The leadership of Mersey Care NHS Foundation Trust has been condemned over a 'toxic culture' at the organisation, according to an NHS England report obtained by the Health Service Journal. The review found a 'pervasive culture of anxiety' across the trust, which provides mental and physical health services across much of the Liverpool City Region.
Report findings
The unpublished report described relationships between board leaders as 'widely regarded as dysfunctional' and noted 'adversarial and mistrustful' dynamics that fostered 'a divisive and toxic culture'. Staff reportedly felt 'fearful, anxious and unable to speak openly'. The authors also warned that a focus on internal politics was 'seen to detract from patient care, operational performance, and staff wellbeing'.
The trust employs around 11,000 people and operates Ashworth High Secure Hospital in Maghull, Clock View Hospital in Walton, and the new Mossley Hill Hospital, along with learning disability and addiction services across Liverpool, Sefton, Knowsley, St Helens, Warrington, Halton, and West Lancashire.
Slide deck summary
A slide deck summarising the findings, dated November 2025, was obtained by the Health Service Journal under the Freedom of Information Act. It describes leadership transitions and board dynamics as 'key sources of tension and instability', with relationships 'adversarial and mistrustful, fostering a divisive and toxic culture'. The slides added: 'There is a clear lack of psychological safety among board and senior leaders, with staff feeling fearful, anxious and unable to speak openly.'
The deck was used to verbally update the trust board on draft findings but was not shared directly with members. The report noted: 'Recurring issues such as mistrust, lack of psychological safety, perceptions of favouritism and nepotism, governance deficiencies, and communication breakdowns have fostered a culture that is both unsustainable and detrimental to organisational performance.'
Trust response
In a statement, a trust spokesperson said: 'Today, we have a cohesive board and executive team... Culture is never static, and we are committed to continually developing our leadership, governance and organisational culture to meet the evolving needs of our patients, communities, and staff.'
The trust was rated 'outstanding' by the Care Quality Commission for leadership in 2023 after more than a decade of stability. However, in 2025, chief executive Trish Bennett and chair Rosie Cooper requested the independent review from NHS England's North West regional team. Ms Cooper stepped down due to health reasons, and three other non-executive directors have since left. The trust welcomed Sheena Cumiskey as chair this month.
Mersey Care said it had 'acted swiftly to strengthen board arrangements, enhance governance and decision-making and further embed the leadership behaviours and standards expected across the organisation'. Specific actions include a leadership development programme over the next 12 months and creating 'further structured opportunities' for colleagues to share feedback and raise concerns.
