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

There was a shared direction and culture managed by capable, compassionate and inclusive leaders. Staff felt safe to speak up. There were good governance structures and close working with partners and the community.

Well led is rated as good. This meant children and young people’s needs were met through good organisation and delivery.

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.

There was a shared vision, strategy, and culture. The vision, values, and strategy had been developed through a structured planning process in collaboration with people who use the service, staff, and external partners. The 2025/2026 strategy, ‘Helping us to deliver Big Moves’ included an approach to tackle health inequalities, focusing on Children and Young People Services with the renewal of the dedicated Children and Young Peoples Board.

Staff told us they understood the strategy for the service, the vision and planned improvements.

Staff and leaders demonstrated a positive, compassionate, listening culture that promoted trust and understanding between them and people using the service. The culture was focused on learning and improvement and there was a mutual trust and respect between leadership and staff.

Staff at all levels had a well-developed understanding of equality, diversity, and human rights, and they prioritise safe, high-quality, compassionate care.

Staff and leaders ensured any risks to delivering the strategy, including relevant local factors, were understood and had action plans to address them. They monitored and reviewed progress against delivery of the strategy and relevant local plans. The service had paediatric executive and non-executive safety champions, these were established in February 2024. The safety champions were able to highlight any safety or quality concerns and develop strategies for tackling these.

The trust had a plan for reaching its sustainability and carbon reduction goals. The action plan to achieve these goals included working with partners in the integrated care system, local authorities, community groups, and other NHS trusts. There was a sustainability steering group which had been set up in 2018 and reported on the progress in reducing emissions and waste and tracked the Green Plan targets. Targets matched those set by NHS England’s net-zero ambitions by 2040.

There was a strong patient-focused culture. Patients were encouraged to give feedback and raise concerns through the trust-wide NHS Friends and Family Test survey.

Staff told us they felt supported by ward managers and matrons, and they felt there was good team working within the service.

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 clear management structure with no vacancies at senior level. Staff were given the opportunity to develop leadership qualities and develop their roles. All matrons, managers and all staff knew their job roles and understood the accountability requirements.

Leaders were visible and approachable, led by example and modelled inclusive behaviours. Staff told us ward managers and matrons were supportive, and they could speak to them regarding any concerns they had. Notes from staff meetings, where managers would raise any concerns they had in relation to staff practices, showed how they could bring improvement.

Leaders were knowledgeable about issues and priorities for the quality of the service and were able to access support for their own roles. They were alert to any examples of poor culture that might affect the quality of care for children and young people or have a detrimental impact on staff.

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

Staff were encouraged to speak up and to raise concerns. Leaders promoted the value of speaking up. The trust had a dedicated Freedom to Speak Up Guardian (FTSUP). The guardian’s role was to support workers to speak up when they felt they were unable to in other ways. Information about speaking up was easily accessible on the trust’s intranet. The staff had a good understanding of what the guardian’s role was. Staff told us they would approach them if they felt it was needed but would generally approach their line manager in the first instance for support and guidance.

There was a good culture of speaking up where staff felt safe to raise concerns without fear of detriment. Concerns were handled sensitively and confidentially and mindful of people’s rights and responsibilities.

The service valued diversity in its workforce. Staff worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. The service had commissioned a cultural review following concerns raised by staff in early 2025 around equality, diversity, and inclusion. Following our inspection the service submitted in evidence the findings of the report which gave the opinion that the department had ‘responded promptly and commendably, demonstrating openness and a genuine commitment to identifying and addressing potential blind spots’.

The service had a diverse staff team and staff felt there was good teamwork and a positive culture around equality, diversity and inclusion.

There was a commitment to supporting equality, diversity and inclusion through peer-to-peer networks. These included staff networks including an ethnic minority staff group, disability networks, LGBTQ+ groups. Also, the freedom to speak up team, staff support from the clinical psychology team, and chaplains.

The trust completed equality, diversity, and inclusion reports, including the headline reports for the Workforce Race Equality Standard and the Workforce Disability Equality Standard.

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

Staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss, and learn from the performance of the service.

The service had a clear governance structure. The managers operated effective governance processes throughout the service and with partner organisations. They had structures and systems of accountability, so all levels of the management knew and understood their roles and responsibilities.

The service had a risk register. The risks were dated from when they had been identified, showed if they had been approved or waiting approval, and how the service was mitigating the risks. One of the top risks was the treatment room on MacGregor ward was being used to resuscitate deteriorating children and young people. Due to the room layout, there was minimal space for the team to effectively resuscitate the child or young person. Also, insufficient space to draw up emergency medication and create a safe environment. To mitigate the risks and provide assurance for patient safety the service ran regular skills drills for the team to ensure they were compliant and familiar with the space. Equipment had been moved if not needed and only essential clinical staff were allowed in the room. They ensured the room was uncluttered and daily emergency equipment checks were carried out by nursing team. The service had plans to make improvements to the treatment room and the actions completed were included on the risk register.

There were a range of meetings to cover governance, quality and safety for both children’s and neonatal services. Minutes recorded from the family health safety audit and governance meeting covered a range of key topics. This included, for example, patient safety reports, staff vacancies, infection control, health and safety, and mandatory training compliance. Incidents were discussed to determine how learning and changes were to be implemented. The team also discussed pharmacy concerns and audit results. The team discussed how they were going to address arising risks and issues. Action plans were assessed for their progress. They showed the issue raised, the assurance received, the action and timescale of when this was to be met.

Minutes for the monthly children and young people’s assurance group meeting covered performance and operational issues.

We reviewed meeting minutes from the family health safety audit and governance meeting which was held monthly. The meeting covered, but was not limited to, infection prevention and control audits and review of patient safety reports. Also discuss were the challenges providing services for the high volume of children attending with mental health needs and the impact on other services for children and young people. The attendees at the meeting identified actions to be completed.

The service reviewed hospital data for learning from deaths, and a review was undertaken every month at the mortality surveillance committee meeting. This panel met monthly to identify actions and shared learning from these reviews with the departments in the service and across the wider trust.

There was a range of audits used to understand care and treatment and the quality and safety of how it was provided. These audits were well documented and completed at different frequencies as pre-determined by the audit schedule.

The service understood the duty to collaborate and work in partnership, so services worked seamlessly for people. Staff shared information and learning with partners and collaborated for improvement.

The service worked well with outside agencies. These included key relationships with the local authority, police, and mental health services. This was to provide care which was joined up and supported people to be safe and live well in their community. There were good relationships with the rest of the trust’s services, where services overlapped or were co-dependent. The service worked well with other local NHS trusts, community services, local schools, and local charities.

The service worked in partnership with the Child and Adolescent Mental Health service (CAHMS), Crisis and Home Treatment Team to ensure children and young people received timely, responsive mental health assessments.

The service had a children and young people’s partnership and transformation group. The group focused on enhancing care through collaborative, evidence-based initiatives. They involved children and young people in giving feedback on the service, their experience and opinions on planned improvements or innovations. The group met once and month and had an agenda and action plans. There was also a part of the meeting for child and parent stories and the development of mental health services.

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 contributed to safe, effective practice and research.

Staff and leaders had a good understanding of how to make improvements happen. The approach was consistent and included measuring outcomes and impact. For example:

• The service had a plan for improvements to the wards including a redesign of the treatment room and the clean utility room. There were plans to increase capacity on the paediatric assessment unit which would allow flexibility to see more patients. The plans we viewed detailed 5 additional bed spaces, 1 consultation/assessment room, 1 multi-purpose room to be used for measuring height, weight, or blood tests. The plans also included extra facilities for staff.
• The service was trialling a paediatric rapid assessment clinic (RAC) to allow some children and young people that previously would have been seen in the paediatric assessment unit to be seen in the RAC. This would only be for patients presenting with specific complaints. Advanced clinical practitioners would lead the RAC, and it was hoped to reduce assessment waiting times and result in less need for consultant follow up. From 1 May 2025 to 30 September 2025, 28 patients had been seen in the RAC. As this is a pilot for the scheme there were 12 clinics over this period. The need for consultant follow-up had reduced by 68%, and 32% of patients were successfully treated and discharged on their first appointment. Feedback from patients, families, and carers was positive. They appreciated access to rapid appointments, and the onward referral and consultant process was clear. The service planned to increase the capacity of the RAC in the future and to include GP referrals.

The service had been praised for innovation and improvement. The Avoiding Term Admissions into Neonatal units’ programme (ATAIN) showed improvements made reducing newborn admissions to the special care baby unit from implementation of the ATAIN programme. NHS England highlighted the work at the service in this programme.

There was fundraising from staff for new facilities. On 31 May 2025, a team of doctors and nurses at the trust completed the Snowdon Sunset Challenge, a sponsored climb to raise funds for the creation of a therapeutic cubicle on the paediatric ward. The trust reported how “This initiative demonstrates our commitment to improving the experience and safety of children and young people in crisis, while supporting staff wellbeing and morale. Funds raised are being used to transform a ward cubicle into a dedicated therapeutic space for children and young people with mental health, neurodevelopmental, or learning disability needs.”

The service focused on continuous improvement, learning from neurodivergent young people and committing to making positive improvements to benefit all patients. They worked with ‘The Young Inspectors Programme’ to introduce and strengthen co‑production and ensure children and young people had a voice directly to influence ward environments. Children and young people had told the trust they wanted more involvement in their care environment. Young inspectors conducted an independent review of the ward environment and spoke with families and patients. They assessed privacy, signage, sensory needs and emotional support on the wards. Recommendations from the Young Inspectors report were clearer signage and quiet zone designation, older children’s room development priorities, and development of an action tracker.

Patient feedback was sought through the trust-wide NHS Friends and Family Test survey. The service received 217 completed questionnaires in the 2024 survey. Recommendations from the survey included:

• Review provision of activities and toys available for children and young people. Where possible, seek to offer a variety of activities for patients to take part in during their stay.
• Address the issues that are bothering children and young people while in the waiting areas. Ensure patients are kept updated about waiting times and next steps and provide activities as distractions if needed.
• Review the access to hot drinks for children, young people, their families and carers.
• Address the issues that are preventing children and young people from sleeping at night. For example, look at the lighting on wards and surrounding areas at night, and monitor noise levels to ensure that staff are aware of actual levels and can act where needed.
• Prioritise addressing why some parents said their child could not get help from staff when they needed it.
• Review resourcing to ensure there is support available while patients are waiting.

The trust developed an action plan and made improvements which included highlighting the play and activity facilities to children, young people, their families and carers on arrival. They put a DVD player and colouring kits in the waiting area. Made hot meals available to all parents and carers 3 times a day. Hot drinks were now allowed on the ward with new cups with lids provided to reduce risk of spillage/scalding. Volunteers were invited onto the ward to help support parents and a clinical team to be allocated to the service in the waiting area.