East London NHS Foundation Trust

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• 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

This means we looked for evidence that the service met people’s needs.

At our last assessment we rated this key question outstanding. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The evidence showed some shortfalls. The service did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Staff developed individual care plans with patients which were reviewed regularly through multidisciplinary discussion and updated as needed. Care plans generally reflected patients’ assessed needs, were personalised, holistic and recovery oriented. Staff said that they involved patients in care planning and risk assessment. However, patients gave a mixed picture of being involved in their individual care plans. Feedback from approximately a third of patients and carers we spoke with indicated they would welcome further opportunity to contribute to and access their care plan.

In the ward rounds we observed, patients discussed their views about their treatment and care plan.

On our arrival to Ash Ward, we were informed that it was designated as a female ward from October 2025. This was done by moving male patients to the adjacent Willow Ward and female patients to the larger Ash Ward. Leaders explained this decision was made in response to the growing demand for female beds to avoid placing new patients out of area. However, we were concerned about the impact on the patients who were nursed on both wards. We were told that one day’s notice was given to patients and staff, and it was not clear how carers or any other relevant parties were informed. Patients were transferred without their established nursing teams, impacting therapeutic relationships and continuity of care. No community meetings were held on Ash Ward between September and December 2025, meaning patients had limited opportunities to discuss their concerns or queries about this decision. Staff also shared their concerns, with one saying these transfers were “never pleasant for patients or staff”.

The service understood the diverse health and care needs of people and our local communities, so care is joined-up, flexible and supports choice and continuity.

Most patients were admitted to wards near their home areas. Staff supported patients to maintain contact with their families and carers in line with their wishes.

The wards offered a range of activities, including exercise, dance, walking groups, cooking, smoothie making, yoga, men’s and women’s health. Whilst there was a schedule of activities, what was offered and when varied. Some wards offered limited activity programmes during the evening or at weekends. Approximately half of the patients and carers told us they would welcome the opportunity for additional activities. Gym provision varied across the wards. Some wards had well-equipped indoor gyms, for example Bevan and Jade wards, while others had outdoor gym equipment. Some patients reported limited gym access, especially if it was located elsewhere on the unit and required Section 17 leave, which some did not have.

Staff worked with other organisations to support patients to engage with activities in the community, for example the recovery college and local voluntary and community sector organisations. We saw evidence of relevant agency involvement in most care records we viewed.

Discharges were sometimes delayed for reasons other than clinical, and the trust was working hard with stakeholders to address this, including the development of new models of community support to reduce the need for admission. Staff across all wards spoke about the pressures in the wider mental health system and demand for inpatient beds. This was coupled with other challenges outside of the trust’s control, such as availability of supported accommodation and social care. For example, at the time of our inspection, one patient had remained on an acute ward for nearly 3 years, and another for almost 2 years primarily due to accommodation issues.

The evidence showed some shortfalls. The service did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff provided information to patients in accessible formats if required, for example by completing communication passports and arranging access to interpreter service.

On most wards there was no information displayed about informal patients’ rights. At the same time, on Townsend Ward posters saying that informal patients could leave were prominently displayed.

Although information was displayed on the boards, not all of it was in accessible formats and some patients did not think they had enough information about the ward. Some said they did not receive welcome packs on admission. One patient said they were more likely to go to other patients for information. Another thought that key information should be repeated, because some people were admitted when acutely unwell and may not retain it.

Since our inspection, the trust told us about actions taken to improve the consistency of its welcome pack provision and informal patients' rights information.

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

Information on how to raise complaints was displayed on the wards and staff we spoke with knew how to handle complaints. Some patients and carers told us they could find out how to complain if needed or said they would complain to external bodies. One carer said they had complained formally about miscommunication about the ward round and received an apology, however this had happened again since.

Some patients told us they were confident to raise issues with staff, in ward rounds, one-to-one or community meetings.

We reviewed a sample of complaint records across the wards. These had been reported on the trust’s electronic system and dealt with appropriately. Complaints were discussed in daily huddles, community meetings, awaydays and a weekly dedicated trust-wide meeting. Themes included staff attitudes, communication, environment and care provision.

We reviewed a sample of community meeting minutes which showed that patients received feedback on the issues they had raised. Some wards displayed ‘You said, we did’ feedback on the information boards. Most patients we spoke with confirmed they attended weekly community meetings regularly. On Ash Ward, no community meetings were held between late September and mid-December 2025. During this time patients had daily morning meetings where they met with staff to discuss any issues they had personally or on the ward, or where they needed support.

The service made sure that everyone could access the care, support and treatment they needed when they needed it.

Managers noted that pressure on beds was very high. Out of area placements had fallen significantly and the trust was able to access their own female PICU unit.

Staff did not move or discharge patients at night or very early in the morning. Patient transfers were planned and took place at times that were appropriate for the patient and team.

Staff planned for patients’ discharge, including liaison with community teams and housing when required. Decisions about discharges were taken by the multidisciplinary teams to ensure patients were clinically well enough and safe. Staff discussed upcoming discharges in daily huddles and the trust’s had dedicated discharge hubs to support this process. Managers monitored discharges and lengths of stay across the service. Two carers said their relatives were waiting for accommodation but there were no estimated dates.

Across Tower Hamlets wards, staff previously ran a quality improvement project to improve patients’ timely discharge as part of a wider trust initiative. This involved embedding daily discussions of criteria for discharge readiness, and had supported an overall reduction in out of area placements and length of stay. Staff on Bevan Ward told us about ongoing work on reduction of PICU length of stay, direct discharge into the community and prevention of readmissions. This was done through early identification of discharge barriers and joint work with the home treatment team.

Staff and leaders actively listened to information about patients who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff we spoke with thought the service was open and inclusive for diverse groups of people, including those with protected characteristics under the Equality Act 2010. We observed inclusive practice on the wards, for example information about anti-racism, Black History Month and LGBTQ+ was on display. Staff used anti-discriminatory practices in supporting transgender patients.

The trust was one of the pilot sites for the Patient and Carer Race Equality Framework (PCREF), NHS framework aimed at reducing racial inequalities in services. The trust had a People Participation group that patients and carers could become involved in. We saw variation in how these initiatives were embedded across the wards. For example, on Jade Ward, staff previously ran a quality improvement project aimed at addressing physical health inequalities, resulting in improved understanding reported by both patients and staff.

Managers on Bevan and Townsend wards told us about monitoring trends in restraint and seclusion data to understand which minoritised groups were overrepresented. Staff on Bevan Ward were also working on improving physical health monitoring. Staff on Tower Hamlets wards were planning a project to improve the experience of carers. On most wards, staff’s understanding of equity focused mainly on individual adjustments, for example for mobility, religious or dietary needs.

The evidence showed a good standard. Patients were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

Staff ensured that relevant health and social care services were involved in planning the care and treatment of patients with complex needs. Most of the care and treatment records we reviewed showed that staff liaised with a variety of teams where appropriate, such as community care coordinators, crisis resolution and home treatment teams, substance misuse services, housing and social services.