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Strong leadership essential to delivering improvement in mental health hospital care

Today we publish a report that explores how seven NHS mental health trusts have been able to make significant improvements in the quality of care and improve their CQC rating.

Driving improvement: case studies from seven mental health trusts explores what trusts that were rated as requires improvement have done to become good or outstanding.

There were common themes that drove improvement across the featured trusts.  Strong, visible and listening leadership is vital, and good leaders engage and empower staff.  Good leadership and good governance go hand in hand, and the report found that most of the trusts had made changes to their systems and processes to drive improvement.

A poor rating for many trusts was a stimulus for improvement. Trusts used CQC’s reports as a springboard to make changes.

Improvement was also supported by cultural changes. The report notes the importance of creating an environment where staff feel able to speak up and speak out. Good and improving trusts are also outward-looking. They work with others in the local health and care system and voluntary sector, and recognise that real and lasting improvement depends on organisations working together. Taking the views and experiences of patients and the public into account is vital to making improvements.

The report is based on interviews, at each trust, including with chief executives, medical directors, nursing directors and front line staff. We also spoke to others who knew or worked with the trust, such as local patient or voluntary groups.

Dr Paul Lelliott, Deputy Chief Inspector of Hospitals (lead for mental health), said:At a time when the mental health sector struggles with challenges including unprecedented demand and workforce shortages, it is especially encouraging that these Trusts have demonstrated that they are able improve because they have strong, visible leadership that is compassionate and inclusive.  This engages and empowers front-line staff and unlocks their full potential to develop and improve patient care.

“In this report, we give examples of how these trusts have worked hard to strengthen their leadership through training, mentoring and development; including through working with NHS Improvement.

“In particular, the report emphasises the essential role of strong clinical leadership that ensures that medical and nursing staff are fully at one with the trust’s ambitions.

“I encourage others to look at and learn from these case studies to help them in their own improvement work. I am confident that the trusts themselves will be willing to share with others the lessons they have learned on their improvement journey so far.”

The following specialist mental health trusts feature in the publication, having been selected on the basis that they had achieved significant improvement on re-inspection, as shown by their CQC ratings.

Trust rating changes




Oxleas NHS Foundation Trust

Requires Improvement


Somerset Partnership NHS Foundation Trust

Requires Improvement


Lincolnshire Partnership NHS Foundation Trust

Requires Improvement


South West Yorkshire Partnership NHS Foundation Trust

Requires Improvement


North Staffordshire Combined Healthcare NHS Trust

Requires Improvement


**Calderstones Partnership NHS Foundation Trust



Sheffield Health and Social Care NHS Foundation Trust

Requires Improvement


This follows on from publication of the state of care in NHS acute hospitals which was published in March 2017. We are developing similar resources for primary medical and adult social care services.

** In July 2016, Mersey Care NHS Foundation Trust took over Calderstones Partnership NHS Foundation Trust and it became the Specialist Learning Disability Division, rated outstanding. Calderstone’s first rating in 2015 was good, but a pre-rating inspection in 2014 revealed serious concerns.



Events of interest:

Clinical Audit Masterclass
Monday 16 April, London


Root Cause Analysis: 2 Day Intensive Training Course
Wednesday 25 April — Thursday 26 April, London


Quality Summit 2018 Meeting and Measuring Progress against the CQC Quality Ratings
Monday 30 April, London


Investigation and Learning from Deaths in NHS Trusts
Monday 14 May, London

19 March 2018


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