟


Barriers, mainly in the form of uncertainties and worries of other staff, need to be
addressed directly. This may be by awareness sessions, or by question and answer,
face to face meetings. Staff involved with Leading by Example in the trust noted this
latter approach was probably the most successful early in the programme.


Hampshire flag the same support, disclosure and mediation issues as elsewhere.
How much support to provide? When to provide it? Issues surrounding the work
readiness of applicants have been successfully addressed by gradually introducing
people to the work environment via the volunteering, and work experience route.


In Hampshire there is a good working relationship between the Employment Co-
ordinator and her opposite number in the Occupational Health Service – this
undoubtedly lowers barriers that could otherwise easily impact the effectiveness of
the employment project.


There is also evidence that Leading by Example has begun to change attitudes.
People are happy to be „out‟ in the trust. There has been an amnesty in respect of
people who never previously disclosed mental health issues, and the fear of
discrimination because of mental health problems has for many staff, been removed.



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In Hampshire some of the lessons of Leading by Example are already clearly
illustrated:


     Nurses and other staff involved have become „more open-minded‟.
     A practical approach to getting people back into work may be the voluntary /
          work placement route.
     How important it is to recognise how „scary‟ the work place can be to
          returnees after a long time away.
     Training for staff is vital because it „makes people more secure in their roles.‟
     The need to have „a group of people who are positive about the scheme to
          make it work.‟


In Hampshire the knock on benefits of embracing Leading by Example are starting to
be felt. The positive experience of staff and the resulting change in attitudes are all
very hopeful signs.


Notwithstanding, attitudes and cultural values remain big barriers to Leading by
Example. The following problems have been flagged:


     „We are a bit stuck in our procedures,‟ limiting flexibility in how the trust
          accommodates service users and others with mental health problems.
     There is an entrenched view that „taking on someone with mental health
          problems is taking on a problem.‟
     Because of existing workloads „people won‟t commit willingly to give someone
          extra support.‟
     There is a failure in that some to see a mental health user working within as
          „just another patient.‟


Change has at least begun in Hampshire and it has caught the imagination of the
people involved in it: „Its an area which is exciting and I wish I had more time to give
to it.‟


Leading by Example is a „big mountain to climb.‟



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                                         Evaluation of the ‘Leading by Example’ Project




Portsmouth City Teaching Primary Care NHS Trust


“Certain project objectives were achieved within the PCT, however to date we have
not implemented a Supported Employment Scheme.”


1. What actually happened


If one defines the Leading by Example programme as an exemplar framework which
includes a supported employment scheme, then strictly speaking, Portsmouth would
fall outside the programme.


However, this would be to ignore the work that the trust has pursued that is
otherwise wholly consistent with the aims of Leading by Example. Moreover, the fact
that a part-time Supported Employment Development Worker post was created to
assist the Lead Occupational Therapist MH in work which may be regarded as
guided by Leading by Example objectives, suggests that the trust was simply
pursuing the programme in its own way.


In 2005/06 the trust implemented and, or initiated:


    A Wellness Policy addressing mental health issues of staff already employed
       by the trust.
    In association with Portsmouth Mind, the lead OTMH and the Development
       Worker delivered Mental Health Awareness Training to staff across the trust
       (with service users delivering part of the training).
    A mapping exercise has recently been completed exploring attitudes of
       service users within the trust.


The Lead OTMH and the Development Worker also ran two workshops at the
Leading by Example event in Manchester.




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                                       Evaluation of the ‘Leading by Example’ Project


The Development Worker has now left the trust.


The main barrier to the implementation of a supported employment service has been
the diversity of the trust. The trust‟s view is that singling out service users with
mental health problems was felt to be discriminatory when there are other
disadvantaged or under-represented groups which also need support to gain
employment.


There are no immediate plans to develop a Supported Employment Programme.
However, the trust intends to set up a group „in the Autumn‟ at which „Exemplar
Employer‟ issues will be raised.


Given that the project ran for twelve months with no current plan to continue or
develop it, it is not entirely clear what level of ongoing commitment for Leading by
Example exists in the trust.




2. What worked


The level of support from the Sainsbury Centre for Mental Health (SCMH), and its
input into reviewing the progress of those work threads which emerged during the
year of the pilot, was described as „terrific‟. Bob Grove, Patience Seebohm and also
Rachel Perkins, from the South West London and St George‟s NHS Mental Health
Trust, all attract praise from the staff involved with the project.


„A great experience working with [SCMH] they were so helpful and supportive,
helping to problem solve and coming up with contacts across the country.‟


Like other trusts the staff involved in the programme in Portsmouth obviously
benefited from the networking opportunities which arose during the year.


In concrete terms service users were employed in a voluntary capacity within the
trust, and mental health awareness training was facilitated and delivered.



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                                         Evaluation of the ‘Leading by Example’ Project


Unfortunately, „the time given freely by the services users appears to be taken for
granted and has become expected.‟ This begs the question as to how much user
involvement is properly valued within the PCT generally.


Leading by Example caught, to a degree, the imagination of those directly involved in
it, who felt at times, that they were a little „on their own‟. Part of this was because
they thought the other sites were „doing it‟ while they were lagging behind. In this
respect they were being a little hard on themselves.




3. What did not work


Support from the South East development Centre (SEDC), apart from initial contact,
was not forthcoming. „The support could have been improved.‟


The absence of a Leading by Example champion in the trust, and „lack of
commitment from with the PCT.‟ A telling comment is: „If I were trying to implement
the project now I would make sure I had HR commitment from Associate Director or
higher level within the organisation.‟


In fact it seems that although the trust‟s senior management „was interested and
understood the aims of the project. HR was more cautious…as they were aware of
an already high level of mental health difficulties…of existing employees.‟


The local steering group was hamstrung by the intermittent attendance of members.


HR concerns about Leading by Example – mostly in the context of past and current
issues surrounding employees with mental health problems – seem to have been the
first and highest barrier facing the project.




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                                       Evaluation of the ‘Leading by Example’ Project


4. What lessons emerged


All stakeholders need to commit to the aims and objectives of Leading by Example if
it is to have a real chance to flourish in an organisation.


In Portsmouth‟s case, the real, or perhaps simply perceived lack of enthusiasm by
the HR Department had a negative effect on the project.


The failure – for whatever reason – to implement a supported employment
programme meant that this pilot was not, and could not be a rounded test of the
possibilities of Leading by Example.


Although the pilot produced new policy documents, provided a mechanism for the
delivery of mental health awareness training and put trust staff in contact with
colleagues doing similar work in other areas, it is hard to see what long term impact
it will have in the trust.


However, there are indications of a shift in attitudes among those who participated in
the initiatives arising out of the trust‟s limited application of Leading by Example.
Recognition, for example, that:


    Although service users should „be assessed as any other prospective
       employee‟, steps should be taken to ensure „there are adjustments in place to
       support the individual.‟
    It was „essential to explore the expectations of the service user and potential
       colleague / manager.‟
    And that sights had to be set high – „it is not good enough to change people,
       you need to change the world.‟


One of the reasons the Occupational Health Department said it could not supply the
necessary help to users was that it was overstretched already, and the existence of
the pilot was therefore, viewed as welcome extra resource and expertise.




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                                     Evaluation of the ‘Leading by Example’ Project


Other insights arising out of Portsmouth‟s experience include:


    There was a fear of colleagues finding out about a previous or current mental
       health problem.
    Particularly among nurses, there was a culture of „not letting the team down‟ if
       someone fell sick.
    Issues of confidentiality was a key issue with practitioners, including fear of
       users viewing friends notes and sharing this information.
    There was a perception that mental health service users would probably only
       be in „low key jobs‟.
    An awareness that there are „people out there‟ who are desperate for work.
    That the only way ahead was to actively challenge stigma.


Finally, the thoughts of the Development Worker during the pilot on working on the
leading by Example pilot. Although working on the programme had not been „as
easy as I thought it would be,‟ nevertheless, it was like ‘working under an umbrella
of motivation and creativeness’.




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                                     Evaluation of the ‘Leading by Example’ Project




CONCLUSIONS


WHERE ARE WE WITH LEADING BY EXAMPLE IN THE FOUR TRUSTS?


In an ideal world we would sit back and enjoy the luxury of four pilot trusts which had
implemented Leading by Example in essentially the same way, albeit with each
trust‟s local variations. We could then pick over the results, sift through comparable
evidence sets, draw unambiguous conclusions.


Unfortunately, that scenario is where we would like to be in an ideal world. We are
not in that ideal world. We are where we are, and now we must make the best of it.
However, before we become too gloomy about the situation, there are many things
we can learn from the pilots.


There are structural things which are probably common through the NHS:


    Left to their own devices individual trusts will produce individual solutions.
    Any major initiative – like Leading by Example – will be subject to the
       turbulence caused by larger change agendas.
    The fact that NHS trusts are supposed to be exemplar employers will not
       mean trusts will welcome or embrace the exemplar standards implicit in the
       Leading by Example programme.


There are local things:


    HR Department barriers effectively hamstrung the Portsmouth pilot.
    In Surrey the trust is still trying to develop a job specification for somebody to
       run a supported employment programme (the delays revolve around the
       grading of the post).
    In Sussex the trust was already headed down a parallel road to Leading by
       Example and it is a moot point whether they revert back to it in future.


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                                      Evaluation of the ‘Leading by Example’ Project


    Hampshire, which probably embraced the programme most wholeheartedly
       has, nevertheless, focussed most of its effort on the employment project side
       of things (an understandable compromise given the need to get the
       programme up and running from scratch in only a year).


In a funny sort of way, we have actually learnt more from the mixture of „fixes‟ and
„compromises‟ comprising the pilot than we would if all four had produced exemplar
solutions.


One view might be that we come to the pilots with overly-optimistic expectations.
Two the pilot trusts were, after all, subsumed in larger entities at the moment they
were supposed to kick off their Leading by Example programmes. In one of those
trusts the pilot got „lost in the changes‟, in the other it was adapted, used to enhance
an existing supported employment project and awareness campaign. In the trusts
which remained relatively stable in 2005/06, Portsmouth decided to run with the
ethos of Leading by Example, while dispensing with some of its substance (an
employment programme). Hampshire, went completely the other way, throwing the
resources it had made available at the supported employment scheme, taking the
view that once this was in place they would then have a foundation on which,
hopefully, to build upon.


The fact that each trust acted differently, and made differing decisions, choices if you
like, may be telling us something about the level of support they received in the initial
stages. Sainsbury Centre for Mental Health (SCMH) gets good to rave reviews from
people in the trusts, while the South East Development Centre (SEDC) gets
universally low marks. In the absence of strong advice and support from the centre it
is no surprise that the trusts went their own way. It has to be noted by the author
that the key link person from SEDC was himself on long-term sick leave during
the majority of the projects time.


So, where are the pilot trusts vis-à-vis Leading by Example:




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                                      Evaluation of the ‘Leading by Example’ Project


    Surrey has plans to do Leading by Example friendly things but delivered very
       little to date.    The failure to implement a supported employment scheme
       speaks louder than words, and stated good intentions count for nothing until
       they morph into something substantial.


    Sussex has had a supported employment scheme in place longest and there
       are many committed people involved in pursuing Leading by Example aims
       but to date only 9 people have been recruited to paid employment in the trust.
       The pilot assisted the development of policies and ongoing work.


    Hampshire is clearly committed to Leading by Example although as clearly,
       the resources have not been allocated to actually deliver its aims and
       objectives.       Nonetheless, the trust‟s employment project is making a
       difference and raising the profile of mental health service users and people
       with mental health problems in the trust.


    Portsmouth‟s failure to implement a supported employment programme either
       in response to their existing worries about people working in the trust with
       mental health issues, or as a part of signing up to Leading by Example,
       speaks of a lack of commitment to the programme.




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                                       Evaluation of the ‘Leading by Example’ Project




CROSS-CUTTING THEMES - A DISCUSSION


“That if it isn’t good enough to change people, you need to change the world”


As highlighted in this report a Leading by Example encompasses several strands in
one project. To achieve the culture shift from mental illness within the workforce
being a taboo subject to something which is commonplace, possibly preventable, but
manageable, I would suggest that the multiple strands must operate in tandem.


The overall aim is to counter the culture of „them and us‟.




Positive recruitment of mental health service users


In varying work opportunities:


    Full or part-time paid employment.         Mainstreamed according to the post
       required - matched realistically with the person‟s capability to do the hours,
       and in line with their skills and competences.
    Employment taster sessions. That are short, time bound and specific around
       a person‟s desired work area.
    Voluntary work. For people who just want to contribute to the trusts running in
       areas where an „extra pair of hands‟ is needed. Perhaps, these could be user
       focused. An example might be helping to facilitate a Patient Council on a
       ward.    This would help those unwell at that time in seeing another user
       working (providing that an individual is comfortable about being „out‟ about
       their condition). Care must be taken that voluntary work is not seen as a
       substitute for paid employment, or as employment on the cheap for the trust.


It is important to offer a range of employment options, and that people can transfer
from one option to another to suit their needs. Support needs to be tailored to the
individual, from the interview to workplace. This can come from the employment co-


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                                     Evaluation of the ‘Leading by Example’ Project


ordinator (as in Hants), or once in post from the line manager, remembering that in
the scenario the manager also has support needs.


It was said that managers have no time to give extra support, and do not want to
employ users for fear of possible high sickness levels. However, we know that users
who have been unemployed make good employees on the sickness record front
because they are only too aware of the threat of losing their job due to taking sick
leave, and over compensate by being extra reliable! This message needs to be put
firmly across to managers.     We should give people a chance.         A much better
understanding of these issues was found in the attitudes of managers who had had
personal histories of health conditions or had near relatives with health issues that
had impeded their chance of gaining employment.


Another issue is that while unemployed users want to work they are not always „fit for
work‟. A dichotomy: that whilst they may not be fit for work when starting, they need
to start work to be able to get ‟fit‟ for it. Sometimes they have real issues with work
and the working environment, i.e. time keeping, behaving in the correct manner.
They need time, understanding and mentoring to be able to fit in.              However,
unacceptable behaviour is just that, and they should be treated the same as anyone
else, once the cause for this behaviour is not found to be due to their mental health
problem. This needs to be handled sensitively. Also, It is important to be realistic
about what people can do and make „reasonable adjustments‟ as directed under the
Disability Discrimination Act (DDA). Work should be viewed as part of the recovery
process. You are not job ready after being ill with a major mental health problem.
You need motivation; support and an enabling culture to bring out your potential.
Work can be - although NOT always - a positive part of someone‟s continuing
„recovery journey‟.


Taking the example of the flyer for the employment project in each recruitment pack
in the Hampshire Partnership Trust, trusts should be encouraging people with mental
health problems from outside them to apply, not just those already known to the
services. A separate question is whether Leading by Example should be used to
address recruitment problems that are really issues around whether rates of pay are
comparable to more marketable employment opportunities elsewhere.


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                                      Evaluation of the ‘Leading by Example’ Project




Portsmouth PCT‟s idea of having „Exemplar Employer‟ issues as part of an
Employment sub-group of the LIT keeps the issue live, and user and carer members
of this group can monitor its progress. Indeed, once a Leading by Example project
has been up and running for a while, more user workers (within reason) could attend
the trusts Leading by Example steering group to keep the issues „real‟.



Healthy workplace initiatives

    Mental well-being in the workplace policies should be instigated.
    Mandatory Mental Well Being Training - Trusts major on control and restraint
       training, i.e. how to do it without being hurt and hopefully causing either injury
       or death. Lifting and Handling. Fire procedures. All these are to ensure safety
       and overt possible injury. Mental Well Being Training would be offered in the
       same vein. The content would include highlighting the responsibilities of the
       individual for their own mental health and that of the employer to them. Some
       of these issues have been played out in compensation claims made through
       the courts over recent years. Recognising stress. Understanding how stress
       affects people in different ways. Coping mechanisms, etc.
    Support mechanisms - Recognising that this should naturally come from your
       every day work colleagues. It would also come from supervision sessions, i.e.
       peer, team, professional, and maybe even clinical supervisions – also via a
       contract with an outside counselling service.


The concept needs to be mainstreamed so that „stress‟ is not just seen as an issue,
say, after a Serious Untoward Incident.       The necessary culture shift is towards
everyone understanding that mental health is an issue for everybody. That they as
individuals and as employers each have responsibilities to ensure a safe working
environment. It is how we interact with each other and giving due attention to stress
caused by working in difficult and sometimes dangerous environments.


All these can amount to a seismic cultural shift within all mental health trusts - who
should be „exemplar employers‟ in this field. Basically, they need „to get their own


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                                      Evaluation of the ‘Leading by Example’ Project


house in order‟. There is a clear danger that if you run an employment scheme in
isolation of any other actions you will retain – and possible further entrench - a „them
and us‟ culture, and myths about who is ill and who is well will not be broken down.
This also puts greater pressure on users in the work place to perform.


Having this pilot happen in a PCT provider trust is interesting in that it serves a wider
patient community than a mental health focused trust. It is interesting that HR did
not want to make a separate policy on mental health as they saw it as the thin end of
the wedge, in that they would later have to develop one for other health issues. This
is, of course, nonsense.      All employers HR units must have healthy workplace
policies covering all issues. They are obliged to understand and actively promote
their duties under the DDA. Leading by Example is about „positive discrimination‟ in
favour of mental health because we know that discrimination particular to this health
condition is prevalent in the general workplace outside of health, contributing to the
large percentage of people with mental health problems on long-term sick related
state benefits.




Who knows about whose mental illness?

Issues were raised about confidentiality:


    The user working for the trust may have access to their own healthcare
       records. Keep them filed separately?
    The user working for the trust may have access to healthcare records for
       people they know and then divulge this information. This scenario requires
       careful handling but cannot be unique to mental health users.
    The line manager not knowing about the users medical history as this
       information is kept by occupational health.          Whilst full knowledge of
       someone‟s medical past is irrelevant, I wonder how much a line manage must
       know in order to make reasonable adjustments to the post? If a person is a
       wheelchair user, then this cannot be hidden and the issue will be addressed
       head on. Why shouldn‟t mental health issues also be addressed directly? It
       would help create a dialogue about the situation, help managers be realistic


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                                      Evaluation of the ‘Leading by Example’ Project


       about what a person can do and when, and tend to help to break down the
       general stigma surrounding this issue. Discretion rather than secrecy.




Resource issues

There needs to be a dedicated and protected budget which is mainstream within the
trust, not sourced from outside. This ensures that the project is not just a flash in the
pan. It will take some time before the required culture shift happens.


There needs to be high-level sign up and a positive „buy in‟ from:


    Human Resources - to tackle HR issues and lead policy change in this area,
       create trust „charters‟.
    Occupational Health – again to specifically address OH issues and make
       policy changes.
    Directorate level - within the main body of the trust governance structure.
       Perhaps, the Director of Nursing or a Director who is also responsible for User
       Involvement. HR and OH functions can be bought in and shared with other
       trusts, meaning this particular trust does not necessarily have a sense of
       ownership at a high enough level for the culture of change to permeate
       strategic thinking at board level.
    At least one worker dedicated to the project. Ideally there would be a team of
       people able to adequately serve the large geographical areas trusts now
       cover. This needs to be graded appropriately so as to give the post gravitas
       and attract individuals capable of making things happen.


A Steering group that meets regularly with all the above people involved along with
key managers who are forward thinking and willing to pilot the actions in the
workplace. Attendance needs to be maintained.




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                                    Evaluation of the ‘Leading by Example’ Project




Leadership & Champions

“Working under an umbrella of motivation and creativeness”


It is important that somebody drives this agenda forward. Whilst a CEO of a trust
heading a steering group gives it prominence, the person who actually drives the
agenda forward must have vision, energy and be able to motivate and support the
initiative. This was flagged up by more than one person in the Hampshire pilot, and
elsewhere. This person needs to have dedicated time allotted to this project.


One of the reasons that the South West London and St George‟s scheme worked is
because it was not only headed by a charismatic leader like Rachel Perkins, but also
because she herself is „out‟ about her own severe mental health problems. She ably
demonstrates that you can have a high level career and be successful whilst having
a significant mental health problem. People like her and Lesley Herbert (Hants) and
others need to be applauded and nourished because until the long overdue change
in culture comes they are continually making a personal sacrifice to spearhead this
cause.




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                                        Evaluation of the ‘Leading by Example’ Project



Appendices

A: Questionnaire 1 – Operational Level (aimed at Project leads, managers & Occupational
Health)


B: Questionnaire 2 – Individual level (aimed at Frontline Staff)


C: Questionnaire 3 – Individual Level (aimed at Mental health Service Users)


D: Telephone Interview sheet – aimed at Lead / Strategic level (CEO or senior managers)


E: Evaluation Sources and Respondents




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                                   Evaluation of the ‘Leading by Example’ Project



A: Questionnaire 1 – Operational Level (aimed at Project leads,
managers & Occupational Health)


                    LEADING BY EXAMPLE – EVALUATION

           Project Leads, Managers, Occupational Health / Operational Level


Trust

Name of Interviewee / Respondent

Position / Role



1. How was the scheme
implemented?

     And what was your
      involvement?
     Were there any
      organisational changes
      during implementation
      (policies, etc.)?
     Any barriers to
      implementation?



2. What worked and what did not
work?

     And how did this change
      how the project was
      implemented?
     What, if anything, would
      you do differently if you
      were implementing the
      project now?


3. Have any gaps in
implementation been identified?
(and if so, what?)

     Where gaps identified
      during implementation or
      later?
     What action has been taken
      since?


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                                    Evaluation of the ‘Leading by Example’ Project



4. What lessons have been learned
from the scheme?

    Has there been an
     opportunity to review the
     project (If YES, please state,
     or provide evidence of it)?
    Anecdotal evidence?



5. Was the level of support from
South East Development Centre and
The Sainsbury Centre for mental
Health appropriate?

    What worked best?
    What could be improved?



6. Do you have any other comments
on the project, or suggestions you
would like to make?

    Positives?
    Negatives?


Are you willing to be contacted about your answers above?              YES / NO

If YES please let me have a number on which
I can contact you:

Completed questionnaires                              T.R. Coldham
should be returned to:                8 Harrow Down, Badger Farm, Winchester, Hants
                                                        SO22 4LZ

  Thank you for taking the time and trouble to participate in this evaluation - If you
         would like to talk to me about this questionnaire, or the evaluation,
                          you can ring me on 01962-854969




A Report by Tina R. Coldham                                          Page 39 of 45
                                       Evaluation of the ‘Leading by Example’ Project



B: Questionnaire 2 – Individual level (aimed at Frontline Staff)


                      LEADING BY EXAMPLE – EVALUATION

                             Frontline Staff / Individual Level


Trust

Name of Respondent

Position / Role



1. Have you worked alongside (or
with) mental health service users in
your Trust?

     If so, in what capacity?



2. What is your reaction to mental
health service users being directly
employed by your Trust?

     Good and bad aspects?
     How does it effect you?
     Do you, or have you worked
      with somebody employed
      under the scheme?
     Do you have any issues
      about working with
      somebody employed under
      the scheme?
     Are you personally
      supportive, or negative about
      the scheme?


3. What difference, if any, has the
scheme made to your practice?

     Positive things?
     Negative things?
     What you expected?
     Raised unforeseen issues (if
      so, please specify)?
     Broadened your view of the
      capabilities of service users?


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                                  Evaluation of the ‘Leading by Example’ Project



4. Do you have any other comments
you would like to make?

    Good things?
    Problems or issues?
    General thoughts?



Are you willing to be contacted about your answers above?              YES / NO

If YES please let me have a number on which
I can contact you:

Completed questionnaires                              T.R. Coldham
should be returned to:                8 Harrow Down, Badger Farm, Winchester, Hants
                                                        SO22 4LZ


  Thank you for taking the time and trouble to participate in this evaluation - If you
         would like to talk to me about this questionnaire, or the evaluation,
                          you can ring me on 01962-854969




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                                     Evaluation of the ‘Leading by Example’ Project



C: Questionnaire 3 – Individual Level (aimed at Mental health
Service Users)


                      LEADING BY EXAMPLE – EVALUATION

                      Mental Health Service Users / Individual Level


Trust

Name of Respondent

Position / Role



1. What motivated you to apply for
a job with the Trust?

     Was it something you had
      wanted to do before?
     Did the Trust approach you
      (If so, who was it and what
      was their position in the
      Trust)?



2. What was the recruitment process
like?

     Good aspects?
     Not so good things?
     Were obstacles put in your
      way?
     Did the Trust smooth the
      way?
     Did you have somebody to
      support you?


3. What do you think could (or
should) be done to improve the
recruitment process for others in the
future?

       Paperwork?
       Interviews?
       Mentoring?
       Liaison with benefits
        agencies?


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                                      Evaluation of the ‘Leading by Example’ Project


     More – or less support?
     Occupational Health?


4. What was your experience
actually working within and for the
Trust?

     What were the good things?
     Any bad aspects or problems
      (ie., staff attitudes, problems
      connected to your mental
      health issues)?
     How were problems
      resolved?
     Is it a supportive
      environment?
     How did you feel (valued /
      respected)?
     How were you treated (ie.,
      like other staff /or not)?



5. Do you have any other comments,
or suggestions you would like to
make?

     Positives?
     Negatives?


Are you willing to be contacted about your answers above?              YES / NO

If YES please let me have a number on which
I can contact you:

Completed questionnaires                                T.R. Coldham
should be returned to:                  8 Harrow Down, Badger Farm, Winchester, Hants
                                                          SO22 4LZ


  Thank you for taking the time and trouble to participate in this evaluation - If you
         would like to talk to me about this questionnaire, or the evaluation,
                          you can ring me on 01962-854969




A Report by Tina R. Coldham                                           Page 43 of 45
                                    Evaluation of the ‘Leading by Example’ Project


D: Telephone Interview sheet – aimed at Lead / Strategic level
(CEO or senior managers)



                         LEADING BY EXAMPLE – EVALUATION

                                    Lead / Strategic Level

 __________________________________________________________________________

Trust:

Name of Interviewee / Respondent:

Position / role:

__________________________________________________________________________

1. What difference has the project made to the Trust (if any)?

         Positives / negatives?
         Success / failure?

2. Impacts at CEO level?

         Their involvement (what, if any)?
         At the time?
         Ongoing?
         Did you have to sell the project to your staff?
         Barriers to implementation?
         Advice for others leading change to employ MH service users?
         Lessons learned If so, what)?

3. Impacts on the whole organisation?

         Staff resistance?
         Discrimination aired?
         Benefits / problems? & are these short-term or longer term?
         Have policies been changed to help implement user employment?
         Staff development?
         Effect on organisational culture (and attitudes)?
         Has the organisation learned lessons? If so, what?
         Is the project imbedded or will it wither on the vine?

4. Support from SEDC/SCMH?

         Any suggestions on future project support?
         Were your needs / expectations met?

5. Any other comments?




A Report by Tina R. Coldham                                              Page 44 of 45
                                       Evaluation of the ‘Leading by Example’ Project


Appendix E: Evaluation Sources and Respondents

The author is grateful for the time and co-operation of the following in the drawing up
of this report and particularly thanks them for their inputs and insights:


Interviewees:

Stephany Carolan (South East Development Centre & formerly of Hampshire
Partnership NHS Trust)
Lucy Coombes (Hampshire Partnership NHS Trust)
Tracie Duthart (Sussex Partnership NHS Trust)
Sheila Greenfield (Hampshire Partnership NHS Trust)
Deborah Hannam (Portsmouth City Teaching Primary Care Trust)
Leslie Herbert (Hampshire Partnership NHS Trust)
Peter Kinsey (Surrey and Borders NHS Trust)
Carol Morant (Hampshire Partnership NHS Trust)
Michael Munson (Surrey and Borders NHS Trust)
Lena O’Reilly (Portsmouth City Teaching Primary Care NHS Trust)


Written Respondents:11

Martin Barkley (Hampshire Partnership NHS Trust)
Sue Beynon (Portsmouth City Teaching Primary Care NHS Trust)
Deborah Hannam (Portsmouth City Teaching Primary Care Trust)
Debbie Hayes (Portsmouth City Teaching Primary Care NHS Trust)
Lee Loveless (Portsmouth City Teaching Primary Care NHS Trust)
Beverley Tate (Sussex Partnership NHS Trust)


Other Contributors:

Many other Trust members will have contributed to the responses of their colleagues
above. The author thanks them all for their support.




11
     There were also anonymous responses.


A Report by Tina R. Coldham                                          Page 45 of 45

				
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