Lincolnshire Community Health Services NHS 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

At our last assessment we rated this key question Good. At this assessment the rating has remained Good, 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

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.

Leadership across the service was inclusive, transparent, and actively engaged with staff. Face-to-face meetings were prioritised wherever possible, reflecting the importance placed on direct communication and meaningful engagement. Staff at all levels were encouraged to participate in governance meetings, which provided opportunities to promote strategic priorities and values, share knowledge, and gather feedback.

The service had well-established and effective leadership strategies designed to support consistent service delivery and cultivate the desired organisational culture. These strategies were embedded through a structured organisational induction, mandatory training programmes, and ongoing support for both individuals and teams. This ensured that the organisation’s vision, direction, and values were clearly understood and consistently upheld.

Leaders were compassionate, inclusive and effective at all levels. Leaders demonstrated high levels of experience, capacity and the capability needed to deliver excellent and sustainable care. There was an embedded system of leadership development and succession planning, to ensure that the leadership represents the diversity of the workforce. Leaders were open, and supportive of all staff, and volunteers, encouraging and supporting them through training opportunities to develop their skill set, and to develop others. The service supported all its staff as individuals and learnt as much as possible about their workforce. They had regular supervision and meetings with staff and volunteers; leaders were open and transparent. They provided a comprehensive induction and training program that educated and empowered all staff to be part of the shared direction and open culture of the organisation. Leaders had a deep understanding of issues, challenges and priorities in their service, and beyond.

Comprehensive and successful leadership strategies were in place to ensure and sustain delivery and to develop the desired culture. Leaders were visible and communicated with nursing teams regularly. Sharing information and values helped them all to understand the vision of the organisation. They gave direction and encouragement to their staff and were inclusive and supportive, staff were listened to. Leaders supported and encouraged them to deliver excellence every day.

Leaders fostered an open and supportive culture, free from reproach, where staff were actively encouraged to raise concerns through the Freedom to Speak Up service. Staff were well-informed about how to raise issues and knew who the Freedom to Speak Up guardians were. Leaders viewed the raising of concerns as a valuable opportunity for organisational learning and improvement. For instance, following the investigation of several concerns, a policy was reviewed and amended to provide clearer guidance and enhance role responsibilities for both staff and volunteers.

Leaders embraced the cycle of change, recognising the importance of every voice in shaping the service. Feedback was actively sought through comprehensive staff surveys, with identified themes addressed and actions implemented to drive improvement. Results from the 2024 NHS Staff Survey and the Collaborative Community Care (CCC), showed a generally positive picture, with clear evidence of staff commitment to patient care, teamwork, and alignment with organisational values. Divisional action plans were agreed and monitored by the Group Leadership Team (GLT). The overall response rate for the 2024 NSS return was 54%. The surveys also highlighted persistent challenges that required focused action, particularly around workload pressures, wellbeing, and opportunities for career progression. Staff continue to express concerns around resourcing and the impact this had on both their wellbeing and ability to deliver care at the standard they aspire to.

Whistleblowing policies and procedures were firmly in place, enabling staff to raise concerns or complaints with confidence, knowing they would be supported and kept informed throughout the process. The Freedom to Speak Up guardian had a formal role in governance meetings, ensuring concerns and feedback were monitored and acted upon where necessary. Meeting records confirmed that leaders responded appropriately to feedback received via the guardian, demonstrating a commitment to transparency and continuous improvement.

The service celebrated its culturally diverse workforce and provided tailored support to help individuals and teams thrive. Leaders were supported by the HR department and Freedom to Speak Up guardians, ensuring that every staff member had a voice and felt heard and supported.

All services were active in welcoming international staff members who have joined the Trust. Teams and colleagues worked together in supporting individuals and their families to settle in the local community and in turn building a stronger healthcare team. A staff member told us, “We are very protective of our international staff members. We admire their courage in migrating and choosing to help the local community by joining the NHS.”

Reasonable adjustments were made for staff with new or existing health conditions wherever possible, reinforcing a safe and inclusive working environment. Flexible working arrangements were facilitated, with input from occupational health where needed, to support staff wellbeing. The service also prioritised work-life balance by enabling staff to take quality time away from the workplace.

Equality, diversity, and inclusion were actively promoted through well-functioning processes. Reasonable adjustments to working practices were made where practicable, considering both individual needs and organisational requirements.

Leaders operated with clearly defined roles, responsibilities, and systems of accountability, which supported strong governance and effective risk management. These structures enabled the delivery of high-quality, sustainable care for people using the service. Transparency was maintained through regular monthly governance meetings, which staff were encouraged to attend.

Staff also participated in sustainability steering groups, contributing to strategic planning aimed at enhancing the long-term viability of the service and its offerings. Recommended actions were implemented, audited, and any learning was shared with staff via electronic communications and team meetings.

Leaders set clear expectations around conduct, care, treatment, and support, and understood the potential impact on service quality if standards were not met. Governance processes were informed by best practice, with outcomes monitored and measured. Lessons learned were used to drive continuous improvement and support the pursuit of excellence.

Robust procedures were in place to manage sensitive data securely, ensuring the privacy, dignity, and confidentiality of individuals were upheld. Governance meeting minutes confirmed that staff from various areas of the service were actively involved in discussions about service improvement.

Staff across all departments understood and supported the organisation’s vision, values, and strategic goals, recognising how their roles contributed to achieving them. The service complied with statutory and regulatory requirements and collaborated with its regulator when necessary. Managers led quality improvement initiatives throughout the service, which were both measurable and impactful.

Nursing teams worked collaboratively and inclusively with external partners and care providers involved in delivering patient care. Patients were actively supported to maintain connections with their local communities and the people and places important to them. Both patients and their families participated in local fundraising events, strengthening community ties.

The service engaged constructively with staff, service users, and all equality groups. Feedback and challenge from patients and stakeholders were welcomed and viewed as essential to driving service improvement. Leaders maintained strong, positive relationships with all service partners, including the local authority safeguarding team, the Integrated Care Board (ICB), and the wider community. Regular collaborative meetings with partners enabled the sharing of best practice and collective learning.

Commissioners, specialist services, and prospective placement partners were actively involved in care planning and delivery. Their expertise was valued and integrated into service development, reflecting a commitment to joined-up working and improved patient outcomes. Partners consistently described the service as open, honest, and highly responsive to patient needs, with care delivery remaining patient-centred. The trust implemented the Neighbourhood Palliative Huddle Model which actively embedded the Trust’s Palliative and End of Life Care Strategy across Lincolnshire through collaborative, multidisciplinary working. This model brought together professionals from across the teams including community nursing, specialist palliative care, general practice, and social care into regular huddles that reflected a neighbourhood-based, integrated workforce approach, ensuring that care is personalised, proactive, and delivered closer to home.

Processes were in place to ensure that service development involved full participation from patients, staff, and external care providers, who were treated as equal partners. Feedback was gathered through various accessible formats including written forms, online submissions, and telephone contact with materials available in different languages and formats upon request. The service demonstrated a strong commitment to acting on all feedback received.

The service monitored themes and trends that were relevant to them, the patients they supported, and the service they provided. The Lincolnshire Palliative End of Life Strategy was developed with a wide range of stakeholders including providers, commissioners and service users/patients to show what people who used services wanted the services to be in the future. This was used as a guiding template when the group worked on any End-of-life quality improvement projects.

The service carried out both audits and clinical audits that were evidence-based and measurable. It demonstrated a commitment to continuous improvement by learning from shared information, which helped drive progress and foster a culture of excellence. Leadership consistently celebrated good practice, using it as a foundation to sustain momentum and inspire further success.

Managers held regular meetings with staff, creating a space where innovation, ideas, and learning were actively exchanged. Effective processes were in place, reflecting a clear, systematic, and proactive approach to identifying and embedding new, sustainable models of care.

The service has a strong track record of sharing its work both locally and nationally. It collaborates with other providers through various benchmarking initiatives and clinical audits, reinforcing its commitment to partnership and quality improvement.