Northampton General Hospital

Updated 13 August 2025

Northampton General Hospital (NGH) provides general acute services for a population of 426,500 in West Northamptonshire and hyper-acute stroke, vascular and renal services to people living throughout the whole of Northamptonshire. The hospital is also an accredited cancer centre and provides cancer services to a wider population of 880,000 who live in Northamptonshire and parts of Buckinghamshire. We rated this service under our previous methodology in November 2024, where it was rated ‘Good’ overall.

We carried out an unannounced assessment of urgent and emergency care (UEC) and medical care services at Northampton General Hospital on 18 & 19 February 2025. The assessment team consisted of CQC inspectors, CQC managers and specialist advisors. The assessment focussed on 24 quality statements under Safe, Effective, Care, Responsive and Well Led domains. Following the assessment, the UEC service has an overall rating of requires improvement, and medical care services has an overall rating of requires improvement. The rating from UEC and Medical Care has been combined with ratings of other services from previous inspections. See our previous reports to get a full picture of all the services at Northampton General Hospital. The overall rating of Northampton General Hospital is now ‘requires improvement’. 

Updated 6 February 2025

Northampton General Hospital (NGH) is part of the University Hospitals of Northamptonshire. NGH provides acute medical services for a population of 426,500 patients in West Northamptonshire. The hospital provides hyper-acute stroke, vascular, and renal services to patients living throughout the whole of Northamptonshire and on the borders of neighbouring counties. The hospital has an accredited cancer centre and provides cancer services to a wider population of 880,000 patients living in Northamptonshire and parts of Buckinghamshire. We last inspected this service under our previous methodology in 2019, when it was rated as ‘requires improvement’.

We carried out an onsite assessment on 18 and 19 February 2025 of urgent and emergency care and medical care as part of a review of urgent and emergency care and systems pathway pressures work.

We assessed 24 quality statements and have combined the scores for each of these to give the overall rating. We looked at all quality statements under the key questions of Safe and Well-led. After our assessment, the service’s rating remained the same.

As part of this inspection, we visited the following wards: Esther White Ward, Creaton Ward, Brampton Ward, Holcot Ward, Becket Ward, Allebone Ward, Dryden Ward, Knightley Ward, Benham Ward, Eleanor Ward, Hawthorn Ward, the Discharge Lounge, and Walter Tull Ward. We visited the hospital to check that suitable care, equipment, and processes were in place during times of higher system pressures. We spoke with 41 members of staff, and 17 patients, observed 3 board or ward rounds and 2 operational bed meetings.

During this assessment, we found some concerns about patient flow through the hospital, infection prevention and control, and record keeping. We raised concerns with the provider during and immediately following the inspection as required.

We found 3 breaches of the legal regulations in relation to infection prevention and control, medicines management, supporting staff with annual appraisals, and training and governance.

Staff did not consistently follow best practices for infection prevention and control and did not always document medicine administration times. We also found that venous thromboembolism risk re-assessments were not always carried out in line with national guidance.

Appraisal compliance for some staff groups was poor.

Governance processes were not managed effectively to ensure risks were identified and mitigated and that action plans for service improvement were monitored and reviewed.

On 20 March 2025, we served a Section 29A Warning Notice to inform the trust that significant improvements were required to improve patient flow through medical care and to ensure timely discharges.

In instances where CQC has decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/ or appeals have been concluded. We have asked the provider for an action plan in response to the concerns found in this assessment.

Updated 6 February 2025

Urgent and Emergency Care services at Northampton General Hospital are provided by Northampton General Hospital NHS Trust. We carried out this assessment on 18 and 19 February 2025 as part of the system pathway pressures programme. We inspected 24 quality statements across the key questions Safe, Effective, Caring, Responsive and Well-led and have combined the score for each of these areas to give the rating.During this inspection, we visited the emergency department (ED) and Same Day Emergency Care (SDEC). We reviewed the environment, staffing levels, looked at care records and prescription records. We spoke with 47 staff members across various grades and 31 patients and observed meetings. We reviewed performance information about the trust and observed how care and treatment was provided.

At our last inspection in 2019, Northampton General Hospital was rated as Good overall and for all key questions for urgent and emergency care. At this inspection in February 2025, we rated the emergency department as “requires improvement”

On 20 March 2025, we served a Section 29A Warning Notice to inform the trust that significant improvements were required to address concerns we found that could lead to patient harm, improve management of patient flow out of the emergency department and make sure patients’ privacy and dignity needs were being met.

We found 3 breaches of the legal regulations in relation to safe care and treatment, safe staffing and governance. We requested an action plan to address these concerns.

People were at risk of harm because risks were not sufficiently identified and mitigated to ensure the delivery of safe care and treatment, in particular deterioration of condition and development of pressure ulcers. People experienced long waits in the department due to the lack of flow to specialist care in the hospital which contributed to care and treatment being provided in multiple escalation areas. Privacy and dignity was not respected, in particular, communication was not always confidential. There was a lack of governance oversight which meant, incidents were not always reviewed in a timely way, learning and actions from complaints, data and audits were not always identified. Medicines were not always managed in line with national guidance, including time critical medicines were not always administered in line with guidance. Staff received training but compliance did not always meet the trust target or national guidance including childrens safeguarding, Oliver McGowan training and medicines management training. Staff did not always have regular appraisals.

However, department leaders and staff worked well together to deliver care and most staff felt able to raise concerns. There were some pathways for patient presenting with poor mental health. The department monitored the use of restraint. Emergency equipment was available to deliver lifesaving interventions. Staffing levels were appropriate and the department worked together to mitigate risks to staffing competency. Staff spoke positively about working in collaboration with other services. Staff understood legislation around consent. People using the department could expect access to translation services and staff were alert to discrimination. Staff caring for people were supported by departmental leaders.

In instances where CQC has decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/ or appeals have been concluded. We have asked the provider for an action plan in response to the concerns found in this assessment.

Updated 8 November 2017

We rated this service as good because:

• There was a well-embedded culture of incident reporting and staff said they received feedback and learning from incidents.
• Safety thermometer data from the last 12 months reported 100% of “harm free” care in the child health directorate.
• There were clear arrangements in place to safeguard children and young people from abuse, which reflected relevant legislation and local requirements. The majority of staff had undertaken the required level of safeguarding training.
• The service performed well in a number of national audits including the National Neonatal Audit (2015) and the epilepsy 12 audit (2014). Gosset ward was working towards achieving Bliss accreditation.
• Staff had the clinical skills, knowledge, and experience they needed to carry out their roles effectively. Mandatory training and appraisal levels were above trust targets.
• Actual nurse staffing levels met planned rotas during our inspection and patient’s needs were met. Medical staffing was appropriate and there was an effective level of cover to meet patients’ needs.
• Feedback from children and parents was consistently positive and parents told they were treated with dignity and respect.
• Services were responsive to the needs of patients, parents and families and were working towards delivering sustainable seven-day services.
• Staff felt that local leadership was strong with visible supportive and approachable managers.
• The child health directorate was continually developing patient services to ensure innovation, improvement, and sustainability.

However:

• There were not always effective systems in place regarding the storage and handling of medicines in the children’s outpatient department. The trust took immediate action to address this once we raised it as an urgent concern.
• Children or young people on Paddington ward could access the corridor to the delivery suite. This was a risk particularly for patients who may be at risk of self-harm or suicide. The trust took immediate action to address this once we raised it as an urgent concern.

• The pathway for patients who needed to cross the road between buildings had not been reassessed to ensure opportunities to prevent or minimise further harm were not missed. The trust took immediate action to address this once we raised it as an urgent concern.
• The child abduction policy was in draft and awareness was lacking in some areas of the service. The trust took immediate action to address this once we raised it as an urgent concern.

Updated 8 November 2017

We rated this service as good because:

• There was a strong culture of reporting, investigating and learning from incidents. Learning was shared throughout the team.
• Adequate medical and nursing staff was provided to meet the recommended staff to patient ratio, as defined in the core standards for intensive care units.
• There were effective systems in place to protect patients from avoidable harm and improve compliance with standards on a continuous basis. The principles of the duty of candour were well understood by all staff.
• There was clear evidence and data upon which to base decisions and look for improvements and innovation. The unit participated in the Intensive Care National Audit and Research Centre (ICNARC) audit and performed better or as expected in six out of eight indicators.
• The critical care outreach team provided 24 hour cover seven days a week cover and assisted with the monitoring and treatment planning of deteriorating patients throughout the hospital, ensuring risks were responded to appropriately.
• Staff were very caring and kind and provided emotional support for patients and relatives, for example, through the use of patient diaries.
• Leadership was well established and there was a clear focus on improvements and patient safety.
• Structured meetings were held throughout the directorate to review all aspects of quality, risks and performance and high risks were escalated and monitored effectively.
• Effective governance arrangements were in place. There were structured meetings to review all aspects of performance, quality and risks and high risks were escalated through the directorate. Innovation throughout the staff team was encouraged.

However:

• The pharmacy team were aware of the shortfall in band 8a specialist pharmacist support and were providing cover with a band 7 pharmacist. A business case had been put forward, which if successful, would ensure standards were being met.
• Medicines were not always stored safely behind locked doors or in restricted areas. We raised this with the trust and this was rectified immediately by the trust.
• The unit did not comply with the Department of Health’s Health Building Note 04-02 critical care unit’s standards; however, this had been risk assessed and was under review. Refurbishment plans were in place to address this.
• Not all medical staff had completed the required mandatory training.
• Hospital wide bed capacity affected the ability of the service to discharge patients to wards at the most appropriate time. Over eight hour delayed discharges were higher than the national average, however, action had been taken and improvement observed for patients waiting 24 to 48 hours.

Updated 23 May 2017

We rated the service as good overall. Many improvements had been made to raise the profile for the end of life care service in the trust and this had led to improvements in the way patients received safe, compassionate care in their last days. However, more work was required to collect performance information about the service and ensure that mental capacity assessments underpinning decisions about cardiopulmonary resuscitation were being evidenced in patients’ records.

Updated 24 February 2023

Updated 8 November 2017

Overall, we rated outpatients and diagnostics as good. We inspected but did not rate the effectiveness of the service, as we are currently not confident that we are collecting sufficient evidence to rate this key question for outpatients and diagnostic imaging. We rated this service as good because:

• Staff were aware of their responsibilities and understood the need to raise concerns and report incidents. Staff told us they felt fully supported when raising concerns.
• Generally, the design, maintenance, and use of facilities and premises met patients’ needs. The maintenance and use of equipment kept patients safe from avoidable harm. Improvements had been made in some areas in the outpatient environment, which included the expansion of the chemotherapy suite and new equipment in the diagnostic imaging department.
• Appointments were prioritised according to referral requests from GPs with urgent requests and cancer referrals booked within two weeks. The imaging department prioritised reporting higher risk examinations not seen by other clinicians.
• We found that medical and nursing staffing levels and skill mix were planned and reviewed so that patients received safe care and treatment.
• Care and treatment was delivered in line with national guidelines. Staff within the service had the appropriate skills, qualifications, and knowledge to complete their roles safely.
• All teams reported effective multidisciplinary working.
• Patients were treated with compassion, dignity, and respect.
• Feedback from patients and those close to them was positive about the way they were treated.
• Staff made patients’ appointments according to the needs of the individual. This included moving them to allow work and other appointments to take place.
• The service consistently met the referral to treatment standards over time. Waiting times for diagnostic procedures was lower than England average. The service was meeting cancer targets for referral to treatment times at the time of the inspection.
• The "did not attend" (DNA) rate for the trust from June 2016 to May 2017 was 7% and this was same as the England average of 7%.
• Outpatient specialties ran additional evening and weekend clinic lists to reduce the length of time patients were waiting. The radiology department offered a walk in service for all plain film examinations.
• Services were tailored to meet the needs of individuals and offered flexibility in choice with appointments being flexed across a seven day service within the diagnostic imaging department.
• The service had a challenging and innovative strategy that supported the trust vision. This included redesign of departments, introduction of support systems to improve performance and repatriation of services to improve patient experience.
• Staff had awareness of the trust vision and strategy. Staff were aware of the risks within their departments. Staff were proud to work at the hospital and passionate about the care they provided.
• The service had leadership, governance and a culture which were used to drive and improve the delivery of quality person-centred care.
• Staff felt that managers were visible, supportive and approachable. Specialties were focused on developing services to improve patient care.

However, we also found that:

• We found concerns about the fire exit in the fracture clinic. This had been addressed by the unannounced inspection and we found the service had also reviewed all fire exits throughout the service.
• We observed poor infection control practices in both the blood-taking unit and the pain relief clinic. We raised this with the service, and immediate actions were taken to review infection control precautions to mitigate risk. This had been addressed by the unannounced inspection.
• We found issues with the storage of controlled drugs in the pain relief clinic. However, when we raised this with the service, senior managers took immediate action to address storage of these drugs. This had been addressed by the unannounced inspection.
• Not all staff had received the required frequency of mandatory training, including safeguarding. Plans were in place to address this.
• We observed poor infection control practices in both the blood-taking unit and the pain relief clinic. We raised this with the service and this had been rectified by the time of our unannounced inspection.