Warwick 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 the last inspection this was rated as requires improvement at this inspection we have rated this as good. This meant there was good leadership and a culture that created high-quality 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 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.

There was a Coventry and Warwickshire integrated care system (ICS) strategy that had been developed between services across the region. Strategic priorities included early identification of palliative and end of life, timely access for all diverse communities, support for people with life limiting conditions, improved quality of care, and delivery of a sustainable system of palliative and end of life care.

Executive leaders for the service told us that work was in progress to develop and implement a new trust wide end of life care strategy. This included developing a clear criteria for when the SPCT should be involved in patient care, capacity, demand, service specification, education, training and governance. The SPCT were reactive to staff and patients’ needs and sometimes got involved in patient care that were not always complex palliative or complex end of life care patients. Leaders told us this was being reviewed as part of developing the criteria. Action plans were being developed as well as a review of a 7-day service model. Leaders were working closely with the Integrated Care Board (ICB), other local trusts, community services and hospices to ensure continuity of care, vision, strategy and consistency across the area.

All staff on the palliative care team were passionate about their work and responsive to the needs of people. The culture of the team focused on patient safety and care. Staff within the SPCT team told us the culture was friendly and supportive.

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.

The chief nursing officer and the chief medical officer were the executive leads for the service. The palliative care team belonged to the out of hospital division and reported to a general manager and lead nurse. The team met with the leaders and the chief nursing officer chaired the end of life care committee meeting. Staff felt supported by their managers and that management were accessible and available.

There was a succession planning document that included training opportunities and needs, leadership development and secondment options. This was embedded into the trusts workforce development strategy.

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

The hospital had Freedom to Speak Up champions. A Freedom to Speak Up Guardian is a named person in every hospital who can provide independent support and advice to staff that want to speak up. Staff told us they were aware of the champions and would access them if required.

Managers supported an open and honest culture. All staff we spoke with felt supported, respected, and valued. The culture encouraged openness and honesty at all levels within the organisation. Staff told us they felt able to raise concerns and they were listened to by the leaders of the service. Staff described a ‘no-blame culture’ which empowered them to raise any concerns.

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 trust consulted with staff, service users and local community groups on its Equality Impact Assessments, which covers all areas of equality legislation including race, gender, disability, age, sexual orientation and religion and belief.

The trust had network support groups for staff including Black, Asian and Minority Ethnic (BAME), LGBT, Veterans, disability and neurodiversity.

There was an Anti-Discrimination helpdesk that was managed by the trust’s Equality, Diversity and Inclusion Lead and Freedom to Speak Up Guardian. All concerns were treated with confidentiality.

There was an equality and diversity policy. Equality and diversity and human rights training was part of staff’s mandatory training programme; 100% of the SPCT had completed this. All staff completed an annual employee survey. Staff completed human factors training which helped staff understand different learning styles, behaviours, cultures, and values.

The Equality and Diversity Steering Group reports to the trust board.

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

There were clear and effective governance, management and accountability arrangements. Staff understood their role and responsibilities.

The local governance structure included daily MDT handover meetings, weekly integrated hospital, community and local hospice MDT meetings and monthly governance meetings. Meetings were held with palliative care services across the wider community, this included other local trusts, hospices and community services. The meeting discussions included staffing, risks, training and Dying Matters week.

The SPCT have not had a local team meeting in the last 12 months, a team meeting was planned for November 2025. However, the team met daily to discuss patients care, staffing, complaints and incidents.

There was an acute end of life care committee, chaired by the chief nursing officer which was reviewing the priorities, risks, commissioning, service review and governance within the new strategy.

Bi -monthly Quality and Performance meetings were held and reviewed staffing, patient referrals, training and appraisal compliance, complaints and incidents. We saw action logs were assigned to staff with dates for completion and escalation.

A variety of audits were carried out by the SPCT team including, NACEL, mouth care, completion of death certificates, anticipatory medication prescribing at end of life and fast track patient discharges. The trust had action plans for audits where they scored lower than the national average.

The service had a risk register with 2 risks recorded, one for staffing and one for the lack of psychological support for some patients in the community. Both had action plans and review dates.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. Staff share information and learning with partners and collaborate for improvement.

The SPCT team worked closely with other local trusts, community staff, GPs, hospices and local charities. The daily MDT meeting discussed patients needs, capacity and staffing levels. Patient information was shared on care and treatments to ensure continuity of care.

One consultant met regularly with the local ICB to review provision for care both in the trust and the community.

The trust contributed to an external website called Care and Support Towards Life’s End (CASTLE) the website had evidence-based guidelines, documents and policies. The website could be used by staff patients and relatives across the trust and community.

The team engaged with local charities that offered support to patients and families at the end of their lives, including a singing choir, hand holding services and listening and counselling services.

Feedback from partners in the community was positive about the engagement of the trust’s palliative and end of life care services. They described trusting and collaborative relationships.

The service focused on continuous learning, innovation and improvement across the organisation and local system. Staff encouraged creative ways of delivering equality of experience, outcome and quality of life for people. Staff actively contribute to safe, effective practice and research.

Staff told us they were committed to learning and improving. There was a strong focus on developing the skills of staff to promote their professional growth within the hospital.

A programme had been developed to enable wards to be given bronze, silver and gold awards, with awards planned in 2026, dependent on the level of staff training and involvement in palliative and end of life care. The purpose was to encourage training, staff involvement and improve palliative and end of life care in the hospital.

Since our last inspection the trust have employed additional consultants to work in the SPCT team. They work closely with other local trusts to ensure there is 24 hour access to consultant support. They are currently reviewing the 7 day service and developing business cases.

Staff follow the trust guidance on making a referral to the SPCT team via email, phone call and face to face, the trust were reviewing referrals to the SPCT to ensure they are appropriate.

The end-of-life care facilitator was developing toolkits for staff, patient and relatives to use for those who are at the end of life including recognising signs of death and care after death. They were using a Robin as a symbol to be easily recognised for patients receiving end of life care. The toolkit included a comfort box with items such as toothbrush, dry shampoo, wooden heart and crosses, paper and pen and lip moisturiser.