Cleveland Clinic London 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

The service planned care to meet the needs of people using a clinically focused, research-based approach to developing innovative care. Staff took account of patients’ individual needs, made it easy for them to give feedback, and acted on this. People could access the service when they needed it and did not have to wait long for treatment. The complementary range of clinical specialties available made many care pathways available on a seamless basis.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Waiting areas were shared with the outpatient department and equipped with comfortable seating, drinking water, tea and coffee, including herbal and decaffeinated options. Staff provided access to quiet or private waiting areas on request and GPs could arrange to meet patients and take them directly to the consultation room.

The global patient services (GPS) team provided or facilitated language interpretation services. The GPS team liaised with embassies and care providers outside of the UK to ensure seamless care when patients moved between them, including patients outside of the provider’s global network. GPs worked with patients to identify access to care services and ongoing treatment when they left the UK. The team understood the needs of patients registered under corporate insurance services as well as the needs of patients using the on-demand concierge service. The team maintained up to date access details for urgent care services.

The hospital was equipped with a range of facilities to support patients to have a positive experience and meet their individual needs. This included multi-faith prayer rooms, private spaces to wait for patients with sensitivities to noise or who were anxious, and gender-neutral, accessible toilets with no-touch technology for security and infection prevention and control.

The service monitored levels of patient centredness by using a combination of results from patient feedback and quality of care audits. These included patient satisfaction with staff communication and clinical outcomes. The service consistently scored 100% in this measure. This was measured overall for GP services.

The provider developed and expanded services to meet patient demand and the needs of the local community. For example, the GP team had expanded women’s health services and introduced skin care appointments.

In the previous 12 months, 98% of patients said they received good or excellent care and 100% said they would recommend the service.

GPs understood the diverse health and care needs of people and the various communities in London. They coordinated joined-up, flexible continuity of care.

The electronic records system enabled health professionals from other providers and services to access patient notes, pathology, and other test results. Amongst providers that used the system, it enabled GPs to share findings and consultations with other services involved in patient care. Such access was granted where necessary for treatment and with the patient’s consent.

The service tracked the number of monthly referrals GPs made to each specialty and used the data to ensure referral pathways met patient need and support capacity planning. Cardiology and gastroenterology were the most common specialist referrals, which averaged 275 in total per month.

GPs worked with the imaging service to arrange investigations including X-Ray, ultrasound, CT, MRI, body analysis, laboratory tests, cardiac, lung function and neurophysiology assessments. They worked with radiologists to discuss appropriate protocols.

Pathology services monitored the turnaround time for blood and sample testing in outpatients against provider guidance. In the previous 12 months, 100% of reports met the target. The team monitored the quality of results taken by staff using point of care testing equipment in GP and outpatient departments. Results showed consistent practice, with the majority of samples of sufficient quality for testing. The results were the same at all 3 outpatient sites.

Reception staff kept patients up to date with waiting and treatment times when patients were in the waiting area. The team actively monitored who was waiting to be seen and let them know in advance if their clinic was running late.

The electronic patient records system was in use across all teams and departments and accessible by all staff involved in care. This enabled the GPs and the wider multidisciplinary team to provide up to date, coordinated information to patients. The GP buddy system meant patients always had access to a doctor for test results, advice, or a new appointment booking.

Staff used an electronic patient records system to document consultations, test results, prescriptions, and clinical advice. Patients could access this using a smart phone app or computer at any time. The platform had a messaging function that enabled clinical staff and patients to communicate with each other to discuss results and treatment plans. The app placed staff-patient communications at the centre of care and reflected a leading-edge approach to providing patients with instant access to information. At the time of our assessment, over 80% of GP patients used this system as their main method of communication. This figure was an overall average across all 3 sites and reflected the choice patients had in which location they received care. Staff provided 1-to-1 sessions with new patients to show them how to use the system, which offered patients 24/7 on-demand IT support.

GPs were trained to resolve minor issues and complaints at the time they were raised and worked with the senior primary care team to do so. A formal complaints process provided escalation, and the service was registered with the Independent Sector Complaints Adjudication Service (ISCAS). The patient safety team engaged with ISCAS to understand complaint trends across the sector and used this learning to proactively adapt the service.

The team worked with patients whose expectations of care and treatment were beyond the capability of available medicine. This included patients accustomed to treatment outside the UK that was unavailable locally, or those well-versed in research often requested treatment that could not be provided locally. In each case GPs discussed alternative options.

In the previous 12 months the service received no formal complaints. In the same period 93% of patients said staff were responsive to their needs and 100% said the team worked well to deliver care.

Patients could book appointments online, by phone, or using the provider’s digital app. GPs scheduled their availability several weeks in advance, which helped patients plan appointments. While the service did not operate a dedicated walk-in service, doctors saw patients on demand if they could meet their needs. In such cases a nurse triaged the patient and ensured their condition was in the scope of the service. Where it was not appropriate for the patient to be seen by a GP, staff arranged an appropriate alternative.

Nurses completed basic observations for each patient before they saw a GP. This meant current vital signs were documented prior to the consultation, enabling GPs to make effective clinical decisions.

GPs provided remote follow-up consultation by video link for patients already seen in the service, such as to discuss test results or treatment plans.

Language interpretations services were available in person or remotely by telephone or video chat. The video system enabled GPs to meet with patients and interpreters jointly for remote consultations.

Patient feedback was consistently good. In the previous 12 months, 100% of patients rated access to care as good or excellent.

A dedicated patient access team supported patients to make the most appropriate bookings for their needs using each individual’s preferred communication methods. The team staffed the reception desk in each clinic and coordinated patient transfers between the provider’s 3 locations if needed. This team ensured any disruption to clinics was coordinated with clinical colleagues at other sites to rebook patients and avoid any delay to care.

The provider offered flexible booking arrangements and the patient booking team monitored cancellations and offered patients rebooking options. Cancellations due to GP availability or booking errors were rare and reflected fewer than 0.1% of total cancellations. This result is an overall figure for all of the provider’s GP services.

GPs actively sought out and listened to information about people who were most likely to experience inequality in experience or outcomes. They tailored care, support, and treatment in response to this.Most patients seeking care, around 60% of the total, were international visitors. The team recognised the unique needs such a patient group presented with and adapted the service accordingly. They worked with embassy doctors and private colleagues in other countries to coordinate ongoing care when the patient moved between countries.

The service was designed to provide same-day, or pre-booked, care and treatment to meet individual needs. This included the treatment of medical conditions and health checks as part of corporate employment or insurance. Patients could request the same GP for each appointment where they had ongoing or long-term needs. GPs ensured all patients received the most appropriate treatment and supported long term condition management for patients not registered with NHS services or who chose to pay for their care privately.

Continuing professional development was focused on delivering care to specific patient groups. For example, corporate wellness checks included the option for a heart CT. GPs undertook training to identify the usefulness of this scan based on age, gender, and pre-existing coronary artery disease.

Staff used an equality impact assessment tool for each policy or standard operating procedure. The tool helped to identify if any group of people, based on protected characteristics, would be disproportionately and negatively impacted by the policy or its update.

All GPs and nurses supporting them undertook training in learning disability and autism awareness and demonstrated high levels of awareness and knowledge. They recognised the barriers to care people could face in relation to communication and understanding procedures and worked collaboratively to overcome these.

GPs were trained to recognise and escalate patient needs relating to self-harm and suicidal intent.

The service supported people to plan for life changes and to make informed decisions about their future. They understood cultural and religious differences and supported patients to make the choices most appropriate for them. GPs often saw patients with long-term health needs managed by other services, including those outside the UK. They based care and treatment decisions on the best available information and coordinated care with other professionals.

The provider facilitated an innovative research culture and proactively sought opportunities and partnerships with other organisations. Research was always focused on improving clinical practice and patient outcomes and staff at all levels were able to access research opportunities. The provider was exploring the use of artificial intelligence (AI) in a joint programme with the UK Government and an IT organisation to identify how AI could be safely and effectively used.

The provider’s sustainability steering group guided teams in reducing their environmental impact and contributing to the sustainability component of the provider’s overarching strategy. Imaging staff we spoke with understood how to minimise waste and demonstrated use of fully electronic, paperless resources for clinical communications as part of their commitment to sustainability. The service managed the disposal of sharps and hazardous waste to reduce the carbon footprint in line with national guidance.