Getting the culture right so we can flourish: Sean Duggan on Sussex Partnership’s next chapter

In Sean Duggan’s office at Sussex Partnership NHS Foundation Trust, a large screen displays real-time National Oversight Framework graphs — live data tracking the trust’s performance minute by minute.

“How can a chair be a chair in a Trust that’s really looking to improve performance without knowing the data?” he asked. It’s a practical question that captures his approach to leading an organisation at a crucial juncture.

Sussex Partnership is, like others around the country, facing multiple challenges simultaneously. A tougher funding climate, big structural changes to NHS England and ICBs, and the arrival of a complex new Mental Health Bill. Inside the Trust, board papers are getting leaner, a new governance spine is bedding in, and a long programme of culture and continuous improvement is under way.

For Duggan, the order of operations is clear: “The more you can be compassionate about wanting your staff to go with you on the journey, the better it will be.” Culture first, then grip. Real-time performance data on a screen in his office. A board assurance framework used effectively. A Mental Health Act subcommittee that meets, reports and actions. Practical changes rather than slogans.

Culture as the foundation

When asked about his priorities coming into the chair role, Duggan is direct: “I wanted to check out the culture of the organisation.” His aim is to “bring out what’s good about decent culture”.

As with any large organisation, issues in relation to culture — both the positive and the problematic — run deep and go back a long way. “Lots of work has been done to improve culture. There’s more to do, and the work is never finished,” he reflected. Now the Trust has found significant resource to invest in an evidence-based continuous quality improvement programme over a long period. This reflects the fact that high performing NHS Trusts demonstrate a sustained focus on both culture and continuous improvement.

This focus on culture connects directly to Duggan’s governance reforms. He believes Sussex has sharpened its governance and risk management. “We’ve got systems and processes,” he explained, but the Trust needed to strengthen them.

The changes are tangible: board agendas have been slimmed from 23 items to 10, and public meetings now run in about two and a half hours. The Board Assurance Framework is used actively, with workshops for non-executives. A five-year strategy was developed with wide engagement: “We had 3,000 staff, patients and partners signing up to this,” he noted, in a 6,000-strong workforce.

That data screen in his office reflects this systematic approach. It’s a daily reminder that improvement requires measurement and accountability.

Read more from our executive interview series:

• How Feroz Patel is reshaping finance at Midlands Partnership NHS Foundation Trust
• Arun Chidambaram on change, culture and the future of mental health care

Drawing on forensic experience

Duggan’s practical approach to implementation has deep roots. His route to the chair’s office runs through forensic nursing, prison mental health, the Department of Health, the Sainsbury Centre for Mental Health and the NHS Confederation. It’s a mix that explains his preoccupation with evidence, implementation, and making change stick.

“I specialised in forensic psychiatry, which of course is very, very apt when it comes to the Mental Health Act,” he said. As a ward manager, nursing officer and senior manager, he was “administrating it and implementing it”, which shaped a lasting interest in how the Act works for service users.

This hands-on experience with mental health legislation proves invaluable now. At Sussex, Duggan has strengthened the Trust’s Mental Health Act governance The Board subcommittee is chaired by a non-executive with an HR portfolio, supported by subject matter experts.

Mental Health Act managers, previously overlooked, have been brought into clearer oversight. The committee is working towards a statement of readiness for the coming Mental Health Bill. “We need to get ready for it,” he admitted. But his view is pragmatic: “The ‘things are changing’ ship has sailed. We are getting ready for implementation.”

Learning from national perspective

After years as a chief nurse, Duggan wanted to see the national picture. At the Department of Health, before NHS England was created, he became Prison Mental Health Lead and then Offender Health Lead. That meant helping put mental health services into prisons and developing court liaison and diversion schemes. He recalled the Bradley Review, which looked at how to best support offenders with mental illness.

From there, the Sainsbury Centre for Mental Health recruited him to run its criminal justice programme. He later ran the NHS Confederation’s Mental Health Network, bringing together NHS providers, voluntary organisations, independent providers and eventually digital mental health companies. “There’s some stigma attached to the independent sector. I’ve no time for that,” he explained. “We need all the sectors to pull together.”

This broad perspective now informs his view of Sussex Partnership’s development needs. The Trust’s heritage in inpatient and secure services is strong, but he wants more depth in early intervention, crisis and community support. “We rely too much on the inpatient beds,” he said. Secure and forensic services are well-developed, but “we’re not as developed with the community, preventative, early intervention, crisis stuff”.

Digital access to treatment is also on his list. Geography adds another layer of challenge, from urban morbidity in Crawley and Brighton to rural distances across East and West Sussex. Travel times are long, but Duggan does not see geography as an excuse. “With digital treatment interventions we’re at the foothills of what is possible there,” he said. He wants Sussex to learn from international mental health tech networks.

Building on existing strengths

Sussex Partnership’s strengths are clear. “We’re very good on R&D,” Duggan commented, pointing to research into neurodevelopmental services. Its status as a university teaching Trust brings accredited links with Brighton and Sussex Medical School.

There are areas he’s keen for others to learn from. Supported housing is one. Years ago, Sussex had high sectioning rates and expensive out-of-area placements. The Trust brought in housing expertise and developed supported accommodation. “It brought down our out-of-area placements to zero,” he added.

He also highlighted the executive team’s development and mutual support, patient experience scores near the top nationally, and strong financial confidence despite deficits. And there’s the council of governors’ transformation. When he arrived, there were challenges. Now, after leadership changes and effort governors are “fiercely defensive”, which protects the Trust’s reputation. “I want that to continue,” he added.

The path ahead

After 40-45 years around the NHS, Duggan thought he was retiring. But then came that call from Sussex Partnership. “The difference between running a think tank or a network couldn’t be more different,” he explained. “The NHS is a very special organisation. It is massive.”

Asked what would count as success by the end of his chairmanship, Duggan is plain: “Back up the league table, but not as an end in itself. Every assessment of our performance, whatever the metrics used, are an important measure of the work we do on behalf of the patients, carers and communities we serve” Financial viability matters too.

His view of the task ahead remains practical and people-focused: communicate clearly and repeatedly, get the culture right, use live data, prepare for change, and shift the balance of care. As he puts it: “The more you can be compassionate about wanting your staff to go with you on the journey, the better it will be.”

Back to that data screen where the numbers tell a story of things working and things not. While it represents a crucial way of keeping track of progress, metric by metric, for Duggan the real measure of success will be whether Sussex Partnership can flourish as an organisation that puts its people and patients first.