Culture of Care is one of the largest quality improvement projects ever undertaken by NHS England, a national project that started in 2024. The project is built around 12 co-produced standards of care to improve patient experiences and outcomes and those of the staff that work alongside our patients. As well as the 12 standards, it is also built on three pillars, those being, Anti Racism, Trauma Informed and Autism Aware.

Culture of Care standards

Vision: People to be consistently able to access a choice of therapeutic support, and to be and feel safe. All care is trauma informed, autism informed and culturally competent.

The 12 Culture of Care standards as a building with each room representing a different standard. Lived Experience - We value lived experience Safety - People feel safe and cared for Relationships - High quality and trusting Staff Support - Present alongside distress Equality - We are inclusive, value difference and promote equity Avoiding harm - Actively avoid harm and traumatisation Needs Led - We respect people's own understandings Choice - Nothing about me without me Environment - Spaces reflect the value we place on our people Things to do - Requested activities everyday Therapeutic support - We offer a range of therapy Transparency - We have open and honest conversations

What is a Culture of Care

A Culture of Care put simply is one that feels like care is at the centre of it – that patients and staff feel cared for and are able to provide the care they want to for others.

In 2023, NHS England convened a group with strong representation from the sector, lived experience leadership and involvement, and people who experience inequality in accessing and using mental health services, to develop a set of Culture of Care standards that describe in detail what this means.

These 76 standards, across 12 core commitments, form the bedrock of the programme and underpin all of our design and delivery. The core commitments are:

1.      Lived experience We value lived experience, including in paid roles, at all levels – design, delivery, governance and oversight.
2.      Safety People on our wards feel safe and cared for.
3.      Relationships High-quality, rights-based care starts with trusting relationships and the understanding that connecting with people is how we help everyone feel safe.
4.      Staff support We support all staff so they can be present alongside people in their distress.
5.      Equality We are inclusive and value difference. We take action to promote equity in access, treatment and outcomes.
6.      Avoiding harm We actively seek to avoid harm and traumatisation, and acknowledge harm when it occurs.
7.      Needs based We respect people’s own understanding of their distress.
8.      Choice Nothing about me without me. We support the fundamental right for patients and (as appropriate) their support network to be engaged in all aspects of their care.
9.      Environment Our inpatient spaces reflect the value we place on our people.
10.   Things to do on the ward We have a wide range of patient requested activities every day.
11.   Therapeutic support We offer people a range of therapy and support to give them hope that things can get better.
12.   Transparency We have open and honest conversations with patients and each other, and name the difficult things.

The Culture of Care Programme is part of NHS England’s Quality Transformation Programme.

This programme aims to improve the culture of inpatient mental health, learning disability and autism wards for patients and staff so that they are safe, therapeutic and equitable places to be cared for, and fulfilling places to work.

Full and authentic co-production:

To establish genuine partnerships where lived experience leaders work alongside ward staff as equal partners.

Organisation-wide support and integration:

The programme’s success depends on active support from all parts of the organisation, not just the frontline.

A focus on addressing health inequities:

This programme must drive tangible cultural change on the wards to address the inequities people often experience in inpatient care.

Shared learning and training:

Build staff capacity and capability in being trauma informed, autism informed anti racism. Improve staff, service user and family experience.

External engagement and shared learning:

We should actively contribute to the national conversation, sharing our progress and learning from others

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