Hertfordshire Partnership University 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

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question Outstanding. At this assessment the rating has changed to Good.

Leaders had the skills, knowledge and experience to perform their roles. Staff knew and understood the provider’s vision and values and how they applied to the work of their team. Staff felt respected, supported and valued. Governance processes operated effectively. Performance and risk were managed well. Teams had access to the information they needed to provide safe and effective care. Staff collected and analysed data about outcomes and performance. They used this to identify improvements. The service worked well with partners to support people’s needs and share learning. Staff had opportunities to participate in research and quality improvement projects.

This service scored 79 (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 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 their communities.

Staff knew and understood the provider’s vision and values and how they were applied in the work of their team. The trust had a set of values and behaviours co-produced with people who used services, carers and staff. These values were: welcoming, kind, positive, respectful and professional.

The trust vision and values were displayed in team locations, formed part of the reception area design and artwork and were available on the trust’s website.

The trust had an overarching ‘Great Together Strategy 2023 – 2028’, that set out the trusts commitment to support people living with mental illness and learning disabilities. The strategy was co-produced and developed with service users, carers, staff, partners and local communities.

Staff described positive, supportive cultures within teams and the wider service that were focused on delivering high quality care for people who used services, as well as staff wellbeing.

The service had inclusive leaders at all levels who understood the context in which they delivered care, 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 did so with integrity, openness and honesty.

Leaders had the skills, knowledge and experience to perform their roles. They had a good understanding of the services they managed, and the people who used services. They could explain clearly how their teams were working to provide high quality care. Leaders had good oversight of their team’s performances and challenges.

Staff felt supported by local leaders and appreciated that they were trusted to do their job autonomously. Staff told us that leaders took positive action when concerns were raised, and that they felt comfortable to ask for help or support from leaders and their multi-disciplinary team members.

The trust held events where staff could speak to the executive team, and senior leaders also visited teams regularly.

Staff described leaders as having a genuine commitment to staff wellbeing, giving examples of wellbeing events such as team lunches and local staff recognition awards.

Leaders listened to and acted upon staff concerns including those raised in the 2025 Staff Survey. The service had its own staff survey action plan which focused on making improvements at work, staff wellbeing, reducing abuse of staff from service users and improving team effectiveness.

Leadership development opportunities were available, including opportunities for staff to complete nursing qualifications, approved mental health professional (AMHP) training and to access leadership training.

The service created a positive culture where people felt that they could speak up and that their voice would be heard.

The trust had a Freedom to Speak up policy and Freedom to Speak up Guardians (FTSUG) in place. A Freedom to Speak Up Guardian (FTSUG) works alongside the trust’s senior leadership team to ensure staff have the capability to speak up effectively and are supported appropriately if they have concerns regarding patient care.

The service also had 9 Speak up champions in place for staff to contact if they had any concerns to raise. Details of the FTSUG’s and champions were displayed in team offices and on the trust intranet. The FTSUG had worked to improve visibility within teams including holding a Freedom to Speak up week that included drop-in sessions for staff, and they attended team locations regularly.

The FTSUG’s had received 36 cases in the year from April 2025 to March 2026 and themes identified were patient safety, bullying and harassment, and staff wellbeing.24 cases had been investigated and closed, whilst 12 remain ongoing. The closed cases were dealt with through a process of acknowledgement, signposting, escalation to relevant parties and resolution.

Staff felt comfortable to raise any concerns either with leaders or through the freedom to speak up process and thought that concerns were addressed appropriately.

The service valued diversity in its workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The trust had a ‘belonging and inclusion’ strategy in place that set out expectations of inclusive leadership and equality priorities.

The trust undertook equality monitoring of its staff and reviewed its Workforce Race Equality Standard (WRES) and Workforce Disability Equality Standard (WDES) results. WRES and WDES data were only available at trust-wide level.

The trust had developed action plans for both WRES and WDES that aimed to achieve an inclusive culture, diverse workforce and eliminate discrimination.

The trust had 9 staff networks in place: ‘Diversability’ network; Embrace (race and cultural equity); LGBTQIA+ network; Carers network, Mental Health network; Women’s staff network; Men’s staff network; Neurodiversity network and a Spirituality network. These aimed to provide a more inclusive and supportive culture for staff.

The trust held events to celebrate race equality week, Pride and the national day for staff networks. These included meet and greet sessions with networks, staff blogs and discussions.

The trust had a flexible working policy in place and staff told us that they felt they could work flexibly, including working from home on occasion.

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

There was a clear governance structure that described how locality management and improvement groups fed into the trust management.

Local practice governance meetings had a clear framework of what must be discussed to ensure that essential information including incidents, risks, NICE guidance, audits, procedural documents, safeguarding, duty of candour and complaints was shared and discussed. These meetings reported into the divisional quality and risk management meeting.

Staff reviewed learning and actions from incidents, Patient Safety Incident Review Framework (PSIRF) and local ‘swarm’ debriefs at governance meetings.

Leaders had access to information on the performance of the service and quality of care through an electronic dashboard that was easy to use. The dashboard was linked to the electronic care records system so was up to date and did not place any additional burden on leaders. They had oversight of risks, issues and performance of teams.

Staff had access to the equipment and information technology needed to do their work. Staff told us the electronic care record system was difficult to navigate at first but there were no problems once used to it.The trust confirmed that it provided training on its digital systems including electronic patient records, and staff could access this training via the trust intranet system.

The trust had a risk register in place at service level and team leaders had access to their local team risk register. The risk register reflected the concerns of staff and leaders, and any new risks could be escalated through the quality and risk meetings.

The trust had business continuity plans in place for emergencies including plans for loss of staff, utilities and information technology and telecommunications and gave staff clear processes to follow in such an event. The business continuity plans were reviewed annually.

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

Managers at the service held regular meetings with external partners to ensure safe systems of care were established. A representative from the Integrated Care Board (ICB) attended Patient Safety Incident Panels that reviewed any learning from incidents.

The teams had effective working relationships with teams outside the trust including the local drug and alcohol teams, local councils, police and GP surgeries. Teams invited partner agencies to attend part of multi-disciplinary meetings to discuss joint working.

The Trust was part of the Hertfordshire public health suicide prevention strategy and provided local training to staff. The suicide prevention pathway e-learning was embedded with partner organisations to ensure a standardised approach.

The trust worked in close partnership with Hertfordshire county council and held safeguarding responsibilities for adults and children under a section 113 agreement.

The service focused on continuous learning, innovation and improvement across the organisation and the local system. They encouraged creative ways of delivering equality of experience, outcome, and quality of life for people. They actively contributed to safe, effective practice and research. Staff had opportunities to participate in research. The PATH - Psychosis: Prevention, Assessment and Treatment in Hertfordshire teams were taking part in research on the ‘Feeling Safer’ clinical trial for people with persecutory delusions and were also taking part in a ‘Sleeping better’ trial for people under the at-risk mental state teams (ARMS). They had also taken part in studies of visual hallucinations and auto-immune diseases in people with psychosis.

The service had a number of quality improvement initiatives in place. These included the Fundamentals of Care dashboard that enabled staff to work more efficiently and freed up more time for caring for people who used the service. The ‘Evidence based pathways’ project aimed to introduce a standardised, evidence-based approach.

The teams at Centenary House and Oxford House were piloting an enhanced physical health check programme for people using their clozapine and depo clinics. This pilot aimed to improve people’s access to health screening, facilitate earlier diagnosis of physical health conditions and work closely with GP surgeries to follow up on screening outcomes. Staff told us that feedback from people using the service had been positive. Staff had seen improved access to bowel, breast and cervical cancer screens, diabetes screening and vitamin D deficiency tests.

Teams participated in national audits including National Clinical Audit of Psychosis and NHS Benchmarking Network/Equally Well: Community Mental Health Benchmarking Project.

All teams within the service had current accreditation under the Royal College of Psychiatrists ‘Accreditation for community mental health services’ (ACOMHS).