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

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

All areas were accessible by wheelchair. The reception area had seating and toilet facilities for patients and visitors.

The booking team said private patients were informed about fees in advance during telephone calls, they received information in the post and again during outpatient appointments. This gave patients opportunities to consider the cost prior to receiving treatment. For patients who did not attend, charges were incurred.

Plans were made for patients with dementia following discussion at ward capacity meetings. We saw dementia boxes and information leaflets for patients and carers. Rooms could be made dementia friendly with signage, sensory items and enabling carers or relatives to stay when needed.

We observed staff communicating with patients, so they understood their care and treatment, including finding effective ways to communicate with patients with communication difficulties. We saw staff had access to a full range of interpretation services and were able to support people with visual or hearing impairments.

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.

There was an admissions criterion so all patients, irrespective of age, gender, race, religion, belief or sexual orientation, could access the service.

The hospital held daily morning huddles (meetings) to plan care, discuss risks and issues. Staff who were unable to attend received emails with meeting notes.

The service liaised with the local NHS trust regarding availability so appointments could be filled with appropriate patients.

There were clear pathways for patients to be transferred to the local hospital if they became unwell. They followed their service level agreement (SLA) with the local NHS hospital to transfer out clinically unwell patients. There was also a transfer standard operating procedure (SOP) which included transport arrangements, accompanying staff and documentation.

Staff were highly experienced and most had been working at the location for 10 years or more. They had also worked in other departments so felt they could explain to patients what to expect in their patient journey. Patients with learning disabilities, autism and attention deficit hyperactivity disorder (ADHA) were included in this process.

Leaders described care adjustments for people with dementia, learning disabilities and anxious patients. These included pre-surgery visits, appointments at quieter times and the ability for a carer to stay.

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

Information governance systems included confidentiality of patient records which were stored electronically. Paper records on site were stored in a keypad locked room behind a staffed desk. Staff received training in information security and data protection, and the system triggered alerts if inappropriate access was attempted.

The service ensured patients could obtain a range of information on treatments and how to provide feedback. Leaflets could be provided in different languages. Information was in forms accessible for particular patient groups including easy-read, large print, braille or speaking forms and in different languages. Staff said there were various ways in which they provided information people could understand including interpretation for people who did not speak English as a first language. They were also able to obtain support for people who were deaf and used British Sign Language (BSL).

Detailed information was provided to patients about what to expect pre and post- surgery with contact numbers for support.

The physiotherapy team provided patients with information leaflets and a telephone number to call if they had any concerns. For example, advice and exercises following hernia repair, lumbar spinal surgery and total knee replacement. Leaflets were informative and included general advice, goals, exercises with photographs and how to use equipment such as crutches.

At time of discharge, patients were provided with information about their medication to take home, including contact numbers if they had any concerns, including the pharmacy team who were available 5 days a week.

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

Patients could raise concerns in a range of accessible ways on the service’s website including QR codes. All patients received patient satisfaction surveys (electronically) to complete which included the friends and family test. Results for the 12 months in 2025 were highly scored in most areas 97 to 100% of patients said they were treated with respect and dignity; 95 - 100% of patients would recommend their consultant to family and friends. Fewer patients (78 to 86%) said they would recommend the hospital to friends and family. However, the patients we with spoke with said their overall experience was excellent (one patient mentioned problems with parking) and everyone said they would recommend the service to family and friends.

There was a facility for website reviews and a patient focus group which met quarterly. All feedback was shared with heads of departments and their teams. There was evidence changes had been made following feedback. The service implemented a change as a result of a complaint about billing and in response they centralised the billing process.

For the year from February 2025 to January 2026 the provider received 14 complaints, 14% were upheld and 50% were partially upheld. 6 were regarding clinical care and 2 regarding billing. Learning from complaints and concerns were seen as opportunities for improvement. Complaints were discussed at monthly and quarterly quality and safety meetings when trends were reviewed. The main theme identified was regarding the provision of parking. The provider had employed a parking attendant to assist patients.

If NHS patients were dissatisfied with responses to complaints, they could contact the parliamentary health service ombudsman (PHSO) or private patients could contact an independent sector complaints service. This information was readily available.

There was evidence changes had been made because of feedback. The time the main reception doors were opened to patients in the mornings was 6.45am. Patients told the service if their admission time was 6.45am they wanted to arrive early. The door opening time was changed to 6.30am to meet patients’ needs.

Leaders provided listening opportunities such as an endoscopy department event for patients to meet consultants at a coffee morning where scoping processes were explained and questions answered.

Most patients told us they knew how to make a complaint or give positive feedback. There was a patient satisfaction board displaying thank you letters and cards from patients.

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

Patients could access the service through several routes, including GP referral, health insurance, self-pay or through their NHS hospital. Most patients said it was easy to arrange their appointments or surgery with 90% of patients privately funded and 10% NHS referrals. There were no long waits for patients. Cancellations by the service rarely happened. If there were cancellations due to, for example, staff sickness, then patients were rebooked as soon as possible. Staff told us this was a rare occurrence. For the year from February 2025 to January 2026, there were 75 cancellations on the day of surgery. If a theatre appointment took longer than expected, the team would try to work later or provide an extra slot the following day to accommodate any delays.

Waiting lists were managed through aligning patient bookings to available capacity, allowing patients the option to choose surgery at a time to suit them and maintain short waits. Patient choice of dates extended to both private and NHS patients. There was a referral to treatment (RTT) improvement action plan to improve the process for NHS patients being treated and to ensure there were no breaches in their RTT dates.

Leaders told us Saturday services were increasing. There was theatre availability for approximately 2 Saturdays per month, generally for orthopaedic surgery.

Staff made reasonable adjustments for patients, for example patients who had mobility problems.

Physiotherapists provided a 7-day service for inpatients and a 5.5 day service for outpatients. Equipment was ordered through an electronic system and there was no difference in provision of equipment for private or NHS patients. Following discharge, the physiotherapy team provided a telephone number for patients to access support such as needing a raised toilet seat or assistance to access stairs in their homes.

Most patients told us they found the service accessible regarding signage and parking. However, a couple of people had problems finding parking spaces. The provider was aware of this issue and was addressing it by employing a parking attendant.

There was a current discharge policy including guidance for carers. A post-discharge enquiries form was completed by staff if patients telephoned with concerns following surgery.

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

The pre-operative assessment identified patients who might require extra support. Staff said they could ensure people’s needs were met and planned in advance with staffing levels changed to support patients. People who used the service had their needs and preferences assessed and understood by staff. They were treated with equality and in a non-discriminatory way.

Staff completed training in equality, diversity and inclusion (EDI). This training was underpinned by the service’s EDI policy which outlined the policy statement of the organisation for a fair and equitable workplace.

Data supplied by the service regarding incidents and complaints did not identify adverse outcomes or inequalities for people with protected characteristics.

People 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.

Patients’ wishes for staff not to attempt resuscitation was recorded in patients’ records. Staff knew how to identify patients’ wishes.

Staff provided patients with information regarding any ongoing care or treatment needs. At time of discharge, patients were provided with information about their medication to take home.

Detailed information was provided to patients about what to expect pre and post-surgery with contact numbers for support.