Nuffield Health Exeter Hospital

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that people were always treated with kindness, empathy and compassion. We checked that people’s privacy and dignity was respected, that they understood that they and their experience of how they were treated and supported mattered. We also looked for evidence that every effort was made to take people’s wishes into account and respect their choices, to achieve the best possible outcomes for them.

At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding. This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

We have not awarded this service a score for Caring.

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

The service was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs. Staff introduced themselves to patients and explained their roles. Staff were discreet and responsive when caring for patients. They took their time to interact with patients and those close to them in a respectful and considerate way.

Patients had private rooms to protect their privacy. Theatre gowns and dressing gowns were worn to protect their dignity and chaperones were available. Patient-led assessments of the care environment (PLACE) were annual inspections of hospitals with focus on the non-clinical aspects of care such as treating people with compassion and dignity in clean and safe environments. The hospital scored 97% ahead of the national average of 92% in 2025 for privacy, dignity and wellbeing.

Staff attitudes and behaviours observed when interacting with patients showed they were discreet and responsive, providing patients with help, emotional support and advice when they needed it.

At times of difficulties, the service offered patients additional assistance such as making phone calls for them, offering for patients to remain in hospital longer than planned or organising transport.

We read one of many thank you cards from a patient when staff supported them through a very distressing personal event during their inpatient stay. Staff organised transport home and stayed with them following discharge until someone arrived to support them. Afterwards staff sent cards and flowers to the patient and checked on their wellbeing.

All the patients we spoke with said they were treated with kindness and compassion. They said they had received safe care and treatment, and staff could not have been more caring. One patient said they would miss all the staff as they had been “lovely” and another said staff had all been “great”. Patients said staff had respected their privacy and dignity.

Since our last assessment, staff now maintained the confidentiality of patient information in electronic format.

The service treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The service took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service made adjustments for patients by ensuring people’s access to premises and by meeting patients’ specific communication needs. Staff made information leaflets available in languages spoken by patients.

Staff understood and respected the personal, cultural, social, and religious needs of patients and how they might relate to care needs. Staff told us about adapting care for a patient with complex physical needs following surgery. Staff were concerned about how they would support the patient to mobilise safely and described teamwork across different teams to support safe mobilisation and discharge.

We reviewed a selection of care plans and saw these were tailored to individual needs and circumstances. Patients told us information about their care and treatment was clearly explained and tailored to their understanding. One patient said staff made adjustments to meet their specific needs and the information they required was provided. They felt involved in the decision-making process around their treatment and care. Another patient said there was good communication between the NHS and the Nuffield. One patient described their experience as “seamless”.

The endoscopy service provided an individualised service for patients with learning disabilities. Patients were contacted pre-operatively at home by the consultant who suggested they come in to view the theatre prior to their procedure.

Staff reviewed patients’ hospital passports when these were presented by patients. These are documents designed to support patients with learning disabilities, autism, or complex health needs when visiting hospitals or receiving care. They provide staff with vital information about patients’ preferences, communication needs, health history, and medications to help staff provide tailored care. For example, staff told us they would allocate extra theatre time either side of a procedure to facilitate their individual needs.

Staff ensured patients could obtain information on treatments, local services, patients’ rights and how to complain. Feedback was gathered through patient surveys and concerns were responded to.

Patients had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances.

The service was exceptional at promoting people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

If, during pre-assessment appointments, patients said they suffered from anxiety they would be contacted prior to their procedure to explore how best to support them and make choices about their care plan. Staff would offer patients a visit to the department to walk through the process (including a walk through theatre), see the room they would be staying in, visit the recovery area and be introduced to the team.

If patients were upset regarding the number of staff present, they would schedule their appointments at the start of the day so they would be first on the list to reduce waiting time. They would also leave room on either side of the appointment to allow a calm and suitable environment.

Staff told us they had supported patients who used mood bands for anxiety. These are wearable tools designed to help individuals, particularly those with social anxiety, autism, or sensory processing difficulties, to communicate their emotional state non-verbally and manage stress levels. These different coloured bands informed staff how patients were feeling and how to best help their wellbeing. Leaders ensured all staff were made aware when patients were using mood bands. There was an example of a carer saying how well a patient’s care had gone after staff supported a patient using bands.

We observed excellent communication between staff and patients in theatres and recovery. For example, a member of staff responded to a patient’s anxieties about their surgery, communicating with care and compassion to reassure them during the whole process to help reduce their anxiety. Patients who were particularly anxious were able to have somebody familiar with them in the anaesthetic room and in theatre when patients felt vulnerable.

Staff told us they support people who, for example, wanted to know the details of the oxygen and observation equipment to alleviate their anxiety. If patients suffered from claustrophobia, staff would place patients in the most appropriate part of the ward and show patients their room prior to their visit. Staff received very good feedback from patients for whom they had made such adjustments.

The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

The service worked with patients to understand and manage risks. The treatment and care met patients' needs in a way which was safe and supportive.

Staff were aware of and dealt with any specific risk issues, such as falls or pressure ulcers and care was planned accordingly.

Staff identified and responded to changing risks to patients with regular monitoring.

Patients told us staff responded quickly if they asked for help. We observed 5 staff respond immediately to the sound of a patient’s alarm in an individual patient room on the surgical ward.

We observed nurses speaking to patients in the recovery area in a calm and reassuring way.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Staff felt valued by their leaders and their colleagues. Staff had opportunities to contribute to service development. Staff were able to provide feedback or raise concerns and would expect responses.

Staff had access to wellbeing, health and financial support. They could access membership to the provider’s gyms to support their wellbeing. The hospital had wellbeing champions who were trained mental health first aiders to support staff. There was a wellbeing room for staff and the service provided discounted food.

We observed the hospital’s daily huddles (meetings) when department leads had the opportunity to recognise staff for their work. Celebrations for staff were arranged including valentine treats, easter biscuits and teas. Also, long service award lunches, employee of the month and year awards which were voted on by staff.

The physiotherapy team had processes to keep staff engaged and develop professionally. Staff were supported to maintain evidence-based practice such as funding available for study days and monthly physiotherapy focus meetings.

The physiotherapy department provided Pilates classes twice weekly. Staff self-referred for example due to back pain.

There was an apprenticeship programme for staff on the wards. The service received letters from trainee students thanking staff for their opportunities and support from staff during their training.

Staff appraisals included conversations about career development and how it could be supported. One team told us there were opportunities to develop and grow within the hospital. They had worked in different roles within the hospital and had progressed to their current roles.

There was a wellbeing lead and a wellbeing and civility board in theatres. These boards were being rolled out across all Nuffield hospitals.