Under-fire trust not functioning well, says NHS

The trust has a base at Trafalgar House in Dudley

A mental health trust struggling with leadership issues and distrust among staff is "not functioning well" with a "tolerance of poor behaviour", an investigation has found.

NHS England visited Black Country Healthcare NHS Foundation Trust in July and September after it was placed under extra scrutiny last November. Chair Jeremy Vanes announced last week he was to stand down.

Findings showed "an apparent disconnect from the board to front-line staff" with some staff feeling isolated and disengaged.

The trust said it fully accepted the findings and was committed to addressing the issues and improving.

However, it also acknowledged praise from inspectors for improvements in some areas and for the dedication of staff.

In May last year, the trust was told to improve following an inspection after several safeguarding incidents, including CCTV footage appearing to show staff sleeping in a patient's bed as he was left lying on a floor.

Last November, doctors backed a vote of no confidence in their management team and in August, an independent investigation into the culture at the trust found distrust among staff at all levels and concerns over leadership.

Throughout 2024, external organisations continued to receive concerns about the trust, mostly anonymously, the trust said in papers for a board meeting on Wednesday.

That led to NHS England and the local integrated care board to undertake an investigatory visit in July with a smaller team visiting in September.

The subsequent report found "staff across the organisation consider that the board is not functioning well, and that it is not able to resolve conflicts constructively.

"There has been tolerance of poor behaviours at board and a hesitancy previously to tackle them," it stated.

'Experiences must change'

Work must be done with all staff to "repair feelings of isolation" and changes in medical leadership over the last year had affected how the trust functions, including relationships and trust between individuals.

"Considerable work is required to improve the culture across the organisation - there is an apparent disconnect from the board to frontline staff," the findings showed.

Some staff said they did not feel heard and some experienced a blame culture, while tensions existed within the board.

In response, trust chief executive Marsha Foster said: "As a board, we take these findings very seriously."

She said the report highlighted unacceptable behaviours, customs and practices "that, though not universal across the trust, should have no place in our organisation".

"In their findings, NHS England and Black Country Integrated Care Board highlighted areas for improvement, but they also shared a number of positives," she said.

"They could see that we had made improvements in clinical and operational performance measures, that we have a strong culture of quality and safety reporting and they came across very clear dedication of staff and patient-focused care.

"We recognise the challenges we face and we understand the concerns of our staff."

Ms Foster added the trust was "committed to working with colleagues to do things differently and deliver improvements across our organisation".