The struggling mental health trust for Norfolk and Suffolk remains in special measures – despite a watchdog lifting it from the lowest possible rating of ‘inadequate’ to ‘requires improvement’ in a new inspection report.

Care Quality Commission experts, who visited the Norfolk and Suffolk Foundation Trust (NSFT) late last year, felt some improvements had been made - noting a shift in culture, and a "step in the right direction".

However, they are still keeping it under review - and feel "more work needs to be done".

Children and adolescent mental health services (CAMHS) and learning disability inpatient services in Suffolk were considered poor, with long waiting lists remaining - prompting parents and carers to pen a letter to the health secretary, West Suffolk MP Matt Hancock.

MORE: 'Still more work to do' - health secretary speaks over 'special measures' NHS trust in back yard

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Norfolk's crisis teams were found to be struggling to hit four-hour emergency targets, and evidence of bullying was flagged in one team in Norwich.

Yet some areas of 'outstanding' practice were identified, and staff were given glowing praise for showing kindness and caring attitudes towards patients.

NSFT chief executive Jonathan Warren, who took up post in April last year, said: "This is a move in the right direction and is down to the hard work and dedication of staff.

"However, we are under no illusions and recognise that the next 12 months and beyond are crucial in not only fully embedding changes already made, but in building upon them so that next time we are inspected, we have shown further significant improvement."

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Key findings from this new report, covering an inspection from October to November 2019, included:

- Waiting lists remained high in the specialist children and young people community mental health teams. Staffing was also a concern

- The environment in the learning disability inpatient service was not safe or fit for purpose. The trust had made little attempt to remove or reduce the number of ligature points or improve lines of sight

- Pockets of low morale were identified in Suffolk, at inpatient wards and some community services in Bury St Edmunds, learning disability inpatient services and CAMHS in Suffolk, with evidence of bullying in one team in Norwich

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- In August 2019, in Norfolk crisis teams, there were 34 occasions here staff hadn't been able to access patients within the four-hour emergency target due to staffing levels


- More staff reported a sense of optimism and hope that real change was happening

- Seclusion and restrictive interventions in acute wards had reduced, an area which inspectors praised as 'outstanding'

%image(14550243, type="article-full", alt="Former health minister Dr Dan Poulter, a mental health doctor himself, said he was "cautiously optimistic" about the NSFT's future Picture: DENISE BRADLEY")

- Most of the premises was clean, well-equipped, well-furnished and 'well-maintained', with the notable exception of the learning disability service

- Staff showed caring attitudes towards patients. Inspectors saw numerous positive interactions between staff and patients. They were respectful and kind.

Chief Inspector of Hospitals, Professor Ted Baker, said: "On our return to the NSFT we found improvements had been made in several areas - but more work still needs to be done. At this inspection, we found that, although some of the concerns had not fully been addressed, there had been a shift in approach and foundations had been laid to improve the direction of travel."

'We're still stuck in Groundhog Day of failing mental health services' - MP

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Reaction to the trust's latest result has been mixed. Dr Dan Poulter, MP for Central Suffolk and north Ipswich, said he was "cautiously optimistic" about the NSFT's future, adding that attention now needs to turn to CAMHS and learning disability services.

Labour's Clive Lewis, MP for Norwich South, said until changes are made, "we'll be stuck in this tragic Groundhog Day of failing mental health services".

He added: "For almost a decade now, distressed mental health staff and their union, service users and loved ones have been telling me it's too hard to get treatment, there aren't enough staff or beds at the mental health trust and too many people are dying.

"They, like me, will be looking at this report and thinking 'is that it?'

"Seven years since the alarm was first raised about local mental health services and all that's happened is that we've gone from failing badly and in special measures to failing not quite so badly and still in special measures."

Those at the Campaign for Better Mental Health Services in Norfolk and Suffolk were also perplexed by the new rating.

"It's hard to understand how the CQC thinks they are improving," a spokesman said.

"The only time we have seen real change is when MPs have become involved. The solution is not to pretend everything is okay. There has to be less funerals."