By Paul Moseley
BBC News, Norfolk
A mental health trust that was named the worst in the country has spent over £800,000 on a public relations firm, the BBC can reveal.
The Norfolk and Suffolk NHS Foundation Trust (NSFT) agreed a contract while it was working to improve its rating by inspectors from "inadequate".
After hiring the company the trust subsequently saw its rating raised to "requires improvement".
NSFT said the firm provided it with support at "a time of great need".
The mental health trust has struggled over the last decade and was rated "inadequate" by the Care Quality Commission (CQC) four times in six years.
In September last year it signed a contract with PR consultants at Hood & Woolf, a firm which has worked with several other NHS trusts.
At the time, it was facing a further inspection from the CQC.
A few months later, the commission said the trust had "made significant improvements".
The BBC has found that Hood & Woolf have been paid at least £814,752.83 since the contract was originally agreed.
During that period, a review was published which said the trust had lost track of its figures for patient deaths.
It later emerged the review was edited to remove criticism of NSFT's leadership.
Then, in September, the trust said its chief executive Stuart Richardson was leaving his role.
Hood & Woolf, whose website said it provided "crisis management" and "major change programme" support, said it had "absolutely no involvement" in the review process.
A source with close knowledge of the trust said he felt the amount paid to the company was "shocking".
"Spending such eye-watering amounts on spin-doctors comes across as rather unethical and quite frankly unnecessary," he said.
"Having worked in multiple NHS organisations I've never come across this before. To spend such enormous amounts of tax-payers money, in my opinion, is an obscene waste of public money."
The Norwich South Labour MP Clive Lewis said he was "aghast" at the cost.
"I think there are genuine questions about how this money has been spent,"
"If (they've) been using public money to tell the CQC that there isn't a problem, then I'd like to know about it," he added.
The trust said Hood & Woolf supplied "specialist capability" that it "lacked at a time of great need for this service."
Deputy chief executive Cath Byford said the firm provided "rapid and sustained access to a range of skills and support."
"Our agreement with Hood & Woolf has now concluded and they are not currently working with us."
Steph Hood, director of Hood & Woolf, said the firm often worked "with some of the most complex and challenged organisations in the country".
"None of the work we have done is in opposition to providing good care to patients, it is essential in supporting NHS colleagues to focus on running the services that people need."
Neither commented on the cost of Hood & Woolf's service, but Peter Passingham, from the union Unison, which represents staff at NSFT, questioned the amount spent.
"That money could be going to pay for clinical staff on the ground. You might be talking about maybe 10 mental health nurses."
"If the trust wants to improve its image, it should spend money on improving its services."
NSFT is not the only NHS trust in Norfolk to have contracted Hood & Woolf.
The Queen Elizabeth Hospital (QEH) in King's Lynn told the BBC it paid the firm just under £580,000 in the financial year 2022/23.
At the time the hospital leadership was campaigning for the site to be rebuilt.
In May this year, the government confirmed it had added QEH to its New Hospital Programme.
The hospital was also rated "inadequate" when it began working with the company.
Following an inspection, the CQC upgraded the hospital's rating, removing it from special measures in April 2022.
Alice Webster, the chief executive of the QEH, said the hospital hired Hood & Woolf mainly as part of its campaign for a new hospital and that its contract ended in January.
"This activity could not be fulfilled by the limited Trust communications and engagement team at the time due to senior vacancies and sickness," she added.
The CQC said it reached its decisions about the mental health trust and hospital by "using a number of different evidence sources" and that it was confident its "assessments were accurate and evidence based".
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