Humber Teaching NHS Foundation Trust

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

At our last inspection we rated this key question good. At this inspection the rating has changed to requires improvement. We found 1 breach of regulation in relation to ensuring people received timely care and treatment. The score of 1 for the quality statement ‘equity in access’ limits the overall key question rating to requires improvement.

Requires improvement: The service did not make sure that everyone could access the care, support and treatment they needed when they needed it.

However, staff helped people with communication, advocacy and cultural support. Care was integrated to reduce the need for people to repeat their story to professionals. Staff supported people with activities outside the service, such as work, education and family relationships. Staff gave people and carers information about care and treatment in a way that met their needs. The service met the needs of all people who used services, including those with a protected characteristic. The service treated concerns and complaints seriously, investigated them and learned lessons from the result.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service mostly made sure people were at the centre of their care and treatment choices. They mostly decided, in partnership with them, how to respond to any relevant changes in their needs.

During our inspection, we reviewed 15 care records and found care plans were holistic and person centred in 8 records reviewed. We found 11 records contained care plans which fully reflected people’s needs and preferences. People we spoke with told us care and treatment was based on their individual preferences and circumstances. Carers told us they were included and actively involved in their loved one’s care and treatment, where appropriate.

However, staff did not always ensure people had copies of their care plans. In 10 out of 15 care records we reviewed we found copies of people’s care plans had not been shared with them. Data provided by the service showed people were not always offered copies of their care plans. Audits showed between March 2025 and March 2026, in Holderness Community Mental Health Team (CMHT), the person had not been offered their care plan in 10% of records audited, in Hull East CMHT this was 20% and Hull West CMHT 22.5%. In Holderness CMHT none of the person’s carers or supporters had been offered a copy of the care plan in records audited, in Hull East CMHT this was 23% and Hull West CMHT 16.6%. The same audit showed in Holderness CMHT only 20% of records audited showed the care plan had been signed or a comment made to indicate the person agreed with their care plan. This was 23% in Hull East CMHT and 19% in Hull West CMHT.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

There were different models of social care integration in the 2 local authority areas covered by the service. In East Riding the service worked in partnership with the local authority, with social workers integrated into the community mental health teams but managed by the local authority. In Hull the service employed social workers directly who acted as care coordinators within the team but also carried out statutory duties under the Care Act. Some staff told us the integration of social workers into teams had been challenging, particularly with the use of 2 different care record systems. However, team leaders were able to access both care record systems which ensured appropriate information could be shared.

Managers told us they worked closely with the local universities to ensure students who used services received appropriate care and treatment, particularly on transfer to or from other areas of the country. They had good working relationships with student services at each university.

Staff told us they worked with a number of neurodiverse people. They worked closely with the trust autism support service for help and advice to ensure care and treatment was appropriate to these individuals’ needs, for example by attending complex case forums. In Beverley Community Mental Health Team (CMHT) staff followed an Attention Deficit Hyperactivity Disorder (ADHD) pathway for people who were also diagnosed with ADHD to ensure they received their annual review of their ADHD medication.

Staff in Psychosis Service for People in Hull and East Riding (PSYPHER) team worked with trust link workers who worked with the local prison to ensure continuity of care between the team and the liaison and diversion team.

Staff in East Riding teams told us they had approximately 12 people on each CMHT caseload with eating disorders. They described challenges working with people with an eating disorder due to the lack of community and inpatient eating disorder service provision across East Riding. Managers were planning to provide training for staff to better equip them to work with people with eating disorders.

The service provided appropriate, accurate and up-to-date information in formats that they tailored to individual needs.

Staff had access to translation and interpretation services for people who did not speak English as their first language. This included access to British Sign Language interpreters. Staff told us they could easily access the service and did not experience any problems getting interpreters.

The service complied with the Accessible Information Standard. The Accessible Information Standard is a legal requirement for organisations providing NHS care to ensure that people with disabilities or sensory losses receive information and communication support in a way they can access and understand. The trust website met accessibility standards and included speech, reading and translation support. It could be translated into 99 languages and read aloud in 40 of the most commonly spoken languages in the world.

We saw information leaflets and posters displayed in public areas of bases we visited. For example, in the Psychosis Service for People in Hull and East Riding (PSYPHER), early intervention in psychosis team office we saw leaflets on family therapy and health and wellbeing workers which explained their role to people and their carers.

We requested the Triangle of Care policy for the service. The Triangle of Care is an improvement tool based on 6 principles to ensure providers include and support unpaid carers. The service told us it did not have a standalone Triangle of Care policy, as the principles were embedded into the therapeutic alliance between people who used services, staff, and carers to improve care, safety, and recovery. The trust’s strategy aligned with the 6 principles of Triangle of Care, as did the patient and carer experience 5 year forward plan for 2023 to 2028. The service had a carers dashboard to identify carers and if they had been offered a carers assessment and signposted to appropriate help and support. Staff gave carers a leaflet which explained how they could access online support resources and information.

The service made it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. They involved them in decisions about their care and told them what had changed as a result.

The trust website included a survey page which explained to people who used services and their carers how they could leave feedback. This included a video coproduced with people who used services which explained why the trust asked for feedback and gave examples of what happened as a result. People could complete the friends and family test online.

The survey page also included details of how to contact local Healthwatch services. Healthwatch is the independent statutory champion for people who use NHS and social care services in England. It listens to public experiences, influences decision makers to improve care standards, and provides local advice.

The service monitored teams where no response to the family and friend test had been received and identified targeted actions to try and increase the response rate in those teams. For example, teams were supplied with business cards and poster promoting the family and friends test and the service was exploring use of a text messaging service to encourage people to give feedback.

Leaders told us and we saw examples of the service employing people with lived experience in different roles and grades across the service. The trust employed a lived experience coproduction lead and a coordinator for lived experience and coproduction. They had created a coproduction stamp that was issued by the Patient and Carer Experience (PACE) team, which was given to teams who coproduced services, information or training. For example, leaflets and plans for trauma-informed care were coproduced including podcasts to educate staff about what it means from the experience of someone using services. The trust held quarterly PACE forums led by the patient and carer experience lead and attended by people who used services, carers, staff and Healthwatch. The trust recognised low attendance at PACE forums in 2025 and redesigned the forums to improve accessibility and participation in 2026.

The mental health division had an action plan to address the findings of the 2024 Community Mental Health survey. The action plan had clear actions to address feedback from people who used services, with action leads and regular progress updates.

The mental health division had a senior coproduction and lived experience lead and a lived experience coordinator who worked with staff to ensure lived experience was considered within service developments. For example, at Hull Community Mental Health Team (CMHT) a person using services and their care coordinator worked together to create a ‘getting to know me’ booklet, which was turned into an electronic version and shared across the division. The knowledge and understanding framework for people with complex emotional needs was coproduced and codelivered with people who used services.

The service received 116 complaints between February 2025 and February 2026, of which 45 were formal complaints. It also received 13 compliments in the same period. The service provided a summary of the last 5 complaints received, 4 of which were about Hull CMHT, with the main theme about support whilst waiting. The service told us 7 complaints were upheld and 19 partially upheld but this included complaints received for mental health crisis services as well as this service. The service told us they were not able to give the exact number of complaints referred to the Parliamentary and Health Service Ombudsman (PHSO) as people are able to contact the PHSO independently the service was only notified if the PHSO requested further information. They told us for the whole trust from April 2024 to March 2025 30 cases were escalated to the PHSO, 10 were closed with no further action required from the trust and none were accepted for detailed investigation.

Managers met weekly with the trust complaints team to review complaints, progression of complaints and any themes. Staff we spoke to knew how to deal with complaints informally and described signposting people to the Patient Advice and Liaison Service (PALS). Managers were supported by the trust complaints team to investigate any formal complaints. Information provided by the service showed staff worked with people to agree solutions to the concerns raised and shared the outcome of complaints with them

Feedback from people who used services, including any complaints or compliments was shared with staff in monthly team meetings. People we spoke with told us the service had been responsive to feedback, including changing key workers when requested and supporting formal and informal complaints processes.

The service did not make sure that everyone could access the care, support and treatment they needed when they needed it.

Hull Community Mental Health Team (CMHT), the Mental Health Triage and Assessment Team (MHTAT) and Psychosis Service for People in Hull and East Riding (PSYPHER), early intervention in psychosis team had high numbers of people waiting for assessment, intervention or allocation to a care coordinator. This included people waiting longer than 4 weeks from referral to treatment. The MHTAT team had 460 people waiting for a full mental health assessment following initial triage.

In the PSYPHER team there were 32 people assessed as being eligible for the first episode psychosis (FEP) pathway waiting allocation to a care coordinator. The longest wait for allocation to a care coordinator was 42 weeks. Of the 32 people waiting for allocation to a care coordinator, two thirds were not in active treatment. This is not in line with the NHS England waiting time standard for Early Intervention in Psychosis (EIP) services which states people experiencing a first episode of psychosis should start a National Institute for Health and Care Excellence (NICE) recommended package of care within a maximum of 14 days from the initial referral. Following our inspection, the number of people waiting allocation to a care coordinator had decreased to 18, all of whom received regular calls from a practitioner.

In Hull CMHT on 31 March 2026 the electronic care records system showed there were 230 people waiting reallocation to a new care coordinator and 286 people accepted onto the CMHT waiting list and waiting first allocation to a care coordinator. Of these the most recent referral was 3 days 21 hours, the longest 6 years and 6 weeks and next longest 2 years 46 weeks. The person waiting 6 years and 6 weeks was actively engaged with the complex emotional needs team. The person waiting 2 years and 46 weeks had been discharged in July 2024 and re-referred in April 2025 and was on the waiting list for medicines review, they had not engaged with other interventions preferring to wait for psychological therapy. There were 32 people who had waited longer than 52 weeks. Staff told us some people were allocated to the CMHT in order to access specific specialist services, such as the frequent attenders’ team or the complex emotional needs team. As they were receiving interventions from those teams those people did not need CMHT intervention at that point. These people had been reviewed as part of ‘Project Assure’ in November 2025, where a clinician had reviewed the care records of everyone on the waiting list.

The service provided data which showed the median waiting time from referral to treatment in February 2026 for Hull CMHT was 122 days. In MHTAT the median waiting time from referral to initial assessment in February 2026 was 47 days.

There were waiting lists across the service for people to access psychological therapy, except in Goole CMHT, which had no waiting list for psychology. The waiting list was highest in Hull CMHT with 141 people waiting for psychology including waits for group work, trauma stabilisation and structured clinical management and intervention. In Haltemprice CMHT, 29 people were waiting for psychology, 8 people were waiting in Holderness CMHT, 8 in Bridlington and Driffield CMHT and 26 in Beverley CMHT. The service did not provide details of how long people had been waiting for psychological therapy.

Quality Statement Score: 3

The service actively sought and listened to information about people who are most likely to experience inequality in experience or outcomes. They tailored the care, support and treatment in response to this.

The trust had assessed itself against the Patient and Carer Race Equality Framework (PCREF). PCREF is a mandatory framework for trusts to follow to become actively anti-racist organisations by ensuring that they are responsible for coproducing and implementing concrete actions to reduce racial inequalities within their services. The progress report to the trust board in February 2026 identified key risks to implementing PCREF and actions in progress. It outlined progress against 5 priority areas and recommended 4 priority areas to focus on in the next quarter including agreeing the trust quarterly PCREF return. Oversight of PCREF progress was through the equality and diversity steering group, and the care, culture and equity steering group who reported to the executive management team.

The online incident reporting system included information on a person’s race and ethnicity which allowed staff to consider this when reviewing incidents.

Between October and December 2025, feedback from people and carers from ethnic minority backgrounds showed satisfaction with trust services ranged between 93% and 91%. This data was for the whole trust not only this service.

The trust monitored the ethnicity and gender of people who had community treatment orders (CTO) applied to them to ensure people from ethnic minority backgrounds were not disproportionately represented. In February 2026, there were 42 people on CTOs across the trust. Of these, 15 were female and 27 male. The majority of people on a CTO (36 people) were from a white background, 1 from a mixed background, 2 from any other ethnic group and 3 where ethnicity was not known.

The service worked with local charities that supported marginalised young women in Bridlington and socially isolated people in Goole to support people to stay mentally well and reduce the need for support from secondary mental health services. In Hull the service supported a women’s book club for women from ethnic minority communities.

Managers completed equality and health inequalities impact assessments (EHIIA) when developing policies and services to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage. They could access an online toolkit on the trust intranet to support them to do this. Policies and strategies we reviewed had a EHIIA completed.

The trust had a health inequalities plan for 2025 to 2028. This included a plan which outlined the strategy’s goals, actions they would take to address health inequalities and the expected outcomes from this. The plan set clear delivery timescales for achieving each of the goals and actions. Progress against the strategy was presented in the health inequalities highlight report made to the trust board quarterly.

Staff completed training in equality diversity and human rights with compliance at 97% across the service.

The service supported people to plan for important life changes, so they had enough time to make informed decisions about their future.

We observed a visit where the person was planning for discharge from the service. The staff member created a plan with the person to identify ways to proactively manage their own mental health. They considered the person’s quality of life post-discharge and made plans for a medicines review which the person agreed with.

Staff in the Psychosis Service for People in Hull and East Riding (PSYPHER), early intervention in psychosis team met with colleagues in the community mental health teams (CMHT) every 2 weeks to discuss people who would be discharged to ongoing CMHT support and make plans for the transfer of care.

People we spoke with were aware of plans for their future care and treatment, including discharge and had been fully involved in planning this.

However, we did not find evidence of effective discharge planning in all care records we reviewed. We reviewed 12 records where it may have been appropriate to have discharge plans and of these only 2 had discharge plans recorded.