The Care Quality Commission (CQC) has rated leadership at Hampshire and Isle of Wight Healthcare NHS Foundation Trust as requires improvement following an inspection in October and November.
The trust provides community and inpatient mental health services for around two million children and adults in Hampshire and the Isle of Wight.
What inspectors found
This was CQC’s first inspection of leadership since Hampshire and Isle of Wight Healthcare NHS Foundation Trust was formed in October 2024, bringing the services from four NHS trusts together*.
CQC gives NHS trusts a single trust-level rating focusing on leadership and culture that replaces all other ratings at that level.
CQC’s response
Serena Coleman, CQC deputy director of mental health in the south said:,
“When we inspected Hampshire and Isle of Wight Healthcare NHS Foundation Trust, we found the trust had undertaken significant work to bring together the predecessor organisations into one new organisation. However, some cultural and governance aspects of this transformation hadn’t fully embedded, or reached frontline services, and this was impacting staff morale.
“Staff told us leaders weren’t visible and described a disconnect between clinical and non-clinical staff. It was concerning that almost 20% of staff said they would be reluctant to raise concerns because they didn’t think their concerns would be acted upon or they felt there would be retribution. When staff don’t feel safe to speak up, risks can go unaddressed and the quality of care can suffer so it’s vital the trust tackles this.
“We found systems, policies and processes were still being developed and embedded at the trust, and in some cases, this was creating risks. For example, delays to finalising the structure of the new organisation meant learning from safety incidents wasn’t always shared in a timely way. This left people at risk of similar incidents happening again. The trust was also using multiple incompatible electronic systems, which risked important clinical information being lost and made it more difficult for staff to complete mandatory training.
“However, we found leaders demonstrated a genuine commitment to compassionate and collaborative leadership. They had ensured the trust’s strategy was co-produced with people who used services, staff, and partner organisations and we were impressed with the work to develop lived experience leads for each division. This is crucial for ensuring people with first-hand experience of health issues have a say in how services are designed.
“We’ve shared our findings with the trust’s leadership, and they understand the improvements required. We’ll continue to monitor progress and return to assess whether the necessary changes have been achieved.”
Inspectors found:
- Some staff in mental health acute services felt safety concerns were overlooked by leaders and that unsafe admissions were affecting the wellbeing of staff and other people on the wards.
- Leaders needed to do more to improve equity, diversity and inclusion. Staff with protected characteristics including race and disability shared negative experiences of applying for promotion and development opportunities. This affects staff morale and can result in a lack of diversity at senior level.
Inspectors also found:
- Feedback about staff was overwhelmingly positive. People said staff involved them in decisions about their care and went above and beyond. Carers said they received regular communication about their loved ones and were involved in key meetings.
- The trust worked well with partner organisations, including primary and social care partners, to support positive outcomes for people.
- The trust was committed to learning and innovation to improve outcomes for people using services. It was ranked fourth out of 43 mental health trusts for clinical research and was using virtual psychologists and consultants to address challenges some people have accessing care and treatment.
The report will be published on CQC’s website in the coming days.
*Hampshire and Isle of Wight Healthcare NHS Foundation Trust formed in October 2024, following a formal merger of Southern Health NHS Foundation Trust and Solent NHS Trust, and the acquisition of some services from Sussex Partnership NHS Foundation Trust and Isle of Wight NHS trust.
News shared by John on behalf of the CQC. Ed
