Thames Hospice

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this. The service provided care and treatment which was effective. The needs of patients and their families were assessed, and they received high quality, personalised care from these. The service focused on evidence-based practice to ensure care was collaborative and person-centred.

This service scored 75 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff completed care plans thoroughly on admission and reviewed and updated them regularly. Care plans were patient-centred and showed individuals care needs were provided for; for example, when patients needed oral hygiene or mouthcare.

Ongoing monitoring and assessment helped staff to identify any risks, such as opioid toxicity, early.

Staff were able to identify patient’s communication needs through information they were provided from previous services, as well as from discussions with patients and their relatives. Communication tools were available if required, such as translators, through online and telephone interpretation services.

The assessment of patient’s wellbeing and mental health took place daily. Staff told us whenever they were at the bedside, they would take time to talk to the patient. This informal approach allowed them to assess the patient whilst getting to know them. Staff demonstrated their understanding of capacity and associated risks. Staff knew who to escalate capacity concerns to and when a best interest meeting may be required to support the patient.

Staff knew about Lasting Power of Attorney (LPA) documents and how to check them. Staff were proud to be advocates for their patients and made sure they adapted to their patient’s needs.

The service was proactive to meet the needs of carers of people who used the service. The service offered support through counselling and dedicated carer sessions. The service recognised the challenges carers could face by attending support sessions independently, particularly when caring responsibilities could limit their availability. Carers were encouraged to contact the service in advance so the service could review how they could provide support whilst the carer was at the session. This flexible approach ensured carers could access support to meet their needs.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff accessed policies in a shared folder on the computer system. The service was pleased to share that they would be having an intranet embedded soon, which would allow for quicker and simpler access to these documents. There was oversight of policies, with documented accountability and ownership to ensure they were up to date.

Policies we reviewed were in line with current evidence-based practice and standards, such as NICE and End of Life frameworks. Data showed the service partook in national patient safety benchmarking, which enabled the service to access large-scale evidence to support shared learning across the speciality.

The provider demonstrated a commitment to effective care by using data to inform practice. For example, a poster was developed which presented evidence-based insights, enabling the identification of areas for development within the local system. Leaders shared patient safety bulletins with clinical teams to support evidence-based learning and promote continuous improvement in practice. One bulletin reviewed falls incidents and provided guidance for how staff could increase monitoring to reduce the risk of harm.

Virtual ward patients were risk assessed to ensure the most appropriate care was provided, with input from the multidisciplinary team to provide oversight and support safe clinical management. People’s physical, psychological, social and spiritual needs were discussed within multi-disciplinary team meetings to ensure they were cared for on every level.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

A multidisciplinary team approach to care ensured multiple specialities worked together to meet the patients’ care needs. One story on the service’s website demonstrated how staff supported a person through palliative rehabilitation by working collaboratively. Staff, including physiotherapists, occupational therapists, pastoral workers and other teams, worked together to meet the person’s wishes to spend time at home. Staff were aware of who they could go to for support and staff described clinical colleagues as approachable.

Internal and external services worked together to provide coordinated care and support. We observed a cross sector online meeting between the service and a local hospital service. The meeting was friendly, and staff shared information and communicated clearly.

Staff demonstrated how they were respectful towards the patient and their loves ones and explained how identification was checked as part of their handover to the next service.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The service provided specialist support including complementary therapy, bereavement support, occupational therapy, physiotherapy, advance care planning and a specialised lymphoedema service.

People were supported to manage their health and wellbeing effectively. A person’s story on the service’s website described how staff provided consistent expertise and support to help manage ongoing symptoms. Staff used their knowledge and skills to deliver person-centred care and empower people.

The service invited bereaved families to access counselling. This was offered after a specific period to ensure that families had time to process and grieve. Leaders advocated for these experiences, recognising their positive impact on people’s emotional wellbeing. They reported that these services had effectively supported individuals who may not otherwise have accessed support.

Feedback from a recent survey of outpatients using the wellbeing service found service users gained from the company of other service users. People utilised these services, where they could complete activities such as crafting and relaxation experiences.

Staff and leaders both demonstrated their passion to support patients to keep their independence, this maximised patient’s choice and control whilst being supported.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service monitored clinical outcomes through the use of the Integrated Palliative care Outcome Scale (IPOS) which measures palliative care concerns. These were used to help shape care delivery and ensure it was patient centred and effective.

The service undertook reflection exercises to review what went well and what could be done differently in the future to improve care. A case study was presented where the preferred place of care was achieved even though complex. Risk assessments and teamwork ensured the person was able to receive care where they wished. The case detailed how the patient and family were supported and their holistic care needs nurtured.

Preferred place of death (PPD) data was routinely collected and reviewed to assess whether individual preferences were achieved. Data for October to December 2025 indicated that 67% of people died in their preferred place, 20% did not, and for 13% the preference was not recorded or known. Actions were being taken to strengthen data quality, including enhancements to the data collection template, to improve completeness and enable a more detailed analysis to drive service improvement and better outcomes.

The service produced regular reports which highlighted clinical performance data, such as responsiveness to admission and time from referral to first holistic assessment. The results and any improvement points were discussed with relevant stakeholders to ensure outcomes were managed appropriately.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

We were told by one patient and their family that care was “excellent”. Staff answered questions with honesty and in clear understandable terms, with no jargon terminology used. This ensured that informed consent could be received, as information was shared in a way that was understandable for service users. We saw consent to care was always sought from patients and/or their families before proceeding.

On ward rounds, doctors did not rush patients; they gave their time with patients and families as needed. They provided patients with clear explanations if any changes were being made to care or medicines.

Staff we spoke with understood the Mental Capacity Act and how it was used in the service. Audits were completed which showed pre-admission checklists, patient notes and mental capacity assessments were reviewed to maintain oversight of patients’ capacity and care. Doctors reviewed patients regularly and re-assessed mental capacity as required.