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

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

This was the first assessment of this service. We rated this key question good.

This meant people’s needs were met through good organisation and delivery.

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.

During our onsite assessment, we spoke with patients who told us they had been consulted throughout their care and treatment making them feel involved in the decisions made. We were told there was good support from the physiotherapists and occupational therapists regarding discharge readiness and they assisted coordinating ongoing care in the community.

The provider had introduced an initiative called home before lunch. The aim of this initiative was to ensure the discharge process was initiated early so patients were discharged and home before lunch time to be least disruptive.

The wards were designed to meet patient’s needs. Each patient had their own room and ensuite bathroom giving them privacy.

Best interest meetings were held to support patients and their relatives when a patient lacked capacity. These meetings put patients’ needs at the centre of any decision and used advocates to ensure any decision made was in the patient’s best interest.

The service understood the diverse needs of the patient population it served and worked with teams across the provider to ensure there was continuity of care. Staff were aware of the diversity of patients they admitted including patients from overseas and the NHS.

Overseas patients were given a point of contact to help ensure their needs were met and staff could use handheld devices to access interpreting services. A large number of patients spoke Arabic as their first language. The provider directly employed an Arabic interpreter to attend appointments, meaning patients were able to understand their care and treatment.

The service had links with NHS providers where many of their clinical staff also worked. Staff gave examples of trauma orthopaedic patients being transferred to the service, when their insurance allowed, after initially being treated in the NHS. This provided patients with continuity of care and the same surgeon was involved in their care from the beginning.

The electronic patient record system allowed a post discharge summary to be sent directly to GPs. The system had a connect function and meant the patients GP could connect directly with the surgeon, view the discharge plans and look up scans and other information.

Patients were referred to private and NHS community services. Staff told us how they researched services and on one occasion, sourced a private company to provide community care for intravenous antibiotics prior to the patient’s admission for surgery.

Information was available for patients in different languages and formats. We saw patient leaflets available in languages other than English and the provider worked with an external company to produce patient literature tailored for each procedure. Easy read formats were available to order, and staff had a catalogue of leaflets they could choose from. This meant patients were able to access information in a way that suited their needs.

The chief nurse told us that self-pay patients were provided with a clear and explicit breakdown of costs prior to treatment, including, inpatient stays, dressings, diagnostics and procedures meaning there were no hidden costs the patient was not expecting.

The provider had an information security policy to help keep patients’ confidential information safe. The policy referenced national guidance and legislation following general data protection regulations meaning the provider was committed to keeping private and confidential information safe.

The service encouraged patients to provide feedback about the service. At the point of discharge, patients were asked to complete a questionnaire on a tablet device, a feedback form or via an email they could access at a later date. The ward manager was responsible for feeding comments back to staff at the daily huddle.

The provider was registered with the Independent Sector Complaints Adjudication Service (ISCAS), who provides an independent service for complaints made against providers in the private healthcare sector. At the time of our assessment there were no complaints being handled by ISCAS.

Inclusion was one of the providers values. Leadership undertook rounding, where they would visit different areas of the hospital to speak with patients and staff and gather their views. Leaders we spoke with told us this was an important way of understanding how improvements could be made by gaining different perspectives. The most recent leadership rounding saw 25 leaders visiting different areas with set questions on the value of empathy.

Patient partners were former patients who played a key role in providing feedback to the provider. They participated in the patient-led assessments of the care environment inspections and contributed to initiatives like menu tastings and reviewing patient information leaflets meaning improvements had a patient perspective.

Patients could access care and treatment they needed without facing barriers, therefore promoting equality. The public areas of the hospital and wards had step free access meaning it was accessible to people with mobility issues.

The global patient services team were an organisation wide team who worked with overseas patients to identify their individual needs. They could access interpreting services to liaise with care providers outside of the UK ensuring seamless care when patients transferred between services.

Patients could access a diverse range of dietary requirements to meet their religious and cultural needs, including vegan and Kosher. As these options were standard, patients did not have to make special requests making them feel singled out.

The global service team liaised with providers overseas and the embassies to manage discharge planning and achieve equitable outcomes in their care. In the UK, staff liaised with NHS services when patients were transferred into their care and patients were treated equally, no matter how the treatment was funded.

The equality impact assessment tool was used each time a policy was reviewed and updated. Staff were required to escalate any potential discriminatory impact of the policy as part of the update to ensure it did not discriminate against a patient or staff group.

The hospital provided mandatory training modules on healthcare inequalities for staff. These modules helped staff understand and address potential inequalities in care, support, and treatment, and promote equality in all aspects of patient care.

Patient partners met quarterly and provided feedback to the service from the patient perspective. Staff used this information to ensure experiences of care were equitable using feedback to tailor its services.

Staff from the post-anaesthesia care unit (PACU) told us they attended the daily theatre huddle as part of forward planning for the ward and to understand the cohort of patients due to be admitted post-operatively.

People who were approaching end of life were identified and appropriate care was provided through ongoing assessments of their needs. Patients and their relatives were included in the decision making and staff talked with patients to find what was important to them at the end of life so care plans could be personalised.

Changes to, or the withdrawal of treatment was communicated and managed openly and sensitively. Staff spoke with relatives to make sure they understood the patient’s resuscitation status based on their wishes meaning they were prepared and knew what treatment they could expect.

The service had access to a palliative care consultant 24 hours a day for advice and input into reviews. They helped with treatment escalation plans and facilitate links with palliative care teams in the community.