Basingstoke and North Hampshire Hospital

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question as good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

The Emergency Department (ED) was effective, using evidence-based guidelines to ensure treatment was reliable and current. The use of specialist teams ensured care could be tailored to meet people’s needs. Key strengths included good teamwork and positive patient outcomes.

We have not awarded this service a score for Effective.

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

Description: We maximise the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The service used a range of risk assessment tools. For example, staff had access to tools for skin integrity assessments, falls, and pain monitoring. Staff reported how they proactively placed patients identified as at risk of falls in observable bed spaces. Staff told us they used body maps to document a patient’s skin condition upon admission, which they stated was crucial for identifying the origin of pressure wounds. And patients we spoke with confirmed they had been asked regularly about their pain and offered pain relief. This meant staff responded to the outcomes of patient risk assessments and adapted their approach to changing needs of patients.

Leaders in the Emergency Department (ED) recognised the increased number of patients with mental health needs. In response, they used specific assessment tools to identify their level of risk. Staff used a ‘Mental Health Risk Safeguarding and Safety Check’ template and performed a mental capacity assessment for every patient with mental health concerns. We reviewed 3 patient records which confirmed these assessments were completed. This process was supported by an audit (February to July 2025) which found 100% of reviewed patients experiencing mental health concerns received an initial risk assessment within 15 minutes of arrival to the department. This demonstrated that staff had the right tools and skills to prioritise patient needs and direct them on the most appropriate pathway.

The ED had a clear pathway for supporting people with mental health needs. The documented level of risk included the risk of suicide and self-harm. The service audited a sample of patient records and found these assessments were completed quickly. Staff told us this was further supported with clinical judgement. We observed this process during our inspection and saw it led to the correct prioritisation of care. Although staff told us patients experiencing mental health distress did not always receive the one-to-one care they needed, we observed 3 high-risk patients receiving this level of care in response to their risk assessments.

Description: We plan and deliver people’s care and treatment with them, including what is important and matters to them and in line with legislation and current evidence-based good practice and standards.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The Emergency Department (ED) had systems to ensure patient care was based on the latest medical information. Staff told us they used a medical app, which provided real-time access to a library of over 300 clinical guidelines from authoritative bodies like the National Institute for Clinical Excellence (NICE) and the Royal College of Emergency Medicine (RCEM). This digital resource allowed staff to quickly reference standards for common conditions, such as NICE’s guidelines for head injuries or RCEM’s guidelines for acute pain management. Additionally, staff used an electronic system featuring evidence-based risk assessment templates and tools like the Malnutrition Universal Screening Tool, to identify patients at risk of malnutrition. This meant patients received treatment that was consistent, reliable, and informed by current research.

The service participated in national benchmarking audits, such as the RCEM Time Critical Medications Audit. This audit focused on ensuring patients receive all expected time-critical medications on time during their ED stay. Clinical decisions using national risk assessment tools meant patients’ needs were identified and planned for.

The ED demonstrated effective teamwork by making it easy for staff to quickly get support from experts, which in turn helped keep the department running efficiently. Staff told us they had access to many specialist teams within the hospital, including physiotherapists, occupational therapists, social workers, and dieticians. Staff reported these teams were responsive. For example, timely social worker involvement was noted as a direct aid in supporting patient discharges. This meant patients with complex health needs received specialist input. And evidence-based care could be delivered effectively by the right teams.

Description: We work effectively across teams and services to support people, making sure they only need to tell their story once by sharing their assessment of needs when they move between different services.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff across the hospital used formal and informal communication methods to coordinate care and manage patient flow. Daily huddles occurred 4 times a day, bringing together site managers, matrons, and other key personnel to discuss patient flow and site status. Doctors held separate handovers 3 times daily to discuss critical patient information.

Ambulance crews and Emergency Department (ED) staff used the SBAR (Situation, Background, Assessment, Recommendation) handover process to help ensure safe patient transitions. This structured communication approach meant nurses and doctors received all vital patient information, enabling them to provide appropriate care. Ambulance staff told us they had a good and collaborative relationship with the ED staff.

The department worked well across teams and services to support patients’ needs. For example, staff told us they established a soft divert arrangement with Winchester Hospital, enabling the 2 sites to work together. This collaboration allowed the hospitals to balance workload, particularly when one location experienced high demand. Furthermore, this pathway ensured patients presenting at Basingstoke Hospital who required specialist services, such as urology or stroke services, could be transferred quickly to Winchester Hospital for dedicated care.

Staff had 24-hour access to the Mental Health Liaison Team (MHLT). Both ED personnel and the liaison team reported a positive and supportive working relationship. This meant ED staff could be supported by mental health specialists when managing challenging mental health presentations.

Description: We support people to manage their health and wellbeing so they can maximise their independence, choice and control, live healthier lives and where possible, reduce their future needs for care and support.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

The service used posters and noticeboards to educate patients and staff on self-care and disease management. For instance, an NHS poster titled, “Improve your inhaler technique here” provided a guide for various inhalers.

The hospital encouraged the public to use pharmacies as a first point of contact for common ailments. An NHS campaign, “Visit your Pharmacy First”, listed 7 conditions – including sore throats, earaches, and shingles, that pharmacies could treat, which helped to reduce the need for a GP appointment and unnecessary Emergency Department (ED) attendance.

To promote healthier lifestyles, the ED displayed posters on public health issues like alcohol consumption. An “Alcohol Awareness” noticeboard gave information on recommended weekly alcohol limits and offered health advice related to drinking.

Description: We routinely monitor people’s care and treatment to continuously improve it and to ensure that outcomes are positive and consistent, and that they meet both clinical expectations and the expectations of people themselves.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The Emergency Department (ED) held monthly governance and bi-weekly performance meetings to review patient outcomes. This constant monitoring allowed staff to regularly review and update patient care protocols and ensure the use of appropriate referral pathways. Similarly, the ED measured its performance against national standards set by The Royal College of Emergency Medicine (RCEM). In the RCEM Care of Older People audit (covering October 2023 to September 2024), the service scored above the national average. This meant outcomes for older patients were positive and consistent, and they met both clinical expectations and the expectations of people.

In the Urgent Emergency Care Survey 2024, the department’s scores for keeping patients updated on their wait times were the same as the national average, reflecting effective communication. Furthermore, the trust’s percentage of patients who re-attended the ED within 7 days of their original visit was consistently lower than both the South-East and national averages from December 2022 to November 2024. This data demonstrated the effectiveness of the initial care provided and the appropriate use of alternative care pathways.

The hospital exceeded its goal for getting older patients discharged within 48 hours. It often reached a 40% discharge rate. This meant the service was efficient at getting older patients home quickly when it was safe to do so. It is important to get older patients home quickly from hospital because prolonged hospital stays (especially for frail or elderly individuals) can lead to negative outcomes, such as deconditioning. The trust was working on reducing the number of older patients returning to the hospital after being discharged. The department was monitoring this and initiated Quality Improvement projects to address this.

Where staff referred patients to the Mental Health Liaison team, they assessed and monitored adults, children, and young people with mental health presentations to ensure they were transferred to the right mental health service.

Description: We tell people about their rights around consent and respect these when we deliver person-centred care and treatment.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

The hospital’s consent policy was built on the legal principle that every adult has the right to decide whether to accept or refuse medical treatment. The service recognised its duty to provide care was balanced by a patient’s right to choose for themselves. When a patient was unable to make a decision, staff had a duty to provide treatment they believed was in the best interests of the patient. Staff also described how they handled refusals, assessing the patient’s capacity and determining if their decision was due to external pressure.

During our inspection, we observed staff seeking consent from patients before providing any care or treatment. Staff had a good understanding of consent, including the difference between informed and implied consent. We reviewed 3 patient records where a concern about the patient’s ability to consent had been noted, and we found mental capacity assessments to be completed correctly. This meant patients’ rights were protected.

Staff received training to support individuals in their decision-making, and the hospital’s policies aligned with the Mental Capacity Act 2005 and the Children’s Acts 1989 and 2004. Receptionists were also trained in these requirements. The hospital respected the capacity of individuals under 18 to consent to their own care in regard to Fraser and Gillick competency. This meant a child could consent to their own treatment if they were deemed to have a clear understanding of their treatment options and would be assessed on an individual basis. This helped to ensure the autonomy of every young person was respected if they were found to be competent to make their own decisions.