National Culture of Care: Staff Care and Development Programme
As part of NHS England's Culture of Care programme, The PSC worked with partners IGA, VMI, Imroc and InHealth to deliver the Staff Care & Development strand, supporting 173 inpatient mental health wards in England to co-produce locally-led culture change.
Mental health services are, in many senses, the people who deliver them. When staff feel cared for, safe, valued and able to grow, they build better therapeutic relationships and support recovery. Yet staff working on inpatient wards can face persistent pressures: staff shortages, high turnover, hierarchical dynamics, traumatic incidents, racism, and disconnection from senior leadership. These directly undermine care quality and staff experience.
From September 2024 to March 2026, we supported 173 wards across NHS and independent providers, working with staff to develop team cultures and systems that help everyone on the ward feel safe, supported and cared for.
The Approach
Our methodology was co-produced and co-delivered with experts by experience. Rather than performance-managing culture from the top down, we aimed to back locally-led change within wards, supported by executive sponsorship. The defining elements were:
- Lived experience throughout. All coaching was delivered in partnership with a coach with lived experience, lived experience was built into programme leadership, and coaching encouraged wards to seek input from service users to shape culture improvement.
- A relational approach. Wards got to know their Culture of Care: Staff Care and Development team and built relationships with their coaches, which developed trust and confidence in the process.
- Individual coaching for frontline staff. Coaching is more usually reserved for senior staff. Offering 1:1 coaching for frontline teams at any level unlocked agency to deliver change.
- No imposed performance measures. Wards defined for themselves what good looked like and a realistic plan for change.
The support included reflective practice facilitation training and supervision, team coaching to plan and deliver a culture improvement project, training workshops, individual coaching, and communities of practice.
The Impact
The programme strengthened teams' confidence and capability to change their own culture and helped them turn ideas into lasting change on the ward.
Staff feel more confident designing and delivering culture improvement.
- Staff confidence to design and deliver improvement projects rose from 63% to 92%.
Staff feel they have the skills to improve their ward culture from within.
- Staff confidence that they had the skills to improve ward culture from within rose from 75% to 96%.
Staff feel more confident meaningfully involving people with lived experience.
- Staff confidence in meaningfully involving people with lived experience rose from 69% to 93%, supporting more co-produced, patient-centred care.
Teams moved from ideas to action.
- By the end of the programme, 48% of co-produced culture improvement projects had reached implementation and 12% were embedded into daily ward routines. Consistent implementation is hard, so this was a significant achievement.
Wards saw real-world improvements in wellbeing and safety.
- One ward co-produced an enhanced wellbeing offer, including a wellbeing board, champions, a peer support system and daily check-ins, and saw improved morale, retention and attendance as a result.
- Another ward introduced weekly Culture of Care Days, where staff and service users take part in activities together off the ward, and recorded fewer incidents, fewer sick days and improved retention. See our final programme report executive summary for details of lots more impactful real-world improvements achieved by individual wards.
The programme reached wards at national scale.
- We delivered 767 hours of team coaching and 321 individual coaching sessions across 173 wards in 58 organisations, alongside 558 workshop places and more than 240 people engaged in peer learning through six communities of practice.
Feedback
The PSC Factor
The PSC's expertise in supporting locally-led, centrally-supported quality improvement, our extensive experience of working with mental health services, and our established connections with mental health trusts across the country gave us a strong foundation for the delivery of this large-scale national programme. We worked in close partnership with IGA, VMI, Imroc and InHealth, convening our partners’ specialist strengths in reflective practice, coaching and lived experience to deliver a rounded offer to ward teams.
Keeping the voices of people with lived experience at the heart of the work was central to our approach. All coaching was delivered in partnership with a coach with lived experience, and lived experience was built into programme leadership. This builds on our wider efforts to embed lived experience involvement across our work, including our delivery of the National Mental Health Act Quality Improvement Programme.
Above all, our relational and supportive approach, rather than top-down performance management, gave frontline teams the agency and confidence to lead change themselves, which is what makes that change last.
Ready to improve cultures of care?
Staff care and development should be treated as core safety and productivity infrastructure, not an optional wellbeing offer. A conversation with our team can help you identify where to start, which wards to prioritise, and how to turn this learning into a practical next step. We work with trusts to design and deliver staff care programmes that are locally-led, evidence-based, and built to last. For more information, read our white paper on improving cultures of care to transform productivity and safety.
Get in touch with Harris Lorie for a conversation.