The New Foscote Hospital

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.

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.

We scored the service as 3. 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.

The provider had a clear set of values and expected behaviours that applied to all staff and anyone working on behalf of the organisation. The values were community, integrity, vigour, innovation and compassion. Staff understood and reflected these values in their day-to-day work. Staff spoke positively about the leadership team and described them as approachable and supportive. One nurse told us the matron was “so approachable” and had an open-door policy, and said they felt able to speak openly with them. Another member of staff told us, “the leadership team are always available, you can always talk with them”. Staff were able to describe the provider’s values and explain how these influenced the care they provided. We observed staff treating patients with dignity and respect. Staff were discreet, responsive and compassionate when caring for patients, demonstrating integrity and a person-centred approach.

Leaders were visible and engaged in the service. Staff told us the senior leadership team were actively involved and maintained an open-door approach. Senior leaders spoke passionately about their role within the local community and worked closely with the local NHS trust through service contracts and shared learning, including participation in study sessions with local healthcare professionals.

Leaders monitored performance against the strategic objectives using key performance indicators (KPIs). Leaders used these reports to measure, review and understand performance. The organisation had a clinical effectiveness model which brought together leadership oversight, audits, learning, and staff and stakeholder feedback to support continuous improvement and better patient outcomes.

Staff told us they were encouraged to contribute to discussions about the service, particularly when changes were planned. For example, when the provider developed in-house sterilisation services, leaders sought staff views and used their expertise to shape the service. The service gathered feedback through annual staff surveys, regular pulse surveys, team meetings, departmental briefings, appraisals and one-to-one meetings. Staff were aware of the Freedom to Speak Up process and said they could raise concerns confidentially. There were also opportunities for staff to engage directly with senior leaders through forums and governance meetings. The March 2026 Staff Survey showed a generally positive staff experience, with strong teamwork, visible leadership, and a culture where staff feel valued and supported. Overall, the findings indicated a positive culture with clear, focused areas for further improvement.

The provider engaged with external stakeholders through contract review meetings, governance forums and service review discussions, which supported shared learning and collaborative working.

There was a wellbeing strategy in place. Staff benefits included an additional day of annual leave for birthdays, private health insurance with 24-hour physical and mental health support, an employee assistance programme, and access to financial and pension advice through a banking service. One staff member told us the hospital was “very supportive” and valued the additional birthday leave entitlement.

We scored the service as 3. The service had inclusive leaders at all levels who 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. They did so with integrity, openness and honesty.

There was a clearly defined management and leadership structure with clear lines of accountability and responsibility. The senior leadership team included the chair and responsible officer, chief executive officer (CEO), director of nursing, director of governance, director of finance, theatre manager, endoscopy lead, operations manager, estates manager and director of information technology. This ensured appropriate leadership oversight across clinical, operational and corporate functions.

There was a medical advisory committee (MAC) in place which provided clinical oversight. This committee included consultants, the responsible officer, CEO, director of governance, director of nursing and department heads. Leaders described how this forum supported effective decision-making and ensured clinical leadership was central to the governance of the service.

Leaders had the appropriate skills, knowledge and experience to manage the service. They understood the service’s priorities and challenges and were able to describe how they monitored performance, safety and quality. Leaders used governance systems and performance information to maintain oversight and support improvements.

Leaders described a “flat hierarchy” and an open leadership approach. Staff confirmed leaders were approachable and visible within the service. Staff told us they felt listened to, involved and described the organisation “like a family hospital”. Staff also told us they knew how to raise concerns, were confident any concerns would be taken seriously and were aware of escalation processes if needed, including speaking with senior leaders.

This inclusive and supportive leadership approach helped to create an open culture where staff felt valued, respected and able to contribute to discussions about the service. Leaders promoted compassion and psychological safety, which supported staff engagement and effective team working.

We scored the service as 3. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The service recognised the importance of fostering a positive speaking-up culture in which staff could raise concerns without fear of blame or detriment. Leaders encourage staff to raise concerns with their line managers. In addition, staff had access to 3 freedom to speak up guardians, whom they had chosen as representative for all staff.

The guardians received training in line with the National Guardian’s Office and promoted awareness through presentations and training for staff and acted as a point of contact for staff.

The provider had a freedom to speak up (FTSU) policy and training and a dedicated email address for anonymous concerns to be raised. And a freedom to speak up report for 2025 reported no concerns. However, the provider is going to review whether this is due to no concerns or if there are perceived barriers to speaking up. They will be sending an anonymous questionnaire to all staff, launch a campaign for new FTSU guardians, have annual refresher training and bi-annual meetings.

Patients were encouraged to speak up about the service through a range of accessible channels. Leaders used this feedback to drive improvement. For example, patients had reported the food could be improved, so the provider started an ongoing review of catering services, allowing patients and carers to be involved in decision-making about changes to the service.

We scored the service as 3. 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.

The provider promoted equality, diversity and staff wellbeing. Workforce monitoring showed a diverse staff group across gender, ethnicity and disability, including staff who identified as neurodiverse. The senior leadership team included 6 females and 4 males, while the wider workforce was mostly female. The provider also monitored equality data to help ensure the workforce reflected the patient population.

A flexible working policy supported staff to balance work and personal commitments, and leaders considered requests individually. Staff also had access to occupational health and confidential counselling services to support their wellbeing and reduce barriers for those with physical or mental health concerns.

There was a 2026 wellbeing strategy which, focused on physical, emotional and financial wellbeing, supported by wellbeing events and monthly occupational health visits. Staff told us they had not witnessed discriminatory or abusive behaviour and felt confident concerns would be managed appropriately.

We scored the service as 3. 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.

There were clear governance and management arrangements with defined reporting structures and responsibilities. Staff understood their roles and knew how to raise concerns. Local governance systems linked into the clinical governance committee and senior leadership team.

Governance meetings took place at both ward and senior levels. Discussions included complaints, audits, patient feedback, staffing, finance, and learning and development. Staff recorded actions and monitored progress through meeting minutes.

There was a risk policy covering areas such as patient safety, finance, legal and reputational risks. This helped the service maintain safe care during disruptions and reduce risks to patients and staff, ‘action cards’ outlined what staff needed to do if specific risks occurred. Staff knew how to escalate risks to the governance team, and leaders reviewed risks regularly at senior leadership meetings.

Business continuity plans covered incidents such as power failure, IT outages, staffing shortages and security concerns. Governance systems also monitored patient feedback, complaints, audits and quality improvement activity. Policies and procedures were regularly reviewed and reflected current guidance. Staff completed daily equipment checks and knew how to report faults or concerns.

The provider maintained appropriate insurance arrangements and monitored practising privileges and professional indemnity for consultants.

We scored the service as 4. The service clearly understood and carried out their duty to collaborate and work in partnership. They always share information and learning with partners and collaborate for improvement.

The provider demonstrated a strong commitment to partnership working, reflecting its ‘community’ value. It worked closely with system partners including the ICB, local GPs and NHS providers. This helped ensure services were joined up, met local needs, and supported better outcomes for patients. These partnerships were also used to share ideas and improve services.

A dedicated GP Liaison Officer supported communication between the hospital and local GP practices. This helped both sides understand each other’s services, referral routes and patient groups. The provider also delivered training to local physiotherapists to improve understanding of services and strengthen referral pathways into endoscopy and other specialties.

The hospital had regular links with NHS trust partners. These meetings were used to share learning, discuss practice and support ongoing service improvement. Consultants with practising privileges also supported staff learning by delivering teaching sessions and sharing clinical expertise.

The provider worked closely with universities. It offered student placements and took part in university recruitment events. It also supported staff development by funding further education, including Master of Business Administration (MBA) programmes.

The provider had good relationships with suppliers, who provided training to staff on how to use equipment safely and effectively. The provider also supported the local community by sponsoring a local football club and grassroots sports teams.

Overall, there was a proactive approach to partnership working, which was embedded and consistently focused on improving services and outcomes for patients. Relationships with system partners, education providers and the wider community were strong and actively used to drive improvement. This demonstrated exceptional collaboration and integration beyond the provider’s own services, contributing to an outstanding rating for this quality statement.

We scored the service as 3. 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. They actively contribute to safe, effective practice and research.

The service promoted learning, innovation, and improvement across the service. Leaders used real-time performance data and reporting systems to monitor quality, identify risks, and support improvement. For example, the provider developed an in-house theatre sterile services unit (TSSU), which improved the reliability, quality, and availability of sterile surgical instruments. A clinically led project was also introduced to improve post-operative care pathways, helping to reduce complications and avoidable readmissions, and improve patient outcomes.

Staff were given time and support to develop improvements and innovation, which led to changes in care delivery. For example, one staff member told us the provider had funded and supported them to complete a master’s degree, which gave them opportunities to take part in research.

Staff used quality improvement methods and understood how to apply them in practice. For example, staff were aware of the implementation of the Patient Safety Incident Response Framework (PSIRF) and could explain the purpose of the approach and how the process worked.

These improvements showed a proactive approach to learning and innovation, with a clear focus on improving quality and patient care.