Publish date: 29 May 2025
In June 2024, the Care Quality Commission (CQC) carried out a Well-Led inspection at the Trust. Well-Led inspection takes place every few years and the previous one for AWP was in 2021.
It began with visits to adult acute wards and community mental health services. We received the reports following these service visits a few weeks ago.
They were positive with both areas rated Good overall, reflecting their ‘inclusive cultures’ and the ‘significant improvements’ they had made.
The overall Well-Led inspection then looked at Trust-wide leadership, governance, management, and culture and included interviews with senior leaders, other staff groups, patients, and partners.
This report will be published tomorrow (Thursday, 29th May), nearly 12 months since the inspection took place, and gives us a Well-Led rating of Requires Improvement.
At the time of the inspection the CQC raised specific concerns in relation to safeguarding processes and governance. They also said there were closed cultures in some areas, especially secure services, and that people with lived experience didn’t always feel involved in strategic decision-making.
The inspectors also felt that we had not ensured our Freedom to Speak Up processes were as effective as they could have been, or that racism and discrimination were fully addressed across all service areas.
We are sorry to anyone who had experienced any form of racism or discrimination, if our response to such issues had fallen short, and if the values of EDI had not been role modelled strongly enough. Racism and discrimination, in any form, have no place in AWP.
The CQC also recognised that improvements were being made in these areas, and highlighted examples of good practice.
This included our green plan, our work to reduce agency staff expenditure which improves the consistency of care we provide, and around our understanding of health inequalities and our approach to addressing them.
While disappointed with the overall outcome, we accepted the CQC’s findings.
Our response:
Some of the issues we were able to address immediately, for example improvements to safeguarding processes and the development of additional safeguarding training.
On the other areas identified, we also believe good progress has been made since June 2024. For example:
- Our staff survey results published in March 2025 now show an increase in the number of staff who said the organisation was inclusive and compassionate, and the number of staff who would recommend AWP as a place to work is also now at a 10-year high.
- We have undergone a culture review within secure services which is showing clear signs of improvement.
- Continuing to embed our co-produced Working Together Strategy alongside people with lived experience which is helping further strengthen the role of patients/families/carers in how we design and deliver services.
- We held an Equality Diversity and Inclusion (EDI) Board summit, supported by our EDI staff network leads to discuss and reflect on the issues raised during the inspection.
- We have board level EDI pledges and objectives in place, and we continue to have EDI reciprocal mentoring for senior leaders.
- And we are now implementing the national Patient and Carer Race Equality Framework (PCREF) to reduce health inequalities that people from black, brown, and other minority ethnic communities experience.
Dominic Hardisty, AWP Chief Executive, said:
“Whilst disappointed with the outcome of the Well-Led inspection, we are pleased to have been rated Good in our adult community services and adult wards, which is a tribute to the hard work of our staff.
“This demonstrates a commitment to, and track record of progress, and over the last year we implemented a range of additional improvements in those areas identified by CQC to further enhance the experience for our patients, staff and stakeholders.”
AWP provides specialist mental health, learning disabilities and autism services across Bristol, North Somerset, South Gloucestershire and in Bath, Swindon and Wiltshire.
NHS Bristol, North Somerset and South Gloucestershire Integrated Care Board (BNSSG ICB) and NHS Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board (BSW ICB) are responsible for the day-to-day running of the NHS in our local area.
Shane Devlin, Chief Executive Officer of BNSSG ICB said:
“We acknowledge the findings of the CQC’s Well-Led inspection and recognise that further improvement is needed.
“We are assured by the progress AWP has already started to make and are committed, as system partners, to supporting its leadership team in driving continued improvements.
“Through close collaboration and a shared focus on quality and accountability, we will work together to ensure the Trust is Well-Led and delivering safe, high-quality care for all.”
Sue Harriman, Chief Executive Officer of BSW ICB said:
“It is vitally important that all our local health and care providers have a strong leadership structure in place, and one that promotes a culture of openness and inclusion so that all NHS staff can come to work in a safe and supportive environment.
“We have a close working relationship with our colleagues at AWP and are encouraged by the improvements that have already been made since the time of the CQC’s visit, and we will continue to support them to continue with this progress over the coming weeks and months.”
