The Yorkshire Clinic

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

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question as good. At this assessment the rating remained as good. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 86 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at making 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.

Potential individual needs or risks were identified during the pre-assessment process before patients came for their appointment, by putting a leaflet in with their appointment letter, asking about additional needs. If needs were identified, a member of staff was allocated to meet the patient at reception and stay with them through their journey in the out-patient department.

The service ensured all patients who required additional support had their particular needs recognised and responded to appropriately. This included people with a disability, impairment or sensory loss and those with religious, social, communication and language needs. Language line interpretation services were available.

Different coloured chairs were used to ‘break up’ the colour in the waiting room to make the environment more accessible to people with dementia.

Diet and nutrition assistant had recently been introduced to ensure all patients receive optimum nutritional intake, through assistance, encouragement and general support. We saw a range of dietary options and specific diet choices such as Halal and vegan options.

A multi-faith room was accessible from the reception area, with a small seating area, prayer mats and range of religious materials available.

All staff had completed autism awareness training and were provided with contact details for specialist services. Following recent dementia and autism awareness sessions from an external agency adaptation to signage and clocks had been made.

Examples of individual adjustments were also given by members of staff, such as working with a patient’s son to ensure that signage in her individual room was in keeping with what she was familiar with rather than standard dementia friendly changes. Dementia champions were in place and a dementia box also suitable for use with anxious or autistic patients was available on the ward. A further example was a patient with autism invited to look around the theatres before surgery.

Appointments were booked at times suitable for patients. We were given specific examples of person-centred care, such as a 20-year-old non-verbal adult with a diagnosis of learning disabilities and significant anxiety, with reduced ability to cope with unfamiliar clinical settings, frequent staff interactions, and the surgical process. In response, the service flagged the patient’s needs through their electronic health record at the point of referral, enabled tailored and extended consultation slots including with a learning disabilities liaison nurse, extended outpatient times planned to avoid waiting, allocation of a quiet room, and an allocated named healthcare professional to support the patient and family throughout.

The patient was given priority to reduce anxiety and distress, arriving at the hospital at 07:45 the admission phase was completed promptly, and the patient was in theatre by 08:15. Simplified communication techniques were used such as visual aids, gestures, and clear and calm language to support understanding. The use of a comfort item for the patient was accommodated in theatre, and the theatre team wore ‘Star Wars’ themed theatre hats, a favourite of the patient. The patient’s mother was present in the anaesthetic room as planned, to support the patient until his general anaesthetic was administered and he was asleep. The recovery nurse who had met the patient pre-operatively on admission was assigned to care for him post-operatively. Adjustments were made to the ward such as dimmed lighting, comfort items, music, pre-agreed pain plan.

A further example highlighted was the care and treatment of a profoundly deaf patient who experienced anxiety and did not like frequent visits to hospitals or locations outside their home. A British Sign Language (BSL) interpreter was arranged for all stages of the process, pre-assessment was completed using video technology, accessible leaflets were sourced, the patient was allocated the first slot on the theatre list and post-operative consultations were carried out virtually.

Another example involved the care and treatment of an elderly patient whose initial assessment was carried out in a quiet, dementia-friendly consultation room with minimal distractions and with their relatives in attendance. The ‘This is me’ care plan was completed collaboratively identifying preferred name and communication style, daily routines and triggers, calming strategies and comfort items. Following this, large-print signage and a memory board with photos and names of staff that would be caring for the patient were placed in the patient’s bedroom. Where possible the same members of staff were assigned to the patient throughout their stay and additional staff were allocated to provide one-to-one support. There were no restrictions on family visits and the service arranged a video link with the patient’s spouse who was unexpectantly hospitalised.

These examples all involved the use of the pre-operative assessment booklet ‘Me and my care plan’, easy-read leaflets and visual guides, and an invitation to a ‘familiarisation’ visit. Adjustments on the day of admission were co-ordinated to involve the surgical patient pathway multi-disciplinary team (MDT), reception staff, the named nurse, and the use of required and individualised adaptations (for example wearing a wristband, compression stockings). These examples resulted in successfully completed care and treatment, improved patient experiences and safe care and recovery.

We scored the service as 3. The evidence showed a good standard. 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 an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff told us the service delivered and co-ordinated services which considered the needs and preferences of different people, including those with protected characteristics under the Equality Act and those at most risk of a poorer experience of care. Aftercare instructions to patients included how to contact the service during the out of hours period and in an emergency to attend the local accident and emergency service.

Patients told us procedures were very well explained at the pre-assessment appointment, and risks were explained. They confirmed there were opportunities to ask questions and they felt fully involved in care planning. The expectations after the pre-assessment had been realised during the admission.

The service liaised with other bodies such as local authorities, NHS community teams, and general practitioners (GPs) to facilitate a safe and supported discharge to co-ordinate care, ensure timely and appropriate discharge planning, adjustments and support is tailored to individual patient needs and clear communication with patients and families.

The service intermediate care team had established links with, for example, the enablement support team, the multi-agency referral hub team, the district council, district nursing services, local adult community services and local equipment services to promote and support healthy lifestyles.

The service also referred patients to a free service in Yorkshire for people aged 18 or over who have had a day procedure, or a hospital stay. This helped in re-building confidence and independence and preventing hospital re-admission.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service provided patients with information available in easy read and accessible formats, and translations in a large range of languages. For example, information on total hip replacement was available in Farsi, Bengali, and Polish as well as other languages, English and large print formats.

We saw pre-operative advice leaflets were provided to patients with basic advice on how to look after yourself pre and post operatively. There were QR codes within the leaflet for more detailed information to be accessed and video links to explain treatment and procedures. The provider had also developed digital booklets including ‘Your procedure Journey’ and ‘Your surgical Journey’.

Clinic materials were written in a clear to understand manner and these could be translated into a range of languages upon request.

Staff told us they received all the information they required to plan people’s care and treatment. They told us they could easily access information such as care records, policies and guidance relevant to their role.

Information such as policies and guidance was available in paper and electronic format. Electronic and paper-based care records were easily accessible by staff and these were held securely.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. They always involved people in decisions about their care and told them what had changed as a result.

Following feedback about long waiting times and a lack of communication around appointments, theatre schedules, and discharge, the service introduced improvements to enhance clarity, reduce anxiety, and ensure patients felt informed and supported throughout their care journey. The clinical team reviewed and updated the information shared during pre-operative calls to ensure patients know what to expect on admission. The introduction of the ‘Sip til Send’ initiative delivered by nutrition and hydration champions had improved pre-operative hydration and created regular ‘touchpoints’ for patients to receive updates on expected theatre times.

In response to feedback about the need for clearer communication and more personalised care, the service launched the ‘It’s All About You’ strategy in April 2025. This empowered staff to deliver responsive, person-centred care by continuously adapting to patients’ clinical, emotional, social, and practical needs. It also supports effective discharge planning by capturing patient expectations early in their journey.

In addition, a patient forum had been established to offer real time feedback to the service and also offered a communication stream in which service developments could be shared.

Each patient was assigned a named nurse, who coordinates care and acts as the main point of communication. From the point of admission, discharge planning is discussed collaboratively with patients and their families. The named nurse ensures all discharge elements are efficiently managed and communicates any delays promptly. The service introduced a standard discharge letter template and a discharge checklist which has led to patients feeling more confident managing their care at home, GPs receiving timely and complete discharge summaries and a reduction in errors and omissions.

A key initiative has been the introduction of the ‘Patient Diary’ which enables patients to document their experiences, preferences, and questions from referral through to discharge. Staff also use the diary to share updates and messages, ensuring continuity and clarity in care. When appropriate, the diary is used alongside the ‘This is Me’ care plan’ (for patients with dementia, memory issues, or communication difficulties) or the ‘Me and My Care’ plan (for those needing additional support), helping to personalise care plans that reflect each patient’s values, goals, and concerns.

Bedside handovers were introduced to involve patients and their carers directly in shift handovers, encouraging shared decision making and had led to increased patient involvement, reduced anxiety, improved accuracy of information, and stronger communication between patients and staff. Patients felt more respected and valued as partners in their care, leading to a culture of openness and trust.

Children accompanying adults to appointments were allowed to wait in reception, receptionists ensured they were supervised by a family member at all times.

Patients confirmed they had been given leaflets explaining how to make a complaint or raise a concern at arrival, as well as data protection information. However, some patients did comment they could not remember being given specific information about how to make a complaint. The service complaints policy did confirm an acknowledgement to a complaint would be received within three working days and a further response within five or twenty working days, depending on complexity. Complaints may also be escalated to an executive director if not satisfied, and a full written outcome received within a further twenty working days. The service had received 36 complaints in the twelve months to April 2025, all had been handled in line with the complaints policy. We reviewed four complaints as part of our inspection and saw they had all been managed thoroughly and within the policy timescales.

The service had also completed a thematic review of all complaints and concerns received in the last twelve months. We reviewed this report and saw each complaint had been further reviewed with key recommendations for improvement. We saw this report was shared with all department leads and discussed as part of the Medical Advisory Committee as a part of an information sharing presentation by The Clinical Governance Committee.

The service had developed the ‘It’s All About You’ initiative to support people with autism and dementia and also help staff to identify specific individual needs. The ‘Patient Diary’ complemented this, with patients encouraged to note questions at each stage of their care and treatment. Patients were aware of this process and some confirmed they had used the diary, staff used this as part of the ‘daily huddle’.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

People who used the service told us they received treatment in a prompt and timely manner and did not experience long waiting times. They told us they were given clear information around appointment and treatment times. Most people could access the service when they needed it and received the right care promptly.

Waiting times from referral to treatment and arrangements to admit, treat and discharge people were appropriate to patients’ needs.

We reviewed data supplied regarding cancellations at the service showing that out of 493 cancellations in the last twelve months, 4% were cancelled for hospital-led reasons (for example staffing issues, equipment availability, or emergency prioritisation) and the remainder by patients (96%) who were offered a new surgery date within 28 days of the original surgery date.

Hospital-led cancellations were formally reported as incidents, each case investigated to identify learning and prevent future occurrences. Patients affected by hospital-led cancellations were also offered a new surgery date within 28 days. The service had a ‘Waiting list policy and management’ in place as part of the corporate ‘Access policy’.

Patients had reported challenges in securing parking when attending the service contributing to increased stress and anxiety. In response the service arranged parking facilities for staff at nearby locations and freed up more parking spaces for patients. The service has priority parking for patients with mobility issues and has increased the number of accessible parking bays.

Patients also raised concerns over the lack of a safe walkway from the car park to the hospital building, making access difficult and potentially unsafe. The service took action to improve pedestrian safety through the building of a safe walkway to the hospital building.

These improved the patient experience by making access to the hospital safer, more convenient, and more inclusive.

We scored the service as 4. The evidence showed an exceptional standard. Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

An example of this was the ‘Bespoke Discharge Support’ for patients who have had bariatric surgery. This involved an ‘immediate post-discharge phase’ consisting of a dietitian review before leaving the service, an appointment with a clinic pharmacist who provided tailored medication counselling, and a follow-up call after one or two weeks by a bariatric nurse to check on the patient’s recovery, dietary tolerance, and any early complications.

The initial discharge support was complemented by a ‘Structured Outpatient Follow-Up Timeline’ consisting of post-operative outpatient clinic appointments with the multidisciplinary team (MDT) to assess progress and address any concerns at six weeks, three and six months. Further reviews are held after one year, eighteen months and two years, and three-monthly vitamin B12 injections available for two years.

Patients told us they were very positive about the outcome of their experience and treatment. We did not receive negative feedback from people who spoke with us about the service. Patients commented that the pre-assessment process went through the procedure and associated risks in detail and well. Some patients had used the patient diary and found it very helpful, they said staff were happy to answer the questions they had identified. The in-room patient handover between staff was very useful and made the patient feel involved.

We saw similar levels of support was provided to patients discharged after undergoing other procedures and took in to account individual circumstances, provided ongoing support from multi-disciplinary teams, clinicians and a named nurse. This approach was designed to maintain standards of care, support early detection of complications, and contribute to improvement.

The service had also developed a ‘Patient Initiated Follow-Up’ (PIFU) in place for all consultants at the clinic, guided by clinical judgement where the admitting consultant determines whether a patient is appropriate for PIFU. Patients are informed at discharge that a routine follow-up appointment has not been booked, but the patient can request a further outpatient appointment if they have any concerns.

Patients told us they were well prepared for discharge following a ‘very good’ instruction from the physiotherapist and found the group physiotherapy session before discharge very informative. Patients told us the discharge process was good, with clear instructions about what to expect at home, and follow up has been good with routine appointments giving reassurance.

Patients had said they were disturbed by unnecessary noise during the night, negatively affecting their rest and recovery. The service had introduced a ‘Quiet Care’ initiative to raise staff awareness on noise disturbance, including information on minimising overnight disruption and unnecessary observations. Intentional night-time rounding had been introduced to proactively address needs and reduce call bell use and soft-close bins, doors, and equipment had been installed, as well as offering earplugs and eye masks to patients.

We scored the service as 3. The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

A discharge group had been developed, and a specific discharge nurse role was being created. This role involves liaising with patients at the beginning of their care and treatment in outpatients particularly to determine any social needs, and to work with external agencies in coordinating care following a review of discharge information and speaking to consultants. Initiatives had been identified to developed enhanced recovery to increase day case options, for example increasing the physiotherapy input to be able to better support earlier discharge.

The service had developed plans to provide an ‘enhanced care unit (ECU) to support an increasing complexity and acuity of patients presenting with complex comorbidities and higher acuity. The service intended to establish a four-bedded unit, providing care for patients with higher acuity needs, reducing the need for transfers to other providers and also supporting local health providers by managing more complex patients closer to home. The unit allows for the early detection and intervention of clinical deterioration through continuous monitoring by skilled staff, and leads to reduced complications such as infections, respiratory failure, or uncontrolled diabetes due to specialist and timely interventions.

Plans had been developed with input from patients for an ‘orthopaedic centre of excellence’ enabling same-day discharge for suitable patients following day case hip and knee procedures. Containing an in-patient rehabilitation gym and a recovery, and a social recovery lounge, the centre is designed to give pre-operative education sessions to prepare patients for surgery and recovery and post-operative recovery plans shared with patients and families.

The service was undertaking an expansion of diagnostic services in response to the increasing demand for timely and accurate diagnostics across the local area. This will enable faster diagnosis and treatment and reduce waiting times for scans and results. Patients will be better informed on treatment choices, leading to improved patient outcomes and a reduction in the risk of complications.

A ‘Meals on Demand’ initiative will be fully rolled out by October 2025 to let patients choose what they want to eat and when, through the use of an interactive digital menu using digital technology.