Northampton General Hospital NHS Trust

Ratings - Well-led

• Well-led Our assessments of NHS trusts now focus on leadership. We no longer rate trusts overall for their safety, effectiveness and responsiveness or how caring they are. We do still publish those ratings for the services they provide.

  Requires improvement

Our view of the service

Northampton General Hospital NHS Trust provides general acute services for a population of 426,500 in west Northamptonshire and hyper-acute stroke, vascular and renal services to people living throughout the whole of Northamptonshire. The hospital provides 790 beds and has a 24-hour emergency department. The hospital also has a cancer centre which provides cancer services to a wider population of 880,000 who live in Northamptonshire and parts of Buckinghamshire. The trust provides a full range of outpatients, diagnostics, inpatient and day case elective and emergency care.

Northampton General Hospital NHS Trust is part of the University Hospitals of Northamptonshire NHS Group along with Kettering General Hospital NHS Foundation Trust. Since forming University Hospitals of Northamptonshire NHS Group in 2021 the group has achieved university status, which has created collaborations within services, such as the head and neck; and ear, nose and throat; and the delivery of a cardiology centre within Northamptonshire.

We assessed how well led the trust was overall, following concerns raised to CQC through whistleblowers, and to update the trust level assessment rating.

In preparation for our trust level assessment, we assessed service groups within the trust which included urgent and emergency care, medical care, and critical care at Northampton General Hospital. We undertook these assessments to ensure we had a thorough understanding of the full range of services provided by the trust.

Following our urgent and emergency care, and medical care assessments in March 2025, we served a S29a Warning Notice to ensure actions were addressed to improve patient flow, review ongoing patient acuity understanding, and staff communication. We reassessed the urgent and emergency care service in August 2025. We were assured that improvements had been made in line with the concerns identified in the Warning Notice.

A trust level assessment was carried out from the 16 to 18 September 2025, we assessed all 8 of the quality statements in the well-led key question used when assessing an NHS trust using our current framework. This included interviews with staff across the whole organisation, including members of the trust Board and senior clinical leaders; we used evidence provided by the trust and stakeholders; and used data and intelligence we hold about the organisation.

We looked for evidence that there was an inclusive and positive culture of continuous learning and improvement that was based on meeting the needs of people who used services and wider communities. We checked that leaders proactively supported staff and collaborated with partners to deliver care that was safe, integrated, person-centred, sustainable reduced inequalities.

The 2024 NHS Staff Survey, of whom 3,616 (57%) staff responded, showed the trust were in line with or just below the national average ratings. The NHS Staff Survey measures against the 7 Peoples Promise elements and against staff engagement and morale. Following the survey results actions were addressed to improve inclusion work, health and wellbeing access, freedom to speak up guardian access and focus on ‘civility within the workplace’ and new processes aligned to grievance and resolution.

During our assessment the trust was going through a significant transformation project to align roles, working patterns and processes across the group.

This is the first assessment for this trust under the single assessment framework. We found a breach in regulation 17 Good Governance pertaining to the lack of an effective system and process for Freedom to Speak Up to assess, monitor and improve the quality and safety of the services provided; and limited assurance of learning from governance processes to mitigate risk. We rated the well led key question as requires improvement.

People's experience of this service

The 2023 Inpatient Survey results for Northampton General Hospital NHS Trust were broadly in line with national trends. However, there were areas of concern around communication, discharge planning, and patient involvement.

The 2024 CQC Maternity Survey results for Northampton General Hospital NHS Trust indicate broadly average performance, with strengths in postnatal care and communication, and lower scores in partner involvement and mental health enquiry. The trusts 50% response rate was better than the national average. Of 57 questions, 54 were rated in line with peers, 2 rated better, and 1 rated worse. Key strengths included postnatal information and pain management. Areas for improvement included personalised support and communication, potentially linked to wider system pressures.

Patient-Led Assessments of the Care Environment 2024, Northampton General Hospital NHS Trusts performance was broadly in line with national and regional averages for cleanliness, food (particularly ward-level provision), and the overall condition, appearance, and maintenance of the premises.

However, 2 domains scored notably below national and regional benchmarks:

• Privacy, dignity and wellbeing (83.26% versus. 88.22% England average)

• Dementia (77.26% versus. 83.66% England average)

The results suggested that aspects of the care environment could be better aligned with the needs of patients requiring enhanced privacy or dementia friendly.