Northampton General Hospital

On this page

• 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

We looked for evidence that people and communities had the best possible outcomes because their needs were assessed. We checked that people’s care, support, and treatment reflected these needs and any protected equality characteristics, ensuring people were at the center of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practices as part of their everyday work. We assessed 4 quality statements.

At our last assessment, we rated this key question as ‘good.’ At this assessment, the rating has remained as ‘good.’ This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

Staff delivered evidence-based care and treatment in line with national guidance. Staff and leaders monitored care and treatment outcomes. Staff supported patients to understand their rights around consent and respected these when they delivered person-centered care and treatment. However, staff did not always work effectively across teams and services to support patients to be discharged when they no longer needed to stay in the hospital, and it was not always evident what action had been taken to make improvements when concerns were identified.

The provider was in breach of legal regulations in relation to supporting staff with annual appraisals and providing training for staff to support autistic people.

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.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

Staff delivered care and treatment in line with national practice guidelines.

Patients received care, treatment, and support which was evidence-based and in line with good practice standards. The trust had developed aide memoirs to ensure patients with symptoms of some medical conditions received care and treatment in line with current national guidance. For example, we saw staff used the aide memoir stickers for patients at risk of sepsis and for patients who were at risk of developing acute kidney injury. The aide memoir sticker prompted staff to take timely action to deliver care and treatment. However, some guidance and policies had not been reviewed when they should have been.

Patients’ nutrition and hydration needs were met in line with current guidance. Staff assessed patients’ risks of malnutrition in line with national guidance and referred patients for dietetic review if needed. We saw staff monitored fluid and food intake when patients were at risk. We observed a lunchtime in Esther White Ward and patients said they were offered options.

Staff did not always work effectively across teams and services to support patients to be discharged when they no longer needed to stay in the hospital. Information was not always shared effectively when patients were discharged.

Staff did not always work well together to ensure patients were discharged from the hospital when they were medically fit to be discharged. Staff spoke of the efficiency of the team in the discharge hub in arranging complex discharges. However, there was an overreliance on the team in the discharge hub, and discharge planning was not seen as everybody’s responsibility. Staff were not always sure about which patients should be referred to the discharge hub and did not always feel it was part of their role and/or that they were empowered to discharge patients. We spoke with some nurses who told us they had not seen a social worker join multidisciplinary meetings since the COVID pandemic.

There was a risk that information was not always shared effectively to ensure patients’ needs were met on discharge. Medical staff wrote electronic discharge notes when patients were discharged but these were not always in sufficient detail, up-to-date, and accurate, which could result in patients being re-admitted. We reviewed 6 incidents from December 2024 concerning failed discharges. The incidents included concerns about the quality of care patients had received whilst in hospital and about lack of sharing of information including changes to mobility, skin integrity, and changes to medicine management. We spoke with medical staff who told us there was no standard template which meant the quality of the information could vary.

Medical staff could refer patients to specialist teams for review and referrals were mostly responded to quickly. However, we noted an inpatient 24-hour cardiac monitoring tape had been requested on a ward round on 30 January 2025 and had still not been carried out when we visited the ward on 18 February 2024. When we enquired about the reason for the delay it seemed the referral had got lost but the referral was re-issued promptly.

During the inspection, we observed that staff did not always have immediate access to information about patients who had been transferred from the emergency department. We reviewed patients’ records and found information about the care they had received in the emergency department was not always available. A printout of care and treatment provided should follow the patients to inpatient wards, but this did not always happen or was not always easy to locate. We raised this with leaders during our inspection who took immediate action to ensure information was shared and stored appropriately when patients were transferred to medical wards from the emergency department.

However, we saw the therapy staff worked effectively as part of inpatient ward-based teams to review and provide care and treatment for patients.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

Although staff monitored patients’ care, audit results were not always submitted. It was not always evident what actions had been taken to make improvements when these were identified.

We reviewed information shared with us about national audit compliance. Data showed the service took part in 22 national patient outcome audits but some actions for 6 national audits were overdue and had no action plan to demonstrate compliance (October 2024). These audits included the National Cardiac Audit Programme and the National Audit of Inpatient Falls. It was not clear how the trust assured itself that national audits were always submitted when they were due and if actions were developed and followed up afterwards. Following the inspection, the trust shared further information about actions taken to address prevention of hospital-acquired pressure ulcers and inpatient falls. While many actions had been completed, the action plans did not provide assurance that all actions had been completed within the set time frames.

The Sentinel Stroke National Audit Programme (SSNAP) is a program of work that aims to improve the quality of stroke care by auditing stroke services against evidence-based standards. Leaders told us the score from the Sentinel Stroke National Audit Programme (SSNAP) audit had declined from a score of ‘A’ to a score of ‘C’ mainly due to the availability of therapies. This was recognised as a risk on the divisional risk register (Risk 883). We checked the most recent SSNAP data which confirmed that the trust had submitted data for July – September 2024 (most recent data available) and confirmed the overall ‘C’ score had been obtained in this period.

Leaders spoke of actions to make improvements regarding patient outcomes. For example, they discussed the prevalence of pressure ulcers and actions to address these such as ‘show and learn’ events, which were run by the tissue viability specialist team every week. Leaders described the number of pressure ulcers and falls for inpatients as a big patient safety risk because of the vulnerable patient group. We asked for an action plan to demonstrate the actions taken to improve pressure ulcers and fall prevention, but we did not receive this.

Matrons and ward managers completed some ward-based audits. For example, there was a monthly audit to assess the completion of the Malnutrition Universal Screening Tool (MUST) across all inpatient wards. Data showed compliance with the MUST risk assessment in January 2025 varied from 75% on Beckett Ward to 100% on Benham Ward and 13 other wards across the trust reaching a target score of above 85%. Ten wards had fallen into ‘amber compliance’ (scores between 61 – 84%). We requested information captured on a ‘matron’s dashboard’ with all audit results for all inpatient wards, but we did not receive these.

The service used the NHS Friends and Family Test (FFT) to obtain feedback from patients and their relatives. Patient satisfaction performance ranged from an average of 86.3% (Brampton Ward) to 100% (Esther White Ward) between April 2024 and January 2025. This information was based on FFT feedback from 110 patients in Brampton Ward and 538 patients in Esther White Ward.

Staff supported patients to understand their rights around consent and respected these when they delivered person-centred care and treatment.

Staff understood the importance of ensuring patients fully understood what they were consenting to and the importance of obtaining consent before they delivered care or treatment. Staff told us they used different consent forms for invasive procedures in line with national guidelines. We saw that different types of consent forms were available to staff to obtain consent from patients who lacked the capacity to give consent. We observed staff obtain verbal consent by way of explanation before they carried out tasks concerning individuals.

The Mental Capacity Act (2005) and Deprivation of Liberty Safeguards were implemented in line with legislation. We spoke with nursing and medical staff about processes to assess patients’ mental capacity and ‘best interest’ decisions. The staff we spoke with understood the importance of assessing patients’ mental capacity and they applied this legislation. We reviewed documentation to record assessments and found these were generally recorded well.

We saw ‘do not attempt cardiopulmonary resuscitation ‘(DNACPR) decisions were made for patients in line with relevant legislation.