CQC rates leadership at Essex Partnership University NHS Foundation Trust as requires improvement

The Care Quality Commission has rated the leadership of Essex Partnership University NHS Foundation Trust as requires improvement following an inspection in March.

The trust provides community health, mental health and learning disability services to more than 3.2 million people across Essex, Suffolk, Luton and Bedfordshire. It employs over 5,000 permanent staff across 200 locations and also delivers care in people’s homes.

Under CQC’s updated approach, NHS trusts receive one trust-level rating focused on leadership and organisational culture.

Inspectors found the trust’s board and management arrangements had developed since the previous inspection, but improvements had not consistently reached frontline services or resulted in positive experiences for staff.

Some employees described a disconnect between senior leaders and frontline teams. While managers were visible and supportive in some services, staff elsewhere reported limited leadership presence and engagement.

Inspectors were particularly concerned that some staff feared negative consequences if they raised concerns. CQC said this could place people at risk by limiting opportunities to learn from incidents and prevent poor care from happening again.

The trust’s systems for monitoring frontline care and providing assurance to the board also required improvement. Overdue safety incidents, including cases involving severe harm or death, were not consistently reported to the board. Some had remained unreviewed for more than two years.

CQC also identified increasing use of restraint within some inpatient services for children, autistic people and people with a learning disability.

The trust did not have a clearly defined strategic approach to equality, diversity and inclusion. Further work was required to improve the experiences of disabled people and people from ethnic minority backgrounds.

Some staff felt leadership decisions were influenced more heavily by financial pressures than by people’s outcomes and said ineffective management had affected their wellbeing.

Before the leadership assessment, CQC inspected long-stay and rehabilitation wards for working-age adults, child and adolescent mental health wards and community health inpatient services.

Inspectors also visited Ardleigh Ward, an acute ward for working-age adults, after receiving concerns about the quality and safety of care.

CQC took enforcement action requiring improvements. The trust addressed some issues immediately, while a warning notice was issued for its long-stay and rehabilitation mental health wards. Inspectors will return to assess its progress.

The trust is also participating in the independent Lampard Inquiry, which is examining the deaths of mental health inpatients in Essex.

Positive findings included stronger clinical leadership within care units and effective financial management, with the trust maintaining a record of delivering its financial plans.

Governors, non-executive directors and external partners also described an organisation becoming more open and transparent, with a greater willingness to acknowledge mistakes and share learning.

Medicines optimisation was identified as a particular strength. Staff reported clear management, open communication and strong support for professional development.

CQC has instructed the trust to address the areas of concern and will continue monitoring its progress.

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