Northampton General Hospital

Updated 3 March 2026

Northampton General Hospital (NGH) 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 is also an accredited cancer centre and provides cancer services to a wider population of 880,000 who live in Northamptonshire and parts of Buckinghamshire.

We undertook a desk-based assessment beginning 21 October 2025. A desk-based assessment does not require us to visit the site. This is because the information we required to make a judgment could be submitted by the trust.

We carried out this assessment of medical care only to check the quality of services in response to a Section 29A Warning Notice (WN) we served to the trust in March 2025 following an assessment in February 2025. The WN required the trust to make improvements in relation to the systems and processes to manage flow and effective records. We assessed the safe, caring and well led key lines of enquiry only. However, we only reviewed specific elements of safe and well led in line with the WN.

We found the service had made improvements and had met the actions of the WN. The trust reported there were still further planned improvements required. New monitoring processes would require further data to be collected to assess the full impact of the changes made.

At this assessment we assessed 1 assessment service group: Medical Care, where we assessed 4 quality statements.

We did not rate the location at this assessment.

Updated 17 October 2025

Medical Care (MC) services at Northampton General Hospital are provided by Northampton General Hospital NHS Trust. We carried out this assessment to check the quality of services in response to a Section 29A Warning Notice (WN) we served to the trust in March 2025 following an onsite assessment in February 2025. The WN required the trust to make improvements in relation to the systems and processes to manage effective patient flows and records. At our assessment in February 2025, we rated the MC service as requires improvement overall.

We assessed 4 quality statements across the key questions safe and well-led. These quality statements related to the areas of improvement required in the WN.

Our concerns were with processes and governance issues which could be reviewed remotely. We asked the trust for various documents and assessed them for evidence that improvements had been made.

Following a review of the information provided by the trust, we are satisfied that improvements have been made and the requirements of the WN have been met.

We did not rate this service at this assessment. The previous rating of requires improvement overall remains. We found:

• The introduction of electronic recording and systems had resulted in discharge planning starting earlier in the patient’s journey and reduced reporting errors.
• Processes had been introduced to identify and escalate concerns with patient flow.
• The trust has a strategy to raise awareness of the new discharge processes and promotion with staff.
• Waiting times in the discharge lounge have improved.
• Closer working with stakeholders to introduce a regional wide discharge process.
• Governance metrics have been introduced and reported against. However, at the time of the inspection there was insufficient data collected to evaluate the full impact of the provider’s actions.
• There was evidence of innovative actions such as the inclusion of the transport manager at daily discharge meetings, a dedicated ‘discharge doctor’ and the introduction of a trusted assessor.

Whilst improvements had been made, managers recognised continued improvements were required to fully embed and maintain the changes overtime. We are monitoring the progress of improvements to services and will re-inspect them as appropriate.

Updated 17 July 2025

Urgent and Emergency Care (UEC) services at Northampton General Hospital are provided by Northampton General Hospital NHS Trust. They provide 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 is also an accredited cancer centre and provides cancer services to a wider population of 880,000 who live in Northamptonshire and parts of Buckinghamshire.

We carried out this assessment to check the quality of services in response to a Section 29A Warning Notice (WN) we served to the trust in March 2025 following an onsite assessment in February 2025. The WN required the trust to make improvements in relation to the potential of harm to patients in the emergency department, systems and processes to manage patient flow and privacy and dignity. At our assessment in February 2025, we rated the UEC service as requires improvement overall. The safe key line of enquiry was rated as inadequate.

During this inspection we assessed 5 quality statements across the key questions safe, caring, and well-led. These quality statements related to the areas of improvement required in the WN.

We visited all areas of the Emergency Department (ED). We reviewed the environment, looked at care records and spoke to staff and patients. We spoke with 7 patients and 14 staff members across various grades. We observed meetings, reviewed performance information about the trust and observed how care and treatment was provided.

Following a review of all the evidence from this follow-up assessment and a review of additional information provided by the trust before and after our inspection, we are satisfied that improvements have been made in line with the requirements of the WN.

We did not rate this service at this assessment. The previous rating of requires improvement overall remains.

At this inspection we found:

There was a greater awareness of the risks to people across their care journey. Improvements had been made to systems and processes to support flow through the department. Risks were assessed, and people and staff understood them. Staff assessed patients risks of developing a pressure ulcer or skin damage.

The service treated people with kindness, empathy and compassion. The service made changes in the environment to maintain patients’ privacy and dignity. Corridor care had been significantly reduced.

Trust wide response to operational pressures within the emergency department had improved. Processes were in place for operational pressures to be escalated to directorate and trust wide leaders. A programme of improvement was in place with clear lines of accountability. A programme of audits had been implemented, and lessons were learned from this.

Whilst improvements had been made, managers recognised continued improvements were required to fully embed and maintain the changes. Environmental upgrades were underway to further improve the safety of patients and flow within the department. These additional building improvements had not been completed at the time of our assessment. We continue to monitor the progress of improvements to service and will re-inspect them as appropriate in line with our process.

Updated 8 November 2017

We rated this service as good because:

• There was a well-embedded culture of incident reporting and staff said they received feedback and learning from incidents.
• Safety thermometer data from the last 12 months reported 100% of “harm free” care in the child health directorate.
• There were clear arrangements in place to safeguard children and young people from abuse, which reflected relevant legislation and local requirements. The majority of staff had undertaken the required level of safeguarding training.
• The service performed well in a number of national audits including the National Neonatal Audit (2015) and the epilepsy 12 audit (2014). Gosset ward was working towards achieving Bliss accreditation.
• Staff had the clinical skills, knowledge, and experience they needed to carry out their roles effectively. Mandatory training and appraisal levels were above trust targets.
• Actual nurse staffing levels met planned rotas during our inspection and patient’s needs were met. Medical staffing was appropriate and there was an effective level of cover to meet patients’ needs.
• Feedback from children and parents was consistently positive and parents told they were treated with dignity and respect.
• Services were responsive to the needs of patients, parents and families and were working towards delivering sustainable seven-day services.
• Staff felt that local leadership was strong with visible supportive and approachable managers.
• The child health directorate was continually developing patient services to ensure innovation, improvement, and sustainability.

However:

• There were not always effective systems in place regarding the storage and handling of medicines in the children’s outpatient department. The trust took immediate action to address this once we raised it as an urgent concern.
• Children or young people on Paddington ward could access the corridor to the delivery suite. This was a risk particularly for patients who may be at risk of self-harm or suicide. The trust took immediate action to address this once we raised it as an urgent concern.

• The pathway for patients who needed to cross the road between buildings had not been reassessed to ensure opportunities to prevent or minimise further harm were not missed. The trust took immediate action to address this once we raised it as an urgent concern.
• The child abduction policy was in draft and awareness was lacking in some areas of the service. The trust took immediate action to address this once we raised it as an urgent concern.

Updated 8 November 2017

We rated this service as good because:

• There was a strong culture of reporting, investigating and learning from incidents. Learning was shared throughout the team.
• Adequate medical and nursing staff was provided to meet the recommended staff to patient ratio, as defined in the core standards for intensive care units.
• There were effective systems in place to protect patients from avoidable harm and improve compliance with standards on a continuous basis. The principles of the duty of candour were well understood by all staff.
• There was clear evidence and data upon which to base decisions and look for improvements and innovation. The unit participated in the Intensive Care National Audit and Research Centre (ICNARC) audit and performed better or as expected in six out of eight indicators.
• The critical care outreach team provided 24 hour cover seven days a week cover and assisted with the monitoring and treatment planning of deteriorating patients throughout the hospital, ensuring risks were responded to appropriately.
• Staff were very caring and kind and provided emotional support for patients and relatives, for example, through the use of patient diaries.
• Leadership was well established and there was a clear focus on improvements and patient safety.
• Structured meetings were held throughout the directorate to review all aspects of quality, risks and performance and high risks were escalated and monitored effectively.
• Effective governance arrangements were in place. There were structured meetings to review all aspects of performance, quality and risks and high risks were escalated through the directorate. Innovation throughout the staff team was encouraged.

However:

• The pharmacy team were aware of the shortfall in band 8a specialist pharmacist support and were providing cover with a band 7 pharmacist. A business case had been put forward, which if successful, would ensure standards were being met.
• Medicines were not always stored safely behind locked doors or in restricted areas. We raised this with the trust and this was rectified immediately by the trust.
• The unit did not comply with the Department of Health’s Health Building Note 04-02 critical care unit’s standards; however, this had been risk assessed and was under review. Refurbishment plans were in place to address this.
• Not all medical staff had completed the required mandatory training.
• Hospital wide bed capacity affected the ability of the service to discharge patients to wards at the most appropriate time. Over eight hour delayed discharges were higher than the national average, however, action had been taken and improvement observed for patients waiting 24 to 48 hours.

Updated 23 May 2017

We rated the service as good overall. Many improvements had been made to raise the profile for the end of life care service in the trust and this had led to improvements in the way patients received safe, compassionate care in their last days. However, more work was required to collect performance information about the service and ensure that mental capacity assessments underpinning decisions about cardiopulmonary resuscitation were being evidenced in patients’ records.

Updated 24 February 2023

Updated 8 November 2017

Overall, we rated outpatients and diagnostics as good. We inspected but did not rate the effectiveness of the service, as we are currently not confident that we are collecting sufficient evidence to rate this key question for outpatients and diagnostic imaging. We rated this service as good because:

• Staff were aware of their responsibilities and understood the need to raise concerns and report incidents. Staff told us they felt fully supported when raising concerns.
• Generally, the design, maintenance, and use of facilities and premises met patients’ needs. The maintenance and use of equipment kept patients safe from avoidable harm. Improvements had been made in some areas in the outpatient environment, which included the expansion of the chemotherapy suite and new equipment in the diagnostic imaging department.
• Appointments were prioritised according to referral requests from GPs with urgent requests and cancer referrals booked within two weeks. The imaging department prioritised reporting higher risk examinations not seen by other clinicians.
• We found that medical and nursing staffing levels and skill mix were planned and reviewed so that patients received safe care and treatment.
• Care and treatment was delivered in line with national guidelines. Staff within the service had the appropriate skills, qualifications, and knowledge to complete their roles safely.
• All teams reported effective multidisciplinary working.
• Patients were treated with compassion, dignity, and respect.
• Feedback from patients and those close to them was positive about the way they were treated.
• Staff made patients’ appointments according to the needs of the individual. This included moving them to allow work and other appointments to take place.
• The service consistently met the referral to treatment standards over time. Waiting times for diagnostic procedures was lower than England average. The service was meeting cancer targets for referral to treatment times at the time of the inspection.
• The "did not attend" (DNA) rate for the trust from June 2016 to May 2017 was 7% and this was same as the England average of 7%.
• Outpatient specialties ran additional evening and weekend clinic lists to reduce the length of time patients were waiting. The radiology department offered a walk in service for all plain film examinations.
• Services were tailored to meet the needs of individuals and offered flexibility in choice with appointments being flexed across a seven day service within the diagnostic imaging department.
• The service had a challenging and innovative strategy that supported the trust vision. This included redesign of departments, introduction of support systems to improve performance and repatriation of services to improve patient experience.
• Staff had awareness of the trust vision and strategy. Staff were aware of the risks within their departments. Staff were proud to work at the hospital and passionate about the care they provided.
• The service had leadership, governance and a culture which were used to drive and improve the delivery of quality person-centred care.
• Staff felt that managers were visible, supportive and approachable. Specialties were focused on developing services to improve patient care.

However, we also found that:

• We found concerns about the fire exit in the fracture clinic. This had been addressed by the unannounced inspection and we found the service had also reviewed all fire exits throughout the service.
• We observed poor infection control practices in both the blood-taking unit and the pain relief clinic. We raised this with the service, and immediate actions were taken to review infection control precautions to mitigate risk. This had been addressed by the unannounced inspection.
• We found issues with the storage of controlled drugs in the pain relief clinic. However, when we raised this with the service, senior managers took immediate action to address storage of these drugs. This had been addressed by the unannounced inspection.
• Not all staff had received the required frequency of mandatory training, including safeguarding. Plans were in place to address this.
• We observed poor infection control practices in both the blood-taking unit and the pain relief clinic. We raised this with the service and this had been rectified by the time of our unannounced inspection.