The many sides of the Tavistock & Portman: educator, innovator, incubator, disruptor

1 November 2017

Two years ago today, Paul Burstow joined the Tavistock and Portman NHS Foundation Trust as our Trust Chair. In this piece, Paul reflects on two years at the Trust and some of the highlights. 

Paul Burstow AGM

“Would I write a short blog offering some reflections marking my first two years at the Trust?”  That was the email from the Trust’s Comms team.  Where to start?

Let me tell you about some of the things I have learned.

First, everyone has heard of ‘Tavi’ but few really know what we do, some even think we’re based in Devon!  Others know the Trust, both the Tavistock and Portman, but find it hard to fit us neatly into a conventional NHS box.  Closing this awareness and understanding gap is still a work in progress. 

Second, Tavistock Centre and Portman Clinic trace their roots back to the end of the First World War and 1930s.  Together they hold, practice and teach a unique set of ideas and approaches to understanding and treating mental distress.  Psychologically informed not psychiatry based: tracing the root causes of a person’s mental distress requires an understanding of environment and context and above all the importance of relationships.

Third, the Tavistock Centre and Portman Clinic are incubators of ideas, theories and innovations.  For example, the Trust is the home of John Bowlby’s ‘attachment’ theory that has transformed social work practice and family policy.  Today that theory informs much of the Trust’s work including the Family Nurse Partnership (FNP) and the Family Drug and Alcohol Court (FDAC) service. 

In collaboration with the Anna Freud Centre we have developed and pioneered the Thrive Model of children and young people’s mental health, a strength based approach which aims to offer young people the skills and tools they need to cope better with the causes of their mental distress.

And it is not just in our children and young people’s services that we innovate –

our adult services have developed a primary care based service that GPs love and which makes a significant difference in the lives of people living with medically unexplained symptoms.  Already reviewed by the Centre for Mental Health and another follow-up study underway the Primary Care service tackles needs that the IAPT programme cannot reach.

Four, not only is the Trust a direct provider of psychologically informed services it also trains the next generation of clinical psychotherapists and child psychotherapists.  We train social workers, psychologists and other professionals offering a multidisciplinary approach to learning.  This year we celebrated our largest ever intake, with 600 students enrolling over 30 different courses.

As well as direct training over the past two years the Trust has developed a new workforce development consulting role for Health Education England which has already seen the development of new competencies and trainings to deliver the Five Year Forward View for Mental Health’s commitment to boosting perinatal mental health.

Finally, some highlights.  There are plenty but a few stand out. 

Kids on the Edge, a three part channel 4 TV series aired in 2016.  Three films turned the spotlight on our Gender identity Development Service (GIDS) for young people, the dedicated work of the staff at Gloucester House school. and the challenges of supporting young people especially when the transition to adult services.  Powerful films telling the stories of some of the young people the Trust works with.

Taking over England’s largest Adult Gender Identity Clinic has given the Trust the opportunity to pool our insights from the national young people’s GIDs, which we already run.  Our aim is ensure that the transition for young people to the adult clinic is greatly improved and waiting times start to fall.

Social investment to spread our FDAC service:  Despite a proven track record of keeping families together and delivering better results for children FDAC has struggled to be commissioned.  The reason could be a case study in the absurdity of silo budgeting.  The cost of doing things the FDAC way fall on Council budgets while some of the savings land elsewhere.  After much hard work the Trust has secured the social investment needed to start spreading this highly effective innovation in family justice.

Like much of the NHS the Trust has recognised that it has a lot to do to promote race equality.   The numbers don’t lie.  Black, Asian and minority staff have not been promoted to senior roles despite their talent.  That must change.  Over the past year along with the Trust Chief Executive Paul Jenkins we have worked with our BAME staff to devise a new strategy to change this.  But I am in no doubt success will only come through making this a whole Trust issue. 

Two years, much to celebrate.  I still have much to learn and the financial climate means like so many NHS organisations we face stormy weather ahead.  However, I am determined that the Trust places itself at the vanguard of those who want to disrupt the mental health status quo and offer the psychologically informed holistic approach the Tavistock Centre and Portman Clinic have refined and practiced for nearly 100 years.

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