Northwick Park 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

At the last inspection, this key question was rated as requires improvement. At this assessment, the rating improved, and we rated the key question good. This meant services were responsive to people’s needs and delivered in a way that supported flexibility, choice and continuity of care.

The service made sure children, and young people were at the centre of their care and treatment choices. Staff worked in partnership with families to respond to changing needs and ensure care was coordinated and person centred. Staff understood the diverse health and care needs of their patients and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment, and support. Staff involved children and young people in decisions about their care. The service made sure children and young people could access the care, support, and treatment they needed when they needed it. Children and young people were also supported to plan for important life transitions, enabling informed decision‑making about their future care.

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 made sure children and young people were at the centre of their care and treatment choices, and they decided, in partnership with their families, how to respond to any relevant changes in their needs.

Children and young people who used the service reported that their needs and preferences were considered. Staff also provided children, young people and their families with information about waiting times and the need for ongoing treatment while awaiting surgery. Individualised care and treatment plans were developed, and children were signposted to additional support, such as community children’s nursing services, where required to ensure their needs were met.

Clinical staff assessed children and young people against the service’s suitability criteria to ensure care could be appropriately provided by the service. Children and young people were referred to relevant services when required. Staff completed risk assessments for each child and young person on their admission to the service, using a recognised risk assessment tool, and these were reviewed at regular intervals, including when needs changed.

During our onsite visit, we observed care plans for children and young people on the wards incorporated detailed risk assessments and demonstrated these were reviewed over time. We also reviewed records that included mental health risk assessments, which directly informed decisions such as staffing allocation for these children and young people to ensure their needs were met.

The care plans for children and young people with long term conditions, learning disabilities or autism were informed by their ‘patient passports” to ensure their specific needs were met. The service used assessment documentation and care plans to describe individual needs and reasonable adjustments. The care records we reviewed had evidence of person-centred care planning and involvement of children and young people in decision making. Staff tailored communication approaches to individual needs that were suitable for the child or young person to ensure they could contribute to their care and communicate with staff.

Facilities were available for families, including access to kitchens and hot drinks. Parents were also supported to stay overnight, enabling them to remain with their child throughout their hospital admission. The service had guidelines and restrictions for parents and siblings visiting the children’s ward. To promote safety, siblings were permitted to visit the wards only when accompanied by their parent or guardian. Staff consistently adhered to established safety procedures for children visiting the ward.

Families of children and young people told us they had consented to treatment based on all the information provided to them by clinicians and felt fully informed. We noted that clinical staff clearly recorded consent in the children and young people’s records. Parents we spoke with stated that they had been given a copy of the consent.

MDT meetings were held to review the needs of children and young people with mental health conditions, autism and learning disabilities, including any reasonable adjustments made to support them. These meetings also included a review of support arrangements for parents with learning disabilities, ensuring that appropriate measures were in place.

The service understood the diverse health and care needs of children and young people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff ensured all children and young people including those with mental health needs, learning disabilities or long-term conditions received care that met their needs. Managers and staff told us children and young people needs were assessed as part of initial assessments, which we saw reflected in the records reviewed.

Transition to adult services from the CYP service was managed at speciality level, the CYP service had a dedicated transition leadership team who provided overarching support for this transition within the trust. Staff used transition plans to support young people moving to adult services. Transition planning was tailored to individual needs and took place over several years where required. This was supported by the trust’s transition policy. The standard operating procedures and terms of reference for transition services we reviewed was in date and reflected national transition guidelines.

Staff understood and applied policies relating to information and communication needs for children and young people with disabilities or sensory loss. The service had policies on equality, diversity and inclusion, interpreting and translation, and the accessible information standard to support staff ensure individual needs were met. Staff knew how to access these policies and arrange support.

The service worked closely with a range of healthcare and social care partners, including local specialist NHS hospitals, community health teams, mental health services, social care, and wider health and support services. Staff described good working relationships with partner organisations.

Children and young person with neurological difference such as autism or attention deficit hyperactivity disorder (ADHD) received appropriate and responsive support, care and treatment. The service had a range of neurodiversity‑specific toys and equipment available to meet the sensory and developmental needs of neurodivergent children. Local mental health services worked closely with ward and clinical staff to support children and young people with additional emotional or psychological needs. The service also maintained close working relationships with the local authority to ensure children and young people social care needs are met.

MDT meetings were held when required, with attendance from social care and other relevant agencies, particularly where decisions were needed regarding community support arrangements or safeguarding matters, such as for looked‑after children.

Children, young people and their families’ needs relating to interpretation and translation were met. There was access to translation services and information in different languages via a hospital web-based application. Information leaflets were available in languages spoken by the local community and were accessible within CYP areas.

The service provided accurate, up‑to‑date information in formats tailored to individual needs. Information was available in different formats, and translation and interpreting services were used to support effective communication.

Children, young people and their families told us staff explained care and treatment clearly and answered their questions.

The service had systems and processes to make sure patient information was handled in a way that supported timely and responsive care, while still meeting all confidentiality, data‑protection and information‑governance requirements. These systems meant that staff accessed, recorded and shared information appropriately, using secure methods that always protected patient privacy. They also ensured that important clinical information was available when needed, helping staff make safe decisions and maintain continuity of care across the service.

Staff followed information governance principles and policies to maintain confidentiality. Patient records were electronic, up to date, with a focus on patient outcomes. Authorised staff were able to access records promptly when patients moved between teams, supporting continuity of care. The service electronic records were accessible by authorised personnel through password access.

The service complied with and staff had access to the Accessible Information Standard (AIS) guidance which staff could use to support people with information and communication needs. The AIS is for people who have a disability, impairment or sensory loss and need to have their information provided in a way they can access and understand. Additionally, staff also had access to trust wide translation and interpreting policy which provided staff with a framework to support communication with patients and carers who were non-English speakers and people who may have other communication needs related to a disability or impairment.

Information leaflets were available in different languages for people whose first language was not English. CYP staff gave families information leaflets to help them after discharge. We were told translation service was available for people using CYP services.

The CYP service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

The service had established processes for children, young people, families and carers to provide feedback. This included the NHS Friends and Family Test (FFT), Feedback from FFT was reviewed routinely, to identify trends and concerns and to improve services and recognise good practice. We were shown an example of changes to pay times and school hours as a results of feedback from children and young people and their families. We noted that children and young person’s concerns were responded to in an open and transparent manner as shown during the meeting with the CYP leadership.

Children, young people, their parents and carers understood how to complain if they were unhappy with the care and treatment given. Staff said that talking as much as possible with children, young people and their families had helped understand if they were unhappy with anything and dealt with any concerns quickly. Staff encouraged families to raise concerns or complaints if they felt it was necessary.

The service monitored complaints and involved people in how complaints were managed and resolved. The main themes for complaints received by the service included waiting lists and appointment pathways. The service had plans for addressing these concerns. We were told all concerns raised were dealt with swiftly or as soon as the service can afford, For example, increased communications around the appointment booking process and ongoing work on waiting lists.

Families were encouraged to raise concerns through staff on the wards or to Patient Advice and Liaison Service (PALS). PALS supported families to navigate the complaints process. The CYP leadership team told us that families received timely responses to complaints, with clear explanations of actions taken, this was demonstrated by the complaint responses we had seen.

The service also spoke with parents to gather patient stories and experiences which were used to identify areas for improvement. Feedback from parents was also shared with staff for learning and development.

The service ensured children and young people could access care, support and treatment when it was needed.

The service demonstrated a clear commitment to equitable and timely access, supported by accessible facilities, reasonable adjustments for children and young people with additional needs, and active monitoring of capacity to improve flow, the monitoring of follow up appointment was noted as an example of what the trust had done. The hospital environment was fully accessible, with level access, lift access, wheelchair‑accessible toilets and designated disabled parking close to the main entrance. Clear signage enabled families to navigate the site independently, and children and young people and their families reported that the outpatient department was easy to access and straightforward to use. The OPD operated a five‑day service and offered a broad range of clinics to meet the needs of children and young people.

Policies and processes were in place to identify and support patients with disabilities, communication needs or other additional requirements. Staff described a holistic approach to care, working across teams to ensure children received appropriate support. Where needed, patients were offered longer appointments and face‑to‑face preoperative assessments. Families told us appointments were offered promptly and that they were usually able to choose suitable dates and times. Waiting times from referral to treatment, and arrangements to admit, treat and discharge patients, were in line with national average. Staff planned discharges carefully, particularly for children with complex mental health or social care needs and liaised effectively with GPs and community services to ensure continuity of care.

Leaders and staff understood how discrimination and inequality could affect access to care. They were knowledgeable about the needs of the local population and worked to ensure equitable access for all children and young people. This approach had a positive impact by reducing barriers to care, improving inclusion, and ensuring that children and young people from diverse backgrounds received timely, appropriate and responsive support.

Staff and leaders actively listened to information about children and young people who were most likely to experience inequality in experience or outcomes, and they tailored care, support, and treatment in response to this.

The service demonstrated a clear commitment to fair, inclusive and equitable care, and staff and leaders listened to information from families about children and young people who were most likely to experience inequality. Care, support and treatment were adapted in response to identified needs, and patient access and outcomes were monitored to highlight any potential health inequalities. Systems for gathering feedback helped the service understand whether children and young people were receiving equitable experiences and outcomes.

People who did not speak English as their first language were able to access interpreting and translation support, and staff had access to communication aids such as hearing loops. Policies and procedures ensured that vulnerable people and those with protected characteristics were not disadvantaged, and staff had completed equality, diversity and human rights training. Families told us they felt well supported, and staff used patient information and feedback to identify where additional support might be required.

Discharge arrangements were planned to optimise outcomes for all children and young people, including those with complex needs or protected characteristics. Staff involved carers and community services where necessary to support a safe return to good health. Staff consistently demonstrated a commitment to delivering fair care, regardless of patient’s ethnicity. Patients reported positive experiences and felt they were treated consistently and respectfully. The service promoted an inclusive culture, supported by 100% compliance with equality, diversity and inclusion (EDI) training and access to an EDI champion and patient experience lead.

Children, young people and their families were supported to plan for important life changes, including preparation for discharge, so they had sufficient time to make informed decisions about their future care.

The service supported children and young people to make informed choices about their care, involving families and carers where appropriate. Staff helped children and young people to plan for important life changes and ensured they had enough time and information to make decisions about future care and treatment. Children and young people and their families told us staff explained treatment options clearly and in a way they understood, and they felt comfortable asking questions.

Care planning was coordinated and considered both current and anticipated needs. Staff worked with families and other professionals to plan treatment, and CYP staff took part in MDT meetings to support decision‑making for complex cases. Children and young people or their families with additional or complex needs were offered enhanced support, including extended appointments, face‑to‑face pre‑operative assessments and consultant anaesthetist reviews for those identified as high risk. Staff discussed the impact of surgery sensitively and adapted care plans to reflect individual circumstances.

Records showed staff considered future care needs when planning treatment, and Mental Capacity Act 2005 (MCA) assessments were completed where required to support personalised decision‑making. Children and young people were included in planning for their ongoing treatment, and relevant professionals were involved, particularly for those needing extra support during recovery or after discharge.

Staff reinforced key information about healthy recovery and provided written advice based on best practice. Children and young people who underwent life‑changing surgery were offered ongoing support to help manage their condition. When children or young people deteriorated rapidly, staff discussed next steps with families in a dignified and sensitive way and consider their views on treatment provided. Discharge summaries were provided, and where possible, GP and follow‑up appointments were arranged before discharge.

Children and young people and their families told us that staff provided clear information to help them plan for the period following discharge. The service worked collaboratively with other health and social care professionals, including GPs, community teams and social services, to support effective future‑care planning.