The Hampshire Clinic

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked for evidence that there was an inclusive and positive culture of continuous learning and improvement that was based on meeting the needs of people who used services and wider communities. We checked that leaders proactively supported staff and collaborated with partners to deliver care that was safe, integrated, person-centred and sustainable, and to reduce inequalities.

At our last assessment we rated this key question good. At this assessment, the rating has remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

We have not awarded this service a score for Well-led.

Find out about when we will not publish a key question score and what we look at when we assess Well-led.

The evidence showed a good standard. The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Staff knew and understood the hospital’s vision and values and how they were applied in the work of their team. The hospital 2025 strategy was focused on improving clinical outcomes, patient experience, engage staff and to develop the business. The outpatients’ service was delivering on plans to upskill and support cross departmental training to increase workforce resilience. Leaders were passionate about improving workforce wellbeing. Staff had the opportunity to contribute to discussions about the strategy for their service.

The evidence showed a good standard. Leaders understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively.

The outpatients department lead worked closely with the leads of the preoperative assessment department and the wards to manage the service effectively. The outpatients lead had a good understanding of the service they managed. They could explain clearly how the team worked well with other departments to provide high quality care and how the outpatients service contributed to a more resilient hospital wide workforce. Staff we spoke with felt both the outpatients lead and senior leaders, such as the hospital manager and the director or clinical services were approachable and visible. This view was shared by consultant doctors working on practicing privileges. The outpatients, physiotherapy and pharmacy leads were able to describe the risks to their part of the service and for the wider hospital.

When performance management was required, leaders were supportive and considered staff members’ circumstance and needs.

The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The hospital had a Freedom to Speak Up (FTSU) service with 1 guardian appointed within the administration team. There were no FTSU guardians appointed from clinical staff, but leader were reviewing this. There were 2 informal FTSU concerns raised between October 2024 and 2025 and neither of these related to the outpatient's service. In both instances, staff felt able to advocate for themselves and concerns were resolved within the departmental teams.

Staff were encouraged to speak up about concerns. Senior leaders encouraged staff to raise these with them directly, through the FTSU service or in open forums. Monthly staff forum minutes showed the main theme of concerns raised by staff was about canteen arrangements.

The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Staff were able to apply for flexible working to account for personal circumstances such as caring responsibilities and health issues. Reasonable adjustments records showed leaders offered staff options to help them manage their role. This included adjusted shift times, phased return to work processes, chronic health condition management, bereavement support and learning adaptations on an individual basis.

Leaders celebrated and recognised the diversity of their workforce. The hospital reception displayed a world map with pictures of staff and their identified ethnicity or cultural ties.

The central provider monitored risks of inequality in its’ workforce and reported against the Workforce Race Equality Standard (WRES). Information about workforce demographics was collated from local hospitals into an overarching national provider level report. Although this provided a national picture of performance, there was limited usefulness for individual hospitals to compare with local population demographics. The most recent WRES report, covering 2024 to 2025, showed a year-on-year increase in staff engagement with the survey. The report showed an improvement between 2024 and 2025, where staff from an ethnic minority background were no longer experiencing higher incidences of formal disciplinary processes. However, the proportion of staff with no reported ethnicity entering formal disciplinary processes had more than doubled in the same period, despite overall improvements in ethnicity self-reporting. Additionally, BAME staff were less likely to be appointed than white staff once they had been shortlisted.

The evidence showed a good standard. The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

Staff participated in local clinical audits. Audits were sufficient to provide assurance and staff acted on the results when needed. Documentation audits occurred twice a year, with 25 sets of patient notes reviewed each time. The outcomes were discussed at monthly staff meetings, and any issues were identified on a 1 to 1 basis.

Policies and documents were updated as part of a regular review cycle. All documents were recorded to a central register and had been reviewed in line with agreed timeframes.

There were no risks recorded to the departmental risk register for outpatients. Leaders were knowledgeable about the challenges to the outpatients service and had strategies in place to manage this. Leaders understood how to develop resilience in their department and were delivering a strategy to upskill staff across services for staffing sustainability. This meant staff who were primarily employed to support care and treatment in outpatients, were also being trained in preoperative assessment. Leaders were well sighted on the current challenges to workforce planning and had ensured recruitment and training to fill temporary posts for this.

Outcomes and progress against actions for audit reports were reviewed at clinical governance meetings. Leaders took ownership of monitoring changes in performance and were accountable for making changes. They followed a standardised agenda to ensure routine and regular discussion of areas such as action log items, safety alerts, and wider provider level updates. Although there were gaps in attendance, there was leadership representation for each team. There was consistent low or non-attendance of some key roles like IPC lead, materials manager, hotel services manager, practice-based educator. This was due to schedule conflicts or absence of post holder but did not cause delays to improvement actions.

Managers were aware of their responsibility to report notifiable incidents and any incidents related to the General Data Protection Regulation (GDPR). The hospital reported there had been no data breaches that were reportable to the Information Commissioner’s Office (ICO) in the past 12 months.

However, senior leaders approved practicing privileges renewals despite some mandatory training records appearing to be incomplete. When we raised concerns, senior leaders said they were assured consultants had the appropriate level of training, as they received copies of each consultant’s annual appraisal from their primary employment. This meant the responsible officer at their primary site of employment had approved consultant appraisals in line with NHS organisations.

The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

The service had built relationships with partners in the local community. Staff and leaders had recently taken part in fundraising initiatives to support a local hospice service. This resulted in procurement of a cuddle bed, providing support and comfort for patients receiving palliative or end of life care.

Leaders engaged with external stakeholders, such as commissioners monthly. Leaders took accountability for the services’ performance and acted to make improvements or changes as needed.

The evidence showed a good standard. The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people.

Innovations were taking place in the service. Leaders and staff valued the lived experience of people, using this to develop service improvements. Following provider initiatives, staff received guide dog training in April 2025 to improve patient experience. Leaders had established an autism and neurodivergence awareness committee in July 2025. The service was working towards a national accreditation to demonstrate their commitment to good practice in supporting autistic people. The committee released their first neurodiversity newsletter in October 2025.

There were no unexpected deaths between October 2024 and 2025. Leaders understood their responsibilities to notify and share information with external bodies when these types of incidents occurred.