CQC rate Norfolk and Suffolk NHS Foundation Trust (NSFT) as Requires Improvement.

The Care Quality Commission (CQC) have today published their latest report on NSFT, upgrading the trust’s rating from “inadequate” to “requires improvement”, following an inspection undertaken between September and November 2022.

As well as its overall rating improving following the latest inspection, the trust’s ratings for being safe, effective, and well-led also improved from “inadequate” to “requires improvement”. Although the inspection found improvement overall, there remain areas where more improvement is needed. There were also a small number of areas where CQC report a deterioration in the quality and safety of care provided to people.

The full CQC report can be read HERE

What do we, and our partners, think?

Jayne Stevens, CEO of SUF said,

“It is positive that NSFT has made significant improvements in the last year, and that the caring skills of staff are recognised in this report.

“Whilst welcoming these improvements, Suffolk User Forum (SUF) is acutely aware that NSFT does not have a track record of sustaining positive change.

“Service user and family/parent carer feedback is essential for the ongoing scrutiny of the quality of services, understanding that people’s confidence in the trust’s improvements will take time to build.

“At SUF, we know from listening to service users that it will be crucial for the trust to address long standing service user and family/parent carer concerns, which include:

  • Care when people are in crisis;
  • Keeping patients safe;
  • Availability of therapeutic interventions; and
  • Safe and compassionate discharge from services.

These must now be key priorities for NSFT’s service improvement”.

Our Partners views

Working with our partners Healthwatch Suffolk and Suffolk family Carers we co-host the Mental Health and Emotional Wellbeing Focus Group with us and Suffolk Family Carers. We are pleased to also share Healthwatch Suffolk’s Statement below which can also be read on their website

Healthwatch Suffolk’s statement:

“CQC’s assessment of the services it investigated this time around are seen as gradually improving. And the regulator also feels the current, and to an extent, new leadership of the Trust is providing a level of stability. It is important to acknowledge that this improvement has been driven by dedicated staff at a difficult time for all NHS services. Naturally, this is to be commended and encouraged.

However, improvement is not noted consistently across all services and CQC has also observed evidence of falling standards in some areas. There remain important issues that must be addressed at pace, and this includes key patient safety concerns regarding ligature points and restraint practices. Such critically important safety matters have sadly featured regularly over several CQC reports.

As a local Healthwatch, it is disappointing that the CQC has not approached us (Healthwatch Suffolk) to make us aware of its plans for re-inspection of the Trust. This includes no offer for us to contribute toward its evidence gathering of people’s experiences. This means that we have been unable to support the outcome of this inspection with evidence gathered from local people using the services, or their family carers.

It is noted that the Trust needs to improve on how evidence of people’s experiences is brought together to identify struggling services at an earlier stage. We therefore invite the Trust to work with us and, other local partners, ever more closely in order to bring people’s experiences to the forefront of its ongoing service improvement. We note that People Participation Leads are employed by the Trust, and whilst they bring valuable knowledge of lived experience to the fore, their perspectives are also those of an employee, feeding back about their employer.

We can work with the Trust both directly, and also through the Mental Health and Emotional Wellbeing Focus Group, which we now co-host together with Suffolk Family Carers and Suffolk User Forum. The group aims to bring people, commissioners and NSFT leaders together, in order to talk about improving mental health support. We hope to see continued meaningful engagement with this group by the NSFT, and evidence of the Trust being responsive to the things people raise about their experiences.

We also see the possibility of the wider health and care system having more of an influence over improvements to standards of mental health support in Suffolk through new mental health collaboratives. They aim to establish a single system focal point for mental health decisions; a place where all partners come together to collectively agree how to invest in services, and how to configure local support. As a key partner involved in this work, we hope to see continued improvement of mental health support in Suffolk.

Norfolk and Suffolk NHS Foundation Trust’s Press Release

The Care Quality Commission (CQC) has recognised the hard work and achievements of all staff across Norfolk and Suffolk NHS Foundation Trust (NSFT) in its latest inspection report which has been published today. The hard work of everyone and the trust’s considerable progress has meant that the trust has been awarded an improved overall rating of ‘requires improvement’.  

Across the CQC domains for the whole trust, it is now rated ‘requires improvement’, with the exception of the Caring domain where its rating remains ‘good’. Looking at individual service ratings, 60% of those services inspected are now ‘good’. And the trust no longer has a legal warning notice relating to concerns about the quality and safety of its care.  

The CQC reported that:

“The trust has moved at pace to make the necessary changes and significant improvements could be seen at all levels of the trust”.   It also described that feedback from patients and service users was largely positive saying they “felt safe and well cared for”, that “staff were supportive of their needs and friendly and approachable”, “staff were kind, they felt listened to and “staff helped them when they needed it” and that “they were fully involved in their care”.  

NSFT’s CEO, Stuart Richardson, welcomed the report and said:

“I am incredibly grateful to staff across the trust for their hard work over the past year to deliver these considerable improvements at a time when health and care services are facing significant and sustained pressure.  

“This report shows just what we can achieve when we work together internally and with our partners across the Norfolk and Waveney and Suffolk health and care systems. These improvements mean we are beginning to provide a better experience for the people using our services and serves as a stepping-stone to get to where we want to be as an organisation – consistently delivering excellent care. We are not complacent and must continue to make improvements at pace so that we can consistently deliver high quality care.”  

Some areas in the trust where there have been notable improvements include Dragonfly  child and adolescent mental health ward, which has achieved a significantly improved overall rating of ‘good’ (previously ‘inadequate’). The acute wards and community-based mental health services which support working-age adults have had positive moves in overall ratings, too. The community-based mental health services for adults of working age also had a pilot programme for cognitive behavioural therapy in Bury St Edmunds recognised by the CQC for outstanding practice.

The report also highlights areas where further improvement is needed.   NSFT’s Chair, Zoë Billingham CBE, said:

“I want to thank staff across NSFT for their hard work and to let our patients and service users, our partners and our wider communities, know that this is just the start.  

“Recognising the trust has struggled to sustain improvements in the past we are taking a different approach to how we improve. We are addressing the root causes of our problems to achieve lasting change and are working more closely with our health and care partners to transform together the way mental health services are provided across Norfolk and Suffolk. We’re doing that with a relentless focus on improving quality, safety and the experiences of the people who use our services and our staff. We are grateful to our Integrated Care System partners in Norfolk and Waveney and Suffolk and North East Essex for their ongoing support and determination to make improvements in mental health services.  

“While we recognise that we still have a lot more work to do, we hope the positive movement in our inspection ratings helps to demonstrate how determined we are at NSFT, working with our partners, to make changes at pace for the people who need us.”  

Howard Tidman, NSFT’s lead governor, said:

“People have worked really hard to bring about this improvement. I am extremely proud of the effort staff have made this past year. The Council of Governors will be pleased about this progress but will continue to constructively challenge the Board to ensure that NSFT consistently achieves high levels of quality and safety. Whilst there is still some way to go, I am convinced that if we can continue the hard work we will be in a position to provide a service we can all be proud of.”  

Jane Ray, CQC deputy director of operations in the east of England, said:

“While the trust has more to do to consistently provide high standards of care and treatment that people have a right to expect, it’s made welcome progress – even at what continues to be a difficult time for the NHS.  

“The trust must now ensure the progress it has made does not slip, and it must apply its commitment to improvement to areas that still don’t meet standards people have a right to expect. It is recognised that the trust will need the support of its system partners, including NHS England and local integrated care boards, to deliver this change.”  

An NHS East of England spokesperson said: 

“The progress made by the trust is encouraging and is testament to the commitment of all involved to improve mental health services for patients in Norfolk and Suffolk. There’s more to do and the trust will continue to receive intensive and targeted help as part of the recovery support programme to make sure improvement is sustained and developed further.”  

Rt Hon Patricia Hewitt, Chair of NHS Norfolk and Waveney, said:

“I welcome the considerable progress Norfolk and Suffolk NHS Foundation Trust (NSFT) has made over the last six months to improve the quality of secondary mental health services available to our residents. I particularly want to thank the staff at NSFT for their hard work and commitment.  

“As the CQC report recognises, over the last year, the new leadership at NSFT has recognised the need to work closely with both the wider Norfolk and Waveney and Suffolk and North East Essex Integrated Care Systems. This has helped strengthen and build upon the excellent work being done across primary care and in the voluntary sector to provide vital support in the community for people who need mental health support.  

“Despite the improvements so far, there is much more to be done to support mental wellbeing and provide high quality mental health services across Norfolk and Waveney. This is one of the highest priorities for NHS Norfolk and Waveney and we will continue to fully support this journey of improvement, working closely with our staff, people and communities to ensure people have the high-quality, mental health services they so rightly deserve.”  

Ed Garratt, Chief Executive of NHS Suffolk and North East Essex Integrated Care Board, said:

“It is promising that the trust has improved its overall rating since the last CQC inspection.  It reflects the hard work and commitment across the trust to providing better quality care.  The challenge now is to sustain these improvements. As a local health and care system, we want our population to experience better quality services now and in the future, and will be working closely with NSFT and other partners to deliver this shared ambition.”  

The charts below show the progress the trust has made in the last year.

Ratings for the whole trustChartDescription automatically generated with medium confidence    
Ratings for individual services