Nuffield Health Exeter Hospital

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence people and communities had the best possible outcomes because their needs were assessed. We checked people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

At our last assessment there was not sufficient evidence to rate. At this assessment we have rated this good. This meant people’s outcomes were consistently good and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

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

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Outpatient appointments were personalised and holistic. We observed 5 patients consultations and 2 physiotherapy sessions, during which staff took time to understand each person’s lifestyle and worked to provide treatment that complemented their individual needs.

We reviewed 5 patient records and saw these included sections on ‘what is important to me’, as well as information about the surgical procedure recommended or notes from the appointment along with the appropriate consent from the patient.

Daily safety huddles were used to review the patients due to attend and to identify any additional needs, ensuring reasonable adjustments were planned. This included arranging additional support for wheelchair users or interpretation services for people who required them. Staff used a telephone translation service when required for people whose first language was not English. Staff described how they made further adjustments for people with mental health needs or a learning disability, including providing access to a quiet room to reduce anxiety and support engagement.

The service always planned and delivered people's care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards.

Staff planned and delivered people's care and treatment in collaboration with the service users. We saw staff discussed treatment options with patients, and there was collaboration between the staff and patient to agree treatment plans.

Staff followed up‑to‑date policies to plan and deliver high‑quality care in line with best practice and national guidance. Policies were developed and reviewed centrally by the provider and were easily accessible through the hospital’s system. Meeting minutes showed when policies were updated, the service implemented the required changes and monitored compliance to ensure they were being followed effectively. The location had a Clinical Governance lead that worked jointly at the Exeter location and at another Nuffield location. They were responsible for ensuring staff were aware of any new policies developed centrally by the provider.

The medical advisory committee (MAC) met regularly to oversee patient safety, quality of care and regulatory compliance. It reviewed incidents and adverse events, as well as mortality and morbidity data, to identify areas for improvement and strengthen patient safety.

Staff took part in clinical audit, benchmarking and wider quality improvement work. The provider, which operates multiple hospitals nationally, used comparative data across its locations to benchmark performance. It also gathered feedback from a range of external customer review platforms to support ongoing improvement. The audit results were positive with scores above 87%. For example, an audit of consent showed positive results of 94%.

Managers provided staff with regular supervision, including meetings to discuss care management, reflect on and learn from practice, and support ongoing professional development. Staff we spoke with told us they received regular appraisals and felt supported by their managers.

Managers identified staff learning needs and provided opportunities for them to further develop their skills and knowledge. Several staff members told us they had been supported to train as nursing associates, a role designed to bridge the gap between healthcare support workers and registered nurses. Other staff said they were encouraged by Nuffield to undertake a part‑time nursing degree. All staff reported having access to a range of electronic training modules. Staff were able to remain supernumerary whilst developing specialist skills until they felt confident in the task they were completing.

The service worked well across teams and services to support people. Staff made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different hospital services.

The service demonstrated effective collaboration with wider hospital teams. The director of clinical services held daily heads-of-department meetings to exchange information, which was then cascaded to staff. Team members confirmed they attended monthly meetings where updates, learning and key messages were shared, ensuring good communication across the service, or had access to meeting minutes.

Consultants spoke positively about working at the hospital. Clear systems allowed them to easily identify their allocated room and review the number of patients booked for each clinic. Staff were scheduled to support consultants in advance, helping clinics run smoothly. Medical secretaries monitored consultants’ workloads and were able to advise when an additional clinic might be needed to help reduce waiting times for patients.

The provider had an electronic patient record system. This meant patient information was easily accessible to all staff who were able to use the system. Consultants told us the electronic system was straightforward and intuitive to use.

The teams had effective working relationships with each other and with other specialist teams, and most staff we spoke with reported good teamwork.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

The service provided a range of written information to support people attending outpatient appointments, including guidance on recovery following specific surgical procedures. In addition, the provider offered free public education events where consultants delivered talks on various health conditions, such as understanding knee pain: symptoms, solutions, and surgical options. A recent patient survey showed patients received written instructions and information from the hospital regarding after-care following surgery.

The service had a range of health promotion information available on the provider’s website. This included mental health, men’s health, women’s health, and cancer awareness. Private health assessments were available to patients who were able to pay.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and they met both clinical expectations and the expectations of people themselves.

Patients were seen in a timely manner. The NHS Constitution states people should wait no longer than 18 weeks for non‑urgent referrals and no longer than 2 weeks for suspected cancer. The service only carried out a small amount of work for the NHS which was approximately 5% of its overall work. Staff told us patients did not experience long waits to be seen in outpatients, and patients confirmed the service had been proactive in providing them with prompt appointments. Waiting lists were monitored by the bookings team.

Staff used technology effectively to support care and improve outcomes. The outpatient department had access to rapid blood test results because it had an on‑site pathology laboratory. There was also diagnostic imaging situated on site which was accessed in a timely way.

Staff contacted patients who had undergone minor surgical procedures after their appointment to check whether they had any concerns. When needed, outpatient staff also carried out wound care reviews for patients if GPs were unable to.

Clinical outcomes were monitored to ensure patient safety. We saw the service audited patient files to ensure the patient had received the clinic letter from the consultant and acted when it hadn’t been sent. Over the past 6 months 90% of patients had received a summary of their appointment following the consultation. The last audit for January 2026 showed 7/10 clinic letters were present.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment. There were clear policies detailing the consent process.

Patients were supported to give informed consent before receiving treatment. We reviewed patient records and found all patients had documented consent. Patients we spoke with confirmed they had been asked for consent where this was required. Feedback from a patient survey showed patients felt clear or very clear about the explanations they received during outpatient consultations, including discussions about the risks and benefits of their procedures.