Birmingham and Solihull Mental Health NHS Foundation Trust

On this page

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

We looked for evidence that the service met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained as good.

This meant people’s needs were met through good organisation and delivery.

The service met the needs of all patients including those with a protected characteristic. Staff helped patients with communication, advocacy and cultural support. The service treated concerns and complaints seriously, investigated and learned lessons from them.

This service scored 71 (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 made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

The service provided individualised care that was compassionate, respectful and responsive to each person’s needs, preferences and circumstances. Staff collaborated with patients, families and carers to plan and deliver care in line with what mattered most to the individual. Support was tailored to each person and addressed both physical and emotional wellbeing.

Patients and carers told us that staff communicated clearly and in a manner that supported their understanding of their care and treatment.

One patient told us they felt staff knew and understood them as an individual. Other patients said they felt actively involved in decisions about their care and treatment.

However, 1 carer expressed concerns about a lack of continuity and ineffective information sharing, reporting that seeing multiple clinicians across appointments meant having to repeatedly explain their circumstances, rather than seeing the same clinician with whom an established relationship had been built. They felt this reduced the time available during the appointment to focus on current needs, treatment options, and future wishes.

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

Care and treatment delivered to patients by the service demonstrated a strong understanding of the diverse health and social care needs within its local communities. Interpreting services were arranged whenever required to support clear and effective communication with patients from all backgrounds.

The service delivered a range of pathways for older people living with organic and functional illnesses. Provision included medication prescribing and the administration of intramuscular medicines. Alongside psychological therapies such as Cognitive Behavioural Therapy (CBT). Occupational therapists completed functional and practical assessments to promote independence and support individuals to remain in their own homes where possible. The memory assessment service assessed, diagnosed and supported people who were experiencing memory difficulties or other cognitive changes. Additional interventions, including electroconvulsive therapy (ECT), were available when clinically indicated.

However, extended waiting times meant that assessments and interventions were not always delivered in a timely manner. This limited staff’s ability to provide consistently coordinated care and maintain continuity across the care pathway. However, once patients accessed the service, multidisciplinary teams worked collaboratively to coordinate care, manage risk, and promote continuity between teams and partner services.

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

Staff made notifications to external bodies as required, including safeguarding referrals to the Local Authority and statutory notifications to the Care Quality Commission (CQC).

The service demonstrated compliance with the Accessible Information Standard by routinely identifying, recording and sharing patients’ communication needs. Information was provided in accessible formats, and appropriate communication support was arranged to promote equitable access to care.

Patients were given information about their treatment options, local services and how to raise concerns or make a complaint. Information was tailored to meet the needs and preferences of the patient group. For example, materials were available in different languages, as well as in bold print and large font for people with visual impairments. The service also signposted patients and carers to online health and wellbeing resources, including content in easy-read formats. Leaflets were available in languages commonly spoken by the local population.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care.

Within the last 12 months the service had received a total of 58 complaints across all teams. We saw that most complaints related to prescribing, poor communication, concerns about staff attitudes and professionalism and timely access to treatment or medication, these areas accounting for the majority of issues reported across all hubs. Of all complaints received, 5 were raised as formal complaints: 2 were partially upheld, 1 was not upheld, 1 was closed due to lack of consent within the specified timeframe, and 1 had remained open and unresolved for around 6 months at the time we reviewed this information. The remaining complaints were received and managed through the Patient Advice and Liaison Service (PALS).

We saw that the service took learning from complaints, discussed them during MDT meetings, and implemented changes based on the feedback received. For example, following a complaint, the service committed to incorporating family members’ views when structuring appointments.

Notice boards in waiting rooms and staff areas displayed information for patients and staff on how to raise concerns or provide feedback. This included details for the Trust’s Customer Relations Team, the Freedom to Speak Up Guardian, and the Care Quality Commission’s feedback process, as well as links to patient and staff feedback surveys. The service also signposted patients to advocacy services to support them in raising concerns.

Staff demonstrated good awareness of the available channels for raising concerns and told us they felt able to speak to service leaders without fear of retribution or discrimination. Managers said that they aimed to resolve complaints locally where possible and understood the formal complaints process, including referral to the Patient Advice and Liaison Service (PALS).

Staff involved patients in the service, when appropriate. For example, a patient at the service in Solihull was part of the trust’s experts by experience programme. This programme enabled current and former patients to be involved in interview panels and specific projects, such as the repurposing of buildings. These experts received training and were paid for their work.

Through review of patient care records, we found that beyond the initial assessment, there was limited evidence that staff consistently sought patients views and wishes or involved patients in care planning and risk assessment on an ongoing basis. The section of the care record capturing patients’ views and wishes was often repeated word-for-word at each six-monthly review, sometimes spanning several years.

The service did not always ensure that care, support, and treatment were provided in a timely manner, waiting times across the majority of the service were high.

Staff told us they aimed to see patients within 4 to 6 weeks of referral, in line with the trust’s target. However, the service was not consistently meeting this standard. Over the previous 12 months, the average waiting time from referral to first appointment was 8.9 weeks. Waiting times varied across hubs, with the South Hub reporting the shortest average wait at 5.6 weeks and the Solihull Hub the longest at 11.5 weeks. Based on the most recent data available, the projected average waiting time across the service had increased to 10.5 weeks. In addition, 98 people had been waiting longer than 18 weeks for a first appointment.

Waiting times for psychological interventions were particularly lengthy in the West and Solihull teams, largely due to periods over the previous 12 months when there was no psychologist in post. Longer waits for complex assessments reflected workforce capacity, senior clinician availability, and staffing vacancies.

The data we reviewed showed that, at the Solihull hub, 20 of the 26 patients were waiting over 13 weeks for psychological assessment, and 16 of the 26 patients were waiting over 18 weeks for psychological intervention, with the longest wait exceeding 49 weeks.

At the West hub, 5 of the 15 patients on the waiting list had been waiting over 13 weeks for psychological assessment, and 4 of the 15 patients had been waiting over 18 weeks for psychological intervention, with the longest wait being 28 weeks.

We saw that the shortest waiting times for psychological assessment and intervention were at the South hub, with none of the patients on the waiting lists waiting over 13 weeks for assessment or over 18 weeks for treatment.

Across the service, first episode psychosis referrals were prioritised, and none had exceeded the 2 week wait for assessment and treatment start over the last 12 months. Urgent, high-risk referrals were prioritised and consistently seen within target times.

For the memory assessment service, the data we reviewed showed the average waiting time from referral to assessment was 31 weeks, compared with the trust’s target of 6 weeks. Reasons cited for the extended waiting times included higher-than-anticipated referral rates and ongoing recruitment and retention challenges. The memory assessment service delivered a ‘Waiting Well’ programme to provide early advice and support to individuals experiencing memory difficulties, promote self-management strategies, monitor risk, and help prevent deterioration while patients awaited assessment.

Staff explained how the service worked to manage and reduce long waiting times. This included arranging additional clinics, offering appointments on non-clinic days when necessary, and consulting the duty team for additional support when required.

The service also worked to reduce waiting times by using clinical psychology trainees to provide supervised therapies and neuropsychological assessment for less complex cases.

Patients on waiting lists for psychological interventions, who were assessed as potentially benefiting from group therapies such as Compassion Focused Therapy, could be offered these while awaiting a more specialist intervention.

We heard how the service was working towards enabling routine, intervention and pathway specific reporting of waiting list data within electronic systems. These improvements were expected to support greater transparency, oversight, and waiting list management.

Facilities were fully accessible to wheelchair users, including building entrances and restrooms equipped to meet patients’ accessibility needs.

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

The service had appointed a member of staff to lead on work relating to the Patient and Carer Equality Framework. Staff had arranged events with local community groups to ensure that diverse communities were aware of the care, treatment and support that was available.

Staff compliance with Equality, Diversity and Human Rights training was 97%. The service provided active bystander training and cultural community training and held cultural intelligence events for teams.

Staff demonstrated a good understanding of groups who had historically under-accessed services and were therefore more likely to experience inequality in access, experience or outcomes. This included specific communities within the local area that had previously had low levels of engagement with services. The service was proactively working to build relationships with these groups to improve awareness, increase engagement and reduce barriers to access. This included providing resources in multiple languages.

Leaders described how they were embedding the Patient and Carer Race Equality Framework (PCREF) within the service and using it to reinforce a clear commitment to zero tolerance of racial discrimination and abuse.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

We saw examples within care records of staff supporting patients and their families to plan for significant life changes, including the progression of illness, future care arrangements and the potential loss of capacity. This involved discussions about advance care planning, lasting power of attorney and longer-term support options.

Progress notes within care records frequently documented patients’ wishes and expectations. However, this information was not consistently captured within the designated care plan section relating to patient expectations and preferences, which reduced its visibility and made it more difficult to locate when needed.

We heard how the service provided post‑diagnostic support and Admiral Nurses for people with dementia, including access to Dementia UK webinars, while carers were supported through Alzheimer’s Society partnerships and Voluntary, Community and Social Enterprise resources to help with future planning.