Northampton General 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

Leaders showed inclusive and positive culture of continuous learning and improvement that was based on meeting the needs of patients 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.

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.

The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

All staff clearly understood the importance of supporting staff wellbeing and were committed to engaging with training and development opportunities. This focus aimed to ensure that staff could deliver high-quality care and achieve positive outcomes for patients. During our inspection, we observed that these goals were actively being met in practice.

At the time of our inspection critical care leaders said there was not a formal written vision and strategy for the service, but this was being formulated. Since our inspection the trust provided a written critical care strategy for 2025-2030 (dated September 2025). The strategy included a vision, strategic aims and objectives, and the trust set of values which were Respect, Compassion, Professionalism and Teamwork. The purpose of this document was to set out Critical Care’s 5-year strategy to deliver, manage and develop critical care services for Northampton General Hospital focussing on safe and effective care, delivered by a multidisciplinary team in a safe environment.

The service had inclusive leaders 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.

The critical care service was within the surgery division. The surgical division had a triumvirate in place. This consisted of a medical clinical lead, manger and divisional nurse, who all shared their specific expertise to provide guidance and leadership to critical care.

At the time of our inspection there had been significant changes in the management of the trust. Whilst this had affected senior managers outside the critical care service other staff seemed unaware of the changes and critical care had continued to operate effectively during this period of change.

Staff said they felt able to raise concerns to their critical care managers, who they felt were visible, approachable and supportive. There were numerous channels for communication and engagement, from formal meetings to email and mobile app group chats. Nursing staff were placed in mentor groups led by band 7 nurses, and staff fed back that they found these groups supportive. Doctors told us consultants were always approachable and supportive.

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

Staff were aware of the Freedom to Speak Up (FTSU) service and how to raise concerns. Staff we spoke to said whilst they were aware how to contact the FTSU service they were confident they could and would raise concerns with critical care managers and they would be addressed.

FTSU Guardians had arranged a listening event and drop-in sessions in November. FTSU Guardian were also scheduled to attend the Critical Care team meeting to present and discuss how staff can speak up, raise concerns, access training and recruit champions.

Posters were available which highlighted the Freedom to Speak up service and were on display. The posters included a QR code which staff could scan and raise concerns anonymously as well as an email address and telephone contact numbers.

The service valued diversity in their workforce. Staff worked towards an inclusive and fair culture by improving equality and equity for people who work for them.

There was an Equality, Diversity and Inclusion policy with the purpose of ensuring fairness for all in addition to an Equality Impact Assessment policy whose purpose was to help to evidence and understand the differential impact that a decision may have on different groups of people covered under the Equality Act 2010.

Consultants told us that leaders supported those with protected characteristics such as age and gender and other characteristics which did not come under the Equality Act, such as caring responsibilities. Nationally critical care consultant work patterns did not typically facilitate caring responsibilities, however work patterns for consultants at this critical care unit had been designed to facilitate and support a flexible approach to work.

Information provided by the trust identified there was a project: ‘Increasing Critical Care Black, Asian and Minority Ethnic Nursing Staff Engagement’. Resources were available within the Trust to support career progression for staff from minority ethnic backgrounds. Leaders in critical care told us they had provided support systems for overseas doctors and nurses both with career development and to raise any specific concerns about progress and integration into the team.

The service had clear responsibilities, roles, systems of accountability and 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 share this securely with others when appropriate.

Staff recorded and were aware of risks around safety and performance. The critical care unit risk register had 2 ‘amber’ risks. The risks related to delayed patient discharge from critical care and replacement of old ventilators. The risk register identified actions to mitigate these risks and a review date. Staff told us their main risk and ongoing concern were the number of delayed discharges from critical care. A delayed discharge is identified when a patient suitable to be moved to a ward is waiting for more than 4 hours. Information provided by the trust identified there had been 644 delayed discharges from critical care between 1 July 2024 and 31 August 2025 this is worse than the national average. Following our inspection senior managers sent us a standard operating procedure to action the delayed discharges.

Managers kept staff informed of governance updates including performance and safety. Critical care had monthly clinical governance meetings during which all incidents including medication errors, pressure ulcers problems with equipment and other key updates such as compliance with the Intensive care national audit & research centre (ICNARC) and standard operating procedures. The surgical division had compiled a Theatres, Anaesthetics and Critical Care (TACC) governance group which met monthly to discuss key information relevant to critical care. This included reviewing ICNARC data, key risks, workforce and performance and finances. Team leader meetings included reviewing areas such as staffing, mandatory training, staff wellbeing events, complaints, compliments and incidents.

Critical care staff had a focus on sustainability and environmental impact. Notably, the ‘Sedation Holds’ project aligned with sustainable healthcare goals. The project had reduced unnecessary sedation, improved patient outcomes, and contributed to lowering the department’s carbon footprint through better resource utilisation.

Another initiative had reduced the risk of infection caused by antibiotic use and a subsequent reduction of the need of personal protective equipment which impacted positively on the environment. Critical care staff had arranged a full day event: Critical Sustainability for the East Midlands Network to promote sustainability initiatives within other critical care services.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. Staff share information and learning with partners and collaborate for improvement.

The critical care service linked with the East Midlands Critical Care Network (EMCCN Quality Service Improvement Group (QSIG)) to share service improvement ideas, standard operating procedures and policies. The critical care team were involved in face-to-face events to present Quality Improvement (QI) projects and learn from other trusts.

The service had a focus 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 contribute to safe, effective practice and research.

The level of engagement from both clinical staff and medical colleagues in driving Quality Improvement (QI) within the Critical Care Unit at Northampton General Hospital was exceptional. Collaborative efforts had led to meaningful enhancements in patient care, staff wellbeing, and the working environment.

Examples included projects to improve the management of sepsis and recording of variable insulin data. These improved patient safety and outcomes including both cure and death rates. Both projects were recognised at the trust’s excellence awards.

Another ongoing standout initiative was the Complex Stepdown Project, which aimed to improve the transition of complex patients from Critical Care to the wards. This project aimed to deliver a 1.9% reduction in critical care readmissions, equating to over £100,000 in savings for the NHS. Other aims included improved rehabilitation outcomes and reduced re-admissions and an enhanced patient journey and experience.

Over the last two years, the critical care unit had been involved in a diverse portfolio of studies, including interventional drug/device trials, physiological studies, and large-scale observational studies. Active studies during the inspection period included conservative oxygen management in critical illness, genetic determinants of critical illness; Short term antibiotic usage in managing sepsis; vitamin D supplementation in critical care; family communication and outcomes in older intensive care patients and prone positioning strategies in respiratory failure.