Hospital's leadership told to improve

A hospital has been told its leadership structure requires improvement after a watchdog found some staff "didn't feel comfortable speaking up" about issues.

The Care Quality Commission (CQC) report followed a two-day visit to Northampton General Hospital (NGH) last September.

The CQC noted "limited assurance of learning from governance processes to mitigate risk", but said "nursing staff gave positive feedback about the nursing and general management".

Richard Mitchell, the group chief executive of University Hospitals of Northamptonshire, said: "We recognise there are areas where we need to improve."

The CQC said its report came in response to concerns raised by whistleblowers.

During a visit on 17 and 18 September, its inspectors found the trust needed to do more to ensure a culture of learning and improvement was embedded across the group.

In a national inpatient survey, people's feedback on receiving care at the trust was broadly in line with national averages. However, people had some concerns about communication, discharge planning and being involved in their care.

Carolyn Jenkinson, from the CQC, said: "We found leaders needed to do more to lead by example and build a positive culture across their workforce to help staff provide care and support.

"While there were some areas of good practice, including their work with partners, the leadership team needs to make further improvements.

"We were concerned that some staff didn't feel comfortable speaking up, as they were worried about potential implications for their career or weren't confident action would be taken."

Jenkinson added that some senior staff and clinicians reported poor management styles and that some members of the executive team were "unapproachable".

She said: "At the time of our assessment, the trust was going through a significant transformation programme to align roles, working patterns and processes across the group.

"As a result, staff were confused about structures, including who their chief executive and chief nursing officer were."

The report highlighted "encouraging" work between the trust and its partners, and noted its board had strong financial skills and experience.

The CQC said leaders had been told that efforts to make improvements would continue to be monitored.

Mitchell said the hospital had taken "clear action" to improve since the inspection, including how it learns from incidents and feedback.

He said: "There is more to do, and we are committed to delivering these improvements with focus and pace. This will support our aim to provide safe, high-quality care and a positive experience for all patients and colleagues.

"We will continue to work closely with colleagues, partners and the CQC to ensure these improvements are embedded and sustained."

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