Inspectors have downgraded South London and Maudsley (SLaM) NHS Foundation Trust from ‘good’ to ‘requires improvement’, citing staff pressure, increasing wait times and concerns over workplace culture, writes Niall Holden…
The Care Quality Commission’s (CQC) report in February noted staff saying they felt disconnected from senior leadership and raised concerns about governance processes and how incidents and complaints were handled.
SLaM, which provides community and inpatient mental health services for children and adults across south London, employs more than 6,500 staff and provides services to more than 40,000 people.
Despite being downgraded, the CQC highlighted positive areas including dedicated and compassionate staff, strong research partnerships and notable efforts to reduce inequalities in care. Collaborative working with local authorities and community organisations was also praised.
However, the CQC had significant criticisms, stating: “Many staff we heard from before and during the inspection described a disconnect between front line staff and senior leaders and said they did not feel their experiences were heard or that their work is always appreciated.
“Staff told us that they no longer felt that they wanted to provide feedback through the staff survey or other means as they did not believe this would make a difference.”
On top of this, the number of people waiting over 12 hours to be seen in acute emergency departments was particularly singled out as being too high compared to most London hospitals.
Staff relations were seen as being a particular problem, with staff recorded as not feeling safe to speak up or being ‘confident that their concerns would be actioned.’
The report clarified: “Cases investigating poor staff attitudes including bullying and harassment were often not investigated appropriately, did not follow trust policy and protocols and were taking too long to conclude.”
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Further mental health crisis service regulation breaches were found, with incidents unreported, use of inappropriate restraint documented, and medicines not managed correctly.
Leadership issues were also brought up, as members of senior teams felt power was overly concentrated in the hands of the COO, with their own powers diminished.
Responding, trust chair Jane Bailey and interim chief executive Ade Odunlade said: “The CQC inspection feedback we have received is invaluable in helping to guide us on our journey of improvement.
“As an organisation, we will be focusing on the areas where we can do better and building on the things we are doing well. We will continue to work closely with our board, directorate and service leaders to update our action plans, which we have already begun work on as part of the 2026 Roadmap, Five Foundations.”
The 2026 Roadmap, Five Foundations is a five-point strategy to improve performance by reducing waiting times, strengthening leadership, enhancing workplace culture, and supporting long-term planning and decision-making.
The Well-Led review, which assesses the leadership and governance of NHS organisations, was held between June and July 2025.
Bailey and Odunlade thanked colleagues for their continued hard work and service.
The full reports can be found on the CQC website.
Additional reporting by Rich Brann.
