Spire London East Hospital

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

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question as outstanding. At this assessment, the rating has changed to good. This meant people were supported and treated with dignity and respect and involved as partners in their care.

The rating changed because, although most patients gave positive feedback and described staff as kind, respectful and reassuring, the evidence did not show the consistently exceptional or distinctive practice needed to sustain an outstanding rating. Some patients experienced delays in response to call bells, limited flexibility with appointment scheduling, repeated cancellations and anxiety about post-discharge arrangements. There were also examples where information was not always accessible, including difficulty accessing documents through the patient portal.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

The service treated patients with kindness, compassion and respect, although this was not consistently experienced by all patients.

Most patients described staff as kind, respectful and supportive. They gave positive examples of staff interactions, including comments that “staff have been nice during care”, “staff were treating him with respect, humour and were lovely”, and “staff have been brilliant during the care”. This was supported by survey data, where 85% of patients rated their overall experience as good or very good, and the Friends and Family Test (FFT) score was 96%. The service also received 127 positive comments in quarter 1 of 2026, including 118 “very good” ratings. In addition, the service displayed feedback from the CYP FFT on an information board in quarter 1 of 2026, which also showed high satisfaction. 95% of patients rated their experience as good or very good, with strong scores for understanding and communication.

Patients told us staff maintained their privacy and dignity and handled confidential information appropriately throughout their care. Most patients also said they knew how to raise concerns and felt comfortable doing so. Staff directed patients to other services when appropriate and supported access to ongoing care. Patients said they were informed about follow-up arrangements, including General Practitioners (GP’s) appointments and physiotherapy, and knew who to contact if they had concerns after discharge. This helped patients feel reassured about their care after leaving hospital.

However, patient experience was not always consistent. Some patients reported delays in responses to call bells and described staffing levels as insufficient to meet their needs in a timely way. A small number of patients also expressed limited confidence that concerns raised would be taken seriously. This reduced assurance that all patients experienced responsive care and felt able to raise concerns openly.

The service treated patients as individuals and generally met their communication, emotional and practical needs. Staff explained care clearly, adapted support when patients were anxious or in pain and involved patients in decisions about their care.

Patients received clear information before and after surgery, including guidance about their procedure, recovery and how to raise concerns. This supported informed decision-making, independence and confidence in managing their care.

Systems were in place to identify and meet individual communication needs. Staff asked patients about communication or information needs at first contact and throughout their care and recorded these so they could be acted on. Information could be provided in accessible formats, including large print, braille, email and easy read. The service also provided access to independent interpreters and translation services, including British Sign Language support, with information displayed in multiple languages explaining how to access this support.

Patients’ dietary, emotional and wellbeing needs were also supported. Patients were offered meal choices, and catering teams could adapt menus to meet individual dietary requirements, allergies and preferences. The service had obtained 2 gold Catering Accreditation Programme (CAP) awards, which reflected good practice in catering. Patients also had access to emotional support through information resources and could request spiritual support, such as chaplaincy services, when needed.

However, care was not always consistently tailored to individual needs and preferences. Some patients experienced limited choice in appointment scheduling and repeated cancellations, which reduced their ability to plan care around personal circumstances. Some patients also reported delays in receiving assistance when unwell and felt their immediate needs were not always prioritised because of staffing pressures. These findings reduced assurance that patients consistently received care that reflected their individual needs, preferences and personal circumstances.

The service supported patients to make informed choices about their care and promoted independence. Patients were usually involved in decisions about their treatment and recovery, although this was not consistent across all aspects of care.

Patients said staff explained procedures, risks and recovery clearly and gave them time to ask questions. One patient said they “had enough time to ask questions” and “understand what happens next”. Survey results supported this, with 68% of patients strongly agreeing they felt fully informed and 73% strongly agreeing they felt cared for and looked after. Consent forms reviewed for surgery were completed appropriately, with associated risks explained, which supported informed decision-making and patient choice.

Patients were given information before and after treatment to help them understand their condition, care pathway and recovery. This included what to expect after surgery, symptoms to monitor and who to contact if they had concerns. This helped patients feel more confident managing their recovery at home and supported independence after discharge.

Staff generally respected patients’ preferences and choices. They checked patients’ understanding, involved them in decisions and supported a patient-centred approach, which promoted autonomy.

However, patients did not always experience full choice and control. Some patients reported limited flexibility in appointment scheduling and repeated cancellations, which affected when they could receive treatment. Another patient expressed anxiety about post-discharge arrangements and a lack of reassurance about how to access care if complications occurred. These findings demonstrated that opportunities for patients to exercise choice and feel supported throughout their care journey were not always consistent.

The service generally responded promptly to patients’ immediate needs and risks, although this was not always consistent.

The service had systems to identify and respond to patients’ immediate clinical needs and risks. Staff assessed patients before admission and during their stay, including identifying communication, clinical, and support needs early so care could be planned and escalated where required. Staff used monitoring processes after surgery to identify changes in patients’ condition, and escalation arrangements were in place when risks changed or patients deteriorated.

Patients were given information about what to do if they became unwell or experienced complications after discharge. This included advice on recognising signs of deterioration, such as infection, and who to contact for support, including the ward or emergency services where appropriate. These arrangements supported timely access to advice and intervention outside normal operating hours.

However, responsiveness was not always consistent. While systems were in place to respond to clinical risks and changing needs, some patients reported delays in receiving assistance when they used call bells and felt staff were stretched at times. This limited assurance that patients consistently received timely support when their needs changed.

The service did not consistently demonstrate effective staff wellbeing and enablement arrangements. Evidence identified low morale, variable recognition, inconsistent support and concerns about psychological safety, which affected staff experience and engagement.

Staff feedback, staff interviews and the September 2025 staff survey identified low morale, stress, concerns about work-life balance, variable recognition and inconsistent support from senior managers. Some staff raised concerns about feeling blamed when escalating issues and had limited confidence that concerns would be listened to, acted on or fed back. This affected how consistently staff felt supported, valued and able to contribute to improvement.

Evidence showed variation in psychological safety and staff experience. Concerns about bullying, harassment, disrespectful behaviour and unfair treatment were raised by some staff and through post-inspection whistleblowing information. These concerns were not universal, and the evidence did not show that this was the experience of all staff. However, the concerns were raised through more than one evidence source and indicated shortfalls in how consistently the service supported staff wellbeing, confidence and engagement.

Recognition of staff contribution was not consistently embedded. Senior managers acknowledged staff work during the assessment, but staff feedback and survey comments identified that recognition, wellbeing support and development opportunities were not experienced consistently across departments.

The service had systems intended to support staff wellbeing and enablement, including occupational health, employee assistance programmes, peer support networks, flexible working arrangements and mental health first aiders. Data provided by the service showed staff engagement activities, including the “London East Easter Egg Hunt” and “Court room drama,” which were intended to support staff engagement, learning and team connection. Some staff reported supportive and collaborative relationships within their immediate teams, and one staff member described their team as “great and supportive,” reflecting positive local team working in some areas. Staff also had access to learning and development opportunities. However, staff feedback indicated these arrangements were not experienced consistently across all areas. This reduced assurance because the evidence showed a gap between the wellbeing and engagement arrangements in place and how consistently staff experienced support, recognition and psychological safety in practice.