Sir Julian Hartley visits Black Country Healthcare NHS Foundation Trust

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22 March 2024

Julian Hartley
Chief Executive

It was great to visit the Black Country Healthcare NHS Foundation Trust, which provides mental health, learning disability and autism services to 1.2m people. The trust has a significant reach across the Black Country, with about 1 in 20 people of all ages having some connection to their services.

The trust board and staff spoke passionately about their mission to achieve health equity for the diverse communities they serve. In the Black Country, 30% of the population are from ethnic minority backgrounds and 50% live in the most deprived 20% of the national population. The trust is focused on tailoring services to suit local communities (which have high levels of intersectionality), such as going beyond the national specification for talking therapies and developing more flexible, targeted approaches. The trust is committed to being on the front foot on cultural competence and has a diverse board and a busy anti-racist programme.

The trust faces challenges in relation to its outdated estate, with many buildings needing repair and modernisation. Insufficient access to capital funding has hampered the trust’s ability to improve, impacting efficient use of resources and care quality. I really enjoyed being shown around, meeting staff and service users, and it was incredibly powerful hearing how nationally constrained resources impact their experiences.


Where the trust accessed capital – through national funding to replace mental health dormitories – it invested in its older adults inpatient service and built a new facility with private rooms. Construction is well underway, with a modern building including accommodation, flexible therapy spaces and gardens due to open this summer. When shown around, I was struck by the high-quality design of a multi-purpose space with therapeutic benefits for older people with dementia.

The trust is the lead provider for mental health, learning disabilities and autism across the Black Country. Carrying out commissioning functions – such as designing services and improving pathways – closer to the frontline, has created significant improvements in patient care. Bespoke personalisation of support packages for citizens has delivered significant reductions and sometimes eradication of out-of-area placements. It also supported a wider strategic shift for the organisation, helping them identify future priorities and models of care.

The trust focused last year on bringing down out-of-area placements, with structured bed management processes and investment in alternative crisis arrangements supporting this improvement. I also heard about how it’s developing early and specialist support for children and young people, including a focus on admission avoidance and community-first models of care.

There’s a real sense of ambition around the trust’s role as an anchor institution. It was fascinating to hear about its wide range of partnerships with local employers and the voluntary, community and social enterprise sector, which aim to improve the social, economic and environmental conditions in local communities. For example, the trust works with employers and GPs on the ‘Thrive into Work’ programme, offering evidence-based employment support.

Above all, I was impressed with the trust’s focus on helping resourceful, resilient and cohesive communities to thrive, and the urgent need to prioritise mental health investment.


About the author

Julian Hartley profile picture

Julian Hartley
Chief Executive

Sir Julian Hartley joined as chief executive in February 2023, having been chief executive of Leeds Teaching Hospitals since 2013, where he led a major programme of culture change and staff engagement to deliver improved quality, operational and financial performance.

Julian’s career in the NHS began as a general management trainee and he worked in a number of posts before progressing to a board director appointment at North Tees and Hartlepool NHS Trust.

In 2019 Julian was asked to be the executive lead for the interim NHS People Plan, having previously worked as managing director of NHS Improving Quality, and in 2022 he was awarded Knight Bachelor for services to healthcare in the Queen’s Birthday Honours. Read more

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