Mersey Care Foundation Trust has been criticised in an independent review for a culture described as "divisive and toxic", with authors finding board relationships that fuelled a wider atmosphere of fear and anxiety among staff.
Review highlights dysfunctional board dynamics
The review, commissioned by NHS England and summarised in a slide deck obtained by the Health Service Journal under a Freedom of Information request, concluded that leadership transitions and strained board relationships were "key sources of tension and instability" at the trust. Authors said those dynamics had contributed to a climate where many staff felt "fearful, anxious and unable to speak openly".
"There is a clear lack of psychological safety among board and senior leaders, with staff feeling fearful, anxious and unable to speak openly."
The slide pack, dated November 2025, characterises interactions at senior level as "adversarial and mistrustful", and warns that a preoccupation with internal politics was perceived to detract from patient care, operational performance and staff wellbeing.
Scale and footprint of the trust
Mersey Care employs around 11,000 people and operates a mix of high-secure, general mental health and specialist facilities across the Liverpool City Region. The review’s concerns therefore have implications across a wide geography and range of services.
| Facility / Service | Location / Area served |
|---|---|
| Ashworth High Secure Hospital | Maghull |
| Clock View Hospital | Walton |
| Mossley Hill Hospital (new) | Mossley Hill |
| Learning disability and addiction services | Across Liverpool, Sefton, Knowsley, St Helens, Warrington, Halton, West Lancashire |
Trust and NHS England responses
Mersey Care’s leadership said the review represented "an important opportunity to reflect and identify where we can further improve." NHS England has indicated the slides were used to verbally update the trust board on draft findings in November 2025. The full report has not been published.
Key elements of the review were disclosed through the slide deck rather than a public report, prompting questions about transparency and how the trust intends to tackle the issues identified. The slide pack’s summary suggests remedies will need to address board culture and the psychological safety of senior leaders as part of improving frontline services.
- Staff impact: Report records staff feeling anxious and reluctant to speak openly.
- Patient risk: Review warns internal politics were seen to detract from patient care and operational performance.
- Governance concerns: Board relationships described as dysfunctional and mistrustful.
The trust’s footprint — from high-security psychiatric care in Maghull to community mental health services across multiple boroughs — means any governance or culture problems could have broad consequences for residents relying on its services. Local campaigners and NHS watchdogs may press for a published account of the full review and a clear action plan addressing governance, staff wellbeing and safeguards for patients.
As further details emerge, attention will centre on what corrective steps the trust board and NHS England set out, and how staff and local communities will be involved in shaping change to restore confidence in leadership and service delivery.
