Cleveland Clinic London Hospital

On this page

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

Patients were at the centre of all aspects of care. Staff considered individual needs throughout the imaging pathway and treated patients with patience, compassion, and kindness. The design of the environment facilitated privacy and dignity. Staff helped patients understand their conditions and scan referrals and provided emotional support and reassurance. The service asked people for feedback, which was persistently and overwhelmingly positive and exceeded the provider’s expected standards. Such standards were furthered by the team’s internal audit system and care ethos that focused on patient-centred, compassionate care. The provider had extensive support programmes in place to support staff wellbeing, including a comprehensive approach to enablement that meant staff had clear progression and development opportunities.

This service scored 80 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider trained staff to treat patients with warmth, respect, and empathy, and to deliver care considering individual anxieties and apprehension. We saw numerous examples of staff providing kind, supportive care during our assessment. They understood certain scans caused anxiety, such as MRI scans where movement was restricted in a small space. Staff worked with each individual to calm their nerves and explain the reason and benefits of the planned scan.

Each patient had a different understanding of the reason for their scan, particularly when they had been referred by an external doctor. In some cases, scans were ordered to identify if patients had serious conditions that would impact their lives. Staff understood this and approached each patient with compassion and time to listen and discuss their concerns. This extended to the electronic patient records app and radiologists spent time allaying concerns and providing information on treatment on demand when patients needed it.

The front desk team provided patients with a private waiting area if they preferred to be away from others. This team recognised when patients were in distress, and they were proactive in providing comfort and dignified support.

The imaging quality lead ensured patients who required a carer or comforter to remain with them during scans were able to do so. The service used a standard operating procedure for this, which met the standards of the IR(ME)R employer’s procedures. For example, for scans that exposed carers to ionising radiation, they were provided with lead equivalent personal protective equipment and given a briefing about the potential risks. This ensured radiation exposure to those required to stay with the patient was monitored, documented, and tracked to keep them safe whilst ensuring the patient would benefit from their presence. The service carried out patient feedback focus weeks to understand the experiences of patients in different modalities in the department. Staff used digital tablets to record immediate real-time feedback. Senior staff monitored this as it was recorded, which enabled them to quickly address any issues or substandard care. Equality, diversity and human rights training was mandatory for all staff and enabled the team to address needs and requests in relation to culture, religion, and personal preferences. The ethos of the service was person-centred and staff demonstrably placed patients at the centre of their work. As part of the provider’s service excellence training, staff completed a course in empathetic listening. This helped them to provide targeted, individualised support when patients needed extra help or had concerns.

Patients spoke highly of access and coordinated care in the service. For example, 3 patients we spoke with said they appreciated how integrated the diagnostics service was with other medical departments, including as part of long-term post-operative care.

Staff delivered care within an overarching privacy and dignity policy that guided them in ensuring patients had choice and as much control as possible in care decisions. This extended beyond flexible appointment times and meant patients could choose how the service could meet their needs relating to culture, religion, and personal identity.

Staff respected each patient’s individual choice and adapted care and treatment to meet protected characteristics, culture, religion, and personal preferences within safety guidance. For example, radiologists considered any additional risks for scans in transgender patients undergoing gender reassignment treatment to reduce the risk of harm whilst ensuring the individual could make an informed choice.

The electronic patient records system included a flagging feature to alert staff to additional needs at the first point of contact when patients presented for an appointment. For example, reception staff could identify quickly if the patient was known to have safeguarding, language, or chaperone needs. They used this system to identify if a patient’s previous behaviour meant they could only be seen with 2 members of staff, or a particular gender of staff, for the team’s safety. As patients could self-refer to a clinical speciality, consultants did not always have extensive medical history information for each individual. They assessed this on an individual basis and ensured care and treatment requests were clinically indicated and appropriate for the patient’s desired outcome and health needs. In the previous 12 months patients rated the service and staff highly. For example, 91% of patients said staff had been responsive to their needs, 98% of patients rated communication with their consultant as ‘excellent’ or ‘good’, and 97% rated nursing care as ‘excellent’ or ‘good’. These figures reflect feedback across all 3 diagnostic’s services in London. All staff undertook cultural awareness education sessions that covered all aspects of how to understand and meet patients’ needs. The provider had a spiritual care service that supported patients, families, and staff regardless of faith. While the provider did not offer a dedicated mental health service on an outpatient basis, psychologists were based in acute medicine and provided support in the event a patient presented with urgent needs. The secure online health management tool enabled patients to communicate with staff securely regarding non-urgent concerns like medical questions, prescription queries, test results, and visit follow-ups. Patients could also use the platform to schedule video chats with their clinician to discuss results or concerns.

Staff wellbeing was at the core of the provider’s values and included a multidimensional wellbeing support system in which leaders were upskilled to understand the psychology of day-to-day staff wellbeing. The provider facilitated psychological safety and empowered all staff to give candid, constructive feedback.

The hospital had increased the number of trained mental health first aiders (MHFAs) four-fold since the programme was introduced, reflecting need. MHFAs undertook an intensive training programme led by a clinical psychologist to be certified as practitioners by an external body.

Staff told us working relationships were underpinned by mutual respect and they felt the department and provider more generally were positive places to work. They spoke particularly well of relationships with outpatient’s colleagues and GPs, with whom they worked closely.

The provider held Pathway to Excellence designation, which was evidence of a practice environment that empowered staff to drive excellence in care. The programme incorporated the importance of work-life balance and required the provider to improve and sustain wellbeing. Staff said the process of accreditation had been useful because it helped them identify how they could identify the impact of quality care through the expansion of their own skills.

In the most recent staff survey, 79% of diagnostic imaging staff said they would recommend the service as a place to work. This was below the provider’s target of 85% and the senior team were working with teams to drive improvement. improvement. As diagnostic imaging staff worked across all 3 London sites, survey results were reported at overall department level. Where staff made site-specific comments in the survey, the senior team acted at site level.

Staff were a key focus of the provider’s vision and values, which included empowering staff to be accountable for their performance and achievements and to be innovative and inclusive in their work.