"This must not be Groundhog Day again."

That is the message from campaigners after the region's troubled mental health trust was lifted from special measures for the third time in less than a decade.

Following its latest Care Quality Commission inspection, the Norfolk and Suffolk NHS Foundation Trust has been upgraded from inadequate to requires improvement.

It comes a year after a damning report highlighted more than 100 things the trust had to do to avoid closure.

Bosses say the improvements are a testament to a year of hard work from its 5,000-strong staff force and insist the trust will not be resting on its laurels.

But campaigners and bereaved families say they remain sceptical about whether history will repeat itself.

Eastern Daily Press: Members of the Campaign to Save Mental Health Services in Norfolk and SuffolkMembers of the Campaign to Save Mental Health Services in Norfolk and Suffolk (Image: Newsquest)

A spokesman for the Campaign to Save Mental Health Services in Norfolk and Suffolk said: "We have been here before.

"Special measures lead to the CQC saying things are better but people keep dying, sometimes due to appalling lapses in care.

"Once the scrutiny is off NSFT they revert to unsafe practice.

"This has happened before - it can not be Groundhog Day again."

Stuart Richardson, NSFT's chief executive, said he understood these fears, but has insisted this time will be different.

He said: "I honestly believe we have done things differently. We have not simply worked through a list of tasks - we have looked for the root causes of our issues.

"We have focussed hard on getting our house in order and now we are thinking about how we can make sure people who come into hospitals spent the shortest space of time possible and get the care they need."

Mr Richardson said he was pleased inspectors had recognised improvements in the trust's culture, an issue that has hampered its progress in the past.

He added: "The amount of work we've put into improving our culture has been clear and we've been focussing on giving people the chance to voice their concerns and use them to drive improvement."

Eastern Daily Press: Zoe Billingham, chair of NSFT. Picture: NSFTZoe Billingham, chair of NSFT. Picture: NSFT (Image: Geoff Pugh Photography Limited)

Zoe Billingham, the trust's chairman, added: "We have been in this position in the past but we have taken a very different approach.

"While we recognise we still have a lot more work to do, we hope the positive movement in our inspection ratings helps to demonstrate how determined we are at NSFT, working with our partners, to make changes at pace for the people who need us."

While the CQC improve the trust's rating however, more progress was needed.

The inspection highlighted that some ligature points flagged up a year ago had yet to be repaired - and that some wards still did not have sufficient staff to function safely.

Jane Ray, deputy director of operations at the CQC, said: "Although our previous inspection found the trust's care was very poor, we noted it had a more stable leadership team and board with the potential to drive improvement.

"This team needed time for its approach to deliver results and our latest inspection found improvements had been delivered at pace.

"However, the trust hasn't shown improvement in all areas and there were some aspects of its care where quality and safety had deteriorated.

"This includes a few acute mental health wards and its wards for older people, where there continued to be ligature points - despite us previously telling the trust it needed to address these. However, there were plans for them to be removed.

"The trust must now ensure the progress it has made does not slip and it must apply its commitment to improvements to areas that still don't meet standards people have a right to expect."