Spire Harpenden 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

This means we looked for evidence that the service met people’s needs. 

We looked for evidence that people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities 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. 

At our last assessment we rated this key question outstanding. At this assessment the rating has changed to good. 

This meant people’s needs were met through good organisation and 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 provided person‑centred care across endoscopy and chemotherapy services. Staff listened to patients and involved them in planning and delivering their care. 

Patients told us they felt at ease before procedures and said staff explained care and treatment in a way they could understand. This helped reduce anxiety and enabled them to take an active role in decisions about their care. Patients told us they were involved in care planning and felt confident discussing their preferences and concerns with staff.  

We observed staff responding to patients' individual needs throughout the endoscopy pathway and adapting their approach to ensure patients felt informed, supported and involved in decisions about their treatment. 

Staff worked with patients to ensure care reflected their individual circumstances and priorities. We saw evidence of discussions between staff and patients receiving chemotherapy which considered the impact of treatment on employment and financial commitments. This enabled patients to access additional support and resources, helping them maintain their wellbeing and manage aspects of their lives that were important to them during treatment. 

Patients receiving chemotherapy told us they had access to their consultant if they had concerns, including over the telephone. This enabled patients to seek advice when needed and ensured care remained responsive to changes in their needs and circumstances. 

The service planned and delivered care in a way that supported safe, coordinated and continuous pathways for patients across endoscopy and chemotherapy services. Staff worked together to ensure care was organised and responsive to patient needs. 

The service provided care for patients with clear care pathways in place. Patient records showed a well‑defined end‑to‑end pathway, and patients told us their care plan was easy to follow and well organised. 

Staff worked flexibly to maintain continuity of care. Low staff absence rates in chemotherapy supported consistent staffing. In endoscopy, staff worked closely with surgical teams and were able to move between areas to cover gaps where needed. This helped ensure patients experienced minimal disruption to their care. 

Leaders and staff reviewed patient needs and risks regularly. We observed daily meetings where department managers discussed medical alerts, risks and operational pressures. This supported timely communication and helped ensure care remained safe and coordinated. 

Staff worked collaboratively to deliver safe, coordinated and effective care. We observed effective teamwork throughout the endoscopy service. Staff carried out safety checks together, demonstrating a coordinated approach to care delivery. This helped ensure important information was shared consistently and supported the safe delivery of care. 

The service also worked with external partners when needed. Team meeting records showed links with local NHS oncology services to support patients who required more specialist input. This supported continuity of care when patients needed treatment beyond the service. 

Patients told us they understood their care and treatment and felt well informed throughout their care journey. Staff explained information clearly and provided aftercare contact details, enabling patients to seek advice and reassurance when needed. 

 The service worked in line with the Accessible Information Standard to identify patients' information and communication needs before appointments and used this information to plan appropriate support. Staff provided information in a range of formats to meet individual needs and help patients understand their treatment, available support and how to raise concerns if required. 

Patient feedback from June 2025 to 2026 showed people felt informed throughout their care, with 79% of endoscopy patients strongly agreeing that general information was good and up to 88% reporting they felt informed at all stages of their care. Patients told us they knew who to contact if they needed advice and felt able to ask questions throughout their treatment journey. 

We saw patient information resources referenced within care records to support discussions during consultations and reinforce information provided by staff, helping patients understand treatment options and make informed decisions. 

The service made it easy for people to share feedback and raise concerns about their care and treatment. Staff listened to patients and used feedback to improve services. 

Staff told us feedback was collected through monthly satisfaction surveys and other channels. Managers reviewed this feedback regularly and described how changes were made to services as a result. Learning from feedback was shared across departments, which supported continuous improvement. 

The service managed complaints appropriately. There were no complaints for chemotherapy services and three for endoscopy, none of which were upheld. However, records showed complaints were reviewed, and learning was identified and shared with staff. Leaders promoted an open and transparent approach, and staff described a culture where concerns were discussed openly and duty of candour was followed when needed. 

We saw evidence that the service acted on patient feedback. For example, patients raised concerns about limited parking at busy times. In response, the service introduced designated parking spaces for chemotherapy patients. This showed the service listened to feedback and took action to improve patient experience. 

The service had also arranged patient feedback sessions for chemotherapy patients. However, these were not well attended, which meant gathering feedback in this area remained a challenge. Despite this, staff continued to seek feedback through other methods to understand patient experience. 

People could access the service when they needed to and received timely care across endoscopy and chemotherapy services. The service planned access to ensure patients could receive treatment without unnecessary delay. 

The hospital had achieved external accreditations for its work to reduce health inequalities experienced by people with a learning disability. A range of reasonable adjustments were available, including health passports, ‘I am autistic’ cards, personalised care plans, quiet rooms and neurodiversity boxes containing sensory resources. Carers could remain with patients throughout their visit. These measures reduced barriers to accessing care and helped ensure support was tailored to people's individual communication, sensory and wellbeing needs. 

Waiting times were short. Data showed patients waited an average of 13 days for endoscopy and 17 days for chemotherapy. This supported timely access to care and reduced the risk of deterioration while waiting for treatment. 

The service ensured patients had access to support when they needed it. A resident medical officer was available 24 hours a day, and chemotherapy patients had access to a 24‑hour advice line. This meant patients could access clinical support if they became unwell or needed advice outside of planned appointments. 

Staff took steps to support people with additional mobility needs. Mobility aids were available and used appropriately to support patients with reduced mobility, helping them access services safely and comfortably. 

The service promoted an inclusive approach to care and took steps to ensure people could share their views and experiences. Patients were encouraged to provide feedback through surveys and focus groups, and staff told us feedback was used to inform service improvements. Patients told us they felt listened to and were able to raise concerns or share feedback about their experiences.  

Staff described a culture where patient views were valued and used to help shape and improve services. Staff were able to demonstrate how feedback, patient experience information and service reviews had influenced service developments and improvements to patient care. 

Staff received equality, diversity and inclusion training and demonstrated an understanding of how individual needs and protected characteristics could affect people's experiences of care. This helped ensure people were treated fairly and with respect.

The service supported people to plan their future care and used systems to identify risks and improve services over time. Staff worked with patients and other services to ensure care was planned and delivered safely. 

Patients told us they were involved in decisions about their care and treatment. Staff supported people to understand their options and plan for future care, which helped ensure care reflected their needs and preferences. 

Staff worked closely with consultants, clinical nurse specialists and local external services to support patients with more complex needs. Teams shared information and discussed patients' ongoing care requirements to coordinate treatment, support and follow-up arrangements. This helped ensure patients had access to the right support at the right time and that changes in their needs could be responded to appropriately.