Essex Partnership University NHS Foundation Trust

Ratings - Well-led

• Well-led Our assessments of NHS trusts now focus on leadership. We no longer rate trusts overall for their safety, effectiveness and responsiveness or how caring they are. We do still publish those ratings for the services they provide.

  Requires improvement

Our view of the service

Essex Partnership University NHS Foundation Trust (EPUT) was formed on 1 April 2017 following the merger of North Essex Partnership University NHS Foundation Trust (NEP) and South Essex Partnership University NHS Foundation Trust (SEPT).

EPUT provides community health, mental health and learning disability services to support more than 3.2 million people living across Luton and Bedfordshire, Essex and Suffolk. The trust employs over 5000 permanent staff who work across 200 different sites, including providing care in people’s homes.

The trust headquarters are based in Wickford, Essex.

There are 42 integrated care systems (ICSs) in England, EPUT provides services in 4 – Mid and South Essex Health and Care Partnership, Hertfordshire and West Essex, Suffolk and North East Essex and Bedfordshire, Luton and Milton Keynes.

NHS England launched a new interactive dashboard to provide a view on how NHS trusts are performing in key areas. This means people can see how their local trust compares with other across England, each trust is placed into a segment depending on their performance in their services and other areas like financial performance. Segment 1 means an organisation is performing well and has fewer challenges, with Segment 4 being trusts with the most challenging circumstances. As of quarter 2 (July – September 2025) EPUT was placed in Segment 3.

EPUT are 1 of 3 lead providers that host the commissioning contract with NHS England for the East of England Provider Collaborative. The Collaborative had established new ways of working together to create services and support patients.

In 2025/26 the trust had a planned turnover of £649.8m and a savings requirement of £31.3m (5%). In month 12 of the financial year the trust was forecasting full achievement of its financial plan agreed with NHS England.

We undertook a trust level (well-led) assessment which included an onsite visit from 24 to 26 March 2026. We also held 12 staff focus groups on and off site and observed a board meeting in January 2026.We assessed all the quality statements in the well-led key question in this assessment.

The well-led review followed assessments of 3 of the trusts frontline assessment service groups (ASGs): long stay or rehabilitation mental health wards for working age adults, child and adolescent mental health wards and community health inpatient services. We also visited 1 acute ward for adults of working age and although this report was unrated some findings are relevant to our well led assessment. These assessments were completed due to the length of time since our last visit and rating. Ardleigh ward (acute ward for adults of working age) was visited due to concerns raised to CQC about the quality and safety of the service.

At the time of our assessment EPUT and the two previous trusts which combined in 2017 were subject to an independent statutory inquiry, The Lampard Inquiry was investigating the deaths of mental health inpatients in Essex between 2000 and 2023. The inquiry was engaged in its 'collecting evidence' stage and the trust were engaging with its requests.

The assessments identified concerns about staffing, risk management, safety and governance and oversight.

At this well led assessment there was a breach of regulation 12 (Safe care and treatment) and 17 (Good governance)

We identified areas for improvement across 6 well-led quality statements. These areas were as follows:

• Further work was needed to improve the culture of the trust with staff reporting differing experiences across teams and care groups and at times a disconnect between senior leaders and front-line services. Some staff said they were worried about speaking up for fear of reprisal. Others said that some managers did not tackle behaviours that failed to represent the values of the organisation.
• Whilst work was underway to improve the leadership development programme and support managers to promote a positive culture, this had not yet been implemented.
• The trust had put arrangements in place to cover for the impending departure of the chief executive. These will need to be kept under review to ensure they are robust and effective.
• There was not a clearly defined strategic approach to equality, diversity and inclusion (EDI) and there hadn’t always been clear leadership in this area. Improvement work is required to improve the experience of people with a disability and people from all ethnic groups equally. The patient and carer race equality framework (PCREF) was at an early stage and the lead role for was yet to be embedded following recruitment.
• Oversight of the care being delivered on the frontline and the assurance received by board needs improving. In two of our assessment service group assessments completed prior to the well led assessment we considered the use of our urgent enforcement powers due to the concerns we found. Restraints were increasing, particularly in children’s inpatient services and in inpatient services for people with a learning disability and/or autism.
• Learning in the organisation happened but was isolated and not always shared. Incident reviews were not consistent, backlogs existed that the board were not sighted on. There were missed opportunities for learning as information on delays does not make its way to board. There were repeated themes and trends in incident reviews that need to be addressed to reduce likelihood of reoccurrence.

However, we also recognised some good practice across the organisation and there were also positive findings across all quality statements. These were:

• The board was collegiate, well formed and able to function cohesively with respectful challenge.
• Effort had been made to ensure the trust was a valued system partner.
• There were good financial management arrangements and ambitions for the next financial year.
• There were ambitious and innovative plans in place for the future, particularly around understanding the culture and implementing a first of its kind system wide electronic patient record.

People's experience of this service

Prior to completing the well led assessment we carried out 3 assessment service group (ASG) assessments at long stay or rehabilitation mental health wards for working age adults, child and adolescent mental health wards and community health inpatient services. We also visited one acute ward for adults of working age and although this report was unrated some findings are relevant to our well led assessment.

Across these ASG assessments we spoke with 41 service users. The feedback from these services was mixed. Many patients reported feeling unsafe at times, due to staffing levels, lack of staff interaction and staff responsiveness when incidents happened. Some patients also reported feeling bored on the wards. However, young people on 2 out of three wards complimented the way staff treated them and spoke specifically about how cared for they felt. Young people also felt involved in their care and could talk about what was included in their care plans.

Overall, we observed mainly positive and caring interactions between staff and service users. Our main concern related to the acute ward where we raised issues with staff not responding to alarms.

A review of service user complaints highlighted that 41% of 155 complaints were against the trust’s response target of 60 days. Twelve complaints were awaiting consent prior to investigation starting, 44 required allocation to a complaint’s liaison officer, 64 were under investigation and 35 were waiting for final approval.

Complaint responses were mainly of good quality. When lessons were identified action plans ensured follow up and the sharing of learning.

People who had previously made complaints to the trust co-produced the complaint process in 2022. Staff described a patient led process where within 3 days a complaint was acknowledged. Following allocation a Complaints Liaison Officer (CLO) would call or write to people ensuring the points are correct and they wished for it to be formally investigated. Staff described the role of CLO as more independent than in previous processes and that support could be sought from clinical advisors who provided clinical information and advice, supported learning and ensured clinical accuracy.

In 2025 EPUT received 5212 responses through iWantGreatCare (a health reviews website to collect patient feedback). Of those responses 94% of people said they had a positive experience.

Feedback from the local Healthwatch, an organisation that champions the voice and feedback of service users, was entirely negative. It related to a lack of person centred care and staff lacking empathy. Feedback was critical of communication and diversity, equity of access and inclusion. Whilst it was reported staff behaved professionally in meetings this was deemed to be due to preparation of a corporate script rather than being a meaningful engagement. Information also criticised the trusts lack of engagement with partners outside of their own geography. Most concerning was a fear of speaking up which has been reflected in various other parts of the well led assessment.