National Mental Health Act Quality Improvement programme - The PSC & VMI

Register now for the next phase of the national MHA QI programme

We're now inviting Expressions of Interest for the wider implementation phase of the programme, open to all NHS mental health trusts and provider collaboratives in England - and are now expanding the offer to involve independent providers of mental health inpatient services, to join this next phase.

Extended deadline for submissions  - sign up now before 14th June 2024

For more updates on the programme - head over to the pilot phase and news & insights page. Or please reach out to, if you have any questions.

Submit Expression of Interest

National Mental Health Act Quality Improvement Programme

This programme is being delivered by Virginia Mason Institute and The PSC in partnership with NHS England

National Mental Health Act Quality Improvement Programme
"I think the programme seems to be about small and large-scale change taking place simultaneously within an organisation, which I think is not always the case – either small QI projects that do not get traction within the organisation, or we focus on large scale transformation without engaging local teams and users of services...

The involvement of people with lived experience is a core part of the project and the feedback has been excellent so far."

Chief Medical Officer, MHA QI Pilot Trust

"The Mental Health Act Reforms are crucial to effecting change within an often oppressive system, led by white euro-centric values. I strongly feel optimistic that - whilst it will be challenging - the programme will contribute to a wider movement of reform and enable a more meaningful and person-centred approach to care delivered under the Mental Health Act."

Chris, Lived Experience Practitioner

"This programme has already significantly made a shift in the culture in terms of freedom to speak up. When I started this programme, I was in fear of saying the wrong thing so we didn't upset or offend people.

Now, through the coaching, tools and techniques we are using, we no longer have that fear on this ward with staff. "

Assistant Director, MHA QI pilot site

"I've been involved in lots of avoidant initiatives in the past addressing topics like inequity and white privilege. But this project is going far beyond lip-service. There is buy-in from the whole senior leadership team of the unit, and not just putting it on staff of colour, to make a difference."

Junior Doctor, MHA QI pilot site

"I’ve learnt from the team that it has been challenging for the team and very welcome from the point of view of our service users who have commented on a shift in power balance.

Medical Director, MHA QI Pilot Trust

"There seems to be something about this programme that is helping to get to deeper issues surprisingly quickly... and subtly changing behaviours of staff, rather than relying on processes to improve outcomes."

Chief Medical Officer, MHA QI Pilot Trust

"The training and support offered to Trusts involved in the programme should lead to real cultural change in how services are delivered - and not just changes in laws on paper."

Phil, Lived Experience Practitioner

"It's a bit of an eye opener for what we can actually achieve and change on the ward."

Nursing Associate, MHA QI Pilot Trust

Introducing The Programme

Introducing The Programme

Background on the Mental Health Act reforms 

In 2021, the Government published a White Paper, Reforming the Mental Health Act, which accepted many of the recommendations from the 2018 Independent Review of the Mental Health Act and set out a series of ambitious reforms to care under the Act. The White Paper included proposals for significant legislative reform but acknowledged that legislation alone would not be sufficient to deliver the broader improvements in culture and practice required to meet the overarching aims of the reforms. To support these improvements, one of the recommendations taken forward in the White Paper was a commitment for NHSE to deliver a national Quality Improvement (QI) programme.

The Independent Review identified inequalities faced by people from ethnically diverse backgrounds and by people with a learning disability & autistic people as one of the most pressing issues which the sector faces:

  • The review noted the disproportionate number of people from black and  ethnically diverse backgrounds detained under the MHA, and the excessively poorer experiences and outcomes for individuals from black African and Caribbean communities.
  • The review also noted that people with a learning disability and autistic people are at a particular disadvantage - for example, professionals do not always take the time or have the skills to understand how best to communicate and understand what is causing their distress.

Addressing inequity of experiences of care delivered under the MHA is core to this QI programme's aim and drivers of change.

Learn more about the Mental Health Act Reforms

Background and overview of key reforms, guiding principles, and proposed legislative and non-legislative changes

MHA Reforms crib-sheet

Working with 52 NHS Trust-run inpatient services to put into practice the principles set out in the reform of the Mental Health Act

Between August 2023 and March 2025, this QI programme will support inpatient services to develop and implement co-produced change ideas that put into practice the principles set out in reform of the Act - tackling inequity of experience faced by groups experiencing significant inequalities under the Mental Health Act. The programme aim is to:

"Improve the equity of experience for people from ethnically diverse backgrounds and people with a learning disability & autistic people when detained under the Mental Health Act in hospitals across England, including improving the cultural appropriateness of care they receive."

The programme will:

  • Work with NHS Trust-run services that provide care of patients detained under the Mental Health Act
  • Provide executive coaching, and service leadership and frontline delivery project mentoring and coaching to
  1. Support cultural change
  2. Build leadership capacity
  3. Empower staff teams to co-produce and deliver change ideas aligned to the programme aim above
  • Incorporate Lived Experience input at all levels - from co-production of change on the ground, to embedded involvement in the core programme delivery group, to representation on the programme's steering group
  • Share and disseminate good practice and learning coming out of the programme

When is the programme taking place?

When is the programme taking place?

Participating pilot services

15 NHS Trust-run inpatient services joined the pilot phase of the programme, covering all regions and service types within scope.

Read more about the pilot phase

The programme takes a phased approach:

  • Phase 1 (Jan '23 - Jul '23): Design work and pilot recruitment 

  • Phase 2 (Aug '23 - May '24): Pilot implementation within recruited services 

  • Phase 3 (Apr '24 - Jun '24): Refinement of programme design and recruitment for wider implementation 

  • Phase 4 (Jul '24 - Mar '25): Wider implementation of programme within recruited services 

  • Phase 5 (Feb '25 - Mar '25): Reporting and communicating key findings to the sector 

How to get involved

To find out more about the programme, reach out to us at or visit our NHS Futures Workspace.

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