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.

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.

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.

Read more to receive further information regarding a career in psychiatry