Safety recommendation
HSSIB recommends that NHS England works with other stakeholders to define the term ‘therapeutic relationship’. This is to support building trust and compassionate relationships between staff and patients from admission to inpatient settings through to discharge, to improve patient outcomes.
Response:
NHS England Mental Health, Learning Disability and Autism Programme welcomes the recommendations of the HSSIB investigations ‘Mental health inpatient settings: Creating conditions for learning from deaths in mental health inpatient services and when patients die within 30 days of discharge’. The recommendations align with the ‘Culture of Care Standards’ NHS England » Culture of care standards for mental health inpatient services published by NHS England. Mental healthcare inpatient staff who are enabled to recognise the importance of the therapeutic relationship as the single biggest predictor of patient outcomes will be empowered to improve their practice. A greater understanding of what is meant by the therapeutic relationship will facilitate improvements in patient safety across the Mental healthcare system.
Actions planned to deliver safety recommendation:
- Work with key stakeholders to agree a scope for a review of existing evidence base in relation to the therapeutic relationship in MH settings, by June 2025. Organisational lead: MHLDA Quality Transformation Team. Resource in place to deliver actions: Time protected within existing team to undertake this work. Other dependencies identified: Availability of stakeholders. Additional comments: All actions and subsequent timelines are subject to change due to the NHSE restructure. All stakeholder engagement will include lived experience representation.
- Establish a working group to collate existing evidence base and agree key inclusion points for a document, by September 2025. Organisational lead: MHLDA Quality Transformation Team. Resource in place to deliver actions: Time protected within existing team to undertake this work. Other dependencies identified: MH PRU have been identified as a key partner to help support this work. Availability and capacity of key stakeholders. Additional comments: All actions and subsequent timelines are subject to change due to the NHSE restructure.
- Create and publish a document that helps define what is meant by the term ‘therapeutic relationship', by December 2025 to start NHSE publication process. Organisational lead: MHLDA Quality Transformation Team. Resource in place to deliver actions: Time protected within existing team to undertake this work. Other dependencies identified: Availability and capacity of key stakeholders. NHSE publications process Additional comments: All actions and subsequent timelines are subject to change due to the NHSE restructure.
Response received on 28 April 2025.