East London NHS Foundation Trust

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Our overall rating of well led has stayed the same. Community Health Services for adults were rated as good.

This service scored 86 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The trust had a shared vision, strategy and culture that was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding and meeting the needs of people and our communities.

Staff knew and understood the trust’s vision and values and how they were applied in the work of their team. Staff could explain to us how they were working to provide better urgent and emergency care and improve health outcomes for people.

Staff had the opportunity to contribute to discussions about the strategy for their service, especially where the service was changing. Staff consistently described a positive and proactive culture in which learning was embedded through regular supervision, team meetings and reflective practice, helping teams to continuously develop and maintain high standards of care.

This shared purpose was further reinforced by strong systemwide partnerships with acute hospitals, the ambulance service and social care, ensuring that all teams worked together to deliver safe and coordinated care for patients.

Staff worked together as a team to support patients despite increase in capacity and demand for the community health services.

The trust had inclusive leaders at all levels who understood care delivery, treatment and support and embodied the culture and values of their workforce and organisation. They had the skills, knowledge, experience and credibility to lead effectively and do so with integrity, openness and honesty.

Leaders had the skills, knowledge and experience to perform their roles. The clinical director of Tower Hamlets CHS was a GP and had experience working in the community with key stakeholders. The Heads of Clinical services provided support to the team leaders.

Managers in Newham Community Health Service (CHS) were undertaking succession planning for a new tissue viability nursing service. This supported the identification and development of staff to take on critical roles, helping to ensure continuity of care and strong leadership.

Leaders had a good understanding of the services they managed. They could explain clearly how the teams were working to provide high quality care. Leaders were visible in the service and approachable for patients and staff.

Leadership development opportunities were available, including opportunities for staff. Staff attended monthly Schwartz Rounds, which provided a valued forum for reflection, peer support and discussion of the emotional aspects of care, to help promote a compassionate and inclusive culture.

The trust created a positive culture where people felt that they can speak up and that their voice will be heard.

Staff reported low levels of stress and felt positive about their work. They described leaders as supportive and focused on staff wellbeing, promoting culture of good practice, quality and safety. Staff knew how to raise concerns, they knew who the freedom to speak up guardian was, and the trust had a whistleblowing policy in place.

Staff were able to give feedback directly to senior leaders and governors. Executive leaders had recently visited Tower Hamlets and Bedfordshire CHS teams, listened to staff concerns and made improvements to support day-to-day working. This included securing parking across Tower Hamlets and providing additional fast-falls pick-up kits, which improved response times and supported staff wellbeing.

The trust used staff survey feedback to identify key themes, including appraisals, staffing and team working, and developed a workforce development plan to address these issues.

Patients and carers had regular opportunities to give feedback in ways that met their needs, including through annual satisfaction surveys, participation forums and monthly focus groups. Feedback was largely positive. In December 2025, 58 patients shared feedback about Bedfordshire CHS, with all rating their overall experience as good or very good.

The Working Together group represented the voices of patents and carers through their involvement in a range of projects and service meetings and as representatives on interview panels.

The trust valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked at the trust.

Staff reported that the trust promoted equality and diversity in its day-to-day work. The trust undertook equality monitoring of staff within the service to ensure it is diverse in its make-up and representative of the patient group. Staff spoke various languages and were able to use this for the benefit of the patients.

Staff could apply to work flexibly. For example, flexible working agreements to account for personal circumstances such as caring responsibilities and health issues. Managers put reasonable adjustments in place for staff members to help them carry out their role.

Staff had received awards for improving service user experiences.

The trust had clear responsibilities, roles, systems of accountability and good governance to manage and deliver good quality, sustainable care, treatment and support. Staff acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

There was a clear framework of what must be discussed at a ward, team or directorate level in team meetings to ensure that essential information, such as learning from incidents and complaints, was shared and discussed. The service held monthly team meetings to ensure essential information was shared amongst the staff. Staff discussed pertinent information such as patient assessments and emerging risks.

The service managers and clinical leads attended regular clinical governance meetings. Managers fed back information from these meetings back to their teams. Staff discussed recommendations from reviews of deaths, incidents, complaints and safeguarding alerts at these meetings.

Staff undertook and participated in audits, which provided sufficient assurance, and they acted on the findings where improvements were needed. Audits included care planning, medicines management, informal carer details, discharge letters and palliative care. In Newham Community Health Service (CHS), staff identified areas for improvement in care records, including skins checks and medicine administration records.

Staff maintained and had access to the risk register at team and directorate level. Staff at team level could escalate concerns when required. Staff concerns matched those on the risk register. This included staffing, IT failures and delays in ordering equipment for patients’ homes.

Where cost improvements were taking place, they did not compromise patient care. Staff went over and above to provide care and treatment to patients. Challenges in timely provision of services by external contractors, including equipment provision had been recognised and appropriately addressed.

The service used systems to collect data from teams that were not over-burdensome for frontline staff. Team managers had access to information to support their roles, including data on service performance, staffing and patient care. They could review key performance information through trust dashboards, with support from quality and data staff to help them interpret data.

Staff were able to access patient records across multiple services, included the local acute hospitals and GP practices, supporting timely welfare checks and effective communication.

Staff had access to the equipment and information technology needed to do their work.

Information governance systems included confidentiality of patient records. Information was in an accessible format, and was timely, accurate and identified areas for improvement.

The trust understood the duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The community health teams had strong and effective partnerships with acute hospitals, ambulance services, primary care and social care, which helped to ensure people received well-coordinated care throughout their care pathway. In Bedfordshire CHS, staff worked closely with the local acute hospital through the discharge to assess model to support safe and timely discharge. This enabled people to continue their recovery at home or in a community bed.

Staff also worked closely with the East of England ambulance service. The urgent community response team could access the ambulance service system to review and accept appropriate referrals from 999 calls. This helped people to receive the right care quickly and reduced unnecessary ambulance waiting times.

Teams worked closely with social services and primary care to jointly manage risks, support complex discharges and ensure continuity of care for people with ongoing needs. For example, the trust worked with several care homes across Bedfordshire to provide continuing care and step-down beds. In Tower Hamlets CHS, staff worked in partnership with the local hospice to support patients and their families at the end of life. In Newham CHS, staff met regularly with the GP practices.

Patients and staff could meet with members of the trust’s senior leadership team and commissioners to give feedback. Patients could attend monthly focus groups and took part in the monthly quality improvement forum, which helped to inform and drive service improvements.

The trust focused on continuous learning, innovation and improvement across the organisation and the wider local system. Leaders encouraged creative approaches to improving equity of experience, outcomes and quality of life for people using services. The service actively contributed to safe, effective practices and research.

Staff were given time and resources to take part in quality improvement (QI) projects that led to meaningful change. In Tower Hamlets community health services (CHS), a QI project focused on improving access to foot health services for people experiencing homelessness. Other projects aimed to increase work experience for young people from local communities served by the trust.

Clinical leads in Tower Hamlets CHS developed a dedicated webpage, ‘I am a GP in Tower Hamlets’, supported by a podcast to raise awareness of community health services and referral pathways. This helped improve understanding of services among primary care partners.

In Newham CHS, staff completed a QI project to reduce pressure ulcers acquired in their care by 10% over 12 months. This resulted in a 31% reduction in pressure ulcers, and staff received an award in recognition of this achievement.

In Bedfordshire CHS, staff completed QI work focused on catheter care, reviewing the pathway from hospital insertion to care at home. This helped improve understanding of referral reasons and supported safer, more appropriate care.

The North Therapies team in Bedfordshire worked in partnership with The Bedfordshire Rural Community Charity to promote digital literacy. The charity provided digital skills training and electronic devices to isolated people across Bedford and Central Bedfordshire, with the aim of improving social wellbeing and ensuring equitable access to digital health and social care services.

Staff also took part in QI projects supporting patients with diabetes to self‑administer insulin safely, working closely with carers and relatives. This promoted independence and reduced caseload pressures within diabetes teams.