South Bristol NHS Community 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

We looked for evidence that people and communities were always at the centre of how care was planned and delivered. We checked the health and care needs of people and communities were understood, and they were actively involved in planning care met these needs. We also looked for evidence that people could access care in ways to meet their personal circumstances and protected equality characteristics.

On our previous inspection, we rated responsive as good. At this inspection this has stayed the same. This meant people’s needs were met through good organisation and delivery.

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 evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Care was planned effectively, and staff took patients’ individual needs and preferences into account when arranging appointments. The trust had launched a service where patients could request changes to their allocated appointment through a portal. This had led to an initial increase in cancellations, although it had decreased the number of patients who ‘did not attend’.

The service identified and met the information and communication needs of people with a disability or sensory loss. Leaders ensured services were delivered and made accessible to take account of the needs of different people, including those with protected characteristics under the Equality Act. Information on the providers website included information regarding accessibility, with photos and information regarding the environment.

Staff spoke of how they supported individuals with specific needs and gave the example of how they had supported a patient with a phobia and how they worked to support their needs.

Patient’s carers, advocates and representatives including family members and friends, were welcomed, and treated as important partners in the delivery of their care. We observed positive interactions between staff patients and the person who attended with them.

Patients told us they were involved in discussions about their treatment and that staff explained clearly what would happen next.

The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The trust planned and provided care in ways which met the needs of local people, and the communities served. The trust had increased the number of clinics offered to serve the local population. Some of these included rapid access as well as the use of telemedicine and virtual clinics. Clinics were held Monday to Friday, closing at 6pm. There were no weekend appointments.

Patients were referred by their GP or other health professionals to the service. Many patients had the option to change their appointment time; this measure helped drive attendance. Patients were advised if they subsequently cancelled, they would be referred back to their GP. Staff ensured patients who did not attend appointments were contacted to make alternative booking arrangements. If the hospital cancelled, an apology was sent along with a reason and a new date arranged.

External specialist clinics from the trust brought specialist staff with them, for example ophthalmic clinics were covered by ophthalmic staff based elsewhere within the trust. If sufficiently skilled staff could not attend, then the clinic was cancelled. On the first day of our inspection, due to staff sickness, a paediatric clinic was cancelled. Cancellations by the hospital were closely monitored.

Emergency provision was in place despite being a nurse led unit. Procedures were in place to support any deteriorating patient, with the additional support from the nearby urgent treatment centre.

As there was no pharmacy onsite, patients were provided with prescriptions to be dispensed at any community pharmacy.

The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information governance systems included confidentiality of patient records. Patient records were held both in paper and electronic format. Computer screens were locked and secured when not in use. Notes were kept securely. Data showed 100% across all staff groups had completed the information governance mandatory training. There had been no recorded information governance breaches at the time of our assessment.

Staff had access to communication aids to help patients become partners in their care and treatment. Staff used patients’ preferred methods of communication, such as letters or phone calls. Resources such as Braille and translation services were also readily available. There was a large information poster in the waiting area with British Sign Language common words.

Staff had access to supportive information to provide to the patient. Information relevant to each clinic was stored and then made available at the relevant clinic. Information was available in a number of languages to meet the needs of patients in the local area. Patients had access to information about making complaints.

The service complied with the core Accessible Information Standard (AIS) policy requirements and had an action plan on how they could improve. The AIS is a legal requirement in England that ensures people with disabilities, impairments, or sensory loss receive health and social care information in formats they can understand.

The evidence showed a good standard. The 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 policies and procedures in receiving, reviewing and responding to feedback. There was no specific survey data for this location outpatient team as the data was collected under the different clinical specialties. Further review highlighted a complaint where a patient attended for a face-to-face appointment only to find that it was a telephone appointment. Some other concerns were raised in regard to waiting for test results and for appointments. Some specific patient feedback referring to the outpatient team was shared; all of these were positive about their experience. Comments included that clinics were on time and the hospital was accessible. We reviewed feedback for upper gastrointestinal and audiology patients which was generally positive.

People were supported if they needed to complain, and staff viewed complaints as valuable feedback and opportunities to learn and improve. Patients told us they knew how to complain. There had been 1 formal complaint in the last 12 months and 5 concerns recorded. No complaints had been escalated to the Parliamentary Health Service Ombudsman (PHSO).

Patient feedback was shared with the outpatients team through the quarterly newsletter.

The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

Services provided reflected the needs of the population served and they ensured flexibility, choice and continuity of care. The service provided access for all patients where they could. The service was accessible to people through referral. Each clinic had specific exclusion criteria, the outpatients department was able to support patients with bariatric needs. The outpatients department could not accept patients who were acutely unwell as no permanent doctors were on site and they were unable to accept patients who were on stretchers.

The service had policies and procedures to manage bookings, cancellations and patients who did not attend appointments. People could access care and support from clinicians. The outpatient department was nurse-led and they managed their biologic clinics. Clinicians from the relevant specialities would attend to conduct their clinics and the outpatients team would support where needed often conducting patient observations as requested. In certain clinics such as paediatrics, qualified paediatric nurses attended to staff the relevant clinics.

The local area had limited transport links and was some distance to the other main central sites. The rationale for South Bristol Community Hospital was to improve appointment attendance by reducing the barriers to attendance for local people and bringing services into the community to improve people’s lives.

Services provided reflected the needs of the population served and they ensured flexibility, choice and continuity of care. The service was proactive in ensuring they provided access for all patients where they could. Information was provided to service users in accessible formats before appointments, including contact details, map and directions, and information about any tests including any preparation. There was information available about how patients could access the service using public transport. There was some fee-paying parking next to the hospital. The outpatients department was located on the ground floor. There were disabled toilets and the service was wheelchair accessible.

While patients were waiting for their appointments, they were sent structured digital questionnaires asking them to identify any additional requirements for booking or attending for their appointments. The trust monitored those patients who did not attend including whether they had a learning disability. Where these patients had missed appointments, they were contacted to identify any barriers to attendance. The service identified the reason for cancellations and patients who did not attend appointments. There were action plans to make improvements in lost appointment times.

Patient’s preferences around communication with the hospital such as whether they wanted to receive a text reminder was recorded. Following a recent review on equity data in relation to ophthalmology patients, the service had now put in several measures to improve equity in access and experience.

The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage. Staff were trained in equality, diversity, inclusion and human rights.

The service communicated its values and minimum standards of care people could expect to receive. Staff used telephone translation services for patients whose first language was not English.

Staff received training in equality, diversity and human rights. At the time of out assessment compliance was 100%.