Leadership improves at ‘toxic’ trust

One of England’s largest trusts previously criticised for its “toxic” environment has made significant improvements to its culture, inspectors have said.

The Care Quality Commission updated its well-led rating for University Hospitals Birmingham Foundation Trust from “inadequate” to “good” following an inspection in April and May.

The trust’s leadership was rated “inadequate” last year and staff reported a “toxic” culture, including bullying, racism and inappropriate behaviour. It has been subject to a string of leadership, cultural and care quality concerns in recent years, and undergone a major overhaul of its senior leadership. 

Charlotte Rudge, CQC deputy director of operations in the Midlands, said UHB should be “proud” of its leadership, culture and governance improvements.

“At the previous inspection, we told the trust leadership they needed to do more work to significantly improve culture and staff wellbeing,” she said.

“In response, they introduced a comprehensive plan and took action to make significant improvements in this area.

“Leaders now provided a clear shared direction for the organisation which didn’t just align plans and objectives but translated them into real action to improve people’s care.” 

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Source: HSJ, 29 August 2025