Improvement Plan

Working together for outstanding care

We know that the people who work with us in Herefordshire & Worcestershire Health and Care NHS Trust are the key to providing the very highest quality community and mental health care possible, with and for the population of Herefordshire and Worcestershire. We are focused on ensuring that Herefordshire and Worcestershire Health and Care NHS Trust is a fantastic place to work.We want to achieve a kinder, more just, and racially inclusive culture which is embedded into every part of working life in our organisation. We want everyone within the organisation to feel empowered to learn and to develop their service, to ensure we are continually improving peoples’ experience of care and listening to their feedback.

Following feedback from our colleagues and CQC, we have heard that we aren’t always getting that quite right, so we are undertaking an exciting and innovative programme of work to make some changes.

We are committed to creating an environment where everyone counts, we work together and take responsibility.  We must be inclusive, just and fair to make things better.


Throughout September and October 2023, the Trust conducted an extensive engagement exercise aimed at understanding staff’s experience of working in the organisation. Over 600 staff were involved in providing feedback which has been used to develop an Organisational Improvement Plan, delivered through six executive-led workstreams:

•     Cultural development and Equality Diversity Inclusion and Equity (EDIE)

•     Systems, Processes and Structures

•     Regulatory standards

•     Communications and embedding priorities in the organisational planning process

•     Risk management

•     Corporate services

Through delivery of the six workstreams we intend to create the environment where a compassionate, just and learning culture is able to develop. All workstreams are interconnected and interdependent.

Cultural Development and Equality Diversity Inclusion and Equity (EDIE)

The purpose of this workstream is to ensure we hear the voice of our staff, create the environment where a compassionate, just and learning culture compassionate and inclusive culture can develop, and ensure those who wish to speak up can, in the knowledge that they will be safe and their concerns will be taken seriously, with relevant actions taken. This is underpinned by putting in policies, training, and support to ensure our workforce is diverse, valued, and accurately represented.

We are working in partnership with A Kind Life to deliver in the process of launching a cultural change program. The program is based upon feedback from our staff about how they want their experience of work to be. You can find out more about this program, including some introductory videos by clicking here.

There is also supported by a new EDIE strategy, Freedom to Speak Up action plan, changes to HR policies appointment of a cultural change partner, and focused board and leadership development sessions to support the creation of the environment and the culture staff have said they want to develop.

Systems, processes and structures

The purpose of this workstream is to ensure the systems, processes and structures are simple, consistent and enable decision making as close to the frontline as possible. We are developing a leadership model which is clinically led and operationally enabled. Our governance and infrastructure throughout all Service Delivery Units and corporate services is being reshaped to ensure consistency and transparency of decision making as close to the front line as possible.

Regulatory Standards

The purpose of this workstream is to ensure delivery against regulatory standards is embedded and clearly evidencable throughout the organisation. Teams across both operational and corporate services will work to recognised accreditation opportunities, taking ownership of improvement at a local level.

Communication and embedding priorities in the organisational planning process.

The purpose of this workstream is to ensure the improvement plan journey is communicated effectively, with two-way communication supporting ongoing development. Secondly this workstream will ensure the core plan is embedded in the annual organisational planning cycle and the within the Trust strategy which is being refreshed in 2024.

Risk Management

The purpose of this workstream is to ensure risk management processes are effective, with management of risks at the right level and board having visibility of the most significant organisational risks.  We are working with the Good Governance (GGI) Institute to support this work.

Corporate Services

This workstream has been established to ensure the expertise of individual services is recognised and effectively deployed to best support clinical and operational services. We are working to provide joined up information to services as well as throughout the levels of organisational governance. We will use innovation and technology to make this work as efficient as possible.

What does success look like?

This programme is ultimately about improving how it feels to work in Herefordshire & Worcestershire Health & Care NHS Trust, enabling them to deliver the highest quality of care they can.  We will know if we are successful through feedback from staff, patients and carers telling us we are improving and when we are getting it right.  This will be monitored through the staff survey, our trust PULSE survey and patient and carer feedback independently collected by Healthwatch Herefordshire and Healthwatch Worcestershire as well as feedback provided directly to our teams.

If you would like further information please contact Scott Parker, Director of Improvement on