Nightingale Hospital Exeter

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 that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics.

This is the first assessment for this service. This key question has been rated good. This meant people’s needs were met through good organisation and delivery.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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 pathways were streamlined to reduce surgical wait times for qualifying patients. For instance, cataract surgeries followed a single-visit admission model. Patients were assessed and offered surgery at the same time.

Patients from across Devon who met specific clinical admission criteria were referred to the Nightingale Hospital Exeter to receive timely and appropriate care. Staff used dedicated, structured surgical pathways that guided each stage of the patient journey, from pre-operative assessment (if required) and admission through surgery, recovery, and discharge. These pathways provided consistent communication, personalised support, and clear treatment information, helping patients feel informed and reassured throughout.

Patients said staff kept them informed throughout their stay and provided clear written and verbal guidance on recovery at discharge. They described it as a 'streamlined service.'

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 service met the diverse local health needs with joined-up, flexible care that supported choice and continuity.

Admission criteria ensured equal access to services for all patients, regardless of demographic or personal characteristics.

This site was established to reduce patient waiting lists across Devon. All local trusts could refer eligible patients. The one-stop cataract service and innovations like bilateral cataract surgery helped streamline care and cut delays. Improving outcomes for patients by reducing the amount of time they required hospital admission.

However, the service found theatre utilisation could be improved, as consultant absences were not covered by their own trust, leading to some empty lists. This was an area the service was looking to address.

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

The service provided accurate, up-to-date information tailored to individual needs, including Braille documents via an agreement with the Royal National Institute for the Blind. It mostly complied with the Accessible Information Standard, offering materials in various languages and translation services when needed. The Accessible Information Standard (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. It has been mandatory for NHS and adult social care providers since 2016 and was updated in 2025 to strengthen its impact.

The website supported zooming up to 300% without text overflow, though some images and older documents had accessibility issues. These were scheduled for resolution by October 2025. The website contained details on treatments, local services, patients’ rights and how to complain.

Staff kept patient records confidential through robust information governance systems.

Senior staff made notifications to external bodies including CQC as needed.

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

The service enabled people to easily share feedback, ideas, and complaints about their care. Patients were involved in decisions and informed of changes made to their care as a result.

Feedback was gathered through various tools, including Friends and Family forms, an external provider, and the hospital’s incident reporting system. Between June 2024 and June 2025, The Nightingale Site services received 12 formal complaints; 6 of these were resolved through early resolution, 2 by executive resolution, 3 remained ongoing and 1 waiting on consent. Staff had identified themes from these for example, needing more support post operation. A tracker was sent up to monitor improvements made following complaints. A copy was sent to us following the site visit. Staff were trained to handle complaints in line with the trust policies. Patients knew how to raise concerns and escalate unresolved issues. Staff told us they tried to address any concerns right away.

A dedicated team systematically collated and analysed feedback. The Lead Nurse reviewed it monthly, with actions tracked via the 'You Said, We Did' tool and themes added to the patient experience workplan.

Regular patient surveys informed ongoing service improvements.

The service made sure that people could access the care, support and treatment they needed when they needed it.

Staff made reasonable adjustments for patients for example, people with mobility issues post-surgery were provided with walking aids to help their recovery. The location had designated spaces for wheelchairs, prams and assistance dogs.

Since all surgeries were scheduled in advance, patients who were neurodiverse or living with dementia could use this location following an assessment. Staff would be able to plan any additional support needed, and family members or carers could accompany them.

The leadership team actively ensured the premises were accessible, commissioning an accessibility audit in 2024. They were working to address all identified issues.

As part of the orthopaedic pathways staff planned for patients’ discharge, once they were back on the ward following their operation. All medication was stored on the ward along with all discharge information given to each patient.

In a medical emergency, staff followed policy by dialling 999 for an ambulance. On-site medical cover was available to assist patients until they arrived. Most staff were trained to level 2 and/or 3 in the resuscitation of adults. A policy was developed for staff to transfer a deteriorating patient to the acute trust. Following the site visit the trust told us, there was a dedicated 24hour senior enhanced medical cover on site. The unit also had an off-pathway transfer Standard Operating Procedure (SOP) which included safe transfer protocols for patients. This included RETRIVE which is a dedicated adult critical care transfer service (ACCTS) for South‑West England. Its purpose is to safely transfer critically ill patients between hospitals, especially when a patient needs higher level care than what their current hospital can provide.

This site offered high-volume, low-complexity cataract surgery via an innovative one-stop pathway, including bilateral procedures when appropriate. Wait times were 6–9 weeks, with 9 patients currently awaiting surgery.

Orthopaedic waiting times were trust wide. As of the latest data provided to us following our site visit, 3,384 patients were awaiting trauma and orthopaedic procedures, and 814 for spinal surgery.

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.

Staff within this service and the wider organisation cultivated an inclusive environment that encouraged patients to express their views.

The provider carried out equality impact assessments to ensure their policies and procedures did not disadvantage vulnerable individuals or those with protected characteristics. Side rooms were provided on the wards for patients as required. Staff told us a transgender patient requested to use a side room to maintain their privacy.

Staff received training in equality, diversity, inclusion, and human rights.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The purpose of this location was to help reduce waiting lists across Devon for cataract and some orthopaedic surgery. Patients were referred to this location by their host trust. Once the surgery was completed and patients were discharged, they would be reviewed at their host trust for any follow up appointments. Therefore, staff would not be actively involved in supporting patients to make decisions about life changes for example end of life planning. However, if a patient had a ‘do not resuscitate order’ (this was a document detailing their wishes not to be resuscitated if their heart stops) or other documents detailing their wishes, these would be followed.