Design of the programme

This programme is based on four key interventions that aims to support wards to provide safe, trauma informed, therapeutic and equity-focused care.

Our approach is trauma-informed, autism-informed and based on anti-racism. Watch these videos to find out more about our approach.

Underpinning everything is our commitment to lived experience leadership, co-production and collaboration.

The programme design, delivery and leadership is a collaboration between people who bring lived and professional experience, or both. For example, half of our programme leadership team bring lived experience. Read more about this.

Culture of care programme overview

 

There are four elements to our programme delivery:

Over 200 wards, across every provider of NHS-funded mental health inpatient care in England are receiving quality improvement coaching for 2 years, aiming to provide a Culture of Care.

Each ward is working with their QI coach to test and implement changes to the way that they work. The wards (including people with lived experience) have ownership of the changes that they make, but they are based on our co-produced change theory, which is itself based on NHS England’s Culture of Care standards.

Milestones timeline

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The middle tier of organisations can make improvement work on wards easier or harder. We will be working with a team in each organisation to help them to make the work the wards are doing easier, using a QI approach.

Each organisation will focus this where it will be of most benefit for them, but we have co-produced a change theory with the aim that wards can make improvements to their Culture of care and are supported by the organisation to do so.

Across England, 103 executives will be coached by our leadership coaches on this programme. 

Each organisation has been allocated a coach who brings lived experience (employed by either Neurodiverse Connection or Black Thrive Global) and a coach who brings Board-level leadership and improvement experience. Some of our coaches bring both.

Coaching will be focused on the supporting wards to improve their culture, and to spread the learning throughout the organisation.

Working change theory

We know from years of evidence and in clinical guidelines that risk assessment tools do not work to accurately predict risk to self, and yet they are used for that purpose, and to make decisions about what care is provided.

The reasons risk assessment tools are still used in this way is complex and systemic, and moving to a personalised approach to risk is difficult.

In year one of the programme we will provide close support to ten organisations to change their approach to risk, and in year two we will spread that learning across every organisation. Support will be led by our partners at National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH).

Some organisations have made great progress in doing this in recent years, and we will help to share their learning. The first step in that is that we have co-produced with them a change theory to guide this element of the programme.

Year 1 cohort

  1. Birmingham and Solihull Mental Health Foundation Trust
  2. Central and North West London NHS Foundation Trust
  3. Cheshire & Wirral Partnership NHS Foundation Trust
  4. Coventry and Warwickshire NHS Partnership Trust 
  5. Dorset HealthCare University NHS Foundation Trust
  6. Gloucestershire Health and Care NHS Foundation Trust
  7. Leeds and York Partnership Foundation Trust
  8. Norfolk and Suffolk NHS Foundation Trust
  9. Sheffield Health and Social Care
  10. South London and Maudsley Foundation Trust

Our approaches

Nav Kapur, Professor of Psychiatry and Population Health (University of Manchester), explains why we should move away from risk categories and risk scores.

Shirley McNicholas, a trauma-informed advisor, explains her understanding of a trauma-informed approach.

Jacqui Dyer MBE, Director of Black Thrive Global, explains why it is important this programme takes an approach based on anti-racism.

The team at Neurodiverse Connection outline why an autism-informed approach to mental health care is needed, what it looks like and the positive impact it has on accessibility and outcomes for autistic individuals.

This video series explores what coproduction and lived experience mean, the challenges of working in this way and what good looks like. They were filmed by a range of colleagues with lived experience who are part of the culture of care work.

What is co-production? What is lived experience leadership?

Mark and Jo discuss the importance of co-production and lived experience leadership.

Watch the full video on YouTube

Why is it important to involve people with lived experience? What difference does it make?

Antonia, Mark, Lucy, Grace and Jill discuss the importance of involving people with lived experience and the difference it makes.

What are the barriers to coproducing well?

Jo, Antonia, Mark and Grace discuss the barriers to co-producing well.

Watch the full video on YouTube

What is the vision for lived experience within wards or trusts?

Mark and Molly discuss their visions for lived experience within wards and organisations.

Watch the full video on YouTube

How do you feel coproduction and lived experience help the equity agenda and support mental health services for ALL?

Jo and Mark discussed how co-production and lived experience help the equity agenda and support mental health services for all.

What is your best example of being involved in coproduction? What did it feel like? How did it change the outcomes?

Mark and Sal provide their best examples of being involved in co-production.

Watch the full video on YouTube

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