Southampton General Hospital

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence of children and young people, their parents and carers always being at the centre of how their care was planned and delivered. We checked if the health and care needs of people and communities were understood, and they were actively involved in planning care which met these needs. We also looked for evidence that people could access care in ways which met their personal circumstances and protected equality characteristics.

At our last assessment we rated this key question as requires improvement. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

We have not awarded this service a score for Responsive.

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

The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff tried to ensure children and young people’s needs were person centred and took into account getting to the right place in the hospital as quickly as possible. The 4-hour performance rates for children and young people who were admitted via the emergency department (ED) ranged from 74.7% in November to 95.8% in August 2025. The target for hospitals having an ED was 95% of patients to be admitted, transferred, or discharged within 4-hours.

Since July 2025, 3 patients who were medically fit on arrival to the hospital were admitted. This was because their current social care placement had broken down, meaning they required a place to live until a new placement was identified. These patients had an average length of stay of 23 days. It was recognised this was not ideal for those vulnerable young people at a crucial time in their lives living in an acute hospital, which did not meet their social needs adequately. However, staff did their best to support these individuals in the best ways they could, given the limited availability of external provision.

The CAMHS, play team, youth team and hospital school were essential services providing holistic support to young people who were in this situation awaiting a placement. Play specialists were a vital and valuable part of the team. Despite there being a vacancy rate of just below 1.7 WTE, the team worked to ensure continuity of care. They had a flexible approach to cover most areas, supplemented by an on-call play specialist who triaged and responded to urgent, same-day requests. This model helped the service to maintain responsiveness and support patient experience despite staffing limitations.

There were several teachers, who were available to support educational needs of children. Whilst not employed directly by the trust, these staff felt part of the team and worked closely with staff to ensure children and young people had access to the same age-appropriate schooling as those in the community.

We saw staff speaking with children and young people, explaining aspects of their care and treatment in ways which enabled the patient to feel informed and agree or not to what was suggested.

The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff ensured there was consideration of patient’s needs and who should be involved in helping to meet these. Care was joined up where other specialists were needed, such as physiotherapy, occupational therapy or dietitians. Discharge planning processes helped to identify ongoing needs and supported continuity of care once the patient was discharged. This included where some children and young people would be returning for ongoing treatment through into adulthood.

Access to specialist teams such as the Learning Disability Team, the Psychiatric Liaison Team, and Palliative care was arranged as far as possible, taking account of the availability of reduced services at occasions.

Virtual (non-face-to-face) attendance rate for paediatric (0-16 years) outpatient attendances under the care of an ENT surgeon data was reviewed by us. The latest data showed that, 52.5% of paediatric (0-16 years) outpatient attendances under the care of an ENT surgeon were virtual. This placed the trust in the best performing quarter nationally. The use of virtual attendances can improve equity in services, improving access for people who would otherwise struggle to access healthcare.

The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Parents who spoke with us said they were involved in discussions with medical and clinical staff about their child or young person’s treatment and care. They had the chance to ask questions and have information explained in ways they could understand. Records of discussions were recorded in patients notes.

Information in relation to serious incidents and unexpected deaths were reported in line with expectations. There were processes to investigate and learn from such cases, which included sharing details on changes in practice following patient safety reviews and after-action reports. Information on these outcomes was shared with staff and any patient or family as necessary.

Patient information records were mainly in paper form and were stored in individual folders, which were kept in a documents trolley. Medicine records were stored on an electronic system, which was securely accessed. Paper records used to handover information to staff coming on duty contained information which needed to be handled sensitively. Each staff member who had a copy of this was responsible for destroying correctly at the end of their shift.

The trust had an accessibility statement on the home page and information on navigating the site. There were links to 6 ways to make a device easier to use if a person had a disability. In addition, there was a link to assist a person who may have wanted information on the website in a different format like accessible PDF, large print, easy read, audio recording or braille. There was access to translation services and other communication aids.

Information leaflets were seen on wards, which parents or carers could have. Complaints information was visible on ward areas. Information was available in different formats and could be requested via the patient support hub. Information on transitional care through the ‘Ready, Steady, Go’ staged approach was available in easy read format, which included coloured text and pictures.

A member of the outreach team said they were most proud of the many specialty teams and the provision of good, joined up care for patients. Complex needs often led to many specialties working together to plan for the child or young person’s care and treatment. Good working relationships helped to ensure information and progress of the patient was shared correctly. Long-term patients or re-attendees often led to the development of good relationships with patients and their families.

Mortuary provision was suitably and securely arranged, with access to a viewing room. This was well decorated, calm and peaceful for families. Memory boxes could be created and there was chaplaincy and bereavement support.

The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

Information about making a complaint or raising a concern was clear and visible in wards and departments. Staff tried to resolve complaints as soon as they became aware of them. The total number of complaints in this financial year, 1 April to 1 December 2025 was 28, of which 6 were not upheld, 5 upheld, 6 partially upheld and 2 manged with local resolution. The remaining were cases in progress, (9). Most complaints arose in the Outpatients department and included delays, access to service, communication and failure to diagnose, by way of examples. Feedback to staff where relevant was communicated directly or via the Big4.

Photos of, ‘you said we did’ boards were displayed in ward areas. We saw families were provided with the opportunity to give feedback on their experiences and make suggestions. Responses to comments and suggestions were shared on notice boards. For example, child friendly cutlery had been increased, and the play facilities were open for longer hours.

The family liaison hub supported children, young people and their families to attend events. There were opportunities to be involved in activities, for example, a young child came in to help with decorating the Christmas tree on one ward.

There were facilities in the hospital grounds for parents to stay, especially those coming from a long distance. We heard staff offer this facility to a parent.

The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

Staff made reasonable adjustments for patients, for example, people with mobility issues were provided with walking aids. There were shower chairs and adaptive bathing facilities. Ward G3 had been refurbished since our last inspection. There were ceiling hoists above beds and within the assisted bathroom.

Cancellations of surgery because of not having enough capacity or technical equipment was very rare. Where patients needed to be cancelled because of emergencies, staff were open about this and aimed to rearrange as soon as possible.

There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency. Staff confirmed there was on-call cover during nights and at weekends, providing support and advice as needed to duty medical staff and clinical staff. A healthcare assistant told us doctors were usually quite good at answering their bleeps and they found them easy to interact with.

We were told there was inequality in accessing palliative care services between non-cancer patients and those with cancer, as well as between child and adult care. This was related to reduced staffing numbers and resulted in ward nurses managing complex patients without the level of expertise.

Staff discussed discharge planning as part of the handover of patient information. Patient notes confirmed to us where planning had commenced and what the patient would need for any rehabilitation or ongoing care. For example, we saw information about training family to care for their child who needed a range of support. This training was in progress ready for discharge. One parent and child had been made aware of what was expected and what they were aiming for. They were aware of the possibility of going home that day.

Information was collected around performance in Children and Young Peoples services monthly. We saw for example related to PICU, which had 14 beds, that in September this year total bed days for the month was 363 (down from 380 in August). There had been 48 discharges, 5 of which were out of hours. This was an improvement on previous figures for August and compared to last year.

In Child Health the average length of stay was just over 3 days, with pre-noon discharges at 22.67% in the rolling 13 weeks. Delayed discharges were said to be related to waits for specialised equipment, such as beds and manual handling devices.

The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Children and young people with a disability, learning needs or who were neurodivergent generally had a good experience. There was specialist support available from a suitably trained learning disability nurse, who was supported by the play team and teachers. Whilst the disability lead nurse aimed to see each patient and their family or referring agency prior to admission, this was impacted at times, if annual leave or sickness occurred. However, other staff had the foundations of knowledge and skills to ensure full consideration was made to individual needs and to meet these as far as possible.

People using the service were encouraged to give their views. An example of this was through the clinical accreditation scheme (CAS), which used intelligence from clinical areas and the completion of self-assessments of performance, as well as review teams visiting wards. An initial contact meeting was held and walkabout before considering findings at an outcome panel. Patient representatives had been included in the reviews. The result of this process was a score being given to the area assessed.

The trusts most recent annual report referred to a health inequalities officer, who had been recruited in early 2025. Their role was to provide leadership and coordinate the trust’s health inequalities programme. A set of objectives associated with health inequalities had been created and these were overseen by the Health Inequalities Board, chaired by the chief medical officer and attended representatives from clinical services, patients, organisational development, patient experience, clinical effectiveness, transformation, communications, sustainability and operations.

In children services an equality strategy had been developed for 2025-2028, which included the aim to, ‘Provide Holistic Accessible, Equitable Care for All Children.’ They were aiming to deliver family-centred care, which was ‘accessible, culturally sensitive, and equitable, regardless of background or need.’ We were informed that the service was working with Southampton City Council on the delivery of their health and wellbeing strategy, including their focus on ‘starting well’, focused on health from birth and childhood.

One example of a local health inequality improvement projects within children’s services, was in paediatric diabetes. They had reviewed real-time continuous glucose monitoring, (which uses a sensor under the skin to automatically check blood sugar levels every few minutes), and insulin pump use for type 1 diabetes and how this differed by deprivation and ethnicity to understand barriers in accessing treatment.

Policies reviewed showed evidence of an equality impact assessments to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage. Staff received training on equality, diversity, inclusion and human rights as part of mandatory subjects.

The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

A health inequalities dashboard had been set up, which enabled users to review several key measures across outpatients, inpatients and the emergency department. The Child Health management team had been chosen as the first care group to explore the data available, due to their interest in this area. Part of the health inequalities work with children and young people’s services included focusing on obesity, tobacco dependence and breastfeeding and expressing.

Staff had access to Oliver McGowan mandatory training on learning disability and autism via an e-learning system. As of the 2 December 2025, 85.3% of staff working in child health had completed this. Tier 1 Oliver McGowan 3-yearly training had been completed by 33.1% out of 121 staff required to undertake. For tier 2 training, 15.9% of the 872 staff expected to complete had done so. Training was limited to availability by the Integrated Care Board.

Patient records showed staff had personalised care plans for each patient, based on their needs, wishes and feelings. Individuals with learning disabilities or who were neurodiverse were made known to the service. This included by direct family contact, referrals from the community and from schools. Once known to the learning disability lead nurse they ensured the patient record had a flag to alert staff, and that staff who would be involved in their treatment or care were informed too.

The learning disability lead made every attempt to meet and engage with the patient and their family or carer. This was to better understand their needs, any negative or stressful triggers to them and how staff would be able to prepare and meet those needs on a personal level. Admission plans included for example, having an early arrival time to the hospital, going to the recovery area rather than a ward and then being able to be discharged directly from the recovery too. This minimised contact points and was further assisted in using pictures and familiar toys to set out the pathway. Play specialists were involved in every part of the patient journey and helped to ensure their hospital passport was followed.