Southampton General Hospital

Updated 25 September 2026

University Hospital Southampton NHS Foundation Trust provides a range of NHS hospital services. This assessment looked at End of Life Care which we rated as good and Children and Young People services which we rated as good. The rating from end of life care and children and young people has been combined with ratings of the other services from the previous inspections. See our previous reports to get a full picture of all other services at University Hospital Southampton NHS Foundation Trust. The rating of University Hospital Southampton NHS Foundation Trust remains good.

Updated 29 October 2025

On the 25 and 26 of November we carried out an inspection of end of life care at University Hospital Southampton NHS Foundation Trust.

We inspected 31 quality statements across safe, effective, caring, responsive and well led key questions.

We looked at 17 patient records which included end of life care plans and do not attempt cardiopulmonary resuscitation forms (DNACPAR). We spoke with more than 27 staff which included consultants, specialist nurses, healthcare assistants and volunteers.

Safe:

The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. People were protected and kept safe. Staff understood and managed risks. The facilities and equipment met the needs of people and were clean, well maintained and any risks were mitigated. There were enough staff with the right skills, qualifications and experience. Managers made sure staff received training and regular appraisals to maintain high quality care. Staff managed medicines well and involved people in planning any changes.

Effective:

People were involved in assessments of their needs. Care was based on latest evidence and good practice. People always had enough to eat and drink to stay healthy. Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions when moving services. Staff made sure people understood their care and treatment to enable them to give informed consent. However there was inconsistency of documentation in end of life care plans and DNACPR forms.

Caring:

People were treated with kindness and compassion. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences. People had choice in their care and were encouraged to maintain relationships with family and friends. Staff responded to people in a timely way. The service supported staff wellbeing.

Responsive:

People were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. People were involved in planning their care and understood options around choosing to withdraw or not receive care.

Well-led:

Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. People with protected characteristics felt supported. Staff understood their roles and responsibilities. Managers worked with the local community to deliver the best possible care and were receptive to new ideas. There was a culture of continuous improvement with staff given time and resources to try new ideas.

Updated 29 October 2025

We carried out this assessment on 25 and 26 November 2025.

Children and Young Peoples care includes services located at Southampton Children’s Hospital (SCH) and Princess Anne Hospital. These locations are part of the University Hospital Southampton NHS Foundation Trust.

We carried out this comprehensive assessment as the services had not been inspected since 2015. We assessed 5 key questions; safe, effective, caring, responsive and well led.

The inspection team comprised of a CQC inspection manager, inspectors and a specialist advisor. We spoke with more than 40 members of staff, including senior leaders. We made observations and looked at documentation related to the services provided and reviewed 8 patient records. Additionally, we spoke with 6 patients and 15 parents.

The trust provided formal evidence to us at our request, which was reviewed as part of the assessment process.

We rated Children and Young Peoples care as good overall because:

People were involved in the assessments of their needs and were given opportunities to make decisions and choices with support where needed. Staff made sure people understood their care and treatment to enable them to give informed consent. Staff reviewed peoples progress and took account of their personal needs, communication and made changes where additional needs were identified. Treatment and care was based on the latest evidence and good professional practice guidance. Staff worked with the multidisciplinary team and other agencies involved in people’s care, to ensure the best outcomes for them. Transitions of care and discharge from services were managed in ways which ensured smooth arrangements.

The service had a good incident reporting process, which included investigations and shared learning. There was a positive culture where people who used the service and staff could raise concerns. People were protected from risks and kept safe from avoidable harm. Patient areas were safe and clean, were well equipped and generally maintained and suitable. Staff assessed and managed risks to patients and themselves well. Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. The service used systems and processes to safely prescribe, administer, record and store medicines. There were mostly enough staff with the right skills and experience to deliver treatment and care safely.

People were provided with information in ways which supported them to understand treatment and care. There was a shared vision and culture based on meeting people’s needs to the highest possible standards, based on listening, learning, openness and trust. Departmental leaders were visible, knowledgeable, and supportive to staff. Staff mostly felt valued and respected and that they were treated equally. They understood their roles and responsibilities. Children and Young Peoples actively sought to make improvements and took opportunities to improve practice, through learning, quality improvement and research.

However, there were constraints in some service areas, which meant staffing was reduced. This sometimes caused delays for patients in having assessments, diagnostics and accessing services in a timely manner. Whilst statutory and mandatory training was available to staff, they did not always undertake this as expected.

Updated 17 April 2019

• The leadership, governance and culture were used to drive and improve the delivery of high-quality person-centred care.
• People who used the medical care services were kept safe from avoidable harm because there were suitable arrangements to enable staff to identify and respond to risks.
• There were sufficient numbers of staff, and they had been provided with safety training. Staff were further supported through service related policies and procedures in addition to evidence based professional guidance.
• Feedback from people using medical care services, and those close to them, was positive about the way staff treated them. Patients and their relatives gave us examples of how staff went an extra mile to provide care and support that exceeded their expectation. For example, the trust registered 18 pets as therapy dogs for both child and adult services.  These pets visited the stroke and dementia wards regularly.  
• Patients told us staff demonstrated genuine affection, care and concern for them. Patients and family members gave us examples of how staff ensured patients’ emotional and social needs were as important as their physical needs.
• Services provided by the medical care reflected the needs of the local population.
• The service used technology innovatively to ensure people had timely access to treatment, support and care.

However:

• Not all nursing and medical paper records for patients were stored securely.
• Incidents and learning from medicine administration errors were not shared across the medical teams.

Updated 13 June 2017

Updated 17 April 2019

We previously inspected outpatients jointly with diagnostic imaging so we cannot compare our new ratings directly with previous ratings.

We rated it as requires improvement because:

• The service did not effectively control all infection risks.
• The service had capacity issues in certain departments and could not cope with the volume of patients attending clinics.
• Systems and procedures to monitor and manage risks to patients had failed which had led to patient harm.
• It was unclear if there was a robust system for providing feedback and lessons learnt from complaints or incidents to staff working in outpatient services.
• It was unclear if the outpatient services had robust, well-established and effective leadership and governance processes.

However:

• Staff were supported through service related policies and procedures in addition to evidence based professional guidance.
• Feedback from people using outpatient services, and those close to them, was continually positive about the way staff treated them.
• Services provided by the outpatient departments mostly reflected the needs of the local population.
• Most patients were able to access the service in a timely way, with many specialties in line with or close to the national averages in waiting times.

Updated 13 June 2017

Updated 17 April 2019

• Treatment was delivered in accordance with National Institute for Health and Care Excellence (NICE) and Royal College of Emergency Medicine (RCEM) guidelines.
• The department was a research active centre, participating in multiple research studies in conjunction with colleagues from across different specialities.
• Where clinical audits demonstrated deviation from benchmarked peers, the department worked to identify contributing factors, instigate changes to practice and then revisit those changes to ensure positive clinical outcomes were achieved.
• The department recognised an unplanned re-attendance rate which was marginally higher than the national average; it was considered this was likely attributable to data quality issues and the way the trust reported their data.
• The department had been dynamic in developing alternative professional development pathways including encouraging staff to undertake the advanced care practitioner course. Nursing staff and advanced care professionals were trained to undertake advanced procedures including the management of patients who presented with acute coronary syndromes. We observed nursing staff managing specific clinical cases with good support provided by consultants.
• The children’s emergency department was staffed by qualified children’s nurses 24 hours a day. The department employed four specialist paediatric emergency medicine consultants who supported the children’s ED whilst also liaising closely with the children’s hospital.
• Twelve health care assistants had received training in dementia and were recognised as dementia champions. Staff working across the emergency department had good knowledge of the procedures and policies to support people in crisis.
• Doctors and nurses of all grades were given protected work time to participate in training.
• The vulnerable adult safeguarding team provided comprehensive support to vulnerable patients. The team comprised of highly competent and experienced practitioners whose role it was to support patients from across a group of vulnerable people. The team worked with both internal and external stakeholders to not only prevent patients being admitted to hospital but to also ensure patients were safeguarded, signposted to appropriate support services and ensure the holistic needs of patients was met.
• The department was an exemplar at demonstrating multi-disciplinary working with both internal colleagues and also across the wider Southampton health system.

There were multiple clinical pathways in place which enhanced the patient experience in the department. Clinical pathways aim to promote organised and efficient patient care based on evidence-based medicine and aim to optimise outcomes.

• Staff had the right skills and knowledge to provide safe care and treatment for patients.
• Clinical education was used to support staff and patients.
• All patients had their nutrition needs and hydration needs met and staff assessed and managed patients’ pain effectively.
• Staff had access to best practice reference guides and trust policies in relation to assessing capacity.
• Staff understood how and when to assess whether a patient had the capacity to make decisions about their care.
• Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• The service supported patients by promoting healthier lifestyles.
• We saw staff being compassionate to patients and their relatives. Patients and relatives spoke highly of the kindness and compassion shown to them by staff.
• We saw staff communicated with and included people so that they understood their care and treatment.
• Staff were non-judgemental and ensured patients were placed at the centre of care planning.
• The trust’s urgent and emergency care Friends and Family Test performance (% recommended) was better than the England average from September 2017 to August 2018.
• The service had managers at all levels with the right skills and abilities to run the service, providing high-quality sustainable care.
• The service had a vision for what it wanted to achieve and we saw evidence of actions to achieve it.
• Managers promoted a positive culture that supported and valued staff, free from bullying, harassment or discrimination, creating a sense of common purpose based on shared values.
• The service had effective systems for identifying risks, planning to eliminate or reduce them, and coping with both the expected and unexpected.
• Learning from complaints were shared across the emergency department through daily regular team meetings. Complaints were reviewed through the emergency department governance meetings. There was evidence of changes to practice and the way the service was provided in response to complaints.
• Leadership at departmental level was considered by staff to be supportive and effective.
• Departmental staff were aware of the departments values and the values of the trust.
• There were assurance systems implemented to ensure the identification and management of risks was undertaken and appropriate action taken.

However:

• Not all staff had completed their statutory and mandatory training.