Worthing 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

We looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care. We assessed all quality statements in this key question.

We found a service where leaders had set a clear vision and values, and fostered a culture of openness, learning and continuous improvement. Staff told us they felt supported, respected and confident to speak up. Governance systems were in place to monitor performance, manage risks and ensure accountability. Decision-making was transparent or carer and informed by evidence.

Leaders used feedback, audits and data to drive improvement and encouraged innovation across the service. However recent listening events had been poorly attended by staff. Staff were involved in shaping the service, and training and development were prioritised to maintain safe and sustainable care. Workforce planning supported the delivery of high-quality services.

Partnership working was well established, with services collaborating effectively with other organisations and the wider community. Leaders promoted integrated, person-centred care and took steps to identify and address health 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 evidence showed a good standard. 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.

The service launched a new way of working, with children’s and neonatal teams creating a simple “Plan on a Page” to guide projects, safety, and finances. Leaders met weekly to track progress, aiming to complete a full improvement plan by year-end. To shape the five‑year Excellent Care Everywhere strategy, the trust ran its “Big Conversation” campaign, which included staff from children, young people and neonatal services. Staff told us they understood the trust’s vision and applied it in their daily work.

The leadership team for children and young people and neonatal care demonstrated a culture of clear vision, collaboration, and compassion. Leaders communicated the service’s goals and values clearly, involved staff, children, and families in decisions, and actively promoted diversity and inclusion. They listened openly, responded to concerns, and created a supportive environment where staff felt valued, safe, and encouraged to learn and innovate. Leaders prioritised safe, high‑quality care, used feedback to improve, and modelled integrity, empathy and child‑ and family‑centred practice. Senior leaders were visible, approachable and worked with staff to address challenges and celebrate successes, building a positive culture.

The evidence showed a good standard. The service had inclusive leaders at all levels 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.

Leaders had the skills, experience, and knowledge to do their jobs well. They were passionate about their roles and supported the development of future leaders through mentoring. Leaders showed an inclusive style that staff appreciated. Staff told us they felt comfortable speaking up and that leaders listened and were open to discussion. They described a strong sense of teamwork, all focused on providing the best care for children, young people and their families. Leaders had a strong understanding of the services they oversaw and described how their teams delivered high‑quality care.

Leaders were visible and approachable to both staff and families using the service. Time was spent ‘walking the patch’ and engaging with staff of all levels. Staff had access to leadership development opportunities, which supported career progression and strengthened team capability. The practice development team provided leadership training opportunities. There were team meetings at all levels to hear the staff voice and work with staff when concerns were raised.

The evidence showed some shortfalls. Staff did not always engage with the freedom to speak up service or attend listening events developed by leaders.

Most staff we spoke with during the assessment felt confident to raise concerns with their line management and to speak up when things were not right. Staff were aware of the freedom to speak up guardian but did not feel the need to raise concerns via that route.

Since August 2023, the trust used an independent service for Freedom to Speak Up (FTSU), which supports staff to raise concerns safely. The service produced detailed reports every month and a full annual report, including the 2024/25 report presented in July 2025. Reports showed closed cases, common themes, key issues, response times, and activities like visiting teams with low confidence in speaking up, including the children and young people team.

The most recent Freedom to Speak Up annual report showed that the Women & Children service accounted for 13% of all concerns raised across the trust. This report included maternity staff, and the data could not be separated to show only concerns from staff working in children and young people’s services. Attendance at events designed to listen to and engage with staff had been low, so the service planned to improve how staff were involved in the future. This included offering online sessions and holding in‑person events at different times of day to make it easier for more staff to attend and share their views.

The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

The service had a focus on wellbeing, flexible working and workplace adjustments to create an inclusive and supportive environment. Staff told us they felt well supported and represented through the variety networks available. Staff told us they could bring their ‘real selves’ to work and were valued as members of the team. No staff raised a concern about experiencing discrimination in the workplace during the assessment.

The trust had an Equality, Diversity and Inclusion (EDI) through its three‑year EDI Strategy and Workforce Inclusion Plan, aligned with national NHS standards and the Equality Act 2010. Staff had access to networks for race, disability, gender, LGBTQIA+, religion, carers and the armed forces, which provided safe spaces, support and learning opportunities.

The evidence showed a good standard. The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

Regular governance meetings, cross‑site boards, risk reviews and guideline forums provided oversight to ensure consistent, safe, high‑quality care. External oversight came from partnership forums, with doctors and nurses actively involved to maintain clinical standards and collaboration. Committees such as the Children and Young People (CYP) Quality & Safety Committee and the Safeguarding Strategy Committee monitored quality, safety, safeguarding, and mental health services. These reported to the Trusts Board.

The service kept a detailed risk register for children and young people, neonatal, and women’s services. There was a service risk oversight group that reviewed and approved levels of risk. Each risk had a score, mitigation and action plan. These were reviewed regularly by the group and new risks added as necessary. The latest minutes highlighted major safety risks, including delays in appointments and assessments that could lead to missed diagnoses or harm. Mental health support for children and young people was also identified as a serious concern.

Staff shared learning from incidents and complaints in meetings and safety huddles. The children and young people safety team met weekly to review serious incidents, oversee complaints and support improvements. Most complaints related to long waits, so the team created a pathway to triage children to other trust hospitals where appointments were quicker. Learning was shared through stories, bulletins and monthly safety meetings.

Staff took part in local clinical audits to check the quality of care and improve their practice. These audits covered infection control, nursing care, children and young people’s experiences, and the National Children and Young People Early Warning Score. Staff also worked closely with other teams inside and outside the hospital to meet the needs of children and young people.

Safeguarding had a clear reporting and discussion structure from ward to board. The chief nurse was the statutory responsible officer for safeguarding and chaired the quality safety group for safeguarding. Safeguarding themes identified at ward level and discussed at the trust safeguarding meetings included mental health and children and young people who were repeatedly admitted to hospital or used services for the same issues, often due to gaps in ongoing care or support.

The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

The trust created its Excellent Care Everywhere strategy by listening to staff, children, young people, the public, and partner organisations. Their feedback shaped the strategy’s main goals and how services will be delivered by 2030. The trust committed to keeping children, young people, and the public involved and working closely with partners over the next five years.

Leaders listened to staff feedback and used it to improve the service. For example, they strengthened cross‑site working to develop consistent guidance, improve care for children and young people, and support staff. Feedback from listening events and the staff survey showed that many staff felt unprepared to care for young people with complex mental health needs. In response, leaders introduced bespoke training for all staff grades and created safe spaces for staff to discuss concerns. Staff reported feeling more confident and this contributed to improved morale and retention.

Leaders engaged with external stakeholders, including commissioners and partner organisations, to support service development and improvement. The leadership team developed close working links with the neighbouring trust who provided Child and Adolescent Mental Health Servies for young people in their service. Records showed that the meetings were multidisciplinary and well attended. Each trust recognised the challenges the others faced, and over time they developed a supportive and open way of working together.

The diabetes team attended poverty-proofing training, analysed deprivation scores, and explored alternative clinic sites to reduce travel costs. The team delivered four annual school-based clinics to minimise disruption to education and sourced mobile phones through charities to support diabetes technology use. Charity funding enabled free residential programmes for young people.

The service ran a joined-up service for children and young people, bringing together therapists, psychologists, and specialist nurses, all supported by strong safeguarding processes. The service trialled virtual meetings with local GPs, which helped reduce unnecessary referrals and made clinicians more confident, although funding was not available to expand this. Doctors also took part in weekly safeguarding meetings and primary care groups improving teamwork and information sharing for children with complex needs.

Doctors had recognised the need for joined up and collaborative working across the trust. A consultant MDT meeting had been held monthly and at the last meeting over 30 consultants attended. This meeting helped stop teams working in isolation and improved support between the different sites.

The safeguarding team worked closely with GP’s, schools and health visitors and shared information to keep children safe. Strategy meetings with local stakeholders developed guidance and pathways with a focus on children and young people’s mental health and sexual abuse.

The leadership team knew that as a main healthcare provider in the area, families often had no other options if things went wrong. They planned to introduce restorative practice, a way of working that focuses on listening, understanding, and repairing relationships when people are unhappy with their care. By using this approach, the trust hoped to improve trust and communication with families and the local community.

Leaders collaborated closely with the local mental health trust and social services to address the needs of children and young people with mental health conditions. This partnership was formalised through a memorandum of understanding and supported by a standard operating procedure for managing admissions. Monthly children and young people quality and safety meetings were held across all three sites, with outputs feeding into tri-site reviews and service governance structures. Additionally, the service participated in clinical governance sessions, including joint meetings with obstetrics, anaesthetics, and regional critical care services, to review mortality and incidents. Research and innovation activities were overseen at service level through the service board, with quarterly presentations delivered by the directors of research and innovation.

The evidence showed a good standard. The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

Staff received time and support to develop opportunities for improvement and innovation, which resulted in changes to care delivery. For example, the practice development team developed a five‑day programme to help staff care for children and young people with complex mental health needs. It was located away from the hospital and provided a psychologically safe space for staff to explore difficult topics. Cohort 10 were being booked into the education program.

The team reviewed a service that brought together GPs and children’s specialists to help reduce waiting times, avoid emergency visits, improve GP skills, and give parents more confidence. Between 2023 and 2024, referrals increased from 26 to 81, and most children (88%) were treated without needing a formal specialist referral. GPs gave more advice themselves, while urgent referrals stayed low. Most parents said they felt more confident and supported by the joint approach.

The service implemented innovations that improved outcomes for children and young people. For example, Bluefin Ward had developed a bespoke contract with an agency who provided expert care for complex children and young people. This care package could be put in place at short notice and provided high quality and safe care for children and young people.

Leaders reviewed how children moved into adult services and found it needed improvement. They set up a transition nursing team and introduced a trust‑wide transition package with personalised plans and joint clinics. The team also updated policies, trained staff and improved how young people were tracked in electronic systems.

The neonatal nursing leadership had planned Gemba walks to engage frontline staff and parent or carers, which led to service improvements. A Gemba walk is a management practice where leaders go to “the real place” (Gemba) — the frontline where care is delivered — to observe processes, engage with staff, and identify opportunities for improvement. The term Gemba comes from Japanese and means “the actual place.”