31 Jul


Loads of practical ideas for improving the daily experiences and treatment outcomes of mental health inpatients

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Mental health wards up and down the country are doing superb work, despite extraordinary challenges, and are creating healing, imaginative and fun opportunities for thousands of patients. Star Wards has been used by mental health wards to improve everyone’s experiences and outcomes – patients, staff, family, friends and carers.

Star Wards, which was a project of the social justice charity Bright, is a catalyst for inspiring positive change. Over the years it created other resources: CAMHELEON, – A scheme designed and run by the brilliant Nic Higham which aims to inspire therapeutic care in Child and Adolescent Mental health (CAMHS) inpatient wards. WARD STARS – An achievement scheme for mental health care assistants and other support staff. MARVELLOUS CARE – For mental health staff looking after patients with a learning disability in acute care. ANIMAL MAGIC – Promoting the therapeutic use of animals in mental health care. BRIEF ENCOUNTERS – A guide for none-mental health wards for coping with emotionally distressed patients. WARDIPEDIA – an encyclopaedic resource of good practice in acute mental health care. TALKWELL – Helping communication between staff and patients. WARD BUDDY – Helping ward patients keep track of their care.

After Brights closure in 2020 Nic Higham took over the management of CAMHELEON.

It’s completely up to wards, hospitals and Trusts how they’d like to use the resources and approach. The main benefit is that wards feel a strong sense of ownership and commitment because they can truly create their own improvement ideas.

In the 16 years of its existence, Bright discovered, celebrated, shared, publicised and inspired excellence in inpatient care – and there is still plenty of that happening! The approach is very positive and pragmatic – based on ‘appreciative inquiry’ principles of focusing on what is working well, validating this and helping amplify the impact of positive practice. It is very clear that the single most important factor in enabling a warmly therapeutic experience for patients is staff morale combined with positive patient inclusion.

We are delighted that, because of Star Wards, staff find their roles more fulfilling (“It’s what I came into nursing to do”) and patients, friends and family are appreciating more relaxed visits and other contact with their loved ones in hospital. Star Wards ideas help wards harness staff and patients’ amazing creativity and skills to make changes which really work for their particular circumstances. The crucial factor is that we encourage ideas rather than impose standards. This gives wards complete, freedom to use their ingenuity and wisdom to make the most of their resources.

There are many fantastic wards out there and you can see this in many ways. Sometimes it’s huge things, like transforming a ward with low morale and high aggression into one where increased safety. This is usually both a result and illustration of the new culture of patient engagement and staff satisfaction. Or it may be just a brief, warm exchange between a patient and staff member, capturing the mutual respect and trust which characterises so much inpatient care.

Wards use and adapt the resources here to stimulate and structure therapeutic and enjoyable daily programmes for their patients. They come from the full range of wards, older and younger adult, rehab, learning disability, secure and specialist.

We wish you well in making use if the ideas on these pages. Thank you for all you do.

75 Ideas for Improving Patients’ Quality of Time and Treatment Outcomes

At the heart of the Star Wards project are 75 ideas for improving patients’ quality of time and treatment outcomes. The crucial changes we would like to see are in relation to:

  • talking therapies having as substantial a role as medication
  • helping patients to enhance their own management of symptoms and treatment
  • having a strong culture of patient mutual support, with the potential for this extending once they’ve left hospital
  • sustaining a full programme of daily activities that doesn’t just eliminate boredom but actively contributes to accelerating patients’ recovery
  • helping patients retain and build on their community ties

The ideas are arranged under seven main themes:

  1. Recreation and conversation
  2. Physical health & activity
  3. Visitors
  4. Care planning
  5. Talking therapies
  6. Ward community
  7. Patient responsibility

Within each theme, we list three stages:

‘Tweaking’ – suggestions require minimal changes to current staffing arrangements, at little or no cost.

‘Turning’ – suggestions take things further and require some staffing changes and new resources

‘Transforming’ – suggestions are the biggies – ideas which probably require the most investment.

All ideas are useful for patients who are sectioned and unable to leave the ward. For those who can leave the ward, many of the suggestions are adaptable for use in the community, which is a great way for the ward to stay connected with life outside hospital. For example, some wards use local gym facilities and even have 5 a side football at the local football club. Others have taken on an allotment for patients who’d like to do some gardening. Blurring the boundaries between the hospital and the outside community is brilliant, not just in terms of the quality of those experiences, but also challenging the stigma of being a mental health patient.


Star Wards Booklet (First edition)

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Star Wards Booklet (Second edition)

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‘Tweaking, Turning, Transforming’ 75 Ideas Chart and Checklist

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75 Ideas Benchmarking Sheet

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If you need help…

We’re offering you the opportunity to book our services, including training days, workshops, project facilitation and coaching (click here for more information). We offer reasonable rates and a bespoke service which aims to enhance the experience of patients, carers/family members and staff. We believe our offer will assist with some of the major challenges services face – to improve standards of safe care and to have less incidents of harm to staff and patients – leading to less staff absence, less complaints, reduced cost of investigation and legal action and reduced reputational damage. It will also help Bright and Star Wards to continue and thrive into the future. We can take you on a Bright Journey fitted to your needs and built around your requirements. For more please information contact us.

What Others Are Saying

“The 75 ideas really help you to look at the ward environment – both physical and social – with fresh eyes. I’ve been pleasantly surprised to find that we were already doing a number of things outlined in the ideas. It was so helpful to acknowledge the things that were already in place and that by making just a few small changes to other areas that the patients felt much more confident and comfortable on the ward.”

Rachel Latham, Occupational Therapist

“[Star Wards] enthusiastically uses patient insights to improve the practice and quality of inpatient mental healthcare and create a more empathetic and therapeutic space on hospital wards. Its work is serious, yet never loses sight of the importance of fun, food and animals, amongst other things, in the delivery of good acute care.”

The Guardian

“Who would have thought when Star Wards was launched in October 2006 that just 18 months later the majority of acute mental health wards in the country would be enthusiastically participating, with a number of other health services keen to adapt the initiative. Why, when the NHS is reportedly overburdened with targets and initiatives, is this so? (click here to find out!)

Star Wards, like most really good ideas, is essentially simple. The initiative is based on service user insight that recognises, taps into and spreads the wealth of innovative practice that occurs in so many local acute mental health services… ‘small things make a big difference’. Things like being listened to, feeling a part of things, having something meaningful to do. Star Wards emphasises the positive, conveying messages of engagement inclusion, involvement, fun and success…

Key to the enthusiastic uptake of Star Wards is that it is owned by the staff and service users on the wards. Star Wards is an acknowledgement that staff working on acute mental health wards are allies of positive change who deserve better recognition of their efforts and achievements…”

Paul Rooney, Joint National Lead CSIP/NIMHE Acute Care Programme

A Happy Partnership

Our former CEO Marion Janner OBE set up Star Wards following her time as a detained inpatient. She was struck by how wonderful the staff were and how hampered they were by the impoverished environment. Since then, Bright (the charity which runs Star Wards) has co-created with wards lots of lovely, practical, attractive publications and schemes which are helping thousands of patients to have more therapeutic and enjoyable admissions.

“Star Wards is simple, practical and upbeat. It’s different, as it’s inspiring, rather than instructional. It’s unique, as ward staff have a strong sense of ownership of the Star Wards project, resulting in very impressive and imaginative new therapeutic opportunities for patients. There is also evidence of a range of staff revealing and extending their skills and experiences and talents.”

Ivan Lewis MP

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“We provide ideas and resources and wards adapt and add to these in fantastic, energising, creative ways. We recognise the huge pressures you’re already under, and try to ease and definitely not exacerbate these! We hope that you’ll want to reciprocate the openness and generosity of Star Wards’ members, by sharing your best practice examples, challenges and resources such as benchmarking tools, and guidelines.”

Marion Janner

Great News

650 wards are members  (about 80% of UK mental health wards). Membership is free for all NHS wards, thanks to generous support from charitable trusts.

Our 2013 Impact Review showed the extent to which ward communities are benefiting from their involvement. The percentages of member wards reporting benefits of Star Wards were:

Increased activities – 88%

Increased patient satisfaction – 77%

Decrease in aggression – 60%

Here’s a sample of what staff and patients have said about why they appreciate being involved with Star Wards:

“In my opinion every acute ward in the country should implement as many of the Star Wards ideas as they possibly can. I have never known an initiative to be met with such enthusiasm by the staff that actually work on our wards.”

“Patients feel more empowered, this creates more motivation, improved relationships between staff and patients, staff and staff, less division, more optimistic attitude, improved mental health for patients and some discharges which I believe have happened sooner.”

“It is helping the patients to socialise and it is great fun. For example we now have karaoke on the ward which is headed up by a patient. We even have patients from other wards who come and join us for this. We are all really enjoying it.”

“Giving the service users the opportunity to participate in the star wards process encouraged and facilitated a sense of involvement, belonging and responsibility for service users.   It was an opportunity for them to feel that their opinions are valued.”

“Somehow it manages to combine improvements in the quality of care for patients with improvements in job satisfaction for our front line staff – a winning combination.”

“Star Wards is a perfect example of how to engage and motivate staff and service users to improve servicers inpatient experience without a mandatory regulation scheme and high cost tag attached.”

“Since the inception of the Star Wards initiative I have become more creative and innovative in the way I execute my role as a SHCA than before. I have made enormous contribution towards the achievement of most of the 75 Star Ward ideas.”

“I am a service user who has become involved in my local acute care forum, and i would just like to let you know i think your input in the booklet is fantastic and it has given me a lot of inspiration to continue. I also love your dog.”