Board in Brief

Board in Brief – October 2025

Reflections from Chair, Phil Gayle

Over the last few months, we’ve been sharing this Board in Brief which is designed to give you a snapshot of the most important topics discussed at Trust Board.

Over the coming months each Board in Brief will be presented by different members of our Board, giving them the opportunity to share their thoughts on the meeting and a summary of some of the topics discussed.

October’s Board in Brief is brought to you by our Trust Chair, Phil Gayle.

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“At each Board meeting, we start with a patient or staff story which really sets the tone to each session. It’s an excellent way of reminding us why we’re here and helping us to focus on the things that matter most to our patients, service users and staff.

October’s meeting began by welcoming some of our Children and Young People division (CYP) colleagues who shared their experiences of transferring staff and services into BSMHFT. They highlighted a smooth and compassionate integration, strong support from HR and ICT and a sense of inclusivity and engagement.

While staff and patients have seen minimal disruption, the Board acknowledged some challenges with ICT integration and pharmacy delays. Moving forward we remain committed to addressing feedback raised in relation to estates and environmental safety, to ensure CYP teams feel fully supported and able to deliver optimal services.

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Reflections
It was promising to hear that the Trust continues to drive culture change and embed the Culture of Care across inpatient wards, with positive impacts on staff morale and wellbeing. Despite ongoing national pressures for greater financial discipline, the Board remains committed to supporting staff and maintaining high standards of care.

Those who came to the AGM in September will know what a wonderful event it was. As well as the stalls, powerful service user stories and the formal part of the annual event, we also celebrated the next stage in the development of the new Trust Strategy, sparking enthusiasm for the future.

I’m pleased that Governance remains robust across BSMHFT, with productive Council of Governors meetings and ongoing service visits by Non-Executive Directors and Governors to ensure frontline voices shape decision-making. I personally love the visits, meeting staff and really getting to the roots of the care we provide across all of our services.

Outside of Team BSMHFT, we are actively engaged with regional partners and stakeholders, aligning efforts with the NHS 10-Year Plan and Oversight Framework to ensure long-term sustainability and quality improvement.

Key updates from across the Trust

Culture of Care is now rolled out across all secure hospitals and launched in acute care, with further expansion planned for older adults and specialties. Early results show improved staff morale, leadership and patient experience.

CQC Well-Led Preparation – there’s ongoing work to address feedback from previous inspections, focusing on care plans, risk assessments, workforce, and governance.

Staff Survey 2025
Launching with expanded participation, including the Children and Young People (CYP) division. Feedback from last year has already led to new leadership programmes and improvements in over 120 teams.

Recovery College is entering a period of reflection ahead of its 10th anniversary, with all learning sessions paused to gather feedback and shape future direction.

National Oversight Framework
The Trust is in segmentation 4 (‘low performing’) and remains focused on improvement plans for key metrics, including length of stay, staff survey scores, and financial performance.

Key developments by division

ICCR
ICCR has made progress on action plans from the Nottingham inquiry, including caseload reviews, improved diagnostic pathways and better next of kin data, while piloting DBT (Dialectical Behaviour Therapy) skills groups and managing increased referrals and staff sickness with targeted interventions. Assertive Outreach Teams have improved patient flow and Specialist Psychotherapies are piloting improved access and supervision pathways.

Primary Care, Dementia & Specialties
The Deaf Service is delivering digital transformation projects and introducing new mandatory training, while the Mother & Baby Unit now offers outreach seven days a week (8am–9pm) with new perinatal support projects. The Dementia & Frailty team has secured three-year funding to address health inequalities and is recruiting new apprenticeship roles.

Children and Young People (CYP)
The division is ahead of national access targets, with zero 52-week breaches, RTT (Referral to Treatment) performance at 83% and no out-of-area CAMHS or PICU admissions for three months, while spot purchase bed use is significantly down. Recruitment and agency-to-bank conversion are positive, but gaps remain in medical and psychology roles.

Secure and Offender Health
Renovations and recruitment are ongoing across Secure and Offender Health, with Reaside progressing on bathroom upgrades and alarm systems and Tamarind seeing improved staffing, positive Culture of Care feedback and continued safer staffing meetings.

Acute and Urgent Care
The Winter Plan prioritises proactive planning, workforce resilience and real-time capacity monitoring, with improved patient flow leading to reductions in out-of-area placements and length of stay. The Culture of Care programme has launched with positive early engagement.

Finance and planning
The Trust is reporting a year-to-date deficit of £1.9m, with a financial recovery plan in place that relies on reducing temporary staffing and non-Trust bed use. Savings delivery is behind target and ongoing financial pressures remain, particularly from the Children and Young People (CYP) division and provider collaboratives. Inappropriate and appropriate out of area placements remain key priorities for action.

Digital and innovation
The Trust is developing digital dashboards to improve data quality and provide real-time assurance from ward to board, while also enhancing e-rostering to support safer staffing and reduce reliance on bank and agency staff.

Other key updates

Winter Planning
Proactive measures in place to ensure service continuity and patient safety during seasonal pressures, including new Recovery House beds and expanded community support.

Quality and Safety
Focus on reducing restrictive practices, improving safeguarding and embedding learning from incidents and complaints. Data quality and compliance with training remain areas for improvement.

People
Sickness absence has increased to 5.7%, appraisal compliance is at 81.8% and there’s lots of ongoing work to address stress, anxiety and discrimination. The apprenticeship levy underspend is also being addressed.

Board Assurance Framework
Also included in the Board papers is the Board Assurance Framework – a concise overview of the Trust’s main risks and how they’re being managed across People, Quality, Clinical Services, and Sustainability. This tool helps the Board ensure risks are identified and addressed, supporting better decisions, compliance, and continuous improvement, so the Trust stays accountable and responsive to new challenges.

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Board Reflections

As is tradition, October’s Board concluded with a Board member’s reflections on our Trust Values.

Deputy Chief Executive, Patrick, shared his experience of judging September’s Team of the Month, highlighting examples of compassion and dedication across our services. He spoke about his visit to Shenley Fields, where the staff’s kindness shone through, and praised the Central Assertive Outreach team for their sensitive work in helping a service user reconnect with family and remain in their home following a physical health diagnosis.

He also reflected on the Ladywood Home Treatment team, whose holistic approach to care includes thoughtful gestures – such as caring for a patient’s dog to provide reassurance and help them engage with treatment.

These stories remind us of the extraordinary commitment of our teams and the real impact of living our Trust Values every day.”

Best wishes

Phil

Birmingham and Solihull Mental Health NHS Foundation Trust

Welcome to the August edition of Board in Brief, providing an overview of the key discussions, decisions, and reflections from the Trust Board meeting held on 6 August 2025 at the Uffculme Centre. The key themes of this month’s meeting were strategic resilience, operational assurance, and staff engagement.

Service User/Carer Story

As always, the Board opened with a service user or carer’s story. This month a carer shared their personal experience of supporting a loved one in care, which highlighted the ongoing need for consistent multidisciplinary team working and the importance of the ‘Think Family’ approach. Their story underscored the value of involving families and carers as active partners in care decisions. These insights are now being used to inform broader organisational learning and shape future practices.

Chair’s Reflections – Phil Gayle

The Chair opened the meeting by acknowledging the continued dedication of staff across the Trust, particularly those working in inpatient and urgent care settings. shared insights from recent service visits to the Tamarind and Zinnia Centres, where he observed firsthand the compassionate care being delivered and the challenges faced by frontline teams

Phil also reflected on his participation in NHS England’s strategic briefing for Chairs and Chief Executives, where the emphasis was on productivity, efficiency, and maintaining public confidence amid financial constraints. The Board was reminded of its collective responsibility to support staff through change while safeguarding service quality.

Chief Executive and Director of Operations Joint Report – Roísìn Fallon-Williams and Vanessa Devlin

The joint report from the Chief Executive and Executive Director of Operations provided a detailed overview of system-wide pressures, operational performance, and workforce priorities. Key highlights included:

• Recovery Services: Continued progress in enhancing recovery pathways, with a focus on community integration and reducing out-of-area placements. The Trust is working closely with partners to ensure seamless transitions and sustained support for service users
• Workforce Stability: Substantive staffing levels have improved, contributing to better continuity of care and reduced reliance on temporary staff. Recruitment efforts are ongoing, with a focus on retention and wellbeing
• Culture of Care: The Trust-wide rollout of the Culture of Care programme is underway, aiming to foster therapeutic environments and support staff wellbeing. Early feedback from pilot sites has been positive, with staff reporting increased morale and engagement .
• CQC Updates: Reaside Clinic’s Section 29A notice was lifted following sustained improvements. We are awaiting the draft report on CQC follow up inspections including other acute wards in the north.
• Challenges and Learning: The report acknowledged ongoing challenges in areas such as self-harm reduction and internal communications. New deep dives and learning initiatives are being introduced to address these issues and promote continuous improvement.

Quality and Safety

The Board noted findings of recent CQC inspections, and acknowledged improvements in staff culture and patient care, especially at George Ward and the Zinnia Centre. They also noted ongoing risks in acute wards, including staff behaviour and care planning.

The Culture of Care Programme is being rolled out Trust-wide, with positive impacts on recruitment and retention. Incident reporting remains stable, with reductions in self-harm and assaults. Complaints are at a 24-month high, mainly about ADHD services, but response times are improving. The Trust continues to focus on learning, safety, and patient experience.

Committee Updates

The Audit Committee presented assurance on the Board Assurance Framework and Corporate Risk Register, confirming that documented controls are functioning effectively. Internal audit reviews on cyber resilience and clinical coding were noted, alongside positive compliance findings on declarations of interest and Fit and Proper Persons requirements. The Finance, Performance and Productivity Committee reported on improved patient flow and access metrics, particularly in community mental health pathways. The People Committee shared insights from the Staff Survey and Listen Up Live sessions, highlighting areas of strength and opportunities for growth.

Staff Experience and Engagement

The Staff Survey showed improvements in morale and the number of staff recommending the Trust as a place to work. However, areas needing attention include bullying and discrimination from the public and internal communication from senior leaders. The Board reaffirmed its commitment to acting on staff feedback and approved a refreshed People Strategy to be launched in Q4.

Looking Ahead – Annual General Meeting

Preparations are underway for the Trust’s Annual General Meeting on 23 September. This year’s event will be held at the Uffculme Centre and is designed to be vibrant, inclusive, and celebratory. The decision not to hire a production team represents a significant cost saving, with resources reallocated to support engagement activities.

British Sign Language interpreters will be provided to ensure accessibility, and the venue’s AV capabilities will be utilised to meet technical needs without external support.

Governance and Assurance

The Board reaffirmed its commitment to agile governance, with Chairs of each committee presenting assurance reports that captured both progress and areas requiring further attention. The importance of maintaining a dynamic approach to risk and assurance was emphasised, particularly in light of evolving external pressures and regulatory expectations.