Part 3 of a 4-part series exploring how acute hospital staff support patients in mental health crisis, and why this directly impacts NHS Oversight Framework metrics that determine organisational performance.
The Strategic Case for Mental Health
The NHS Oversight Framework uses the CQC’s Safe Inspection Score to assess patient safety. As of 2025, the CQC has determined that meeting mental health needs is a non-negotiable part of all acute settings, including urgent and emergency care. The CQC will “closely scrutinise” trusts’ ability to provide adequate care to patients attending due to their mental health (CQC, 2025). Trusts are expected to show evidence of their provision, and findings will inform their overall provider-level rating.
There is no excuse and nowhere to hide: mental health care is part of the job. This responsibility cannot be offloaded or deferred. Over one million people attend emergency care due to their mental health each year. Acute staff are providing and responsible for their care.
This is a strategic issue. The mental health and safety of patients directly impact CQC inspection scores – and, therefore, organisational ratings.
Why This Happens
A CQC report highlighted that staff feel unprepared and unsupported to provide care for patients in mental health crisis. Consequently, high-risk patients were not always provided with safe, therapeutic care (CQC, 2020). This is supported by our own research: 1 in 3 staff are unsure their hospital provides safe care for patients in a mental health crisis.
The CQC identified a clear need for specific mental health training to improve care. As part of its “Steps to improving practice,” the CQC recommended “Trust-level changes” and “Support for staff,” stating this must include “training for staff that gives them the skills and confidence to meet people’s mental health needs” (CQC, 2020).
The problem is systemic. Sending a handful of staff on lengthy specialist training, or deploying generic e-learning with no impact data, represents a failure to grasp the scale and urgency of the issue. All staff need foundational mental health knowledge to underpin and support other measures in place. This is what “trust-level change” looks like.
Like safeguarding, mental health requires both specialists and a body of staff with a foundational understanding. While organisations have specialist teams who oversee and intervene in complex cases, every staff member must understand basic safeguarding principles. Mental health is the same. All staff need to identify risk and administer safe, compassionate care to patients attending due to their mental health.
The Solution: Permission to Help
The barrier to cultural change isn’t willingness – it’s confidence. Staff want to help patients in mental health distress. They just don’t feel prepared to do it well. What they need is permission: permission to use their existing skills, permission to engage, permission to make a difference.
Our partner trusts recognise this reality: staff need the foundational knowledge, skills and confidence to positively contribute to patient safety. We Can Talk’s evidence-based one-hour e-learning is designed to do this, at scale, for all hospital staff – highlighted by the CQC as an area of outstanding practice and “the only programme of its kind in the NHS” (CQC, 2019).
Amongst partner trusts deploying We Can Talk, the results are clear and measurable:
- Staff report a 58% increase in confidence asking patients directly about risk or suicide
- Staff show a 52% increase in knowledge about why people attend hospital due to their mental health
These improvements translate directly to safer care. When staff feel equipped to ask about risk, they do. When they understand mental health presentations, they respond appropriately. When they have confidence, they act.
Patient safety is at the absolute core of hospital care. The CQC has rightly identified mental health as a component of this. A growing number of trusts are tackling this strategically – ensuring all hospital staff have the mental health education necessary to perform their jobs effectively. By doing so, they meaningfully enhance the effectiveness and capacity of existing mental health strategies and specialisms.
Investing in foundational mental health training should be a strategic priority for trusts serious about improving patient safety and CQC inspection outcomes – critical to NHS Oversight Framework performance.
Stay Updated on the NHS Oversight Framework Series
This is the third in a four-part blog series exploring how acute hospital staff support patients in mental health crisis, and why this directly impacts NHS Oversight Framework performance.
Part 1 -Access to Services: The Mental Health Crisis in Emergency Care
Part 2 – Effectiveness and Experience of Care: The Hidden Crisis of Patient Experience
Part 4 – People and Workforce: Why Patient Mental Health is a Workforce Crisis
The underpinning policy evidence from this series is now available in our briefing report: The NHS Oversight Framework, Acute Hospitals, and Mental Health.