Birmingham and Solihull Mental Health 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 good. At this assessment the rating has remained as good.

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care. 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.

This service scored 75 (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. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Leaders communicated a clear vision and strategic direction for the service. Staff aligned their practice with the organisation’s overarching aims and values: To improve mental health and wellbeing through the delivery of safe, compassionate, and high-quality care. To promote equality and inclusion. To work in partnership with service users and communities, and to continuously improve through innovation and learning.

There was consistent evidence that this vision was understood across the teams and embedded within everyday service delivery.

Staff described the core values of the service as fostering a respectful and inclusive environment that was responsive to the needs of the patient group. Practice was centred on delivering high-quality assessment and evidence-based treatment, alongside ongoing support and advice tailored to individual need. Interventions were described by staff as person-centred, strengths-based, and collaborative, with a clear focus on promoting both physical and mental wellbeing, stability, and independence.

Leaders and staff demonstrated a compassionate, respectful, and open culture. Team members reported feeling listened to and supported, with transparent communication and mutual respect. This culture promoted trust and psychological safety within the team and enabled effective multidisciplinary working in the best interests of service users.

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

Staff feedback consistently described a positive and harmonious team culture, with a supportive environment in which colleagues worked collaboratively and provided effective cover for one another. Communication within the multidisciplinary team was reported to be strong and well established, contributing to well-coordinated and consistent care delivery.

Leadership was viewed positively, with recognition of the current team manager’s visible and supportive approach. Staff described an improvement in structure, clarity, and team focus under the present leadership, which was felt to have strengthened overall team functioning and cohesion.

Staff reported that managers were approachable, responsive, and proactive, consistently listening to staff and being receptive to ideas, creating a supportive environment where team members felt valued and heard.

We heard that the Chief Executive had visited one of the teams to discuss matters raised in the staff survey. Managers said that staff engaged well with this visit and were able to ask lots of questions about the service and the trust.

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

Staff were able to share their views and provide feedback about the service through a range of channels, including business meetings, MDT meetings, supervision sessions, and staff surveys. These forums enabled staff to openly discuss a wide range of topics, share ideas, raise concerns, and influence practice.

Staff reported feeling able to raise concerns, provide honest feedback, and make complaints without fear of retribution, discrimination, or negative consequences.

The trust had a Speak Up Guardian who staff could access in order to raise concerns confidentially, seek independent advice, and feel supported to speak openly about issues relating to patient safety, professional practice, or workplace culture, without fear of reprisal.

We saw examples of how the service had reviewed complaints received from patients or their families and applied lessons learned to inform changes and improvements to future practice. Including reviewing and improving the prescription request and completion process, after complaints had been received in relation to these areas.

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.

Staff reported that reasonable adjustments were made to support individual needs, including health-related needs, such as modifying work schedules. This enabled them to carry out their duties safely and effectively.

A staff member told us about the reasonable adjustments that had been put in place to support them with their disability in the workplace. Management had implemented adjustments in line with a flexible working agreement, including the ability to work from home one day per week and flexibility to leave work early when required. Additional equipment was provided to improve comfort, and a workstation assessment was completed to ensure appropriate support. The staff member said they had felt well accommodated and supported as a result.

At the East Hub, staff told us that, following consultation and engagement to gather their views, an arrangement was introduced allowing all staff to work from home one day per week. Staff said they valued and appreciated this flexibility.

Team managers were setting up a project to analyse patterns of recruitment in relation to the workforce race equality standard. This included analysis of interview panels and raising awareness of unconscious bias.

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

Staff reviewed incident reports to identify themes and patterns of incidents. This information was reported to the Clinical Governance Committee for the Specialist Directorate.

Managers from each of the teams met each month. During these meetings manager discussed staff awards, quality improvement projects, audits, team updates and key performance indicators.

Performance was measured against key performance indicators (KPIs) set by the trust. These KPIs related to visiting people who had been discharged from hospital, the frequency of care programme approach reviews, referral and waiting times and recording the outcomes of visits and appointments. Managers discuss teams’ performance at the monthly managers’ meetings.

Regular multidisciplinary and team meetings were structured around a clear agenda framework to ensure essential information was consistently shared and discussed. This included learning from incidents, complaints, and safeguarding alerts, helping to strengthen the safety and effectiveness of the service. We saw evidence in business and managers’ meeting minutes that key items from the risk register were regularly reviewed and monitored.

Staff had access to the equipment and information technology required to carry out their roles effectively, including electronic patient care records and an electronic incident reporting system. Staff told us that the IT infrastructure, including the telephone system, worked well and supported effective communication, accurate record-keeping, and the overall quality and safety of care.

The service demonstrated strong governance, clear leadership, and well-defined accountability arrangements. Staff understood their roles and responsibilities.

Learning from audits, complaints, incidents, and safeguarding alerts was embedded across the service, with staff reflecting on findings in team meetings to continuously improve processes and patient outcomes.

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

The teams had effective working relationships with teams outside the organisation (for example, local authority social services and GPs). Doctors sent regular letters to patients’ GPs to ensure they were aware of the outcomes of any assessments, and understood the care and treatment being provided. Community nurses worked collaboratively with staff at local authorities to arrange placements in more supportive accommodation. Staff often referred patients to local groups and voluntary organisations. For example, local voluntary groups facilitated activities for people with dementia. Some care homes ran dementia cafes. Staff also referred people to specific nursing services that provided specialist dementia nursing support to family carers with multiple and complex needs, using a range of therapeutic interventions.

At the East Hub, the team had established close working relationships with the nearby Learning Disabilities Team, which they could access for advice and support when caring for patients with a learning disability.

The service focused on continuous learning, innovation and improvement across the organisation. 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.

We heard about several quality improvement projects undertaken within the service, including one aimed at reducing ‘Did Not Attend’ (DNA) rates. The project sought to reduce DNAs for medical outpatient and physical health clinic appointments within the South Hub by 30% over 12 months.

Following implementation of multiple interventions, such as patient questionnaires, revised appointment letters, appointment cards, and enabling caller identification for reminder calls, data showed a significant reduction in DNAs, exceeding the 30% target. This project led to the South Team being nominated for a Quality Improvement Initiative of the Year at the Health Service Journal (HSJ) Awards.

We were also made aware of a quality improvement project titled ‘No Borders, No Bias’ which aimed to strengthen cultural awareness and promote an anti-racist culture to improve both staff and patient experience. The initiative included a cultural intelligence event and the provision of active bystander training for staff.

The project team was nominated for a Trust Values Award in recognition of this work.

A dementia blood screening quality improvement project had been introduced to set clear standards for the triage of new referrals. The aim was to ensure routine blood tests were completed, helping to identify possible delirium and avoid delays in starting appropriate medication.