Boston West 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 provided care and treatment which met patients’ needs. We saw that patients who used the service were actively involved in planning and delivering their care. Patients could access care in ways that met their personal circumstances. Staff ensured that information was shared with other agencies so that there was a continuity of service. Relevant information was provided in a way people could understand, and people could provide feedback and raise concerns. Access to the care was straightforward and people experienced positive outcomes. The service worked to improve inclusivity.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and responsive 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.

Staff we spoke with told us that their focus is on the patient and their care and comfort. Staff were flexible in appointments to best suit individuals’ needs. Leaders told us that if patients had specific requests about access to their surgery, different teams would work together to meet these requests.

We checked the current data available on the Private Healthcare Information Network (PHIN) about the service. This showed that 83% of over 1300 people who shared their views, felt the service fully met their needs.

Staff worked with patients after their surgery to make sure patients still received a personalised approach to recovery. For example, consultants could arrange additional prescriptions with patients’ local GPs if needed.

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.

The service had relationships with other local healthcare providers which maintained communication and ensured joined up care for patients. Most patients were referred by the NHS for surgery. Staff were in regular contact with local GP services, the NHS trust and musculo-skeletal (MSK) practitioners. Ophthalmology patients received a multi-disciplinary follow up care package with GPs and local opticians working with service staff to ensure the best outcomes.

Leaders told us they were committed to working more closely with the local community and being more inclusive. The service was actively working to achieve the Autism Accreditation Inclusion award.

The service considered the diversity of the local population. At the time of the inspection, Boston had a diverse population, particularly from Eastern European countries, and with an increasing number of older adults. Staff offered translation and interpretation services for patients who required this. They also liaised with local taxi services transport providers where patients required this to ensure patients were taken home safely.

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

We reviewed patient feedback and found it to be positive. Patients told us they were given booklets before procedures which explained their treatment and how it was appropriate for their needs. They said they felt well-prepared for their procedure and their care plans supported their recovery. Patients were fully informed and given choices around sedation and pain relief.

Staff gave appropriate and accurate information to patients at various stages of their treatment. Patients and their families were kept informed of the next steps in their care and were contacted promptly about any delays or post-procedure issues. Patients had access to easy to understand, up to date leaflets about specific conditions which had information about potential complications and long-term recovery following surgery. Most leaflets were available in other languages.

Staff followed policies to enable accessibility for patients who had physical disability or sensory impairment. The service frequently offered ophthalmic surgery and so written information was available in formats for people with reduced eyesight. The service also provided a hearing loop for those who required this assistance.

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.

Staff told us they encouraged patients and their families to be open and honest about problems. They tried to handle issues as soon as they were raised as they felt concerns were most effectively resolved using this method. This meant they received fewer formal complaints. Staff told us they were made aware of the outcomes of any complaints. Any learning and improvements arising from concerns were shared in staff updates and bulletins.

The service’s "Ask Listen Do" initiative, enabled patients with a disability to be able to give real time feedback. Staff were reminded to use these to ask and respond to those patient's individual needs.

We saw leaflets about the complaints process and fees for self-funded private patients. One patient told us: “everything was well explained, even the forms. [Staff] read parts out and then explained what that meant in easy-to-understand terms, breaking it all down”.

Patients told us they felt confident they could speak up if they had concerns about their care or wellbeing. Most people we spoke with said they would initially speak to a staff member before using a more formal approach.

The service analysed feedback from patients regularly and were responsive to concerns raised and formal complaints. Leaders handled complaints directly and offered to speak to people face to face to resolve issues.

The service had received 2 complaints in the 6 months prior to the inspection. We saw that leaders apologized, addressed the concerns raised and explained how the service would make improvements. The service also provided information about the next stage in the complaints process if patients wished to take their concerns further.

Patients we spoke with on the day of inspection said they had no complaints about the service. They knew about the complaints process and felt confident they could raise concerns with staff members. Most people said they would speak to a staff member straight away if they had a complaint.

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

The service was open for day case surgeries between 7am to 6pm, Monday to Saturday. They offered elective procedures, some of which had specific exclusion criteria. Less than 1% of patients were waiting over 52 weeks. At the time of the inspection, the service had 4 patients waiting over 65 Weeks. These were patients waiting for spinal surgery. Leaders explained that factors such as limited spinal specialist availability, and the need for approval from the local Integrated Care Board (ICB) for spine procedures meant patients sometimes had longer waiting times for their surgeries.

The service’s overall waiting times had seen a recent improvement of 5% for those patients waiting over 18 weeks for their procedures. Leaders confirmed that although there was capacity for more patients to be seen, the local ICB has implemented a minimum week 16 week pathway, meaning patients could be seen in clinic and receive diagnostic tests but could not receive surgery or treatment within 16 weeks. Some patients could be offered quicker treatment at an alternative Ramsay hospital as this operated under a separate ICB, with different waiting times criteria.

There were policies to provide guidance to identify and support patients with additional needs, such as patients with a disability or who required interpreter services. Staff told us they considered patients’ care holistically and discussed individual cases across multi-disciplinary teams to ensure patients were given the best options for their care.

Patients told us they were able to choose their appointment times within clinic hours and appreciated the opportunity to attend appointments or have procedures on Saturdays.

Staff confirmed they contacted patients 48 hours before their procedures to check they were able to go ahead and if necessary re-scheduled surgeries to fit with patients’ change in circumstances. This pro-active and flexible approach also helped limit non-attendance at appointments.

The location had recently had renovation works and the layout of the reception and waiting areas had been improved. We saw the reception area was light and spacious and the design of the reception desk enabled people using wheelchairs to be able to speak to staff and complete forms easily.

People told us they found the service easy to find and the surgical areas easy to navigate. However, some noted that finding a place to park a car could be an issue at busy times.

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 service’s location enabled people to access elective treatment in the local area rather than having to travel to a larger facility further away.

Staff within the surgery team and wider service promoted a culture in which the patients felt empowered to give their views. All staff had completed equality, diversity and inclusion training and they could access policies which provided guidance to ensure they did not put any patients at a disadvantage.

Staff monitored outcome data promptly and followed up with patients if there were issues. If data from the national Patient Recorded Outcomes Measurement (PROMs) indicated that a patient’s score was worse post-operatively, an email alert would be raised on the action register and updates could be recorded. The consultant would also be made aware of this score so that they could provide guidance or suggest follow up action.

The service was pro-actively working to offer new services for local people, including clinics for moles and other skin issues.

Patients told us that they had a positive experience and outcomes from their treatment. One patient said that although the procedure hadn't delivered the expected results, the team were working with them to look at alternative treatments to improve their condition.

People were supported to plan for their treatment and rehabilitation, so they could have enough time to make informed decisions about their treatment and follow up care.

Patients said that staff discussed the initial expected outcomes and longer-term progress with them during appointments. Staff also ensured GPs and other practitioners were informed of patients’ outcomes and ongoing prognosis.

The service provided follow up physiotherapy appointments and signposting to other agencies to help patients with their recovery and rehabilitation after surgery.

End of life care was not a provision within the service and was not reviewed during this assessment.