Calderdale and Huddersfield 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
• Environmental sustainability – sustainable development

We have not awarded this service a score for Well-led.

Find out about when we will not publish a key question score and what we look at when we assess Well-led.

In a well-led trust, leaders should ensure a clear, shared vision and strategy across the organisation, and staff understand how their roles contribute to achieving these goals. The vision, values, and strategy are developed collaboratively with staff, service users, and external partners through a structured planning process. Both staff and leaders should foster a positive, compassionate culture focused on trust, understanding, and continuous improvement. They should aim to prioritise equality, diversity, and human rights and promote safe, high-quality, and compassionate care. Efforts should be made to address any workforce inequalities, with actions taken to resolve identified issues. Additionally, leaders and staff should assess and manage risks that could impact the delivery of the strategy, ensuring there are actions in place.

Score 3

We scored the trust as 3. The evidence showed the trust had a clear shared strategy and direction. The trust understood the challenges and the needs of people and their communities. The trust’s vision was well-established and there was a supportive culture within teams.

The trust had a corporate strategy for achieving trust priorities which included a commitment to “delivering outstanding compassionate care to the communities we [the trust] serve”. The trust had a five-year strategy for 2023-2028, which had been built on and refreshed the previous strategy. The trust was halfway through their Five-Year Strategy at the time of the well-led assessment, and we found that the trust was on track with its delivery of this. Staff, patients, carers and local stakeholders were able to contribute to discussions about the current strategy in a series of meetings, workshops and engagement activities and events, resulting in 1300 patient contributions.

The trust five-year strategic plan is aligned to the strategies of the integrated care system and the local Place. The trust plan goals were to:

• Transform services and population outcomes
• Deliver the best quality and safety of care – “Keeping the base safe”
• Ensure an inclusive workforce that supports local employment and development opportunities
• Deliver financial, economic and environmental sustainability

The trust’s board reviewed the trust’s strategy in a board workshop session and with the council of governors in July 2025 following the publication of the NHS Ten Year Plan. The board confirmed the strategy aligned to the ambitions of the NHS 10 Year Plan and that it would enable the three strategic shifts from analogue to digital, from hospital to community, and from treatment to prevention.

The strategy committed the trust to four strategic themes and goals. Each theme included an identified measure of success and the key drivers. These were clearly measurable, and the trust provided evidence to show there was a robust plan for delivery of the strategy with clear objectives and timescales.

The trust identified board level leaders to hold responsibility and accountability for delivering each component of the trust’s strategy and delivery plan. The trust monitored and reviewed how it delivered strategic objectives with regular board-level reports. We saw the March 2025 key achievements in the delivery of the strategy had been presented to the board, and that all objectives had been RAG rated green and on track for delivery.

The trust had robust and realistic strategies for achieving the priorities and developing good quality, sustainable care across all sectors whilst addressing strategic challenges. We reviewed the 2026-27 draft annual strategic objectives and saw they had been part of a board strategy development session in February 2026.

We saw several key trust enabling strategies which sit below the overall corporate strategy. The trust had a Dementia Strategy which had been co-produced with partners and key stakeholders and was aligned to local and national policies. The development of the strategy had also been supported by patients and their families, who had shared their experiences with the trust.

The trust was in the process of drafting a learning disability and autism strategy. We reviewed a draft version of this document, which was yet to be viewed by the participation groups. There were two participation groups, the first was the learning disabilities group that had developed the existing strategy and the operational delivery of this. This group was led by the nurse consultant for learning disabilities, supported by representatives from each clinical division. The group included members who have learning disabilities who provided an expert lens on all activities to ensure that actions meet the needs of the patient group. The second participation group was the patient experience and involvement group which includes colleague with a learning disability who was employed in the patient experience team. There was support for colleagues to understand the lived experience of people with learning disabilities. The draft learning disability and autism strategy contained a clear emphasis on ensuring that all staff within the trust took shared ownership of the experiences and outcomes experienced by patients with a learning disability and autistic patients. The strategy identified health inequalities as a clear driver for improvement and clearly outlined goals to deliver improvements.

We saw examples of clear, committed and motivated leadership at a senior level within the trust which aimed to drive a proactive and positive culture in relation to patients with a learning disability and autistic patients. Structures and processes had been developed which aimed to improve oversight of quality and equitability of experience and outcomes.

The trust had a nursing and midwifery strategy 2024-29, quality strategy, experience of care strategy, digital, data and technology strategy, health equity strategy 2025-28, estates strategy and a range of strategies in relation to their workforce. The trust had separate plans for inclusive talent management, to manage workforce retention and development, as well as a leadership development offer. We saw evidence of the trust’s strategies aligning with the corporate strategy. The trust clinical strategy was one part of the five-year strategic plan that was supported by many enabling strategies.

The trust had a ‘Widening Participation strategy’ 2025-28, which involved working with local communities to create employment opportunities for all as part of the trusts ‘Grow Our Own’ approach. The strategy played a key part in the trust delivering strategic objectives, including ensuring they had an inclusive workforce which supported local employment and development opportunities.

Patients and the public had the opportunity to contribute to the trust’s Patient and Carer Experience and Involvement Strategy 2026-29 through listening to patients, carers and families. The trust included sources of feedback, including complaints, surveys, reports, volunteer feedback and visits to their services. The key themes from this work led to the development of the four goals of the strategy and the subsequent commitments within each goal. The findings were also themed against the NHS England ‘Experience of Care’ framework. This was an example of how the trust had engaged with people using services in developing a trust strategy document.

We received positive feedback from partners about how the trust met the ‘shared direction and culture’ quality statement and specific examples of how the trust had worked in collaboration with partners. We heard how the trust was working with external partners to develop new strategies and saw evidence of this.

The trust had an aspirational vision and a statement of values. The trust’s vision was established within the trust’s purpose statement which was ‘together with partners, we will deliver outstanding compassionate care to the communities we serve’. This was underpinned by four pillars of behaviour which guide how the trust work, these were the trust values:

• We put patients and people first
• We ‘go see’ (learning from others)
• We work together to get results
• We do the ‘must do’s’ (to ensure regulatory and statutory compliance)
• We care for ourselves and each other in the same way we care for our patients through One Culture of Care

The trust’s values were well-embedded and had been established for some time. We consistently heard throughout our assessment that One Culture of Care was embedded throughout the work of the trust and staff understood how their work demonstrated this.

Our assessment of the trust’s frontline services found these areas of the trust demonstrated a positive culture of collaboration, openness, integrity, respect, and collective responsibility. NHS Staff Survey results in 2025 showed higher levels of engagement, with the trust achieving its highest response rate at 50.6%, compared to 36% in 2024. The trust score for the ‘We are compassionate and inclusive’, ‘We are recognised and rewarded’, ‘We each have a voice that counts’ and ‘We are always learning’ People Promise element were all higher than the overall average for comparable trusts. The elements of ‘engagement’ and ‘morale’ both scored higher than the average overall for 2025.

The feedback we received during our assessments of the trust’s frontline services was mostly positive about the culture within services. Staff and leaders were proud to work at the trust, and all staff we spoke with could describe the trust's vision and values.

The trust had mechanisms to identify and address behaviours that were inconsistent with the values of the NHS. The trust's disciplinary group policy and procedure had been updated to version 4.1 in April 2024 and the trust's grievance procedure we reviewed had been updated recently in February 2026. Both policies were reviewed in line with the Policy Framework and with Staff Side representatives. The polices had been approved through policy sub-group and staff management partnership forum and ratified at Executive Board. We reviewed recent examples of both disciplinary processes and grievance processes. All examples had been carried out in line with the trust’s policies with the processes completed within reasonable timescales.

The trust had mechanisms to ensure staff were fit and proper for their roles at the point of recruitment. The trust had effective systems to monitor professional registration. The trust provided information about Disclosure and Barring Service checks for 6056 staff. The data showed all employees were compliant with DBS checks. The trust had robust processes in place to ensure staff remained fit and proper persons for their roles, including clear oversight and monitoring for professional registrations of staff.

In a well-led trust, leaders should have the experience, capacity, capability and integrity to ensure the organisational vision can be delivered, and risks are well managed. Leaders should be visible at every level, lead by example, and model inclusive behaviours. High-quality leadership is sustained through safe, effective, inclusive recruitment and succession planning. Leaders must be knowledgeable about issues and priorities for the quality of services and can access appropriate support and development in their role. Leaders should be alert to any examples of poor culture that may affect the quality of people’s care and have a detrimental impact on staff. They address this quickly.

Score 3

We scored the trust as 3. The evidence showed a good standard. The trust 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. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The trust’s board had an appropriate mix of skills and experience to ensure effective and visible leadership, including clinical leadership, across the trust. The board was comprised of executive and non-executive directors. There were six voting executive directors including the chief executive; deputy chief executive; medical director; director of finance; chief nurse, and director of workforce and organisational development. There were six non-executive directors in addition to the trust’s chair. The trust board meets the requirements of the NHS England code of governance for NHS provider trusts.

The board had four interim positions within the executive team due to the secondment of the substantive chief executive into another trust. The trust’s non-executive team were appointed between 2020 and 2024.

The executive team held lead roles for specific priority areas. The chief nurse was also the chair for the Quality Assurance group and the Quality Summits. The director of corporate affairs was the chair of the risk and compliance group.

The board were supported by a senior leadership team with the appropriate range of skills, knowledge and experience. This included deputy directors for estates, information, finance, medical, nursing, operations, and people.

The trust leadership team had a good knowledge of current priorities and challenges. Leadership relationships were appropriate and had a good amount of professional challenge. The team were able to drive strategic direction, partnerships and quality improvement within services.

There was a programme of board visits to services and staff fed back that leaders were approachable. The trust had a board development programme with six learning sessions planned between February 2026 – December 2026. The board development programme included planned sessions covering team dynamics and psychological safety, quality including learning from deaths and reporting for assurance.

We met with senior leaders and the learning disability consultant nurse who were leading on the learning disability agenda within the trust. This was well regarded in all parts of the organisation, with a motivated leadership team behind this. The learning disability and autism service was in the process of being expanded at the time of our inspection in recognition of the increasing workload and profile within the organisation. There was a clear commitment amongst leaders to the learning disability agenda, but this was not matched by an equitable focus on autism in a tangible way. We spoke about the cultural messaging that could be seen by using charitable funds to purchase sensory items to support those with sensory needs when accessing the emergency department. Senior leaders had not recognised that this approach could be inappropriate or that it risked sending unintended messages about the importance of ensuring equitable experiences for patients with sensory needs.

The trust was in the process of identifying a non‑executive director to provide strategic leadership for learning disabilities and autism, with the role expected to commence in April 2026. This appointment was intended to strengthen the board’s oversight and challenge in relation to these areas.

The trust had systems to ensure leaders were suitable for their role. We reviewed a sample of files for voting members of board. The sample included files of both executive and non-executive directors. All members of the board had received an annual appraisal within the previous year. The trust maintained a record of annual appraisal dates for both executive and non-executive directors.

Partners shared positive feedback about their experience of working with the trust’s leaders.

Succession planning was in place throughout the trust. The trust had implemented processes to ensure succession planning at senior levels. Leaders told us deputies were supported to act up in interim leadership positions for an extended period ahead of formal recruitment processes.

Staff and leaders must act with openness, honesty and transparency. Staff and leaders should actively promote staff empowerment to drive improvement. Leaders should encourage staff to raise concerns and promote the value of doing so. All staff should feel confident that their voices will be heard. Leaders should ensure a culture of speaking up, where staff actively raise concerns and those who do (including external whistleblowers) are supported without fear of detriment. When concerns are raised, leaders should investigate sensitively and confidentially, and lessons would need to be acted upon. When something goes wrong, people should receive a sincere and timely apology and be told about any actions being taken to prevent the same from happening again.

Score 3

We scored the trust as 3. The evidence showed the trust was performing well in Freedom to Speak Up, that it was prioritised and embedded within the trust. The trust’s freedom to speak up processes ensured the independence and protected time required for the role for both guardians. The training for the guardians met the requirements and they spoke positively on how this benefitted their application of the role. People told us they felt they could speak up and that their voice would be heard.

The trust had appointed two Freedom to Speak Up Guardians equal to one whole time equivalent position, this was intentional by the trust to ensure guardian availability as much as possible. The Freedom to Speak Up Guardians told us they received protected time for their dual roles, and this ensured they were able to balance their responsibilities. The board had non-executive and executive leads for Freedom to Speak Up. The Freedom to Speak Up Guardians were supported by 44 Freedom to Speak Up Ambassadors. Staff also had access to a speaking up portal to raise concerns confidentially or anonymously. The Freedom to Speak Up Guardians told us they hold weekly drop-in sessions at both Huddersfield Royal Infirmary and Calderdale Royal Hospital to enable staff to call in and raise any concerns. The Guardians also told us about the ‘Be Seen in Green’ stalls at both locations which took place twice yearly to raise awareness of Freedom to Speak Up and its processes.

Leaders were satisfied with the trust’s Freedom to Speak Up processes and felt they were appropriate to the trust’s size. There was a growing number of ambassadors in the trust from diverse backgrounds.

The Freedom to Speak Up Guardians provide a half year and annual report to both the Workforce Committee and the Board of Directors. These showed staff increasingly using the trust’s freedom to speak processes to raise concerns. Data provided by the trust showed 159 cases were raised by staff in 2025/26, which was a 25% increase in the total number of concerns raised 2024/25. The trust’s reports identified reductions in the number of staff raising concerns anonymously, reducing from 44% last year to 22% this year. We saw evidence of a Board Learning Session that had taken place in August 2025 and had been delivered by the freedom to speak up guardians.

The Freedom to Speak Up Guardians attended shared learning meetings with the Quality team and looked at trends from incidents and complaints. The audit and risk committee ensured there was a robust process around speaking up processes within the trust and that the organisation had an up to date speaking up policy that met NHS England’s standards. These arrangements were then audited. A deep dive into processes for speaking up (including Freedom to Speak Up) was undertaken by the trust's Audit and Risk Committee in July 2025. This followed an internal audit of Freedom to Speak Up in April 2025 which had received High Assurance. The Trust had also benchmarked positively in Audit Yorkshire’s Benchmarking Report 2025, with no recommendations.

The trust provided training in freedom to speak up with compliance rates meeting target. The training included ‘Speak Up’ for all staff, ‘Listen Up; for managers and ‘Follow Up’ for leaders. The aim from the training was to embed a proactive culture. The guardians received supervision for their freedom to speak up work and had a direct link to the trust's psychological support provided, showing the trust prioritised supporting the guardians work and impact.

The trust had a freedom to speak up strategy which was first introduced in 2016. The strategy had developed and been regularly reviewed. It aimed to make speaking up ‘business as usual’ to improve patient care and staff experience, specifically to align with the trust's ‘One Culture of Care’ which we found to be strongly embedded.

NHS Staff Survey results for 2025 showed staff felt increasingly confident to speak up within the trust. The survey showed 63% of staff who responded felt it was safe to speak up if they had concerns within trust, an increase from 60% the previous year. The trust’s results were also 4% higher than the average for comparable trust's and in line with the average for trust's within the local integrated care system.

Staff confidence in the trust acting on concerns was higher than the previous year, with 50% of respondents feeling confident that the trust would address concerns about compared to 47.5% the previous year. The trust’s results were 4% higher than the average for comparable trust's.

The trust staff survey results were the most improved acute trust in the country, with a 4.4% increase in colleagues who agree or strongly agree with recommending their organisation as a good place to work. The overall response rate for the staff survey was improved to 51%.

Partners felt the trust did have a culture where staff could feel free to raise concerns. The trust had a collaborative approach which involved all key stakeholder groups. We saw divisional management teams were reviewing staff survey findings to identify clear themes and priorities for action and working directly with colleagues. The trust was engaging staff representatives through their established engagement channels, Equality Network Group Chairs and members, FTSU Guardians and Ambassadors and through Wellbeing Ambassadors. Through working with colleagues, the trust was collecting a ‘you said, we did’ approach.

There were regular action progress reports shared with the Board of Directors, Workforce Committee and Executive Board. Performance Review Meetings (PRMs) were utilised to assess the divisional action plan implementation.

In a well-led trust, leaders should be committed to continuously improving the organisation's culture, focusing on equality, diversity, and inclusion. Leaders should actively address disparities in the experiences of staff with protected characteristics and those from marginalised groups, ensuring that interventions are regularly monitored for impact. Steps will have to be taken to remove bias from practices, ensuring fairness in opportunities and experiences for all employees. This includes reviewing policies and procedures to tackle structural discrimination and promote an equitable culture. Leaders also work to prevent and address bullying and harassment, particularly for those with protected characteristics, and ensure that disabled staff receive reasonable adjustments to support their roles.

Score 3

We scored the trust as 3. The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

The trust’s Workforce Race Equality Standard (WRES) highlighted differences between the experiences of white and black and minority ethnic (BME) staff.

NHS Staff Survey 2025 results showed staff felt equality and diversity were promoted in their day-to-day work and when looking at opportunities for career progression. The trust’s results showed a slightly better experience in providing equal opportunities for career progression or promotion for other ethnic staff (52%) when compared to the national average (49%).

The most notable difference in experience between white staff and staff from other ethnic groups at the trust related to staff experiencing harassment, bullying or abuse from patients, relatives or the public in the last 12 months. The trust’s results showed 31% of staff from all other ethnic groups had experienced harassment, bullying or abuse from patients, relatives or the public, compared to 26% of white staff. The trust’s results were 2% higher than the national average. Whilst the result showed worse outcomes for staff from all other ethnic groups compared to white staff, this also matched the national picture compared to the previous year. Outcomes for all other ethnic groups showed improvement in comparison to the previous year’s results.

Leaders highlighted some of the trust’s achievements. We saw the board reports and associated action plans following the previous WRES/ WDES report and how the trust monitored progress of actions set.

The trust had implemented processes to support colleagues from Black, Asian and Minority Ethnic communities into more senior positions. The trust’s Collaborative Inclusion Strategy worked to support progression for colleagues within the trust. Data provided by the trust showed 89% of staff in executive positions were White, while 11% were Black, Asian or Minority Ethnic. As of November 2024, the Trust had 17% of its Board members from ethnic minority backgrounds.

The trust’s Workforce Disability Equality Standard (WDES) results showed staff with a long-term condition or illness had worse outcomes than staff without, though their responses showed better results in most areas compared to the national average. The most variation between those with and without a long-term condition or illness was for the percentage of staff who were satisfied with the extent to which the trust valued their work. Just over 45% of all staff without a long-term condition or illness felt the trust valued their work, whereas just over 64% of staff with a long-term condition or illness felt the trust did not value their work. The trust had slightly lower than national average numbers of staff with a long-term condition or illness reporting bullying or harassment.

The trust collated data demonstrating the diversity of staff. This showed the trust employed 27.8% of its staff from Black, Asian and Minority Ethnic backgrounds, it also showed 2.8% of staff identified as LGBTQ+ and 6.4% identified as having a disability. Staff networks were in place promoting the diversity of staff. The trust had several staff equality networks representing protected characteristics including Pride Staff Network, Race Equality Staff Network, Disability Staff Network, Carers Staff Network, Women’s Voice Staff Network, Men’s Mental Health Staff Network, and Change Society Staff Network. We saw each staff network had its own terms of reference and was able to make recommendations and escalate issues via the Workforce Committee.

The trust staff sickness rates were at 5.1%, against a target of 4.3%, with stress being cited as the largest area of concern for sickness.

The trust had an effective policy of over-recruitment managed at trust board level. This has reduced vacancy rates in nursing and allied health professionals (AHPs) and had helped to reduce agency rates.

We received limited feedback from partners in relation to this quality statement, although some partners shared that they felt the trust promoted equality, diversity and inclusion.

In a well-led trust, there should be clear and effective governance, management, and accountability structures in place. Staff should fully understand their roles and responsibilities, while managers hold staff accountable for their actions, behaviours, and performance. The systems designed to manage current and future performance, as well as risks to service quality, should take a balanced approach that allows for innovation and new ideas to be tested safely within the service. Data and notifications should be regularly and reliably submitted to external bodies as required, and there should be strong systems in place to ensure the availability, integrity, and confidentiality of data and records. Information must be used effectively to monitor and improve care quality. Leaders need to implement relevant quality frameworks, standards, and best practices to enhance equity in service delivery and address existing inequalities, ensuring better outcomes and experiences for those using the services.

Score 3

We scored the trust as 3. The trust had clear responsibilities, roles, systems of accountability and good governance. Governance and risk management systems and processes were in place. The systems for identifying, recording and managing strategic risks and mitigating actions were well-established.

As a Foundation Trust, the trust had a Council of Governors, which was a key part of the local accountability and governance arrangements. We saw evidence of clear communication between the board and the Council of Governors, including examples of where issues were fed back from local communities.

The trust had a financial deficit, but had a clear long-term plan to address this. The trust was in segment three of the National Oversight Framework (NOF) and was performing above average in other performance metrics such as referral to treatment (RTT) and cancer waiting time targets, where the trust was the third best performing trust in the country.

The trust had two Interim Directors of Finance, who were working well with the operational and strategic portfolio. The finance team were experienced and well respected within the trust. The team told us they were focused on the key priorities of the trust and those of the local health system.

The trust received ‘high’ assurance on its Board Assurance Framework’ in 2025/26, the well-led development review undertaken had shown the trust had a strong culture, engaged board of directors, strong focus on freedom to speak up, good partnerships and collaboration and strong overall governance.

The trust had governance structures in place with systems, processes and regular meetings in place. The trust board was supported by five board committees. These were the audit and risk committee; the finance and performance committee; the workforce committee; the nominations and remuneration committee and the quality committee. The trust board was also supported by the transformation programme board.

Senior leaders had regular meetings alongside the board’s formal committee structure. There was a weekly executive leadership team meeting and a weekly executive board (WEB). Both the WEB and monthly executive leadership team meetings were chaired by the chief executive officer. The Weekly Executive Board (WEB) was the principal executive and senior leadership forum for strategic oversight, operational performance, financial management, people management, and quality and safety governance across the organisation, bringing together Trust Directors and clinical, operational and corporate leads. It ensured alignment of executive decision-making with organisational priorities and regulatory expectations. We could see that outputs from WEB informed sub-committee and operational groups where appropriate. There was a bi-weekly leadership briefing of all senior operational, clinical and corporate managers across the organisation.

Leaders told us the workforce committee had been established to ensure there was effective governance and oversight of issues affecting the people working for the trust.

The trust’s quality committee was accountable for the oversight and governance of quality of care within the trust. This committee was supported by many sub-committees for areas including safeguarding, medicines management, clinical outcomes, learning disabilities, and mortality surveillance.

We observed meetings of the trust’s board of directors and quality committee. Committee papers contained appropriate information. We observed meetings were chaired effectively with appropriate discussion of specific agenda items.

Senior management committees and the board reviewed performance reports. Performance reports were of good quality and identified areas of high-performance and persistent shortfalls using statistical process control. The trust was aware of its performance using KPIs and other metrics. This data fed into the considerations of strategic risk within the board assurance framework.

At the time our inspection, recent areas of responsibility had been reviewed, and changes had been made to align with non-executive areas of experience. Leaders told us they were confident the changes would support enhanced board oversight of the trust. Non-executive and executive directors were clear about their areas of responsibility. There were six non-executive directors in addition to the trust’s chair. Each sub-board committee had a non-executive director as chair and another as a voting member. Non-executive directors told us they were also members of working groups and other committees within their areas of expertise. They had a good understanding in terms of their primary responsibilities as unitary board members and as members of their board committees.

There were clear governance structures and oversight of key elements of the care and treatment of patients with a learning disability. The trust did not have robust systems to identify autistic people using the trust’s services. The trust had introduced systems which ensured senior staff were aware of where patients with a learning disability were in the hospitals, and the processes that were there to ensure their specific needs were identified were in place. Electronic systems were in place which aimed to pull specific information from patient records and collate into themes for reporting purposes. This meant there were clearer lines of information available from an operational level up to board level which supported more effective oversight. However, we discussed incidents related to patients with a learning disability and out of the 13 incidents we reviewed, 4 of these were short notice postponements of surgery or procedures due to a lack of preparation around consent and or reasonable adjustments for such from medical staff. We were not assured that significant learning or improvements had been implemented as a result, and this was not something that executive leaders were able to talk about confidently. There was therefore a risk that themes were not always being picked up through audit or sufficient oversight, or that opportunities for learning and improvement were consistently identified and implemented.

The trust had systems and processes in place to monitor and maintain safe staffing levels and we saw evidence that these operated effectively in most areas. However, some services did not always have sufficient numbers of suitably qualified staff, and some services fell below national staffing standards. We reviewed the nurse staffing levels in the paediatric emergency department (PED) to make sure they met the standards set out by the document “Facing the Future – standards for children and young people in emergency care settings” specifically in relation to nurse staffing standards which say departments should use registered sick children’s nurses (RSCNs) to staff the emergency department. We spoke with staff about working in the PED. Some told us that although they were not RSCNs they worked shifts in that department but always with an RSCN to support them. Staff who were not RSCNs were given additional training called Paediatric Positive to equip them with the skills to care for and treat babies and children. Staff training compliance was at 88% at the time of our inspection with priority given to those who had not yet attended the course. Most staff told us they were comfortable working in PED however some staff told us they did not feel confident working in this area because it was not their specific area of training and qualification.

The trust had a six-monthly safer staffing report in line with requirements of the National Quality Board. The latest report for February 2026 showed the overall trust position for Registered Nurse cover during the day was 88% of expected staffing and overnight was 93%. The overall HCA staffing levels had fluctuated due to vacancies and increased one to one care demand.

The trust had exceeded the bank and agency staff reduction target overall, with a temporary increase in October 2025 due to staff sickness.

The trust had completed an audit of their processes regarding development of workforce safeguards. The trust received positive feedback from NHSE on this work and it was shared across the region.

The trust’s overall compliance with mandatory training was 94% which was higher than the target of 90%. Four modules of mandatory training for the trust were above the trust stretch target of 95%. The trust’s overall compliance for dementia awareness was 99%.

In February 2026, the non-medical appraisal rate at this point in the year was at 91%. For medical staff, appraisals were undertaken throughout the year in line with revalidation dates for staff. In 2024/25, the appraisal completion rate was 99.34%.

Appropriate governance arrangements were in place in relation to Mental Health Act administration and compliance. The trust had a service-level agreement with another NHS provider for support in relation to the Mental Health Act.

The trust had well-established systems for identifying, recording and managing strategic risks and mitigating actions. The trust board had sight of the most significant risks and mitigating actions were clear. Risks to the delivery of the trust’s four strategic objectives were monitored through a Board Assurance Framework (BAF). The trust had identified 13 strategic risks, of which 3 were assessed a posing high or significant risk (risk scores of 16-20). The BAF included details of the trust’s risk appetite. During our assessment, we observed consideration and review of strategic risk within the trust board and board committee meetings, showing that these processes were well-embedded. Leaders had consistent view of the highest risks facing the trust, and their concerns mostly matched the strategic risks identified on the BAF.

The trust had a risk assessment and risk management policy which had been implemented in April 2025 and was due for review shortly after our assessment. The trust had also implemented a risk management strategy in January 2017, that was currently undergoing a structured review at the time of our inspection. The review was informed by the recent transition to a new risk reporting platform. The strategy set out management of clinical, organisational and financial risk within the trust. The trust maintained a corporate risk register to identify, record and manage risks and mitigating actions. This was presented to the board alongside the BAF and was presented at each Board of Directors meeting, covering both clinical and corporate divisional risks scoring over 15.

Leaders expressed confidence in the quality of data provided by the trust. The data security and protection toolkit had met the required standards, which demonstrated it was practising good data security and personal information was handled correctly. Systems were in place to collect data from wards/service teams.

In September 2024, the Data Security and Protection Toolkit (DSPT) changed to adopt the National Cyber Security Centre’s Cyber Assessment Framework (CAF) with the new framework including additional cyber and information governance requirements. The trust had commissioned an independent audit; the final report was released in June 2025 and showed the trust meeting compliance in all 47 outcomes in the framework. This matched previous evidence where the trust had self-assessed and the outcome had matched this, providing overall confidence was high.

The trust had established robust governance structures, which included the Information Governance and Records Strategy Committee, which had oversight of policy implementation, risk management, and incident response at board level. The trust enforces Multi-Factor Authentication (MFA) for all users who accessed critical systems and privileged accounts, supported by policies such as the Password Group Policy and Network Security Group Policy, this ensured enhanced access control and accountability. Information governance systems were in place although maintaining the confidentiality of patient records.

The trust had processes to support people using services to raise complaints. Complaints were monitored through the trust’s governance systems. We reviewed four examples of complaints. The complaints were handled within the trust’s process and included an apology to the patient. The trust’s Quality committee received the annual complaints report 2024/25. The report for 2024/25 showed the trust had received 426 formal complaints, an increase of 6 from the previous year. The trust’s complaints handling performance had only slightly improved with 16% of closed complaints requiring being reopened compared to 19% of complaints the previous year. The overall performance for complaints was 83% of complaints completed within the target trust response time which was 95%. The trust monitored the themes of complaints. The top three themes were communication, patient care and clinical treatment. The annual report provided examples of where the trust had made improvements to services because of complaints.

There were plans in place for emergencies and other unexpected or expected events. Leaders described how the trust tested emergency preparedness through simulations. The trust’s compliance with national emergency preparedness, resilience and response (EPRR) standards was 77% which was an improvement from the previous year and similar performance to trust's in the local system.

Where cost improvements were taking place there were arrangements to consider the impact on patient care. Leaders monitored changes for potential impact on quality and sustainability. The trust’s chief medical officer and chief nurse jointly led on quality impact assessment processes at executive level. This reflected shared medical and nursing leadership oversight of quality, safety and patient experience. The trust had a process which established the criteria triggering the need for quality impact assessments. It identified the processes for undertaking equality impact assessments in cases of service redesign.

Leaders submitted notifications to external bodies as required. The trust monitored Freedom of Information compliance on an ongoing basis. The trust’s responded to 83% of requests under Freedom of Information within the statutory timeframe within the February 2026 report.

Fire risk assessments had been completed in all trust-managed premises within the last two years.

Partners described the trust’s governance processes as clear and well-structured governance.

In a well led trust, staff and leaders should be open and transparent and should encourage collaboration with all relevant external stakeholders and agencies. Staff and leaders should work in partnership with key organisations to support care provision, service development and joined-up care. Staff and leaders should actively engage with people, communities and partners to share learning with each other that results in continuous improvements to the service. They use these networks to identify new or innovative ideas that can lead to better outcomes for people.

Score 3

We scored the trust as 3. The evidence showed a good standard. The trust collaborated with relevant stakeholders and partners. They had a strong focus on identifying and addressing health inequalities and we saw examples of joint service development work. The trust had a process to engage with local people, communities and partners in the development of their strategy and future developments. Partners were positive about their experience of working with the trust.

The trust had a strong focus on identifying and addressing health inequalities. The trust’s Health Equity Strategy 2025-28 was built on the trust’s work to date to reduce health inequalities and aimed to embed health equity in everything the trust did as a core part of trust colleague’s work. The plan established the trust’s ambitions which were linked to the trust’s strategy and were designed to address health inequalities within Calderdale and Huddersfield. The trust served a diverse population with 18% from an ethnic minority group, 26% of the population the trust served lived in the most deprived quintile (IMD 1 and 2), this meant more deprived than the national average.

The trust had an established Health Equity Strategy Group, which oversaw development and delivery of workstreams and actions to address health inequalities. The trust’s previous strategy ‘Population Health and Inequalities Strategy 2022’ had included a number of workstreams including ensuring high priority care for patients with a learning disability and reviewing waiting list data to identify and address any inequalities. The current strategy was intended to be more of a framework and resource aimed at empowering all trust staff, regardless of role or division, to understand how health equity and inequalities were relevant to their role and to take action to address them. The trust also had a Health Equity Learning and Action Group, which was a forum with membership open to all and had external partners involved.

Progress on the strategy was regularly reviewed by the Health Inequalities Strategy Group and reported on to the Board of Directors. The Trust had an Executive Lead for Health Inequalities, who was also the Interim Deputy Chief Executive. We saw clear governance structure, monitoring and annual commitments each year to focus on delivery.

Leaders viewed partnerships and system working collaboratively to improve the health of the local population. Leaders consistently described strong and valued relationships with system and local partners.

The consultant nurse for learning disabilities had built strong relationships with system partners which proved beneficial in improving services for patients. Additionally, the trust had had a strong focus on hearing the voices of people with lived experience of a learning disability when considering training for staff and resources for use by prospective patients. Similarly, the patient experience team were working to better understand the impact of system pressures on the experiences and outcomes of patients with a learning disability.

Prior to our inspection, we wrote to relevant partners and stakeholders to request feedback on their experience of working with the trust. We received positive examples of how the trust engaged and worked in partnership with voluntary sector organisations. Partners told us the trust’s senior leaders ensured the trust worked as a strong partner.

We undertook specific interviews with partners within the local health and care system and received positive feedback in relation to how well the trust acted as a system partner. Leaders within the trust provided examples of how they engaged with the system including some examples of development partnerships across the system, place and neighbourhood, including the local acute NHS trust's, neighbourhood teams and community organisations.

The trust had worked in partnership as part of West Yorkshire Association of Acute Trust's (WYAAT), which was an innovative provider collaborative bringing together six NHS trust's across West Yorkshire to deliver joined up acute hospital services. We saw the trust working together with other trust's where it made sense to do so, for example pathology and radiology programmes.

The Chief Digital and Information Officer shared a strong approach regarding the cyber risk management at the trust, which included working in partnership with another trust In West Yorkshire as well as alongside WYAAT.

The trust had a close partnership with a local University, which included collaboration on the Huddersfield Community Diagnostic Centre, which aims to improve early diagnosis and access to care.

The trust had a strong Social Value Legacy Plan, to ensure investment in services, buildings and workforce which aimed to deliver lasting benefit for Calderdale and Kirklees communities.

The Trust leadership described examples of social value initiatives which included one example was that the trust's subsidiary (Calderdale and Huddersfield Solutions) won an award with the local authority for its commitment to local employment.

The trust delivered community health services in partnership with local providers across Calderdale and Kirklees. Services were designed to put people at the centre of their care, supporting them to make choices about treatment and responding in partnership to changes in their health needs. For example, the trust operated specialist nursing services for bladder and bowels, cardiac rehabilitation, Parkinson’s disease, tissue viability and diabetes within the community.

The trust worked with partners to review services. The local Healthwatch had supported involvement activities over the previous 12-18 months which had included the visiting review, a review of leaving hospital and experiences of discharge and a ‘15 steps walk around’ of maternity services with the Maternity and Neonatal Voice Partnership at Calderdale Royal Hospital. The trust developed an action plan because of this activity. The trust had also participated in a place partnership led piece of work with the local authority and integrated care board, Family Hubs, and voluntary sector partners to understand the experiences of pregnant women accessing antenatal care in Calderdale postcodes. The trust collaborated closely with community midwifery teams, hosted engagement activity in clinics and on the postnatal ward and supported the involvement process through the Maternity and Neonatal Voices Partnership and Engagement Champion

At the time of our inspection, the trust consulted with stakeholders, staff and the public on the new clinical building at Calderdale Royal Hospital, which was due for completion in 2029. The trust had carried out specific engagement meetings with partner organisations including primary care, ambulance services and neighbouring NHS trust's.

The trust had processes to engage with and seek feedback from people using services. The trust had recruited Experts by Experience and Patient Safety Partners in the last year as voluntary roles to help the trust better understand patient and carer perspectives. The contributions from these volunteers had already influenced improvement across a range of groups including the patient experience and involvement group, Discharge Quality Group, Mortality Review group and Carers Champion group. In addition to this, bi-monthly meetings were held, and we saw examples where this had improved patient information, improved surveys and supported the new clinical build. In the development of Martha’s Rule, a Patient Safety Partner had participated in the working group and engagement had taken place across several community forums to ensure the information and rollout had been more accessible. The trust had recently introduced a new analysis tool to support Families and Friends Test (FFT) data analysis which highlighted almost 3,000 comments for the 12-month period between January 2025 – December 2025 complimenting staff. The latest results (January - December 2025) showed 90% respondents using the trust’s inpatient responses felt their care was very good or good. The trust provided details of an additional local surveys planned or completed in 2025-2026 covering a range of services.

The CQC Adult Inpatient Survey 2024 looks at the experiences of 62,444 people, across 131 NHS trust's, who stayed at least one night in hospital as an inpatient during November 2024. Responses were received from 470 people using the trust’s services. The trust’s results were about the same as comparable acute trust's with score of 8.2/10 for overall experience. The CQC Maternity Survey 2025 received 125 responses from people using services at Calderdale and Huddersfield NHS Foundation Trust with the results about the same as comparable acute trust's. The CQC Children and Young People's Survey 2024 received responses from 238 people at Calderdale and Huddersfield NHS Foundation Trust. The results were also about the same as comparable acute trust's.

The trust worked appropriately with trade unions. Local and regional staff side representatives et regularly with senior leaders through established joint staff side and management partnership groups. Trade unions were engaged in both policy development and policy review.

The trust encouraged volunteering and was well supported by 166 dedicated volunteers. Volunteers undertook different roles within the trust including signposting and supporting patients and visitors to move around the hospital. The trust was introducing an annual report for volunteering in 2026, which would be the first volunteering report the trust will have published. The trust submitted quarterly returns to NHS England for volunteering data.

In a well-led trust, staff and leaders should demonstrate a strong understanding of how to drive improvements, using a consistent approach that includes measuring outcomes and impact. They need to involve service users, families, and carers in the development and evaluation of improvement initiatives. There should clear processes to learn from both mistakes and successes, with leaders promoting reflection and collaborative problem-solving. Staff need to be encouraged and supported to develop their skills in innovation, guided by a strategic approach that emphasises continuous improvement. Leaders should actively listen to staff ideas and foster a culture of trust and openness. The service needs to also benefit from strong external partnerships, engaging in research and integrating evidence-based practices to enhance innovation and care quality.

Score 3

We scored the trust as 3. The evidence showed a good standard. The trust focused on continuous learning, innovation and improvement across the organisation and 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.

The trust’s overall compliance with mandatory training was 94% which was above the target of 90%. There were five areas achieving compliance in specific modules across the trust at above 95%, achieving above the trust stretch target set. The trust was achieving 98% compliance in dementia awareness training.

The trust had low compliance with the mandatory training requirement in learning disability and autism. The training requirement consisted of two parts which included eLearning training in part one, and face-to-face training in part two. Whilst over 90% of staff had completed eLearning, there were no areas of the trust where compliance with the face-to-face training requirement was above 20% at the time of inspection. This meant there was a potential risk that staff were not equipped with the necessary skills to meet the specific needs of patients with a learning disability or those who were autistic. We spoke with leaders about this who explained that staff delivered person centred care, which was backed by the training they had undertaken, and that all patients whatever their need would therefore receive care and treatment in a personalised way. Staff received bespoke training as part of their induction and preceptorship programmes in learning disability and autism. The trust had a plan to take suitable action and there was strong evidence to show the trust would improve compliance rates with the further training requirements assessed as required learning. CQC assessed that whilst this was an area for improvement, there was limited evidence of impact and appropriate mitigations were in place which meant the trust did not breach regulation.

The trust had effective processes to identify, report and investigate incidents. The trust had a patient safety and incident response policy which was in date and a patient safety incident response plan (PSIRP) 2025-27.

The Patient Safety Response Framework (PSIRF) was launched nationally in the autumn of 2022, and the trust adopted a phased approach to implementation to ensure readiness for the transition. The trust fully transitioned from the Serious Incident framework to PSIRF in February 2025. The trust's PSIRF plan and policy described their response process which used a system-based learning method. We saw this included swarm huddles, patient safety incident investigations (PSII), after action reviews, MDT/ case note reviews and thematic analysis. The learning responses were tailored for each case, and we saw person centred care as the focus for continuous improvement. Learning responses were overseen at Divisional Patient Safety Event Panels and then shared with the Divisional Patient Safety Quality Board (PSQB). We also saw that a summary was provided through the trust Quality Report into the Quality Committee. This meant that learning from patient safety was shared through a range of routes to reach teams more effectively, examples we saw included ward meetings, staff huddles, safety briefs and learning posters. The trust had established a Learning Forum to provide effective monitoring and oversight of lessons learned from patient safety events.

In addition to national priorities, the trust has also identified several local priorities in relation to patient safety incidents and resulting investigations within the trust’s Patient Safety Incident Response Plan 2025-27. Local priorities identified included:

• All instances of Healthcare Associated Infections
• All categories of pressure ulcers and tissue damage resulting from hospital stay or attributed to trust community services
• Patient falls resulting in injury
• Recognising and responding to deteriorating patient

The trust has identified separate local priorities specifically for maternity care within the plan which included:

• Antenatal or Postpartum haemorrhage (PPH) >= 1500
• Delay in acting on foetal monitoring
• All unexpected admissions to the Neonatal Unit.

The trust had achieved their targets and at the time of inspection, 97.6% of staff were trained in level 1 - essentials of patient safety. Level 2 compliance was at 96% within the quality and safety training.

We reviewed five examples of patient safety incident investigation reports. There was consistent evidence of family involvement in patient safety incident investigation processes. The trust had appropriate processes in place to comply with the requirements of the Duty of Candour and compliance with timely adherence to the Duty of Candour was at 100% between 1 January – 31 March 2026, meeting the trust target of 100%.

The trust had 75 staff members trained in systems methodology and therefore able to lead a PSII. They had seven train the trainer staff members in ‘Human Factors’. The trust held Human Factors training monthly with sessions available for trust staff. There were 150 staff trained in this area at the time of inspection.

Trust internal training was trust wide for staff in action-action reviews, MDT reviews, thematic analysis and SWARMs. The trust held Quality Improvement sessions for staff. These were 1hour sessions and took place over 6 sessions. The trust had 25 staff members trained in Silver Award level in Quality Improvement (QI).

Audits were used consistently to drive improvement within services. Data provided by the trust showed that as of June 2025 most audit recommendations had been implemented on a timely basis.

Leaders were satisfied that clinical and internal audits were sufficient to provide assurance and teams demonstrated acting upon results where needed. The trust had clear processes to assess the quality of care against national standards.

Patient-Led Assessments of the Care Environment (PLACE) involve local people (known as patient assessors) going into hospitals as part of teams to assess how the environment supports the provision of clinical care, assessing such things as privacy and dignity, food, cleanliness and general building maintenance and, more recently, the extent to which the environment is able to support the care of those with dementia or with a disability. Both Huddersfield Royal Infirmary and Calderdale Royal Hospital scored higher than the national average in all areas in 2025 PLACE data. The national average for cleanliness was 98.55% and the trust scored over 99.5% at both locations.

The trust had developed significant growth over the last decade in their research and at the time of inspection, we saw they had a strong department delivering high performance. The trust produced two reports per year to Quality Committee. The trust also had an annual Research and Development report in which we saw they had exceeded the annual NHIR recruitment target. There had been a significant increase in the trust commercial portfolio across an expanding number of specialities, which had increased further since becoming part of the Bradford and West Yorkshire Commercial Research Delivery Centre in April 2025.The most recent report showed the trust had recruited 3099 participants, against its annual target of 1450. The trust achieved 214% against target for participant recruitment.

The trust did have a structured and evidence-based quality improvement methodology aligned with the NHS improvement approach. The trust provided multiple examples of quality improvement to showcase how the methodology was operationalised within services within the last year. The examples consistently used the quality improvement methodology adopted by the trust and delivered impactful results within the intended programme that did lead to improvements in care:

• A Deteriorating Patient (adult) observation on time programme launched using the model for improvement and Plan, Do, Study, Act approach. Phase one of the programme supported Acute Floor, Huddersfield Royal Infirmary, Surgical Assessment Unit to ensure 75% of patients on 4 hourly observations were completed on time by March 2026 and 90% by March 2027. The programme was on track and was now rolling out to phase 3, the final phase in its location programme.

The trust supported divisional teams to identify priority areas for improvement, define clear and measurable objectives, and was shown to plan for effective testing. The trust provided specialist training and coaching to ensure clinical and non-clinical colleagues with the capability and confidence to apply improvement principles. This showed a commitment to embedding a culture of learning, continuous improvement and accountability across services.

The trust had systems to identify and learn from deaths. The trust had good performance in completing structured judgement reviews, with 100% within the target of completion with eight weeks.

The Summary Hospital-level Mortality Indicator (SHMI) reports on mortality at trust level across the NHS in England using a standard methodology. NHS Digital describe SHMI as the ratio between the actual number of patients who die following hospitalisation at the trust and the number that would be expected to die on the basis of average England figures, given the characteristics of the patients treated there. The SHMI deaths occurring in hospital and deaths occurring outside hospital within 30 days of discharge. The SHMI does not make any adjustments for patients receiving palliative care and is not a direct measure of quality of care. The SHMI for November 2024-October 2025 was 1.17. This was above expected range, which the trust were aware of and was as a result of including the SDEC data from the trust up until April 2025.

The learning disability consultant nurse led a committed group of stakeholders who were keen to ensure opportunities existed for staff to consider their impact on patients with a learning disability. Additional “lunchtime learning sessions” had been delivered and the celebration of learning disability and autism awareness weeks had seen a programme of events available to staff across the trust. Further, the group had produced a new set of videos for potential patients to view on the trust website which aimed to answer questions and/or anxieties they may have about visiting hospital. These were produced by individuals with lived experience.

The Trust had a new learning centre in Calderdale, which was supporting recruitment and retention. There was a well-developed Quality Improvement (QI) methodology, supported by an in-house, 2-day training programme which was evident to be well used.

The trust's data analytics was well developed, and they had a strong use of their data warehouse. The trust was using population health data aligned with its own improvement methodology in many areas of its work, evidencing innovative good practice. Examples of this included reducing ‘Did Not Attend’ (DNA) rates and increasing predicative demand modelling in Same Day Emergency Care (SDEC).

We received positive feedback from partners in relation to this quality statement. We saw examples of initiatives to support learning and development including significant commitment to apprenticeship schemes (including digital apprenticeships), and strong links with the local University.

In a well-led trust both staff and leaders should recognise climate change as a major threat to public health and empower their teams to understand sustainable healthcare practices aimed at reducing the environmental impact of healthcare services. They should aim to promote a shared vision of delivering preventative, high-quality, low-carbon care, emphasising the health benefits of reducing environmental factors like air pollution, which can lower risks for conditions such as heart disease, stroke, and lung cancer. Green Plans should be implemented to make care settings as low carbon as possible, focusing on energy efficiency and renewable energy use. Additionally, leaders actively embed net-zero principles into care planning, ensuring resource-efficient, timely, and sustainable healthcare delivery.

Score 3

We scored the trust as 3. The evidence showed a good standard. The trust had complied with national directives in relation to Green Plans. The trust demonstrated how it understood any negative impact of its activities on the environment. There were examples of how the trust was striving to make a positive contribution in reducing environmental impact and supporting people to do the same.

In 2020, the NHS became the world’s first health system to commit to reaching net zero emissions. The Health and Care Act 2022 reinforced this commitment, placing new duties on integrated care boards (ICBs), NHS trust's and foundation trust's (referred to collectively in this guidance as trust's) to consider statutory emissions and environmental targets in their decisions.

An additional duty was placed on trust's in 2025 to publish and share a refreshed green plan by 31 July 2025. The trust met this deadline with a Green Plan in place which described the trust overall approach to environmental sustainability. The plan included a decarbonisation strategy which was signed off by the trust board in March 2022. There was also an annual Green Plan report presented to board.

The trust lead for Environmental Sustainability was the Managing Director of Calderdale and Huddersfield Solutions Limited (CHS). CHS was a wholly owned NHS subsidiary company responsible for estates management. The lead attended board to report on matters related to sustainability but was not a member of the Executive Team. The lead had completed Carbon Literacy training and chaired a regular Green Planning Committee which focused on environmental sustainability and the move towards net zero. There was not a direct Executive Director Lead for sustainability and the Green Plan. There was also no current Non-Executive Director with Environmental Sustainability included as an explicit part of their portfolio. A consultant anaesthetist was the clinical lead for sustainability. In 2013/14 the trust total carbon footprint was 19855 tons of CO2 equivalent in 2023/24 this had reduced to 11583 tons of CO2 equivalent.

The trust had identified climate change as an operational risk and had undertaken infrastructure resilience planning, which included extreme weather preparedness plans in place.

There had been a clear approach to manage the estates to improve overall sustainability and decrease the carbon footprint of the trust. Examples included grant funded replacement of lighting with LEDs, the installation of solar panels, air-source heat pumps and the use of some battery technology. The trust had a ‘switch off’ campaign for lighting and equipment when it was not in use. The trust had a ‘zero to landfill’ approach to waste management. Metal was directly recycled with the proceeds returned to the trust. There was a ‘Dump the Junk scheme’ in operation aimed at re-using items. Patient aids such as crutches and walking frames were reconditioned for re-use with the quality of the refurbishment being overseen by the Occupational Therapy Department. The Trust had a ‘buy local where possible policy’ and operated a structured procurement approach that embeds Social Value (SV) and Carbon Reduction (CR) as core evaluation criteria within all relevant procurements. A minimum combined 10% weighting to Social Value and Carbon/Net Zero was applied to tenders. Electric Vehicle (EV) chargers had been installed with an extra 40 being installed in the new multi-storey car park. EV chargers had also been installed adjacent to the emergency department for ambulances to use. The emergency department had been awarded a ‘Building Research Establishment Environmental Assessment Method (BREEAM) Excellence Award’. We saw a plan in place to increase external building insulation (using safe materials). There was also a programme for replacing less efficient windows and boilers. The trust ensured they used suppliers as much as possible and practicable. There was a zero tolerance for car idling for contractors. Home working for appropriate staff had been introduced. The trust tracked its carbon footprint, and this showed a clear decrease over time. The trust had a single use plastics reduction programme in place.

All nitrous oxide ports had been decommissioned to counteract leakage and desflurane was no longer used as an anaesthetic. There was a ’Green Operating Theatre’ checklist in place and recycling introduced into operating theatres including a review of clinical waste and bin allocation. Re-usable plastic instrument trays were in place and there was a ‘gloves off’ (where appropriate) policy in theatres and ICU. There was a plan to implement re-usable sharps bins in the immediate future. We were aware of upcoming clinical sustainability webinars for clinical staff. The respiratory team had introduced improvements in the choice of inhaler to minimise harmful emissions.

There was a ‘cycle to work scheme’ for staff including a salary sacrifice scheme for cycle purchase to make this option more accessible. There was a shuttle bus between the hospital locations and park and ride service to both hospitals. 90% of all trust vehicles were electric at the point of inspection. There was a car share scheme in place for staff which was utilised by 5-8% of the workforce. The NHS car fleet scheme for staff only provided staff with options to purchase electric vehicles.

There was 20 Green Champions in the trust, representing a range of departments. Environmental sustainability was part of the Trust mandatory training with 90% compliance. The trust has a ‘free trees for staff’ scheme and had given over 200 trees to staff for them to plant at the point of inspection. The aim from this was to improve biodiversity and carbon reduction. The trust had planted over 800 trees across its estate, and we saw a wellbeing garden for staff and patient use.

The trust catering services had returned to being trust run, with an aim of greater control over food procurement and decrease wastage, there was a policy of local sourcing whenever possible. Food chillers within catering areas had been upgraded to be more energy efficient.

We saw evidence of good partnership working with the trust sustainability lead being part of the ICB Net Zero Board and the Green Plan aligns with the ICB plan. We saw the trust actively works with the Climate Commission in Huddersfield. Placements were arranged for local sixth form college students to join the green committee. The Trust was working with the local university in relation to attitudes to sustainability and behaviour change.