CQC report on our emergency department and medical services

Northampton General Hospital

An open letter from the University Hospitals of Northamptonshire’s Chief Nurse, Julie Hogg, and Medical Director, Hemant Nemade 

On August 13 the Care Quality Commission published an inspection report on Northampton General Hospital’s emergency department and medical services. Inspectors visited our hospital in February 2025 and concerns were raised about how long it was taking to see patients in the emergency department, and the potential risks this brings. They were also concerned about the difficulties in how patients move through the hospital because of a lack of beds and difficulties in discharging patients home or onto other care settings. Our buildings were also seen to be overcrowded and there were issues around privacy and dignity. 

We are truly sorry that we have not provided the level of care that our communities need and deserve. We are committed to learning and improving to ensure every patient receives safe, high-quality care. We want to reassure you that, since the inspection was carried out in February 2025, we have undertaken significant work to address the CQC’s concerns. Many new processes are now in place to improve and monitor safety and care, enhance privacy and dignity and improve how we support patients throughout their emergency care journey.  

We remain committed to delivering safe, high-quality care and we will continue to listen to and work with our patients, staff, and system partners to offer the best care possible. 

Some of the key work has included: 

• Strengthening leadership in both medicine and urgent care by recruiting to all leadership roles. We are also launching a leadership programme for ED staff and supporting external peer reviews to ensure we are delivering best practice care.
• A new initial assessment process in the emergency department with walk-in patients being seen in an expanded assessment hub and those arriving by ambulance now receiving a face-to-face handover in the department. A ‘release to respond’ initiative has ensured we are improving on our 45-minute handover times for ambulance handovers.
• We have created new care standards for our staff to follow including two hourly senior nurse reviews of patients waiting in temporary escalation spaces and two-hour safety huddles (meetings) with the nurse in charge, clinician in charge and the operational management team. 
• We are developing a fundamentals of care programme focussing on the core components of patient care e.g. continence care, pain management, privacy and dignity, nutrition and hydration. This programme will be led and embedded by the experienced nurses.
• Monitoring patient vital signs in real time using our new Nervecentre electronic patient record which enables staff to use handheld devices to update care records as soon as care is delivered. The Nervecentre Electronic Patient Record was introduced at NGH in June. 
• Reassessing how we provide temporary escalation spaces during busy periods and investing in better beds, chairs, screens, call buttons and signage to encourage patients to ask for our assistance if they need food, drink or other care needs during their stay.  
• Putting in place ways to audit and assess safety, flow, and privacy and dignity issues.
• Promotion of privacy and dignity by closing temporary escalation spaces in the emergency department’s resuscitation area and main corridor. 
• Improving how we assess patients to prevent pressure tissue damage (bed sores) including a new assessment, weekly meetings and a peer review. We have also invested in additional pressure relieving equipment.
• Expanding the opening hours of our same day emergency care area to reduce crowding the main emergency department.
• Work to standardise ward rounds across the hospital to improve decision-making and discharge planning.
• Twice daily discharge hubs have also now been in place from April 2025 to minimise delays for supported discharge. 

We hope the programme of work described above demonstrates the extraordinary efforts that our dedicated teams are making. We are committed to learning, improving, and ensuring every patient receives safe, high-quality care.