Warwick 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 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.

The service made sure people were at the centre of their care and treatment choices. 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 supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff and leaders actively listened to information about patients who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Patients 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.

However,

The service did not always make sure that people could access the care, support and treatment they needed when they needed it.

At our last assessment we rated this key question good. At this assessment the rating has remained. 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.

We scored the service as 3. 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.

Patients received person-centred care that reflected their individual needs, preferences and circumstances. Patients told us staff listened to them, involved them in decisions about their care and treatment, and kept them informed about treatment plans and discharge arrangements. Patients said their needs were met and described care that was tailored to them as individuals.

Staff made reasonable adjustments to meet people's needs and preferences, including supporting them to maintain contact with family members and enabling treatment at home where appropriate. Care was planned and delivered with a focus on achieving the best possible outcomes while promoting independence and choice.

Patients who required additional support received personalised care based on a holistic assessment of their physical health, mental health, wellbeing and safety needs. Individualised care plans were developed and reviewed regularly to reflect changes in patients' needs. We observed staff providing compassionate and responsive care that promoted people's wellbeing and dignity. Activity coordinators supported patients to engage in meaningful activities that reflected their preferences and interests.

The High Intensity User (HIU) team supported patients with complex needs, including people living with mental health conditions and learning disabilities. The team worked with patients to understand their individual circumstances and ensure care was delivered in the most appropriate setting. They also promoted continuity of care through follow-up support after discharge, including home visits where required.

Staff made reasonable adjustments for patients with learning disabilities and autistic people. The learning disability team proactively identified patients who required additional support, reviewed care arrangements and worked with ward staff to ensure individual needs were met. Hospital passports informed care planning and communication, and staff had access to communication aids, sensory equipment and practical guidance to help people engage with their care. Environmental adjustments, including the use of side rooms where appropriate, helped ensure patients were cared for in a setting that met their needs.

The frailty team demonstrated a holistic approach to care by assessing patients' health and social care needs and considering their preferences when planning ongoing care. Where appropriate, alternatives to hospital admission, including virtual wards and same-day emergency care services, were used to support people to receive care in the setting that best met their needs. The team also provided follow-up support following discharge to promote continuity of care.

The Dementia and Delirium Outreach Team (DDOT) provided specialised support for people living with dementia and those experiencing delirium during admission. The team carried out early assessments, supported staff to understand and respond to behaviours associated with unmet needs, contributed to discharge planning and provided follow-up support in the community where required.

We scored the service as 4. The evidence showed an outstanding 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.

Staff and leaders demonstrated a strong understanding of the needs of the local population and designed services to respond to these effectively. Leaders recognised increasing levels of frailty within the local population and had developed a comprehensive range of services to meet this need. These included a frailty assessment area, frailty SDEC service, dedicated frailty wards and care of the elderly wards. The acute frailty service provided rapid specialist assessment for patients arriving at hospital and worked proactively with community services to avoid unnecessary admissions and support timely discharge.

The service had developed innovative pathways that enabled people to receive care in the most appropriate setting for their needs. Services including virtual wards, community ambulatory care pathways, medical day case units and SDEC allowed patients to access specialist assessment, treatment and monitoring without requiring admission to hospital. These pathways were available across a range of specialties, including gastroenterology, endocrinology, respiratory medicine, rheumatology and cardiology. As a result, patients received timely treatment closer to home whilst reducing avoidable hospital admissions and preserving inpatient capacity for those with the greatest clinical need.

Leaders worked collaboratively with partners across the health and care system to ensure services were integrated and responsive to local need. For example, the service had introduced a community medical unit in the local area which , improved  access to treatment for patients who would otherwise need to travel to Warwick Hospital. The acute frailty service also operated a 'call before you convey' model, enabling ambulance clinicians to access consultant-level advice and identify alternatives to hospital admission where appropriate.

Patients with complex health and social care needs benefited from coordinated multidisciplinary care. Specialist teams worked together to provide joined-up care throughout the patient journey. The HIU team supported frequent attenders and patients with complex needs through proactive case management, multidisciplinary working and follow-up support within the community. Specialist nurses identified patients early in their admission, coordinated treatment pathways and supported discharge planning to help ensure continuity of care.

The Dementia and Delirium Outreach Team provided specialist support for people living with dementia, delirium and cognitive impairment. The multidisciplinary team undertook ward-based assessments, supported staff to respond to behaviours associated with unmet needs and contributed to discharge planning. The team also followed patients into the community after discharge to help ensure ongoing support was in place and to reduce the risk of readmission.

The service placed a strong emphasis on continuity of care and effective discharge planning. Staff worked closely with community health and social care partners to ensure patients' ongoing needs were identified, and appropriate support was available following discharge. Patients who remained in hospital for more than 7 days were reviewed through regular multidisciplinary 'stranded patient' meetings. These meetings focused on reducing delays, addressing barriers to discharge and ensuring patients were supported to leave hospital safely and at the earliest appropriate opportunity.

Leaders demonstrated a proactive approach to managing complex discharge arrangements for patients who lived outside of area such as Coventry, Rugby and Nuneaton. Weekly multi-agency discharge events (MADE) meetings brought together operational teams, ward staff and partner organisations to review patients with out-of-area health and social care needs. This helped ensure discharge planning started early, services were coordinated effectively and patients experienced smooth transitions between hospital and community services.

Patients had timely access to a wide range of specialist services, including physiotherapy, occupational therapy, speech and language therapy and dietetics. These services were integrated into patients' care and treatment pathways and played an important role in supporting rehabilitation, recovery and coordinated discharge planning.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff ensured patients and those close to them received clear, timely and accessible information about their care, treatment and rights. Information about care and treatment was provided in a range of formats, including verbal explanations, written information and electronic resources, to support people to understand their care and make informed decisions.

Staff identified and responded to patient's individual communication needs. Reasonable adjustments were made for people with disabilities, people who did not speak English as a first language, and deaf people who used British Sign Language. Staff had access to interpreting and translation services, and people who required additional support to access written or digital information were assisted appropriately.

Patients were provided with information about available services, treatment options, their rights and how to raise concerns or make a complaint. Information on providing feedback and accessing support, including patient advice services, was clearly displayed and accessible. This helped ensure people knew how to share their experiences and raise concerns when required.

Staff understood the importance of maintaining confidentiality and handled personal information appropriately. Private areas were available for confidential discussions, and staff shared information discreetly and in line with trust policies.

Information leaflets were available in a range of languages to help meet the needs of the local population, although translated versions were not readily available for all information displayed within clinical areas.

Patients and those close to them were kept informed about progress, treatment plans and discharge arrangements. Patients told us staff provided regular updates and explained their care in a way they could understand. Relatives and carers were involved in discussions where appropriate and were supported to remain informed about the patient's condition and ongoing care.

We scored the service as 3. 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.

Patients, relatives and carers knew how to share feedback about their experiences and how to raise concerns or complaints. Information about how to do this was clearly displayed in patient areas. Patients told us they felt comfortable raising concerns with staff and were confident issues would be addressed. People we spoke with did not feel they needed to make a formal complaint because staff responded appropriately to concerns at the time they were raised.

Staff understood how to respond to concerns and complaints. Managers investigated complaints, identified themes and shared learning to support service improvement. From July 2025 to June 2026, the service received 40 complaints. We reviewed 3 complaint investigations and found concerns had been appropriately acknowledged, investigated and responded to. Responses included explanations, apologies where appropriate and identified learning to help prevent similar issues occurring again.

Leaders monitored complaints and feedback to identify opportunities for improvement. During the reporting period, 9 complaints were referred to the Parliamentary and Health Service Ombudsman, of which 3 were upheld and 6 were partially upheld. Learning from complaints was used to inform service development and improve people's experiences of care.

The service had implemented the Call for Concern process as part of Martha's Rule. This enabled patients, relatives and carers to request an urgent clinical review if they were worried a patient's condition was deteriorating and felt their concerns had not been fully addressed. This provided an additional route for people and those close to them to raise concerns and be involved in decisions about care and treatment.

We scored the service as 2. The evidence showed some shortfalls. The service did not always make sure that people could access the care, support and treatment they needed when they needed it.

People could not always access care and treatment in a timely way. Performance against key access standards remained below national expectations. Cancer waiting time performance was below both NHS operational standards and national averages. In July 2026, the trust achieved 56.9% against the 28-day Faster Diagnosis Standard, 88.3% against the 31-day decision-to-treat standard and 52.4% against the 62-day referral-to-treatment standard. This meant some patients experienced delays in receiving a diagnosis and starting treatment.

Referral-to-treatment performance for medical services was 79.69%, below the national 18-week standard. However, the trust had maintained low numbers of patients waiting more than 52 weeks, with 17 patients (0.23% of the waiting list) exceeding this timeframe. Leaders monitored waiting lists through regular performance reviews and patient-level tracking and had implemented improvement plans to reduce delays and increase capacity in areas under pressure.

Patients attending through urgent care pathways were generally assessed, investigated, diagnosed and treated promptly. The service developed a range of innovative admission avoidance and same-day care pathways to improve access to treatment, reduce unnecessary hospital admissions and ensure inpatient beds remained available for patients with the greatest clinical need. There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency.

Several initiatives demonstrated the service's commitment to improving equitable access to care. The 'Call Before Convey' scheme enabled paramedics to access consultant advice overnight for frail patients who may otherwise have been conveyed to the emergency department. Between December 2025 and June 2026, 192 patients were safely managed at home, resulting in an estimated 399 bed days saved. This approach improved patient outcomes by reducing exposure to hospital-acquired infections and the risk of deconditioning associated with hospital admission.

The service further improved access through SDEC pathways, including dedicated frailty and respiratory services, which enabled patients to receive specialist assessment and treatment without requiring hospital admission. Between September 2025 and January 2026, the respiratory SDEC service alone saved 147 bed days. Additional alternatives to inpatient admission included virtual wards for cardiology, respiratory medicine and frailty, an ambulatory care service, and a medical day care unit which supported patients to receive treatment while remaining at home wherever clinically appropriate.

A heart failure virtual ward had been established to facilitate both admission avoidance and early discharge for patients with heart failure. Leaders told us this had improved patient outcomes and reduced inpatient length of stay. The medical day care unit, opened in 2022, continued to provide an effective alternative to admission, delivering 7,179 treatments between July 2025 and June 2026 to patients who would previously have required an inpatient stay.

The service had systems to support patient flow and reduce delays in access to care. Despite consistently high bed occupancy rates, averaging 92.4% between July 2025 and June 2026, admission avoidance schemes helped ensure inpatient capacity remained available for the most clinically unwell patients. A live digital patient flow system enabled leaders to monitor capacity and demand in real time and support timely decision making across the medical care pathways.

Staff planned for discharge from an early stage and worked collaboratively with community teams, care coordinators and integrated discharge services to facilitate timely access to ongoing support. The trust had established structured reviews for patients with lengths of stay greater than 7 days. These multidisciplinary meetings identified and addressed barriers to discharge, including delays in diagnostics, specialist reviews and community placements. Actions were monitored through a shared tracking system, and progress was reviewed regularly to help prevent unnecessary delays.

We scored the service as 3. The evidence showed a good standard. Staff and leaders actively listened to information about patients who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Patients received care, treatment and support that promoted equity, removed barriers to access and protected their rights. Staff assessed patients' individual needs prior to admission and identified any reasonable adjustments required to ensure they could access care safely and effectively. For example, where patients experienced language barriers, interpreter services were arranged for appointments and admissions to support effective communication and informed decision making.

Leaders and staff demonstrated a strong awareness of the potential impact of discrimination and inequality on patient's experiences and outcomes. The trust collected demographic information to help ensure services were inclusive and responsive to the needs of the local population. Equality impact assessments had been undertaken for policies and procedures to identify and mitigate any unintended disadvantage for vulnerable patients or those with protected characteristics.

Staff were well supported to deliver inclusive care. Training records showed that 97% of staff had completed equality, diversity and inclusion training. Staff we spoke with understood the requirements of the Equality Act 2010 and were able to provide examples of how they made reasonable adjustments to meet individual needs. This included supporting a transgender patient to ensure care was provided in an environment that respected their identity and preferences.

Patients were encouraged and empowered to share their views about the care they received. Patients told us staff listened to them and took account of their individual needs and circumstances. Information about how to provide feedback was displayed throughout ward areas, and we saw 'You Said, We Did' boards demonstrating how patient feedback had been acted upon to improve services.

Staff and leaders proactively identified groups of people who may be at greater risk of experiencing inequalities in access, experience or outcomes. They used this information to tailor care and remove barriers wherever possible. Staff highlighted issues affecting patients who were more likely to experience disadvantage and worked with colleagues to develop practical solutions that improved patients' experiences and outcomes.

The service recognised and responded to inequalities in access to community services. For example, staff identified that patients in south Warwickshire had limited access to medical day care. To mitigate this, the service had set up a pilot at to deliver a medical day care which was more accessible.

The trust had introduced several initiatives to improve communication and inclusivity. For example, communication boards had been developed in a range of languages, including Punjabi, in response to patient feedback and the linguistic needs of the local population. There were plans to expand this approach to additional languages to further improve accessibility for patients whose first language was not English.

The service also recognised and responded to patients' cultural and religious needs. Medical patients on the wards were offered special menus during religious and cultural festivals, helping to ensure care was respectful of individual beliefs and preferences.

We scored the service as 3. The evidence showed a good standard. Patients 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.

Patients were supported to make informed choices about their care and plan for their future health and wellbeing. Patients told us they were kept informed about their care, treatment and future appointments, helping them understand what to expect and participate in decisions about their ongoing care.

Staff demonstrated a good understanding of shared decision-making and generally worked in line with national guidance relating to mental capacity and consent. Patients and, where appropriate, those close to them were involved in discussions about treatment options and future care plans. This included sensitive conversations about situations where further treatment may no longer be beneficial. Records we reviewed showed decisions relating to Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) were appropriately discussed, documented and reviewed.

Staff were knowledgeable about the trust's resuscitation processes and the use of Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) documentation. The ReSPECT process supported personalised planning for future emergencies by recording patients' wishes, preferences and clinical recommendations. ReSPECT forms were easily accessible within patient records. However, staff did not always fully document what mattered most to patients when completing forms during hospital admissions. This was consistent with findings from the trust's most recent audit and represented an area for improvement.

Information about palliative care and the ReSPECT process was displayed across most wards. This supported patients, relatives and staff to understand the support available and the approach to future care planning.

The service planned effectively for patients' future care needs through multidisciplinary working and collaboration with external partners. Occupational therapists, physiotherapists and specialist teams assessed patients' ongoing health and social care needs and contributed to personalised discharge and care planning. Specialist teams, including the DDOT team, admiral nurses and the learning disability team, supported patients with complex needs and helped ensure care plans, including advance care plans where appropriate, reflected individual preferences and circumstances.

Staff told us they discussed advance care planning with patients and those close to them when appropriate, giving patients opportunities to consider and communicate their preferences for future care, including end-of-life care. These discussions helped support informed decision-making and ensure future care reflected patient's wishes.

Staff worked closely with palliative care and pain management teams to support patients approaching the end of life. This helped ensure patients received care that prioritised their comfort, dignity and individual needs.