According to an assessment, employees at a major health trust felt “fearful, anxious and unable to speak openly” due to a “dysfunctional” relationship between senior management.
The Health Service Journal’s inquiry led to the publication of the evaluation of Merseycare, which provides mental and community health services throughout Merseyside, late last year.
The issues were so severe that they were “seen to detract from patient care,” according to the study, which was made public following a Freedom of Information request by the specialised Health Service Journal.
According to the trust, they have moved quickly to enhance the culture and are implementing an improvement program to make sure employees feel comfortable speaking out and know they will receive assistance.
Over 1.4 million people in Merseyside and some areas of Lancashire and Cheshire get community and mental health services from the Merseycare Foundation Trust.
It has long been seen as a success story; the Care Quality Commission, a government watchdog, gave it a good rating during its most recent inspection three years ago, and its leadership received an outstanding rating.
“Afraid and nervous”
However, this assessment, which was requested by the trust itself and commissioned by NHS England in June 2025, presents a different picture.
It emphasised a “divisive and toxic culture” that was “significantly affecting staff well-being” as a result of a “dysfunctional” interaction amongst board leaders.
A staff survey conducted for the assessment indicated low morale, with some employees characterising the organization as “toxic, anxious, divisive, and fearful.” Some of those employees were described as “fearful, anxious, and unable to speak openly.”
The emphasis on internal politics “is seen to detract from patient care, operational performance, and staff wellbeing,” the research continued.
This report, which was released in November of last year but was never made public, was commissioned by NHS England at the request of Merseycare Foundation Trust.
The trust claims that a lot has changed, including some changes at the board level, eight months after the initial findings.
A spokeswoman claimed they “acted swiftly to strengthen Board arrangements, enhance governance and decision-making and further embed the leadership behaviours and standards expected across the organisation”.
“Our senior leadership team consistently engages with staff through staff forums, listening events, visible leadership, and open dialogue,” they continued. Our improvement program is being directly informed by this input, with an ongoing emphasis on making sure coworkers feel comfortable speaking out, are heard, and are treated with respect and decency.”
“Our focus remains on maintaining the highest standards of care, supporting our people and building an organisation that continues to learn, improve and deliver outstanding services.”
A “toxic culture” within the NHS trust has led to criticism of Mersey Care’s leadership. A “pervasive culture of anxiety” was discovered throughout the organization, which offers mental and physical health care throughout a large portion of the Liverpool City Region, according to an independent review that NHS England commissioned.
According to the Health Service Journal, the Trust’s leadership assessment, which was commissioned last year, revealed that “adversarial and mistrustful” relationships had created “a divisive and toxic culture” and that employees felt “fearful, anxious, and unable to speak openly.”
The relationship between the board leaders of Mersey Care Foundation Trust was “widely regarded as dysfunctional, resulting in a pervasive culture of anxiety across the organization,” according to the authors of the unpublished review.
Additionally, they cautioned that concentrating on internal politics was “seen to detract from staff wellbeing, operational performance, and patient care.”
With almost 11,000 employees, Mersey Care runs the new Mossley Hill Hospital, Clock View Hospital in Walton, and Ashworth High Secure Hospital in Maghull. Operating in Liverpool, Sefton, Knowsley, St Helens, Warrington, Halton, and West Lancashire, it also offers addiction and learning disability services.
The assessment was a “important opportunity to reflect and identify where we can further improve,” according to the trust’s executives.