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

People were involved in discussions about their care and planning the care they received. They understood options around choosing to withdraw or not receive care and they views were acknowledged. The service provided information in a way people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People we spoke with told us that they felt they were at the centre of their care and treatment and were involved in planning and making shared decisions about the care and treatment they received.

Staff we spoke with told us how they considered patients individuals needs and preferences. They stated they undertook risk assessments to identify specific needs such as nutrition, hydration, mobility and pressure area care and planned individual care based on these assessments.

Senior leaders told us patient experience was at the centre of all they did. They regularly visited patient areas speaking with staff and patients gathering a well-rounded selection of views and opinions. Feedback from patients was reported at the critical care quality board, highlighting the positive feedback they had received and areas for improvement and learning from complaints. At the time of the assessment there was one active complaint, and staff were in constant communication with the patient and their family.

Delivering and co-ordinating services considered the needs and preferences of different people, including those with protected characteristics under the Equality Act. During the pre-assessment stage, patients were able to express their needs, and this was recorded on the electronic notes and used at all stages of their treatment including during their stay in critical care. Patients we spoke with told us their identified needs had been met.

The consultants working on the unit were directly employed by the provider ensuring a continuity of care for patients and had oversight of their treatment.

Patient information booklets were available in different languages and formats, including Arabic and braille. The provider used an independent company to produce information about procedures in different languages and an easy read format, so all patients felt informed.

Patients were informed about the cost of their care before they agreed to attend the hospital, including the cost of the critical care stay. If this was required. A clear breakdown of costs was provided with the different packages available. The provider liaised with various insurance providers to ensure it was clear to the patient what was or was not included by the insurer. However, one patient we spoke with told us there was a delay in the insurance provider confirming what care would be funded and the information they received from the provider was complex, and they found it difficult to understand where the delay was in confirming what the insurers would pay for.

Following feedback from a complaint, the provider was improving how patients and relatives were approached when insurers did not cover specific aspects of the care. The provider acknowledged it was a stressful time for patients and bereaved relatives, and they would assess the best way to discuss financial aspects of care, taking an individual approach to each case.

All patients were given the opportunity to provide feedback on the care they had received. They could access comments cards or use a tablet onsite to complete the feedback form or via an email link if they wished to complete it at a later date. All feedback was reviewed at the monthly critical care governance meeting and action taken where necessary. Senior leaders were able to tell us how they had used feedback to improve the service. For example, the providers bereavement pack was under review at the time of our assessment after comments from a family highlighted areas for improvement.

Patients were sent a survey following their discharge as part of their stepdown of care. Feedback from patients showed they didn’t realise this was a second survey to follow up on their step-down care. The service initiated a patient outreach programme and contacted patients to inform them to inform patients this was another chance to share their experiences once they had had a chance to reflect on the care they received.

Information on how to make a complaint was available at the hospital and online via the website enabling patients to make complaints if they wanted to. The website had a timeline of when people could expect a response and guidance for the compliant process.

The patient experience team carried out a monthly audit of a selection of random patients to review notes ensuing the appropriate care was provided.

The service produced a ‘you said, we did’ poster which showed what action had been taken as a result of patient feedback. A family member had fed back they had concerns over their relative’s skin care, the provider introduced a skin management initiative to ensure skin protection in weekly rounds with weekly skin rounds part of the care plan.

People could access care, support and treatment when they needed it. Pre-assessment checks prior to surgery identified patients who might require a higher level of care. The service would pre-book a bed for the patient in critical care ensuring their surgery was not delayed. Some admissions were unplanned, to ensure there was enough capacity to admit deteriorating patients, the service did not run at full capacity. Referrals were also received from other providers who could not provide the level of care the patient required. The service would assess the capacity and the admission criteria before accepting them into the service.

Patient partners were former patients who met quarterly to discuss their experience of the service. Staff told us they found this feedback helpful in understanding the patient perspective and what improvement needed to be made.

The service could accommodate patients with a variety of needs, for example bariatric equipment was available to support patient needs. Staff told us they saw patients from a variety of cultural backgrounds and the global service team supported them to ensure the patients had their needs met.

Patient outcomes were tracked, reviewed and submitted as part of their data submission to ICNARC.

Patients were included in planning future treatment. People approaching end of life were identified and patients and their relatives were able to discuss what was important to them and personalise their care plan.

Staff told us they communicated with patients and relatives sensitively and openly, for example, when discussing a change or withdrawal of treatment. These conversations were documented and staff supported patients having difficult conversations with relatives if they decided to sign a do not resuscitate form. Consultants were available to talk with relatives and spent time answering any questions.

Following a concern raised by a family, the unit worked with relatives to improve the patient information leaflets and help improve the experience of future patients accessing the service.