Whipps Cross University 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

We looked for evidence that people were always treated with kindness, empathy and compassion. We checked that people’s privacy and dignity was respected, that they understood that they and their experience of how they were treated and supported mattered. We also looked for evidence that every effort was made to take people’s wishes into account and respect their choices, to achieve the best possible outcomes for them.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people mostly felt well-supported, cared for and were treated with dignity and respect.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service always treated people with kindness, empathy and compassion and respected their privacy and dignity.

We observed that staff were responsive, they provided patients with help, emotional support and advice at the time they needed it. Staff took the time to interact with people who used the service in a discreet, respectful and considerate way and gave them the time they needed to understand information provided. Patients told us that staff were “friendly, polite and amazing”, and said they felt safe and well cared for throughout their appointments.

Staff told us that they supported patients to understand and manage their care, treatment or condition. Patients told us they understood why they were attending and what to expect.

Staff understood the individual needs of patients, including their personal, cultural, social and religious needs. For example, patients we spoke to who preferred a radiographer of the same sex were either offered this option or had their preferences respected without needing to ask. We were told that staff ensured when intimate personal care and support was given by a member of the opposite sex, patients were offered the option of a chaperone. Staff ensured, where possible, that chaperones were the same gender as the patient.

Staff maintained patient confidentiality. When staff were discussing confidential information, this was done in private. We saw that privacy blinds and curtains were used to promote patient dignity during examinations. Patients also told us that their privacy was respected and that they felt secure during their appointments. During the inspection, we observed staff treating people with dignity, kindness and compassion.

Staff were compassionate and sensitive in their interactions. One patient who used a wheelchair described the environment in the breast clinic as accessible and accommodating and told us that staff were helpful with dressing and undressing during procedures.

The service used patient surveys to gather feedback. Posters with QR codes were displayed to encourage responses. Majority of the patient feedback we received was positive, with patients commenting that staff were “always kind, informative, helpful and considerate”.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Independence, choice and control during this assessment. The score for this quality statement is based on the previous rating for Caring.

The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Staff supported people in a kind and respectful way. We observed staff recognised when patients required additional support and acted promptly, for example providing extra time for explanations or adapting their communication to ensure patients fully understood why they were attending to have diagnostic testing or screening.

Staff had access to telephone translation services and key patient information sheets were produced in 50 languages. This included MRI safety questionnaires and Buscopan information leaflets available in other languages, supporting patients to be involved in their care.

Staff made reasonable adjustments to help patients access services and made efforts to offer choice in appointments. This included offering pre site visits to the MRI scanner for patients with additional needs or claustrophobia and allowing for a chaperone to be present when it was safe to do so. Patients were offered ear protection and monitored via CCTV during MRI procedures to ensure safety and comfort.

Accessibility improvements had been made in response to patient feedback. This included refurbishing the GP X-ray department to relocate one X-ray room to the outpatient building, reducing the need for patients to cross the hospital site. The redesign also introduced a dedicated changing area to enhance privacy, and the areas were clearly signposted to guide people to the correct location. A new site map was produced to support with guiding people to where they needed to be, showing key services such as GP X-ray, outpatient clinics, and accessible toilets. This helped patients to navigate the hospital more easily and reduced anxiety for those unfamiliar with the site layout.

The hospital offered limited weekend services, but we saw plans to extend both CT and MRI to a seven-day service. People felt the service was efficient and told us they generally did not experience long waits throughout the service. Where there were delays in seeing patients, we observed staff keeping patients informed.

The service had made improvements to promote the wellbeing of their staff. However, further work was needed to ensure all teams felt supported and respected.

Most staff we spoke to told us they felt valued, respected, enjoyed their roles and felt part of the team. They told us there were cooperative and supportive relationships among staff. Although many staff members told us that they had seen marked improvements in the culture across the service, there were still areas where further work to improve the culture was needed. Feedback from staff working in ultrasound about the culture was variable, some told us they felt the poor relations with management contributed to high staff turnover. However, some staff spoke positively about management and told us they were supported well by leaders. Radiologists in the breast clinic also told us about ongoing bullying and harassment they experienced by members of the multidisciplinary team.

Staff survey data showed improvements in several areas of staff experience and culture. This suggested a significant overall improvement in culture and workplace relations. There was a 22.4% increase in staff agreeing that colleagues were kind and understanding, and a 20.5% increase in staff confidence that the organisation would address concerns. Staff also reported an 18.8% improvement in perceptions of fairness in career progression and promotion. Additionally, staff recognition schemes, including “Star of the Month” and “Barts Hearts,” helped foster a culture of appreciation and peer recognition. However, there was a 35.8% decrease in staff reporting bullying, harassment, or abuse, they experienced. This indicated there was still further work required to improve psychological safety and trust in reporting mechanisms. Job satisfaction metrics also declined, including enthusiasm for work and feeling worn out at the end of their shift. Imaging was identified as a wellbeing hotspot, with only 43.8% of staff agreeing that the organisation took positive action on wellbeing.

The service took action to address concerns raised in the staff survey and through other feedback mechanisms. We saw evidence that leaders had formed plans with teams to address staff survey themes.

A CQC staff survey for the trust performed in 2023 indicated there was a negative culture in the service and poor communication and relationships between staff and management. We saw evidence that leaders took action to address the concerns identified from this survey, including initiating a rapid improvement programme. During our inspection most staff felt they were able to provide feedback and suggest ways to improve the service or staff experience. We saw evidence that the service acted on staff feedback. This included holding team away days and upgrading equipment.

Staff who worked on the reception desks felt confident in contacting security if they were feeling anxious about patients’ behaviour. They told us in the past when they have contacted security they have had a quick response.

Staff told us they generally felt there were opportunities for progression and development. We spoke with an imaging assistant who told us they had been supported to train as a radiographer via an apprenticeship. We also saw that continued professional development (CPD) sessions were provided for staff, including image interpretation, freedom to speak up, and simulation training. Some staff expressed a desire to engage in further external opportunities to support their CPD, data we reviewed showed a training needs analysis was performed annually for external course funding across all modalities. This was informed by manager and staff appraisal conversations. Staff also told us there was not always sufficient time to complete training due to staffing pressures and the workload.