Bradford Teaching Hospitals 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

Date of assessment 16 to 18 April 2024.

Bradford Teaching Hospitals NHS Foundation Trust is responsible for providing hospital services for the people of Bradford and communities across Yorkshire. They serve a core population of around 500,000 people and provide specialist services for some 1.1 million.

The trust employs more than 6500 staff who work over several sites, includingBradford Royal Infirmary, which provides the majority of inpatient services, andSt Luke’s Hospital, which predominantly provides outpatient and rehabilitation services. The trust also manages local community hospitals atEccleshill,Westwood Park,Westbourne Green, andShipley.

We assessed the whole well led framework (all 8 quality statements). Around the time of the well led inspection, we inspected the maternity, medical care and neonatal services at the trust. We rated maternity and medical care as good for well led and neonatal as outstanding for well led.

In the months leading up to the inspection, the board had experienced significant transition. At the time of the inspection, the new Chair had been in post for only three weeks so was not yet able to provide full oversight.

Leaders were committed to the trust. However, difficulties and tensions at the board had affected their ability to carry out their roles and ability to function effectively.

There were arrangements in place for people to speak up, but not all staff felt they would be listened to and heard. Some staff feared there would be detriment if they did speak up. Not all staff trusted the leaders in the organisation.

There were initiatives to support inclusivity across the trust, but some staff told us they felt behaviour sometimes went unchallenged. Some staff felt there was bullying and harassment and that it wasn’t taken seriously enough by leaders.

Leaders told us they had been more internally focused than they would have liked over recent months. They acknowledged the challenges the board faced had left them less time to focus on their wider obligations.

There was a system of governance and risk management based around delivering safe and good quality care and treatment.

Information about risks, performance and outcomes was readily available and used to help improve care.

Patients were encouraged to give feedback on their care. Feedback from the assessments we carried out of the neonatal, maternity and medical services showed that services considered feedback from patients and adapted the service accordingly.

The trust had a quality improvement approach in place and used improvement methodologies to improve outcomes and performance.

The leaders within the trust demonstrated an understanding of environmental sustainability and had started to develop an approach to reaching this goal.

Following the inspection, we escalated our concerns about the board to NHS England (NHSE). CQC then monitored the development and stability of the board after the appointment of the new Chair. We observed that progress was being made, and the trust had implemented an improvement plan while awaiting the findings of investigations into the allegations that had been raised.

People's experience of this service

The trust engaged with people and communities to seek their views and feedback and to ensure co production. The trust told us they developed their Corporate Strategy with patients, people, the public and partner organisations.

Healthwatch commented in the trust’s quality account they were pleased to have seen numerous changes to services that put patients, and their carers at the heart of decision making.