Wexham 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

We assessed a total of 3 quality statements from this key question. We have combined the scores for these areas with scores based on the rating from the last inspection, which was outstanding.

Our rating for this key question has changed. We rated it as good.

The service made sure people were at the centre of their care and treatment choices and decided, in partnership with them, how to respond to any relevant changes in their needs. The service provided appropriate, accurate and up-to-date information in formats tailored to individual needs. The service had systems and processes in place to make sure everyone could access the care, support and treatment they needed when they needed it. However, due to challenges with flow in the hospital patients did not always have access to care and treatment when they needed it and experienced long waits and overcrowding.

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.

We reviewed patient records and care plans, and they reflected patients physical, mental, emotional and social needs, including those related to protected characteristics under the Equality Act. We heard from patients, including those with complex needs, that they were being cared for as individuals and in a non-judgemental way. During times of high capacity, and when patients were being cared for in the corridor, staff followed the ambulance arrival standard operating procedure which had guidance on how to prioritise moving patients from the queue based on severity of illness and patient need. For example, patients that were confused, had mental health needs or were at a risk of falls, would be moved into cubicles as they became available in priority of other patients. Post inspection the service informed us the length of time patients spent being cared for on the corridor, was audited to understand the complexities of corridor care, and to identify how timely patients were relocated to a non-escalation area of the unit. This information was used to see where improvements could be made and to help reduce the time patients spent being cared for on a corridor.

Patients we spoke with told us there was good communication with the clinicians in charge of their treatment and they were involved in decision-making where appropriate. The clinicians explained what was happening to them and encouraged questions. Patients were triaged quickly when arriving to the department, fast-tracked if needed or had diagnostic tests started. However, some patients raised they had waited a while for their initial assessment with a doctor.

The service actively wanted to hear the peoples’ voice. This helped the department understand how care and treatment felt from the patient’s perspective, their lived experience. The service used this information to improve the quality of care, enhance patient satisfaction and foster a more patient-centred approach. For example, there was a youth forum in place for 11-25 year olds to help users of this age group engage in how they would like the service to run. There was a patient representative on the clinical governance committee as a voice of the patient. They had been instrumental in helping with improvements to the waiting room display screens.

Patients received the most appropriate care and treatment for them as the service made reasonable adjustments for them where necessary. We were given examples of where dietary needs had been met, and adapting care to meet cultural and religious beliefs. The service used triage and risk assessments to identify patient need and preference and to work out individual care plans. This was documented in the electronic patient record.

Patients received the most appropriate care and treatment for them as the service used specialist teams or clinicians to provide person-centre care. There were specialist leads who provided expertise and guidance in specific areas of emergency medicine, such as frailty and trauma. There were also in-reach services available in ED that focused on early intervention and prevention in the aim to address issues before they escalated. For example, the in-reach frailty team was a multidisciplinary team which provided specialised care for frail older patients who presented to the department. They focused on early comprehensive geriatric assessments and rapid intervention to improve outcomes and reduce hospital length of stay. The service also had access to specialist nurses and teams in the wider hospital, such as the dementia team or stoma nurse. Staff would contact them if patients with specific needs attended the department and support or advice was needed.

To help frequent attenders to the ED, joint meetings were held with the mental health trust and other relevant parties to discuss patient needs, and to collaboratively develop an individualised wraparound plan of care for the patient.

Children were cared for in a separate but co-located emergency department. It was designed to provide a child-centred environment with specialised medical and nursing staff, equipment and services, ensuring children received appropriate care for their unique needs. This included, a play specialist to utilise play as a therapeutic tool for younger children, a quiet room and the services of youth workers for older children.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

The service was accessible and sign-posted from the main road. The emergency department (ED) could be accessed from a separate entrance to the rest of the hospital. Signage to ED was seen throughout the hospital which helped visitors find their way to the department. Signage denoting ED were always red.

The service used posters at the entrance of the department to ask patients to consider if the ED was the best option for their needs, and to explore alternatives services such as NHS 111, pharmacies, or urgent care centres. This approach aimed to ensure patients receive the right care in the right place, and to alleviate pressure on the service by reducing the number of avoidable ED visits.

There was a brightly formatted poster in the waiting room, which explained the patient ED journey depending on their illness and severity. It used visual aids as well as words.

The service divided its emergency department into zones based on severity of health issues. For example, the green area was for minor injuries and the blue area for major injuries. This helped patients navigate there way through the department.

Television screens in the main waiting area displayed the number of patients allocated to the zone and the current waiting times for initial assessment by the nurse, and initial assessment by a clinician. They also displayed the waiting times at the local urgent care centre if patients with a non-life-threatening condition, wanted to be seen there instead of ED. Displaying waiting times managed people's expectations of when they were likely to be seen. Patients waiting in the corridor queue did not have access to this information and therefore raised more complaints about wait times and the feeling of not knowing what was happening. Another television screen in the waiting area scrolled information patients might find useful. For example, explanation of zones, how to sign up for health care access, information on the local urgent care centre, and how to escalate pain concerns whilst waiting. Posters were also displayed in the area, including explaining about long waits, advertising the youth forum group and that the service did not tolerate abuse towards others waiting or towards staff.

The department had measures to help meet the Accessible Information Standard (AIS), a statutory requirement for NHS and adult social care providers, which ensures individuals with disabilities or sensory loss receive information and communication support in a way they can access and understand. Post inspection the service provided information on how they met this standard, for example how the department would support patients with a learning disability as detailed in the trust's supporting patients with a learning disability policy, but did not supply us with an AIS policy or procedure. A policy would have demonstrated how the service and wider hospital shared and were consistent in their approached to AIS.

The department had access to an interpreting and translation service for those whose first language was not English. A face-to-face interpreter could be pre-booked, or a telephone/video interpreter could be accessed, this included, if a patient required a British sign language interpreter. The staff were from a diverse background that represented the community. This meant many languages were spoken by staff. The service had a language board in the main hub of the department which displayed what languages were available in the department at a given time. This board was updated at each handover so was current.

Information leaflets were available to patients and their families, for example, how to raise concerns, or information on a clinical condition, and were available in accessibility options.

Patients were provided with discharge summaries. This gave a concise report of the person's stay, including reason for admission, investigations, treatments, medication changes and aftercare recommendations. Medication changes would also be verbally discussed with the patient. Discharge summaries would be sent to the patient's GP to ensure continuity of care.

Staff received General Data Protection Regulation training (GDPR). Patient records were held on a secure electronic patient record system which was accessed by individual staff log in.

The trust had an online platform/ application called MyFrimleyHealth Record which provided patients with personalised and secure online access to their medical records. Examples of what people could do via the application included, viewing details of current appointments and booking follow ups, view medications, test results, allergies and letters, and safely send messages to care teams.

The trust had a website where the public could access information about the trust and its hospital, including information regarding the ED at Wexham Park Hospital. The website had a translation button which changed the website content to several different languages. There were also accessibility buttons to change the font size or the contrast to make words appear sharper against the background. This helped make the website accessible to more people.

We did not look at Listening to and involving people during this assessment. The score for this quality statement is based on the previous rating for Responsive.

The department was open 24 hours a day all year round and saw patients regardless of residency status.

Equity in access to emergency care means that all individuals, irrespective of their socioeconomic status, ethnicity, disability, location, or any other characteristic, have the same opportunity to access timely and appropriate emergency healthcare services. This involved addressing barriers to access and ensuring fair treatment for all patients.

The service measured equity in access by analysing data such as, complaints, incidents, utilisation, wait times, and patient outcomes to identify and address disparities.

The service worked to national operational targets and assessed their performance against those. Information was shared monthly with the team and leaders to form part of the continuous improvement project.

The initial assessment of a patient's condition to determine urgency and priority, should ideally occur within 15 minutes of arrival or registration to the department, as prompt and accurate triage is crucial for optimising patient care and outcomes in the emergency department. We reviewed data which showed between September 2024 and February 2025, 71% of patients received a triage within 15 minutes of arrival to the department, with a mean time to triage of 14 minutes. The service had measures they put in place if the time to initial assessment started to increase, such as additional staff assessing patients.

The service also captured data on timeliness to treatment from initial screening for certain time critical conditions.

For example, data showed between February 2024 and January 2025, 100% of patients audited received a sepsis screening upon arrival, and in the same timeframe, 82% of patients who required sepsis care, received antibiotics within the National Institute for Health and Care Excellence (NICE) timeframe of 1 hour.

Between April 2024 and March 2025, of those patients requiring a mental health assessment after their initial assessment at triage, 87% of patients received it within the 1-hour referral target, with the average time to assessment being 1hr and 4 minutes.

When the service was experiencing high patient volumes, they always allowed the ambulance crews to hand over care to the emergency department (ED) staff, meaning patients were never held in ambulances outside the department, which can lead to risks and delayed care to patients, and ambulances unable to be redeployed to attend to emergency needs in the community. The service had policies and procedures for escalation and care of patients in non-designated areas such as corridor care, to mitigate the main risks from crowding. However, staff were not always able to make reasonable adjustments when the department was overcrowded. For example, staff told us they were not always able to meet needs for patients living with dementia or a learning difficulty as they would sometimes have to be cared for in the corridor.

The department prioritised patients due to severity of illness and would always see the life-threatening patients immediately. However, the service planned to have a clinical assessment of all patients within 90 minutes of them arriving at the department. However, data showed, due to demand outstripping resource, the service had managed to see an average of 38% of patients within this timeframe between September 2024 and February 2025.

The interim national target of 78% of patients attending ED being admitted, transferred or discharged within 4-hours was not currently being met. Between September 2024 and February 2025, the service was achieving the 4-hour target 69% of the time. The service closely monitored this target and shared with us plans for improvement, which included working with the wider hospital and external healthcare providers.

The number of patients waiting longer than 4-hours was therefore 31%, which was below the England average of 37%. The service also monitored how many patients waited more than 12-hours from arrival to being admitted, transferred or discharged. Between September 2024 and February 2025, 6315 patients waited over 12-hours, which was 9% of the total attendees to the emergency department. This was lower than the England average of 12%.

The hospital closely monitored flow and capacity at the hospital, with site meetings 3 times a day. We observed one of these meetings. Managers from around the hospital discussed patient flow, bed availability and strategised for efficient patient admissions and discharges with the aim to maintain optimal hospital capacity and patient care. At the meeting we attended, it was seen the number of patients for admissions from ED was greater than the ward discharges. This meant although patients were ready to be transferred to hospital wards there was not the space to accommodate them and they would be held in ED until a bed became available on a ward. In addition, more people would be coming into ED needing a bed. This would result in more people being cared for in the corridor and the department being overcrowded. Action plans were immediately put in place to accommodate for this, for example increasing the staff numbers to make sure there were enough staff to patient ratio to care for staff safely. Data provided by the trust showed that in December 2024 patients waited an average of 15hrs and 42mins to be admitted to the ward and in February 2025 patients waited an average of 20hrs and 34mins. The longer wait times for ward admission had a direct impact on the department, leading to overcrowding and delays in treating other patients.

The service had appropriate and safe systems to redirect patients to alternative pathways from ED at initial assessment. These included the ambulatory emergency care unit, the paediatric assessment unit and the same day emergency care (SDEC) units. These SDECs provided emergency care to patients who would otherwise need hospital admission, allowing them to be assessed, diagnosed, and treated on the same day without needing an overnight stay. From September 2024 to February 2025, 8% of ED attendees were streamed to SDEC services. The service was looking to see if this number could be increased in a safe way to patients, to ease the burden on ED and to improve patient experience of long waits in ED.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.