Northampton General 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 as good. Good: This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

The service was effective and birthing women received care and treatment that achieved good outcomes. Staff completed comprehensive assessments and delivered evidence-based care, supported by strong multidisciplinary working. Birthing women described being assessed promptly on arrival and kept informed throughout their care. Outcomes were monitored and used to drive improvement, and care was coordinated and personalised, reflecting best practice across maternity pathways.

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.

Maternity services had transitioned to electronic records in November 2025, and staff reported that the system was working well, supporting improved monitoring and quality assurance. The service used an electronic patient record system, which enabled real-time documentation of assessments, risk factors and care plans, and records were secure and accessible via mobile devices. Staff completed comprehensive health assessments in a timely manner at, or soon after, admission. These included booking assessments, clinical observations, risk screening and fetal assessments, to inform care planning and ongoing monitoring.

The service monitored booking activity and population needs. Monthly bookings ranged between 349 and 450. The percentage of women booked by 10 weeks ranged between 67% and 81% against a target of over 75%. Staff recorded smoking status, carbon monoxide levels and safeguarding information at booking. Face-to-face booking rates ranged between 75% and 90%.

Most women told us they were seen on arrival by midwives and, where required, obstetric or medical staff. Women were referred into the service through elective, emergency, or self-referral pathways, and staff demonstrated how these were managed effectively within the electronic system.

Women presenting to the service were assessed through a structured triage process. The service used a recognised triage system to assess and prioritise women based on clinical need, alongside risk assessment tools and early warning scoring systems to monitor maternal observations. We observed staff completing risk assessments and documenting care in triage, birthing areas, and within the high dependency unit (HDU). Fetal monitoring was used to assess fetal wellbeing. Midwives, obstetricians and junior doctors were seen reviewing women, including those in HDU, where ongoing observations, assessments and discussions about care and treatment were carried out.

Birthing women had access to their care journey and were actively involved in their assessments and care planning. Women were supported to understand their care, and we observed meaningful engagement with women and their partners across all areas, including HDU. Staff explained clinical observations, treatment options and progress. Staff demonstrated a person-centred approach and promoted shared decision-making.

Care plans reflected risks and needs identified during assessments. Midwives demonstrated a good understanding of clinical risks and acted appropriately. We observed a midwife identify increased blood pressure during an assessment and escalating this to the medical team, resulting in closer monitoring and more frequent reviews for the woman. Care plans were personalised and holistic, developed in partnership with women and their partners. Risks identified during assessment were discussed with women and incorporated into care planning.

Most women and their partners told us they felt involved in decision-making and that staff communicated clearly, enabling them to make informed choices. One woman told us, “Since being here they have kept me informed throughout and keep me updated on what they are doing.” Staff were observed discussing treatment options in detail, outlining benefits and ensuring informed consent.

The service monitored outcomes to anticipate and assess women’s needs. Term admissions to the neonatal unit ranged between 3% and 6%. Postpartum haemorrhage of 1500mls or more was generally below 3.8%. Third- and fourth-degree tears were within expected thresholds. Breastfeeding initiation ranged from 70% to 87% against a target of 75%. Patient satisfaction scores were high across antenatal, birth and postnatal services.

Care plans were updated when required using the electronic system, which staff felt improved safety and consistency. Governance and quality leads monitored the system by auditing the quality of record completion and risk assessments, alongside oversight of risk events and clinical outcomes.

Information was available in multiple languages to meet the needs of the local population. The service adapted care to meet diverse needs, although some feedback indicated that culturally appropriate meal options could be improved.

The Clinical Audit of the Antenatal Care Pathway (data as of end of March 2026) showed strong performance in several key areas of antenatal care. The Pain Management in Maternity report (based on questionnaires in 2024), 73% of people felt the pain relief they received was always adequate, and 53% had pain relief within 15 minutes. Actions were in place to drive improvements.

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.

Community midwives and maternity staff demonstrated skills in supporting women with complex physical, mental health and social needs across both hospital and community services. Staff described clear care pathways, particularly for perinatal mental health, and women told us they understood the support available to them. Women with previous traumatic birth experiences were identified early in pregnancy and supported through personalised birth planning and appropriate mental health input, which improved confidence and emotional wellbeing. Women confirmed they were involved in decisions about their care and understood referrals made for additional support.

The service had access to a full range of specialist maternity expertise, including safeguarding, fetal medicine, perinatal mental health, bereavement support and neonatology. This ensured women received coordinated and multidisciplinary care throughout their maternity journey.

The home birth service had been restarted and expanded in response to women’s needs. Leaders described ongoing work to review models of care so that complexity of need was better reflected in workforce planning and service delivery across both community and hospital services. Communication and collaboration between teams had improved, supported by shared processes and developing governance arrangements.

Leaders recognised that integration across the two hospital sites was still progressing, with further work planned to embed consistent pathways and oversight.

Staff were experienced, appropriately qualified and had the skills and knowledge to meet the needs of women and babies. Managers provided structured induction for new staff, including completion of the Care Certificate for healthcare support workers. Staff told us they had access to clinical supervision, although leaders recognised that appraisal and supervision processes required further strengthening. Improvement plans were in place to address this.

Managers supported staff to develop their skills through education days, role-specific training and access to study leave. Staff told us they were supported to attend training, although this could at times impact staffing levels. Regular team meetings were held, and managers identified learning needs and monitored staff performance. Staff understood how to raise concerns, including through Freedom to Speak Up processes, and leaders gave examples where concerns had been acted upon and led to improvements.

There was a developing focus on quality improvement and multidisciplinary working across maternity services. Staff participated in clinical audit and benchmarking activity, with themes discussed through governance processes to support learning and improvement.

We reviewed a neonatal hypoglycaemia quality improvement project, which demonstrated effective use of audit findings to improve clinical practice. This included repeated audit cycles, multidisciplinary team engagement and targeted education to improve adherence to national guidance and reduce avoidable neonatal admissions. Staff described increased confidence in managing babies at risk, and leaders had systems in place to monitor progress and outcomes.

The service also completed an audit of pain management. This showed good compliance with initial assessment and use of pain scoring tools. Areas for improvement were identified in relation to reassessment following analgesia. Actions were implemented through a structured plan, including staff reminders and targeted learning. Progress was monitored through governance arrangements, with re-audit planned to assess sustained improvement. Evidence from records reviewed and local audit findings showed that pain relief options were discussed, offered and documented appropriately. Documentation demonstrated that women were involved in decisions about pain relief and that their preferences were respected throughout labour and birth. Audit and performance data were reviewed by the service to understand variation in outcomes by ethnicity and other protected characteristics. Improvement actions had been developed to reduce inequalities and improve access to culturally sensitive care.

Staff and leaders demonstrated a commitment to continuous improvement, with systems in place to monitor practice and quality improvement, identify learning and support safer, more effective care for women and babies.

We saw that there was a robust monitoring programme for review of NICE guidance and national reports to check compliance with national recommendations. As of 13 February 2026, 82.3% of the 127 maternity documents and policies were in date, with 17.19% due for a review. This was monitored at the Risk and Governance meetings held.

Quarterly audits took place including maternity triage 24-hour activity, national MEWS, maternity Venous thromboembolism assessments, and informed choice- birth choice and after-thought clinics. Audits were used to drive continuing improvements.

The service supported safe infant feeding through Optimal Safe Infant Feeding. Staff promoted safe, evidence-based feeding, including breastfeeding and formula feeding.

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 4. The evidence showed an excellent standard. The service worked very well across teams and services to support people. They always made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

We saw excellent Multidisciplinary Team (MDT) working with a positive culture. We observed excellent multidisciplinary working, which demonstrated mutual respect within and across the professions. Staff held regular and effective multidisciplinary meetings, which supported clear oversight of maternity activity and safe coordination of care. Handovers on the second day of our visit showed that information was shared in a structured way using the Situation–Background–Assessment–Recommendation (SBAR) framework. SBAR is a system widely used across healthcare to ensure information is shared clearly, concisely, and accurately during patient handovers or when escalating urgent clinical problems. Doctors’ handovers were multidisciplinary, night and day consultants, registrars and resident doctors attended along with the anaesthetic consultant and registrar. Neonatal team also attended usually. Effective SBAR handovers between teams. We noted the excellent team working.

Night staff completed their handover before the morning shift. Midwifery handover took place at 07:15 and the medical handover at 08:00. These were attended by consultants, registrars and senior clinicians from maternity and anaesthetic services. Staff said the neonatal team was expected to attend, although none were present on 25 March.

Senior leaders, including the Head of Midwifery, the Director of Midwifery and the senior leadership team, were described as supportive and visible within the service. The coordinating midwife provided oversight across all areas and monitored workloads throughout each shift. Staff worked in an integrated way across the birthing unit, the postnatal ward and the labour suite. They understood the risks, acuity and clinical priorities in each area. Staff described strong teamwork and said they “pulled together,” even when busy. Staff also prepared for emergency and elective activity and planned ahead to anticipate changes in demand.

We saw highly effective and efficient midwifery handovers. Handovers included introductions, review of risks and agreement of priorities for the day. Staff discussed risks relating to birthing women, and concerns from the night before were shared clearly to support continuous safe care. Escalation routes were clear, and senior decision-makers were accessible when needed. Staff said they raised concerns promptly with medical staff and received support.

Positive communication was very evident between day and night teams and across maternity, anaesthetic, discharge and specialist services. Obstetric clinical leads, midwives and the neonatologist worked together to plan elective activity, staffing and emergency triage through daily huddles. Staffing pressures continued, but staff said the organisation had plans to improve staffing levels. Good MDT working in theatre took place when we observed an elective caesarean procedure.

Safeguarding leads and mental health support were available when concerns were identified. Specialist pathway leads promoted consistent practice and strengthened teamwork across the service and operationally. Quarterly infection prevention and control meetings provided oversight of safety standards.

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.

Women had access to clear, easy-to-understand information throughout the maternity service. Staff supported healthier lifestyles using posters, leaflets and written materials on topics including smoking cessation, healthy eating, vitamin supplements, foods to avoid, safer pregnancy, and emotional wellbeing. Additional information covered fetal anomaly screening, financial support, and national guidance such as genital herpes in pregnancy and emotional changes before and after birth.

Women and their partners said staff encouraged questions and responded with clear and reassuring information.

Information on alcohol use in pregnancy was clearly displayed, including guidance that the safest option is not to drink. Materials explained risks to the baby and signposted support.

Information was accessible in clinics, waiting areas and communal spaces, as well as via the maternity self-referral website and digital app. Resources were available in multiple languages. Staff used these materials to support discussions and informed decision-making, and the website and app supported early access to care.

Community midwives described how they supported women across antenatal, intrapartum and postnatal care. They worked with women during antenatal assessment to understand risks and develop personalised birth preferences, which were shared with hospital teams to ensure continuity and respect for individual needs.

Staff understood the needs, risks and demographics of the local birthing population and tailored care and information accordingly.

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.

348 deliveries took place in January and 296 in February 2026. Deliveries at home or in the maternity led unit formed 5.5% of deliveries in January and 8.4% in February 2026.

No babies had needed transfer to cooling in February 2026 and there had been one admission to intensive care. In the period April 2025 to February 2026, there had been 9 neonatal deaths (babies born at NGH who died at NGH or other location within neonatal period) and no maternal deaths. There had been no stillbirths in February 2026. Spontaneous vaginal deliveries formed 20.9% of deliveries in February 2026. In February 2026, the caesarean section rate was 49%, of which 22.6% were elective caesarean sections. Induction of labour took place in 26.7% of deliveries in February 2026. 3rd or 4th degree tears for all vaginal deliveries were below the trust target of 3.4% for the past 6 months. Major Obstetric Haemorrhages (MOH) for an estimated blood loss of 1,500 ml or more was at 2.3% in January 2026 and 4.1% for February 2026. Breastfeeding initiation rates were consistently higher than the trust target of 75% in the period April 2025 to February 2026. NGH continued to perform close to the smoking-reduction target, with consistently low rates at both booking and birth. For APGAR scores of less than 7 at 5 minutes, NGH remained relatively stable and consistently below the target threshold, with only minor month-to-month variation. The percentage of preterm births fluctuated around the national 6% target with most months sitting close to or slightly above the threshold.

Staff demonstrated an understanding of the risks associated with pregnancy, labour and birth and routinely discussed individual risk factors with women as part of ongoing assessment. Staff used recognised tools, including the Maternity Early Warning Score (MEWS), to support early identification of deterioration and timely escalation of care. We observed a woman with raised MEWS scores being promptly escalated to senior review, resulting in increased monitoring and transfer to a higher level of care. MEWS provided pregnancy specific thresholds and clear escalation pathways, enabling appropriate senior review. Consultant involvement was evident, with senior clinicians contributing to risk assessments and remaining accessible to support emergencies. Staff described how risks were continuously reviewed during labour and changes prompted timely escalation to obstetric, anaesthetic or emergency teams.

Community midwives actively managed and monitored risk during pregnancy and the postnatal period, supporting early identification of concerns in community settings. They identified risks such as reduced fetal movements or mental health concerns and escalated these appropriately for further review. This demonstrated a shared approach across maternity pathways. Birthing women and partners said care felt coordinated between community and hospital services.

The electronic records system strengthened monitoring of outcomes and improved access to information. Staff recorded clear, consistent information and accessed real time clinical records across services. Birthing women had access to their information and could view and understand their care in simple terms. Data was used to review escalation triggers, intervention rates and postnatal care needs, supporting improvements such as monitoring caesarean section rates, induction of labour and 1:1 care in labour. Governance and quality leads used this information alongside audits, incident reviews and safety investigations to monitor performance and improve outcomes.

Care was delivered in line with national guidance and evidence-based programmes. Clinical interventions, including pelvic health and perineal care, were implemented and audited. Audit findings improved documentation and consistent assessment, including monitoring perineal trauma and postpartum haemorrhage. Population data was reviewed to understand variation in outcomes related to deprivation, ethnicity and access. This informed targeted improvement work such as smoking cessation pathways, continuity of care models and personalised approaches, including monitoring variation across ethnic groups.

MBRRACE-UK 2024 UHN Overview report (March 2026) showed that NGH neonatal mortality sat below comparator average and showed a stable/lower trajectory than comparator trusts. The MBRRACE 2024 report includes deaths reviewed via the PMRT process. Learning had directly informed the UHN Perinatal Safety Improvement Programme, aligning PMRT themes with PSIRF principles and reducing duplication between reviews, incidents and quality work. The main purpose of MBRRACE-UK is to conduct robust national surveillance and investigate the deaths of women and babies who die during pregnancy or shortly after pregnancy in the UK.

Northampton National Neonatal Audit Programme data for 2024 (November 2025 report) showed good or excellent performance in 9 of the NNAP measures. In the 6 that needed improvement, we saw robust actions were in place to make improvement. NNAP supports professionals, families and commissioners to improve neonatal care for babies born too early, with a low birth weight, or a medical condition requiring specialist care. We noted that the service achieved outstanding status in the NNAP 2024 measures for Retinopathy of Prematurity (ROP) screening with 98% compliance (compared to the national position of 80%). ROP screening is an eye exam performed by an eye specialist to check for abnormal blood vessel growth in the retinas of premature babies

In a paper to the UHN Perinatal Assurance Committee (dated 21 January 2026), from May to October 2025, a review of born before arrival (BBA) cases revealed that none involved instances of incorrect triage advice being given over the phone or women being inappropriately advised not to attend. In all cases, the individuals either did not contact the hospital prior to arrival or were enroute when the birth occurred. Several women who laboured or delivered on the Maternity Observation Ward (MOW) or Snowdrop area did not receive appropriate intrapartum care or timely escalation, even in some instances when staffing levels could have allowed it. Common concerns included escalating pain not being adequately managed, pressure to undergo vaginal examinations, and feelings of being dismissed. Leaders were taking action to address these findings.

Governance and oversight were strengthened following the merging of maternity services across the organisation. Leaders identified areas for improvement, including reducing variation across population groups, improving equitable access and strengthening continuity of care. These areas were monitored through governance meetings with defined actions.

The service submitted data to the Maternity Services Data Set (MSDS) to the required standard. The service used the National Perinatal Mortality Review Tool (PMRT) to review perinatal deaths that occurred from 1 December 2024 to 30 November 2025 to the required standard.

Outcomes were monitored through incident reviews, clinical audits, complaints and feedback from women and families. Themes such as communication and escalation were reviewed and shared with staff. Feedback informed service improvements, particularly in communication and involvement in care. Leaders triangulated information to support learning and continuous improvement, including reviewing satisfaction, complaints and outcomes by ethnicity and population group. For the Saving babies lives initiative, NGH was assured compliance at 97%, with ongoing improvement work focused on demonstrating diabetes specialist leads in place and increasing the number of smokers setting a four-week quit date. UHN was on track to meet all 10 Safety Actions under Year 7 of the Maternity Incentive Scheme. Smoking at booking across UHN remained consistently above the 6% national target, while smoking at the time of birth had shown a sustained downward trend, with rates below 6% since July 2025.

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 fully respected these when delivering person-centred care and treatment.

Birthing women were supported to make informed decisions about their care and choice of treatment. Women and their partners said staff explained options, risks and care plans clearly and accessibly, supporting meaningful consent. Staff communicated sensitively during assessments, explaining observations, changes in condition and reasons for decisions so women understood what was happening and why.

Women and their partners said they felt informed and supported throughout their care. Staff led discussions clearly, checked understanding and supported women to feel reassured and confident when making decisions and giving consent.

Staff demonstrated a good understanding of mental capacity principles and completed decision-specific capacity assessments where required. These were recorded appropriately. Staff considered women’s wishes, feelings, cultural backgrounds, and personal histories involving birthing women and partners. We spoke with midwives across maternity and heard examples of birthing women facing complex decisions receiving support. Records reviewed showed full compliance with trust policy.

Staff understood the needs of women from different ethnic and cultural backgrounds and adapted communication to support understanding. This included the use of translation services and tailored approaches. Women said staff sought consent appropriately and ensured they understood information before decisions were made.

Women described good access to services throughout pregnancy and said early access to care supported timely decision-making and informed consent. Birthing women had access to their information through electronic records and had full control of their information, presented in simple terms to support understanding of their care and choices.

Women from diverse backgrounds said their needs and preferences were respected. Staff adapted discussions to reflect cultural perspectives, including options for pain relief and care approaches, ensuring decisions were informed and individualised.

The Birth Choices Pathway provided a clear referral process for women identified by community or hospital teams who may benefit from Consultant Midwife input. Following assessment, women received individualised support and, where required, their care is reviewed through multidisciplinary discussion involving Consultant Midwives, Consultant Obstetricians and the wider maternity team. For women whose choices fell outside local guidance, bespoke birth plans were developed using a shared decision-making approach. These plans were tailored to the woman's individual circumstances, values and preferences, ensuring that informed choice was respected while considering safety, risk mitigation and coordinated multidisciplinary care.

Staff were developing a wider cultural improvement approach led by a midwife for culture and inclusion. Staff said this had improved understanding of women’s experiences and supported more personalised care. Women and partners said the service listened to feedback and made improvements. Consent and women’s views were central to care delivery and monitored through feedback, audits and outcomes.

The Consent for Maternity procedures carried out in theatre report (with the time frame of January 2025 to June 2025) showed an average of 99% compliance with the 8 measures checked on the consent forms. However, improvements were needed to comply fully with RCOG standards for explanation of risks and consent for planned caesarean section before the day of surgery. Actions were in place to drive improvements.

Safeguarding level 3 training included detail on mental capacity, Gillick competence and Fraser guidelines and Deprivation of Liberty Safeguards. Gillick competence and the Fraser guidelines are legal principles used to decide if a child under 16 can consent to medical care without parental knowledge or permission. Staff demonstrated a thorough understanding.

The 2025 CQC Maternity Survey highlighted strong themes of informed consent, shared decision-making and collaborative care at NGH, with women reporting high levels of involvement, particularly antenatally and postnatally. This was supported by local audit data showing 100% consent documentation across most procedures. These findings provided assurance of a positive consent culture.