Frimley Park Hospital

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

At our last assessment this key question was not rated due to insufficient evidence. This key question has now been rated as good. We assessed four quality statements.

Patients were kept informed of what was happening and were offered something to eat and drink if they had been in the department for a long time. The service carried out regular audits, including monitoring against the emergency care standards. Staff worked in a strong culture of evidence-based practice. Staff worked together and with others when assessing people's needs and shared information to maintain continuity of care

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

We did not look at Assessing needs during this assessment. There is no previous rating for the Effective key question so we cannot yet publish a score for this area.

The trust's intranet contained a comprehensive range of up-to-date policies and standard operating procedures which reflected current practice. It had guidance for staff around collaboration with multi-agency teams and for delegation of clinical tasks to ensure the right people delivered evidence-based care and treatment.

The service planned and delivered patient's care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. For example, we saw patients who had a fractured neck of femur (hip) were given a nerve block promptly. The use of nerve blocks in the emergency department (ED) has been shown to provide effective pain relief in the acute setting and to reduce the use of opioids (strong painkillers such as morphine).

The trust audited practice against evidence based research. During 2024 the service was compliant with screening sepsis upon arrival in the emergency department. The trust target was 90% and in 10 months they exceeded their target with 100% compliance. However, for 2 months they were below target.

Systems were in place to ensure staff were up to date with evidence-based guidance and legislation. Clinical records we saw demonstrated care was provided in line with current guidance. For example, we reviewed the records of a patient who attended with a head injury. We saw care and treatment provided was in line with NICE guideline: Head injury: assessment and early management May 2023.

Triage questions were appropriate for the patient and their needs for example, people presenting with emotional needs were properly and sensitively assessed.

Patients said they had been offered something to eat and drink. We observed volunteers offering patients refreshments. In response to patient feedback soup was now available in addition to sandwiches and hot food. Volunteers undertook a one day bespoke training course to support patients during meal times. The volunteers offered support to patients who may have difficulty feeding themselves or who were at risk of malnutrition or dehydration if they didn't get some help.

The service had effective processes to direct patients to other departments and organisations for patients who did not require emergency care. For example, the service had treatment units, frailty services and same day medical and surgical units.

Staff have access to the information they need to appropriately assess, plan, and deliver care, treatment and support in line with people's individual needs. Feedback from staff was positive regarding the electronic patient record system, other system partners used the same IT system, so information was easily accessible to all.

The service worked well across teams and services to support patients. Leaders told us staff were responsive across the organisation when requested to support the ED. For example, during the assessment an operating theatre session was cancelled and so nursing staff reported to the ED to provide support.

Leaders told us they were constantly seeking areas to improve communication and flow. For example, audio headsets for staff will be implemented for quicker communication between key staff to streamline patient care.

Staff told us there was clear inter-departmental communication facilitating streamlined patient care. For example, if pathology was facing a delay in updating on the electronic patient record, the pathology team would call through with results or print the results and send the results to the team.

Care was coordinated, and everyone involved in their care worked well with them. We observed good quality, kind and compassionate interactions between staff and patients. Information was displayed on ward notice boards relating to care, advocacy access, information for carers, charities, mental health and feedback on care.

Staff we spoke with explained how they accessed support and information needed to provide good quality person centred care. Staff worked well with external partners involved with patients.

External partners, such as GPs, community nurses and social workers were involved to enable continuity of care and support for discharge.

We did not look at Supporting people to live healthier lives during this assessment. There is no previous rating for the Effective key question so we cannot yet publish a score for this area.

Staff told us treatment plans were evidence based and monitored for outcomes. There was a Quality Improvement project called 'A spoonful of Ondansetron helps the fluids stay down’: This was an early intervention quality improvement project for children presenting to the ED with vomiting. Children attending with vomiting were placed on the ondansetron (anti-sickness medication) pathway with the aim of avoiding an admission to hospital.

Patients care was reviewed and updated, and appropriate referral pathways were in place to make sure that needs are addressed. For example, there were specific pathways for patients who had suffered a stroke or a heart attack.

In the Urgent Emergency Care Survey 2024 results in response to were you kept updated on how long your wait would be rated better than the national average.

The service ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. The department took part in The Royal College of Emergency Medicine (RCEM) audits and benchmarked performance against best practice and other regional emergency departments. For example, in the RCEM Care of Older People audit between October 2023 and September 2024 the service scored above the national average with the exception of one standard.

The trust percentage of patients reattending the ED within 7 days of the original attendance was consistently lower than South East and England percentages between December 2022 and November 2024.

Staff told us the electronic patient record system had the ability to take photographs of wounds using mobile devices. This had reduced the delays in waiting for the medical photography team out of hours and made it easier for staff to monitor changes of wounds during admissions or on return to the department.

Patients understood their rights around consent to the care and treatment they were offered. Patients received information about care and treatment in a way they understood and had the appropriate support and time to make decisions.

Staff had access to the trust consent policy and understood the relevant consent and decision-making requirements of legislation and guidance, including the Mental Health Act (1983), Mental Capacity Act (2005) (MCA), Deprivation of Liberty Safeguards, and the Children Acts (1989 and 2004). Staff knew who to contact for advice.

Staff had access to the mental health team 24 hours a day to support them and patients. We were told the team were responsive and supportive.

We observed staff gain consent from patients for their care and treatment in line with legislation and best practice guidance. Staff received training on the application of the Mental Capacity Act for staff who would need to assess patients to give consent.

When patients did not have capacity to consent, staff made decisions in their best interests and documented them.

Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation. DNACPR status was recorded on patient identity wrist bands to alert staff in an emergency.