Leaders lacked 'shared vision' to drive forward change, CQC finds

Leaders at Nottinghamshire Healthcare NHS Foundation Trust lacked 'a shared vision or strategy to consistently drive forward effective change’, the CQC has found.

Ifti Majid (c) Nottinghamshire Healthcare NHS Foundation Trust

Ifti Majid (c) Nottinghamshire Healthcare NHS Foundation Trust

The trust was again rated requires improvement for well-led in September. The report followed 39 inspections between May 2024 and August 2025 as part of the formal review commissioned by health and social care secretary into the attack carried out by Valdo Calocane in June 2023.

While people were generally positive about the care and treatment they received,  some had more negative experiences of staff who weren't compassionate or professional. They also highlighted issues accessing mental health services and long waiting times, and didn't feel involved in decisions about their care.

In addition, the CQC said leaders had not been proactive in making significant improvements and removing shared living, dormitory style accommodation. The trust was told to take immediate action to remove this accommodation and prioritise improving the estate and environments across its services.

The trust was asked to submit an action plan that addresses how they will embed and make progress on its shared vision and strategy, a strategic culture to deliver workforce equality and diversity, and the Patient and Care Race Equality Framework (PCREF).

Ifti Majid, chief executive, Nottinghamshire Healthcare, said: ‘We are committed to providing high quality, effective and safe care to those people who need it most. External inspections are an important way of helping us learn and to make the improvements that are needed. 

‘We accept the CQC's findings and recognise where improvement is needed. We have already made significant improvements since the CQC's last inspection but fully appreciate there is still more to do. We will be addressing all areas identified in the report.'

The trust said the inspection had taken place while it was under statutory enforcement and required to prioritise a mandated Integrated Improvement Plan. Since then, a board development programme had been implemented, a clearer accountability framework approved (July 2025), executive portfolios strengthened and a new chair recruited.

Staff culture and engagement concerns were being addressed through continued Big Conversations, strengthened leadership visibility, compassionate and just-culture programmes, expanded Freedom to Speak Up activity, enhanced recognition and wellbeing support, and targeted local culture interventions where survey results were weakest, the trust said.

On the continued use of dormitory style accommodation, the trust said a lead director has been appointed to manage capital delivery, funding remained ring-fenced and a full planning submission for dormitory eradication was scheduled for March 2026 with completion targeted for March 2027, subject to national capital approval.

The trust added governance, advocacy and multidisciplinary oversight of long-term segregation had been strengthened, with formal design and capital planning underway to improve environments.

 

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