CQC Rates Leadership at Hampshire and Isle of Wight Healthcare NHS Foundation Trust as Requires Improvement

The Care Quality Commission (CQC) has rated the leadership of Hampshire and Isle of Wight Healthcare NHS Foundation Trust as Requires Improvement following an inspection carried out in October and November 2025.

The inspection marked CQC’s first assessment of the trust’s leadership since it was established in October 2024 through the merger of four NHS organisations. The trust provides community and inpatient mental health services for around two million children and adults across Hampshire and the Isle of Wight.

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

Cultural and Governance Challenges Identified

Inspectors recognised the significant progress made in bringing the four predecessor organisations together but found that elements of the new culture and governance arrangements had not yet become fully embedded across frontline services.

CQC reported that some staff felt senior leaders were not sufficiently visible and described a disconnect between clinical and non-clinical teams. Inspectors also found that almost one in five staff said they would be reluctant to raise concerns because they believed they would not be acted upon or feared negative consequences.

The report also highlighted that several governance systems, policies and processes were still being developed. Delays in establishing the new organisational structure meant learning from safety incidents was not always shared promptly, increasing the risk of similar incidents occurring elsewhere. Inspectors also found the trust was operating multiple incompatible electronic systems, creating challenges for sharing clinical information and monitoring mandatory staff training.

Areas Requiring Improvement

Inspectors found that some staff working within mental health acute services believed safety concerns were not always acted upon and said unsafe admissions were affecting both staff wellbeing and patient care.

CQC also concluded that the trust needed to strengthen its approach to equality, diversity and inclusion. Some staff with protected characteristics, including race and disability, described negative experiences when applying for promotion and development opportunities, raising concerns about fairness and representation within senior leadership.

Positive Practice Recognised

Alongside the areas requiring improvement, inspectors identified several strengths across the organisation.

Feedback from patients and carers about frontline staff was overwhelmingly positive, with many describing staff as compassionate, supportive and committed to involving people in decisions about their care. Carers also reported receiving regular updates and being included in important discussions about their loved ones.

Inspectors also praised the trust’s collaborative working with primary care, social care and partner organisations to improve outcomes for patients.

The report highlighted the trust’s commitment to innovation, noting that it ranked fourth out of 43 mental health trusts for clinical research and was using virtual psychologists and consultants to improve access to care for people experiencing difficulties accessing services.

Next Steps

CQC said it has shared its findings with the trust’s leadership team, who understand the improvements required. The regulator will continue to monitor progress and carry out further assessments to determine whether the necessary changes have been made.

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