Northwick Park Hospital

On this page

• 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 and understood that 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 felt well-supported, cared for and treated with dignity and respect.

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 always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Throughout our visit, we observed patients receiving end of life care in a kind, compassionate and respectful way. Interactions with patients and their loved ones was respectful. Family members we spoke with were grateful that relatives were peaceful and comfortable. They expressed that care was kind and compassionate.

We spoke with members of the palliative care team, hospice team, ward teams, the spiritual care team, bereavement team, purple butterfly team members and the mortuary team. Everyone we spoke with placed value on delivering compassionate end of life care that treated people with dignity.

The purple butterfly scheme had been in place at the hospital for a year. It involved volunteers sitting with patients who were in the last days or weeks of life, offering respite to relatives. The initiative provided companionship, comfort and emotional support to patients who were dying and to their families, promoting dignity and personalised care. We spoke with and observed the purple butterfly team members giving care. They gave us examples of what their role had included, such as making tea and coffee for relatives, holding a patient’s hand and combing hair. Volunteers had received training from the palliative care team and purple butterfly charity and end of life education team where there was an emphasis on compassion and dignity in care. Families and ward staff told us they were highly valued. The palliative care team told us they had helped to raise the profile of end of life care within the hospital.

The purple butterfly initiative had reached 6 wards at the time of our visit, with further roll‑out planned during 2026, supported by further recruitment of purple butterfly volunteers.

The most recent Friends and Family Test (FFT) data (June 2026) for the trust stated that 93% of inpatients reported a positive experience with 4% reporting a negative experience.

The palliative care team told us they placed value on the free text boxes within the FFT because of the basic nature of questions asked within the survey. The trust collated this information from the free text boxes which was fed back to the palliative care team for learning. What was done well and what had not been done well was shared with the end of life education team and incorporated in to learning streams such as handovers, staff meetings, governance meetings and steering groups.

We attended palliative care team multidisciplinary meetings where we observed referrals to the spiritual care team being discussed and made for emotional, spiritual, and religious support to patients and families.

The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. Staff took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Relatives of all patients we spoke with told us that care and ongoing management of care had been planned with them and met their loved ones’ individual needs. The relatives of one family told us they were happy with the care their loved one had received on the ward. They explained to us how over the weekend care had not been delivered in the way it had been discussed with them on the Friday. However, they told us that on the Monday they had met with a CNS from the palliative care team who had apologised for this. They told us it was explained to them what had happened, which had assured them that the care was individualised and met their needs.

The psychology team had 3 full-time psychologists who worked within the oncology team and supported people’s emotional needs. We attended palliative care team multidisciplinary meetings where we observed referrals made for psychology support were discussed and made, ensuring these specific needs were met.

Ward staff told us they valued and appreciated the visits by the palliative care team and how individual team members helped them meet patients’ and families’ needs and preferences.

There had been weddings for people at the end of life facilitated at short notice by the trust. The palliative care team told us they were able to call upon people to assist such as the registrar and chaplain and the trust always supplied a cake. The Emergency Marriage / Civil Partnership Chaplaincy Standard Operating Procedure outlined roles and responsibilities to ensure a smooth process.

On all leaflets and patient information on websites it stated that information was offered in in different languages and formats including large print and Braille, with links and contact details for obtaining further assistance including access to interpreter services.

The accessibility sign posting group had worked on improvements to signage around the trust hospitals. This has involved replacing a lot of signage, accompanied by artistic work to brighten up the hospital.

The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

We reviewed care plans including the care plans of patients where we had met them and their relatives. Patients and relatives and a review of the notes confirmed they had been included in discussions about their relative’s care.. We found these conversations had been documented which reflected that people had choice about their own care and treatment. Preferred place of care and preferred place of death had been documented. We found examples where people had been transferred to the hospice because it was their preferred place of care. Single rooms were offered to patients where possible unless a bay bed was preferred. The universal care plan was used for handovers with other services. It shared personal care preferences with other services ensuring consistent care without having to repeat them.

The palliative care team were all trained to level 2 psychology and in advanced communication skills. They told us this helped to facilitate their understanding about people’s choices with their own care. To further support people’s involvement in their own care an initiative called ‘4Ws +1’ had been introduced and taught by a palliative consultant. It involved the use of prompts to enable better enquiry and understanding of what people wanted, thought and were concerned about during difficult conversations, giving people more choice and control over their own care.

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.

Throughout our visit, we observed patients receiving end of life care in a way that responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. We reviewed care plans and found them fully completed and found that care was being delivered in a way that met the needs of people who were at the end of life. We found that pain and hydration needs were being managed through effective symptom management. This included syringe drivers, anticipatory medicines and as required ‘PRN’ medications at appropriate dosages. The NACEL audit for 2025 showed that families reported sufficient pain relief.

A patient we spoke with told us they were very happy with their care and staff. They said they felt very well looked after, and that their dignity was important to them. They told us staff listened well and communicated clearly.

Family members we spoke with told us that discomfort was minimised. They expressed that care reflected the needs of their loved ones.

We spoke with members of the palliative care team, hospice team, ward teams, the spiritual care team, bereavement team, purple butterfly team members and the mortuary team. Everyone we spoke with placed value on listening to and understanding people’s needs, views and wishes. They were able to give examples of how they had worked to understand people’s needs and respond in a way that worked with their views and wishes.

The palliative care and hospice team understood how anger and aggression interacted with bereavement and had completed training modules on its management. They were able to give examples of how they had deescalated situations for containment and staff support.

Interpreter services were available via telephone and video call. The palliative care team told us they prioritised the need for good communication to understand people’s needs and did not use families for this purpose.

The National Audit of Care at the End of Life (NACEL) bereavement survey was used to collect information from relatives of patients who died in hospital. There was a nationally low uptake of this survey from bereaved relatives. Service leads told us about the steps they had taken to try and improve this at the trust. They had included a specific leaflet on the survey in the newly published bereavement pack which included a QR code to link to the survey for easy access. We found this available at a variety of locations around the hospital. The most recent NACEL bereavement survey for 2025 reported that relatives felt their loved ones had received enough pain relief and rated their care good or excellent. However, low uptake numbers meant the trust interpreted the results with caution.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

The palliative care team received clinical supervision from the trust’s psychologists. It provided time to reflect on care and casework. There were regular debriefs for the palliative care teams to talk about what went well and what had been a challenge.

The 2026 palliative care team’s trust wide staff survey was used to consult on key areas of staff engagement, motivation, leadership, team dynamics, wellbeing, safety culture, and professional development. Overall findings demonstrated the team’s strong commitment to patient care, good working relationships and line management support. It highlighted the need for better staff recognition; more focus on psychological safety and development opportunities.

Staff told us that when they started work at the trust they were given lots of information on the trust’s values regarding respect and valuing the workforce. There was information about supporting staff available on the intranet that included access to psychological services.

Staff told us the trust took the issue of violence and aggression towards staff very seriously. A tiered yellow and red card warning system had been introduced which involved verbal and written warnings before exclusion. There was also a zero tolerance towards violence.