Nuffield Health Brentwood Hospital

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s needs were met through good organisation and delivery.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Patient care was based around individual needs and preferences. We observed patients being offered a choice in meals and times for support with care. A patient we spoke with told us “My nurse was kind her approach when viewing my surgical wound, I feel the care has a more personal approach.”

Endoscopy services booked patient appointments flexibly around patient preference and needs where possible. Upper gastrointestinal endoscopy patients were given the choice of sedation used for procedures.

A patient told us that they were given the option of 2 different surgical options, and the consultant took time to explain them so that they could make an informed decision.

The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Patients were met in reception, brought to the ward and shown to their room. Patients were informed of what to expect and how long their stay would be.

Handovers and morning huddles were held in departments to ensure all staff had the relevant information for each patient. We observed a morning handover where key information was shared to ensure continuity of care. For example, a patient’s medication had been stopped due to side effects and the team were informed of this change.

Physiotherapy staffing was planned in line with the planned admissions to ensure adequate support on the ward. They updated nursing staff of changes in mobility to ensure that patients were supported to be as independent as possible.

The hospital worked closely with the local NHS hospital trust and Integrated Care Board to reduce the referral to treatment (RTT) times for orthopaedic and gynaecological patients. Commissioning of the whole pathway (pre admission to post operative review) meant that care was joined up.

Prior to discharge, follow up appointments were booked. Written confirmation was provided alongside a discharge letter and after care advice sheets such as wound care leaflets. Patient leaflets could be printed in larger fonts if required. However, staff told us Nuffield Health did not provide multilingual leaflets. Walking aids were provided prior to discharge and follow up appointments were booked if required.

Monthly breast reconstruction awareness meetings were held at the hospital to give women the chance to meet and get support, information and insights into breast reconstruction, from women who had been through the same experience.

The service supplied appropriate, accurate and up-to-date information. However, these were not available in formats that were tailored to individual needs.

Staff made notifications to external bodies as needed. For example, the hospital submitted a notification to the Medicines and Healthcare products Regulatory Agency (MHRA) due to a faulty Oxygen flowmeter. Partner agencies told us they were informed of incidents in a timely manner, such as when radiology reporting was not available. The hospital presented an after-action review to share identified learning.

Staff ensured carers and families were regularly updated about the patient’s progress.

Information governance systems included confidentiality of patient records. Patient records were kept in a locked office area. Information leaflets were available for patients with useful contact numbers for the hospital and ward. Additional surgery specific leaflets such as breast reconstruction information had useful timescales for recovery and websites for additional support if required. Leaflets reviewed were version controlled, therefore staff could be sure they were given the most current information.

Staff told us that information could be provided in a form accessible to the particular patient group, for example a larger font. However, staff were not aware if these were available in other languages should this be required. We were told that the Venous Thromboembolism (VTE) patient leaflet was not available in different languages.

The service reviewed patient feedback and complaints about their care, treatment and support. However, there was a lack of evidence to support that feedback led to changes.

Patients were encouraged to offer feedback following their care. This was gathered via a QR code on discharge. Results were discussed at governance meetings and fed back to staff via email, team meeting and displayed on digital board in staff canteen.

Complaint information was not publicly displayed on the surgical ward. However, all patients we spoke with said they would feel comfortable to raise a concern and would ask to speak to the most senior person on the ward.

We requested the total number of complaints relating to surgery in the 12 months prior to our assessment. We were provided with the number of complaints since January 2025 in surgery. A total number of 46 complaints had been made and 12 had been upheld and were at stage 1. Stage 1 meant that this was a formal complaint which meant the senior manager investigated and aimed to have a local resolution, providing a response in writing within 20 working days. All complaints were logged on a live tracker and progressed in line policy . The most common theme within the surgery complaints data provided related to consultant attitude and behaviour. There was evidence of investigations and 2 were upheld.

When patients complained or raised concerns, they received feedback. We requested to review the last 3 complaints investigations. We were provided with 3 complaint investigations and responses. We found that these were dealt with in line with policy. For example, one complaint related to a cancellation of surgery due to not treating an infection during POA screening. An acknowledgment of the complaint was sent and telephone call was made by the POA manager, offering an apology and steps taken to prevent recurrence. There was evidence of an apology letter at 24 days. Details of how the process had been amended to ensure positive screening results were not missed and communicated with patients. Leaders did not provide examples of changes made in response to complaints in the last 12 months when this was requested as part of our assessment. Therefore we were not assured that the service was learning from complaints.

Senior leadership and heads of departments told us they communicated feedback to staff on the outcome of investigation of complaints and actions taken. Staff we spoke with were not able to give us any examples of changes that had been made because of complaints. A manager told us that there had been a complaint from a patient who on the day of surgery felt they did not know the procedure they had consented to. A 2nd consent stage was introduced as a result. This meant the consent form was reviewed with the patient by ward staff before being taken to theatre for the specific surgical approach or technique. Leaders did not provide examples of changes made in response to complaints when this was requested as part of our assessment.

The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

Patients could access care at Nuffield Health Brentwood through self-pay, GP referral, choose and book or through their NHS hospital where they met the admission criteria. NHS referrals were screened against a criteria to ensure safe care and treatment. The NHS booking team regularly reviewed wait times and capacity to ensure that patients were offered a timely appointment. The community partners we spoke with during our assessment did not have any concerns with performance. Weekly meetings had recently commenced with the local NHS trust due to an increase in complaints relating to patients which did not meet the admission criteria. The team felt this communication would be effective in evidencing reasons for refusal against the hospital’s admission criteria.

There was a team of administrators dedicated to ensuring self-pay and NHS patients were offered timely appointments with speciality consultants. This was managed using an electronic system, however staff reported that this was slow. There were plans to move to a different system in 2026. Cancelled surgery dates were rebooked to avoid further delays to patients. The service was flexible to meet the demand, for example there was a backlog within gynaecology due to a lack of consultants. The team worked with the senior management team to stop new bookings and senior management recruited more consultants to meet the demand.

Staff made reasonable adjustments for patients. For example, patients with dementia or high risk of falls were placed in an adapted room with red signage and support bars. There was a close monitoring room which was used when patients required enhanced monitoring following surgery.

People with mobility issues were loaned walking aids on discharge. NHS patients were referred for follow up therapy at their local hospital. However, they could return to Nuffield Health Brentwood for continuity of care at a 20% reduced fee. Self-pay patients would return to the outpatient department for follow up physiotherapy. Contact numbers were given to patients on discharge for their relevant services. We saw evidence of a referral f or care package via Thurrock council to support a safe discharge.

There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency. Anaesthetists and consultants were contactable in line with policy during the patient’s pathway and would support staff with concerns regarding their surgery.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes.

The service reviewed patient that may experience inequity in experience or outcomes and acted pre operatively where able. Multidisciplinary meetings were held where admission criteria was not met to support treatment at Nuffield Health Brentwood. For example, we saw evidence of surgery being postponed whilst anaesthetic discussions were had with family and physiotherapist had recommended an increase in care package and support to facilitate a timely and safe discharge.

The service did not provide us with evidence that they monitored people most likely to experience inequality or outcomes such as those with protected characteristics or ethnicity. Therefore we were not assured that they collected and reviewed this data to address potential shortfalls in care.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. Patient satisfaction audit data showed the hospital was consistently performing in line with other Nuffield Health sites across all domains. Likelihood to recommend the hospital to friend and family if they needed similar care or treatment was 100% for self-pay and 96% for NHS patients. This meant that overall satisfaction of care and treatment felt equitable to patients.

The service submitted outcome data to the National Joint Registry (NJR) Patient Outcome Measures (PROMs). This is national patient-reported data on the quality of care provided during joint replacement surgeries. The hospitals data for hip and knee surgery was within the expected national average or above against each measure. This meant that patients reported an improvement in health in line with or better than the national average following surgery at Nuffield Health Brentwood.

Staff were trained in equality, diversity, inclusion and human rights.

People were supported to plan for important life changes, so they could have enough time to make informed decisions.

When people had expressed their wishes about cardiopulmonary resuscitation, this was documented and communicated with staff prior to admission and supported with documentation within the care records.

People’s decisions and what mattered to them was supported and shared with others who may need to be informed. Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people with complex needs. For example, we saw evidence of a pre-operative therapy assessment carried out for a patient with additional support needs. Recommendations and arrangements were made for equipment, increased care package and family support. This individualised assessment leads to improved outcomes by identifying patient needs, risks, and home environment factors before surgery, leading to better functional recovery, reduced complications, shorter hospital stays, and enhanced patient satisfaction through tailored preparation plans.