Northampton General Hospital

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that people were always treated with kindness, empathy, and compassion. We checked that people’s privacy and dignity was respected, that they understood that they and their experience of how they were treated and supported mattered. We also looked for evidence that every effort was made to take people’s wishes into account and respect their choices, to achieve the best possible outcomes for them. We assessed 3 quality statements.

At our last inspection, we rated this key question good. At this inspection, the rating has changed to Requires Improvement. This meant, the service did not always observe, communicate and treat people in a way that promoted dignity and confidentiality.

We issued a Section 29A Warning Notice to the trust of 20 March 2025 as a result of some of the concerns raised within this domain.

Staff did not always treat people with kindness, compassion and dignity. Demands on the department did not always allow for staff to observe, communicate and treat people that promoted dignity and confidentiality. People’s pain was not always managed in line with guidance. Leaders of the department cared for the well-being of staff, however it was recognised that morale amongst staff was low with limited resources to improve this.

We have not awarded this service a score for Caring.

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

People did not have their privacy and dignity respected. The service did not always treat people with kindness, empathy and compassion.

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People\u2019s privacy and dignity was not always respected and upheld. 8 out of 9 of patients we spoke with told us that they felt their privacy and dignity had not been respected. All of these patients were being treated in various treatment escalation spaces. We spoke with 3 patients being treated in the corridor temporary escalation space who told us they had received an update on their test results without their privacy being respected and they were not aware of their plan of care.

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Staff were not always able to maintain patients\u2019 privacy and dignity due to the environmental design and layout of the temporary escalation spaces and other areas in the department. We saw doctors talking with patients and delivering results to patients in areas that could be overheard by other patients.

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Staff working in areas not designed for treatment did not always recognise when patients required privacy. We also observed that a patient had been left visibly upset in an open area following the doctor giving them their test results. This had gone unnoticed by staff until our inspection team made them aware. We observed patients actively vomiting in the waiting room with no privacy in Waiting Area 1.

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Where staff needed to perform intimate examinations, they did so in cubicles. During our assessment these were scarcely available, which could lead to delays in care. Following feedback, the service told us they were going to make sure rooms were available for private conversations and examinations, however we did not receive evidence this was working well.

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It was unclear what action was being taken to address privacy and dignity for people. In a monthly clinical governance meeting in January 2025, it was discussed that privacy, dignity and long waits in chairs were a common theme of complaints in the friends and family test. It was unclear from this meeting, what action was being taken to address the concerns.

Patients did not always feel they were treated with kindness, compassion and dignity. We heard mixed feedback on how people felt about the care they had received. Some people we spoke with reported staff were kind and respectful but busy, others reported that not all staff had been kind, they felt ignored and had delayed pain management.

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The patient satisfaction score in December 2024 was 73.3% against a target of 88%. We saw evidence that the trust reviewed patient feedback themes and although feedback was generally positive, where themes of patients dissatisfied with their care were collated and discussed during meetings, it was not clear what action was being taken to address them.

There was a dedicated room for bereavement and a policy for the management of the death of child.

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We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Independence, choice and control during this assessment. The score for this quality statement is based on the previous rating for Caring.

The service did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

People’s needs, views, wishes and comfort were not always a priority and staff did not always quickly anticipate these to avoid any preventable discomfort, concern or distress.

People did not always have their pain managed or appropriately assessed in line with Royal College for Emergency Medicine (RCEM) guidance for the management of acute pain in adults (2024) or local guidance.

People we spoke with during the inspection told us their pain was not always managed in a timely way. People we spoke with who had been triaged as “fit to sit” told us they felt very unwell, had needed to request pain relief and were uncomfortable in a chair.

The department had conducted monthly audits into initial pain management standards for adults in the emergency department. The results of these demonstrated between August 2024 and January 2025 compliance for each standard was below expected. Patients first pain score measured and recorded within 15 minutes of arrival in the department was between 37% and 61% and for analgesia given according to RCEM/local guidelines was between 30% and 50%. For the second pain score being measured and recorded within expected timeframe was the lowest at between 3% and 12%.

Despite the intent to share key learning outcomes on a monthly basis during departmental meetings there had been no significant improvement in the results over the 6 months. We were not assured appropriate action was being taken to address people’s pain.

The NHS Friends and Family Test (FFT) is a feedback tool that anyone can use to give quick, anonymous feedback to providers of NHS services. FFT data was collated and reviewed, but the trust did not provide evidence of what action was taken to learn from this data and information.

The service made efforts to care about the wellbeing of their staff, however mechanisms to support this had not been effective.

People were supported by staff who felt valued by their leaders and their colleagues. However, mechanisms to recognise and respond to meeting staff wellbeing and enabling them to provide safe, effective and person-centred care were not fully effective. While the impact of low staff morale was recognised by leaders in the department, pressures on operational delivery meant this was not always acted upon. A nurse we spoke with told us they felt supported to speak up, however felt required to use annual leave to prioritise their own health and wellbeing.

There were mechanisms to support staff if they were struggling at work, but these were not always effective. Staff were provided with team meetings and away days. There were also Trauma Risk Management (TRiM) trained practitioners in the department. This provides a trauma focused peer support system designed to help people who are likely to face trauma or potentially traumatic situations. 15 of the 30 trained practitioners in the hospital were in the emergency department including 2 full time TRiM practitioners at the time of assessment. However, it was acknowledged where it was not the practitioners full time role, that clinical work for patients often took priority over being able to release practitioners for 1 to 1 or group sessions.

Systems and processes to enable and respond to staff feedback, concerns, or suggested ways of working to improve the service and staff experiences were not fully effective. The department did not review staff survey results at emergency department level. We requested evidence of staff surveys and were sent the results from the hospitals as a whole. We were not assured that the department were reviewing staff survey results to improve staff wellbeing.

There had been some improvement for staff with diverse backgrounds across the trust. Amongst ethnic groups, the percentage of staff experiencing harassment, bullying or abuse from staff in the last 12 months who answered the question on the staff survey had decreased over the past 4 years. However, this was at trust level and it was recognised at the board meeting in February 2025 that the equality, diversity and inclusion strategy for staff was out of date and therefore may be having an impact on employing new staff. It was added as an action to the risk register with a completion date of June 2025. Therefore, further work was needed to ensure staff have easy access to personalised support that recognises the diversity of a workforce with proactive and reactive measures.