The Hillingdon 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

The service did not always treat people with kindness, empathy, and compassion, or respect their privacy and dignity. While the service treated people as individuals and ensured their care, support, and treatment met their needs and preferences, staff did take account of people's culture and protected characteristics. The service promoted people's independence, however, the service did not always listen to and understand people's needs, views, and wishes. Staff did not always respond to people's needs in the moment or act to minimise any discomfort, concern, or distress. The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care. At our last assessment we rated this key question requires improvement. At this assessment the rating has remained good. This meant people felt supported, cared for and treated with dignity and respect.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People felt they were treated with kindness, compassion and dignity in their day-to-day care and support. Most patients told us they were pleased with the care provided. Although they expressed concerns about significant lengths of time spent in the ED, they felt that staff were hospitable, polite and “brilliant”. People felt that staff listened to them and communicated with them appropriately, in a way they could understand. One patient said, “it is like sitting with friends”.  

Staff said children could stay in ED for several days waiting for a bed or suitable placement, they spoke of how they supported children and young people who became anxious or had neurodiverse needs. 

We observed patient care in the resuscitation area was very positive, consultant led and appropriate. We also observed end of life care in this area was well managed, communication to the bereaved relative by staff was empathetic and compassionate. We observed staff assisting a patient who was trying to get out of bed, then explained the importance of using the call bell. 

People we spoke with felt that staff knew and understood them, including their preferences, wishes, personal histories, backgrounds and potential. Staff were compassionate and understanding towards people attending the ED due to their mental health. Staff said they were committed to helping patients recover.

However, people's privacy and dignity were often compromised. Staff expressed concerns about treating patients on the corridor without privacy or confidentiality due to the lack of screens or curtains. The two triage rooms in the Urgent Treatment Centre were separated from the waiting area by curtains but people could hear discussions going on in the triage room. 

People’s communication needs were generally met to enable them to engage in their care, treatment and support to maximise their experience and outcomes. The service had systems to support communication and choice. There were hearing loops at the reception area to support people who required it.  The service could arrange translation services and a sign language expert for people who required it.  

Staff treated people as individuals, considering any relevant protected equality characteristics. People’s individual needs and preferences were understood, and these were reflected in their care, treatment and support. People’s personal, cultural, social and religious needs were understood and met. Information was available to staff to help support people with individual needs.

People were supported to maintain relationships and networks that were important to them. People had access to their friends and family while they were using the service. Friends and family could visit patients in the ED. 

Our observations confirmed that there were systems and processes to support people to have choice and control over their own care and to make decisions about their care, treatment and wellbeing. For example, we saw that doctors ensured chaperones were present during intimate examinations. 

People’s needs, views, wishes and comfort were not always a priority and staff did not quickly anticipate these to avoid any preventable discomfort, concern or distress. People were unsure that staff would respond to their needs quickly and efficiently, especially if they were in pain, discomfort, or distress.

We saw a patient in a distressing situation and at risk of avoidable harm. The patient was unable to get the staff’s attention as the staff were busy with other patients. We were required to call staff to care for the patient to minimise the risk of further harm.  

The service had access to six WTE patient champions who provided 24-hour cover to support patients in the ED. They help patients run errands around the hospital, call family or taxis, book GP or district nurse appointments and guide patients. They also assisted patients who did not have GPs or had language needs. In addition, elderly patients had access to a team of volunteers who ran errands for them, settled them back at home and provided other forms of assistance. 

Staff told us they did not feel adequately supported when struggling at work. Although staff were mostly positive about their work, they felt stressed by staffing issues, long waiting times, and aggression from some patients and visitors. Some staff told us this has had a huge impact on staff morale. Staff did feel supported in their role with flexible rotas, opportunities to work part-time, and swap shifts.  

The trust recognised the pressures staff were under and tried to meet the well-being needs of staff. These included the necessary resources and facilities for safe working, such as regular breaks and rest areas. Staff wore body cameras for their safety due to an increase in assault and verbal aggression from people. Staff informed us this was probably a result of long waits. Senior staff explained that they completed welfare checks and supported staff where they have been victims of such aggression. This included referral to occupational health and psychologists. Staff had access to well-being officers when required and could access updates via a wellbeing newsletter.  

Staff have health and well-being offers, including staff networks, financial well-being, mental health, feedback opportunities, an onsite nursery, and flexible working. The trust had staff recognition programmes and awarded staff for their contributions at work. The initiative allowed for recognition of both teams and individuals through nominations. 

The health and well-being data from the national 2022 NHS Staff Survey showed a mixed picture. This data reflects those overall indicators for staff perception of health and well-being remained the same compared with 2021.

The lone worker policy was in date and next due for review in January 2025.