Nuffield Health Derby Hospital

On this page

• 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 patients and communities were always at the centre of how care was planned and delivered.

The service placed patients at the centre of their care, involved them in decisions and adapted support when their needs changed. Staff used established systems to support people with complex needs, sensory loss, learning disabilities, dementia and mental health conditions. Trained staff offered familiarisation visits. Staff arranged interpreters, including British Sign Language, for people that did not speak English. Staff adapted catering to meet cultural and religious preferences. They also ensured private and self‑pay patients received full information about costs in line with national guidance.

Staff coordinated care across multidisciplinary teams and external partners, communicating clearly and handing over information effectively to ensure safe transitions. Staff worked closely with NHS services when escalation or onward referral was required. Staff provided clear, accessible information and complied with the Accessible Information Standard. They also completed GDPR and information governance training to maintain high compliance.

The service encouraged patients to give feedback and made it easy for them to raise concerns or complaints. Staff managed complaints through a clear staged process and focused on resolving issues early. They used feedback from surveys, conversations and online reviews to improve services.

People accessed care when they needed it because staff monitored waiting times and kept them within national standards. Staff minimised cancellations and rebooked appointments promptly. They considered patients holistically and made reasonable adjustments through flexible pathways identified at pre‑assessment. Leaders included equality and diversity statements in policies and monitored outcomes to ensure no disparities existed for protected groups.

Staff supported patients to plan for treatment and rehabilitation and provided enough information to help them make informed decisions. They ensured GPs and other professionals received timely updates.

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

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 service made sure patients were at the centre of their care and treatment choices and they decided, in partnership with patients, how to respond to any relevant changes in patient’s needs.

The service used established systems to support patients with complex healthcare needs, sensory loss, mental health conditions, learning disabilities and dementia. Staff gave examples of arranging familiarisation visits so patients could see the hospital before surgery and reduce anxiety. Staff accessed additional support from colleagues with specialist training when needed.

Managers ensured staff, patients, families and carers could access interpreters, including British Sign Language, whenever required.

Catering staff adapted meals to meet patients’ needs. They offered food and drink choices that reflected cultural and religious preferences.

In line with the Royal College of Surgeons of England guidelines, staff informed private and self‑pay patients of all planned and potential costs, including future surgery and possible complications.

The service understood the diverse health and care needs of patients and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff worked effectively within multidisciplinary teams to coordinate care across internal pathways and external organisations. They incorporated multidisciplinary team outcomes and specialist recommendations into people’s care records, which supported continuity and safe decision‑making.

The service worked collaboratively with NHS partners to support integrated care. Staff described how they communicated directly with acute trusts, ambulance services, GPs and specialist teams when people needed further investigation, emergency escalation or onward referral. They used clear handover processes and shared clinical information, diagnostic results and treatment plans to ensure people experienced seamless transitions between services. Patients told us staff arranged onward referrals when diagnostic tests revealed incidental findings during their surgical pathway.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Patients told us staff gave them clear information to help them understand their treatment options and what to expect before, during and after procedures. They described receiving information verbally and in writing, which gave them time to reflect and ask further questions. Patients said clinicians took time to answer their questions and provide the details they needed.

We saw notice boards displaying information for staff and patients, with leaflets readily available. Staff provided patient information leaflets in a range of formats to meet individual needs, including easy‑read versions and different languages. These formats supported people with varying communication needs to understand their care, treatment and options. Patients could also scan a QR code to access information online. ((A square, scannable symbol that stores information such as a link, message, or phone number)

When people had additional communication needs, such as requiring interpreters, staff arranged professional interpreters or adapted how they shared information to support informed decision‑making. Staff also arranged British Sign Language interpreters for patients who communicated this way.

The service ensured full compliance with the Accessible Information Standard (AIS), which requires services to give people with disabilities, impairments or sensory loss information in a format they can understand.

The service complied with the General Data Protection Regulation (GDPR) to maintain data security. Records showed that 92% of relevant staff had completed training in health record keeping and 91% had completed information governance and cyber security modules.

The service generally made it easy for patients to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved patients in decisions about their care and told them what had changed as a result.

Staff encouraged patients to provide feedback, both positive and negative, about their experience of the service. They displayed clear information throughout the hospital to show patients how to share feedback, and they made details about the formal complaints process and the complaints policy easy to access.

Managers designed the complaints procedure to prioritise early, local resolution (stage 0 complaints) and explained how patients could escalate concerns if issues remained unresolved. Staff aimed to resolve stage 0 complaints within two working days and stage 1 complaints (complaints requiring formal investigation) within twenty working days, and they kept complainants informed if investigations took longer. The service also explained how patients, whether NHS‑funded or privately funded, could access external adjudication processes.

Patients could share feedback through surveys, comment cards and direct conversations with staff. Staff encouraged people to speak openly and patients described them as approachable and receptive to comments or concerns. When people raised issues informally, staff acted quickly to resolve them and escalated concerns appropriately when needed. Staff also reviewed feedback from online review sites to identify improvements.

The service usually made sure that patients could access the care, support and treatment they needed when they needed it.

People who used the service could access it through several referral routes, including the provider’s own pathway, other independent healthcare providers or the NHS.

The service applied defined exclusion criteria and referred patients who required alternative care to a more suitable NHS or private provider, ensuring surgery took place in the safest setting and that decisions were based on clinical need rather than discrimination.

People accessed the service when they needed it and received prompt, appropriate care. Staff kept waiting times from referral to treatment within national standards and managed admissions, treatment and discharge efficiently. When waiting lists developed, staff monitored them closely and reduced them over time.

Managers monitored waiting times where necessary and ensured patients accessed services when needed and received treatment within agreed timeframes and national targets.

Managers worked to minimise cancellations. When appointments or operations were cancelled at the last minute, managers rearranged them as soon as possible.

Staff told us they considered patients’ care holistically and discussed individual cases across multidisciplinary teams to ensure patients received the best options for their care. Staff created flexible pathways to make reasonable adjustments for patients who needed them. They explored these adjustments at pre‑assessment to ensure everything was in place before the day of surgery.

Leaders included an equality and diversity statement in the service’s inclusion criteria to confirm they had considered potential exclusion based on protected characteristics when developing the criteria. The statement confirmed the policy did not discriminate on the basis of any protected characteristic.

The service also had a policy on gender-affirming surgery (GAS) . Although the service did not regularly treat patients seeking this type of surgery, leaders emphasised the importance of staff understanding the policy to ensure equitable access.

Staff and leaders listened to information about patients who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The service cared for a large number of self‑pay and private patients, which made it harder to identify or compare outcomes for people with protected characteristics. However, when we reviewed incident data, staff culture information and feedback from people using the service, we did not find any disparities in care experiences, adverse outcomes or inequalities for people with protected characteristics. Service policies and procedures included equality and diversity statements that showed leaders had considered the risk of discrimination against protected groups. The service also maintained an equality, diversity and inclusion policy.

Patients were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff supported people to plan for their treatment and rehabilitation, giving them enough time and information to make informed decisions about their care and follow‑up needs. Patients told us staff discussed expected outcomes at the start of treatment and reviewed longer‑term progress with them during appointments.

Staff ensured GPs and other practitioners received timely updates about patients’ outcomes and ongoing prognosis. The service offered follow‑up physiotherapy appointments and joint‑school sessions for hip and knee patients. Staff also signposted patients to other agencies to support their recovery and rehabilitation after surgery.

The service did not provide end‑of‑life care, and we did not assess this as part of the review.