Alexandra 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 rated well led as good. There was an effective vision and strategy for children’s services aligned to local plans within the wider health economy. Leaders were committed to improving children and young people’s experience of care and treatment. There was a positive and supportive culture for staff. Managers promoted equality and diversity. Managers worked within a clear system of governance and risk management based around delivering safe and good quality care and treatment. Managers encouraged innovation to develop and improve services and the experience of children and young people within the trust.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff told us they enjoyed working within children and young people’s services. Staff told us the culture was focused on children, young people and their families, and they had the opportunity to develop and progress in their career. One member of staff gave an example of how she had been supported by leaders to develop her skills and expand her knowledge.

The wider paediatric directorate had a strategy for 2023 to 2026 (for the entire trust), which was developed in October 2023 with all relevant stakeholders with the safe care and needs of children and their families central to it.

The vision and strategy were aligned to local plans within the wider health economy. There were plans in place for funded workforce and estates for phlebotomy, a joint strategic needs assessment for children and young people and an increase in the number of outpatient clinics carried out at the site.

The service had an open culture with appropriate processes in place for children, young people, their families and staff to raise concerns without fear. Staff that we spoke with told us they knew how to raise concerns and felt confident they would be dealt with appropriately.

Leaders had a genuine commitment to improve children and young people’s experience, care and treatment. Leaders of the children and young people’s services included senior clinicians and managers. There was positive work between partner organisations and commissioners to improve services to meet children and young people’s needs.

Staff felt supported by their leadership team. Leaders were available when needed and led by example. Leaders focused on staff wellbeing and ensured a culture which promoted good practice, good quality and safe patient care.

Leaders and managers supported staff, and staff we spoke with were clear on their individual roles and responsibilities.

The service had managers at all levels with the right skills and abilities to run a service providing high-quality sustainable care. Clinical leaders were visible across children’s services.

Leaders had effective support opportunities to develop and maintain their credibility and skills. Staff had opportunities to develop including for future leadership roles. There was inclusive recruitment and succession planning. The trust had effective recruitment processes and ongoing checks to ensure all staff met legal requirements to work in the trust.

Staff and managers across the service promoted a positive culture that supported and valued one another. Managers met with staff regularly to complete appraisals and performance reviews.

Staff told us there was a positive culture and they could approach leaders if they had any concerns.

The trust had 1 ‘Freedom to Speak Up Guardian’ and ‘Freedom to Speak Up Champion. Staff told us they knew how to contact the freedom to speak up team. A Freedom to Speak Up Guardian is a named person in every hospital trust who provided independent support and advice to staff that wanted to speak up. They hold the board to account if it failed to focus on the patient safety issue. There was a process for staff to follow if they wanted to use the freedom to speak up service, information about this was available on the trust intranet.

Staff that we spoke with said they felt able to raise concerns without fear of retribution.

Staff were encouraged to raise concerns directly with their line manager or clinical lead. The Trust also hosted a monthly “Exec Live” forum where staff could ask questions to Executive team members, and an online “Rumour Mill” process was in place for staff to ask questions and receive responses via the Trust’s intranet page. Staff could also attend ‘How was it for you’ sessions with the chief nursing officer or call a confidential whistleblowing hotline.

The freedom to speak up team presented a bi- annual freedom to speak up report to the trust board. The report contained details on the number of people who had raised concerns on the types of concerns that had been raised. Concerns could be raised anonymously when people did not want to disclose their personal details.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff that we spoke with during the inspection understood their role and responsibilities.

Leaders and staff apologised and responded quickly with candour when things went wrong. People were meaningfully involved in implementing actions to prevent reoccurrence.

The service had effective systems for identifying risks, planning to eliminate or reducing them. The service collected, analysed, managed and used information to support all its activities.

The trust’s children and young people’s service had an established governance process that was appropriate for their service and was across all sites where children’s services were delivered. There were a range of regular meetings held between managers and staff, and managers and senior managers. The meetings identified clinical concerns, performance and emerging risks. Managers clearly recorded any actions arising from these meetings and ensured they shared these with staff. Staff could access all required policies and procedures. Staff took patient confidentiality and information security seriously.

We did not collect enough information from patients about their experience of partnership and communities to express their views in this report.

We did not collect enough information from staff and leaders about partnership and communities to express their views in this report.

Commissioners and other partners positively identified how the trust’s children and young people’s service worked to develop and improve care and treatment. This included a youth support group for patients living with diabetes enabling them to connect with others in similar situations.

There were systems in place for the service to engage with children, young people, their families and carers including the diabetes support groups.

Staff were committed to learning and improving services. Leaders encouraged innovation to develop and improve the services and the experience of children and young people within the trust. This included the development of ‘hot clinics’ (this is a fast access clinic for patients needing urgent care and treatment) and improved digital technology for the monitoring and management of diabetes in children and young people.

The service supported improvement and innovation work, including leaders and managers shared learning across children and young people's services.