Derriford 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

We looked for evidence that people and communities had the best possible outcomes because their needs were assessed. We checked people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

At our last assessment we rated this key question requires improvement. At this assessment the rating has improved to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Risk assessments were completed at pre-assessment appointments, including Venous Thromboembolism (VTE) and Waterlow (risk of pressure ulcers).

Staff were able to describe how they monitored people’s care and treatment, including undertaking vital observations. They understood how to identify and manage people with suspected sepsis or those whose health condition deteriorated. Staff had access to the Sepsis 6 Pathway and guidance about what actions to take in the event of suspected sepsis.

Staff had access to policies for patients requiring reasonable adjustments.

On wards, patients told us their physical and mental health needs were discussed with them and were met. However, 2 patients said it would have been good to have additional mental health support.

The service planned and delivered people's care and treatment with them, including what was important and mattered to them. Staff did this in line with legislation and current evidence-based good practice and standards.

Staff had access to policies and procedures which were in line with national guidance and acted to ensure risks for patients relating to surgical procedures were reduced by following best practice guidance.

The trust participated in relevant national clinical audits. Outcomes for people were mainly positive and mostly met expectations.

The service used the nationally recognised World Health Organisation (WHO) 5 Steps to Safer Surgery checklist. Information received indicated the trust had improved since the last assessment and was now compliant with the checklist.

Most people said they received enough pain relief. However, one person said they had some problems accessing pain relief overnight.

The service worked well across teams and services to support people. Staff made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. We saw multidisciplinary team working in all areas. Clinical staff including nurses, doctors and allied health professionals worked well together. Nursing staff told us they worked well as teams and had good relationships with surgeons and management.

There were regular multidisciplinary meetings during the day where doctors, nurses, discharge coordinators and allied health professionals discussed patient care, ongoing treatment, and discharge plans. They held multidisciplinary team safety huddles twice daily to plan and coordinate care and treatment. Staff safety huddles were held twice daily to ensure all staff had up-to-date information about risks and concerns.

Staff referred patients with acute mental health conditions to the Psychiatric Liaison Team (PLT), provided by a system partner. Staff said the team was responsive and available to support patients.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

The service had processes to support people to have relevant screening and manage their health and to be in their best condition for their planned surgery. People who smoked were signposted to a local external community service for advice.

Patient information leaflets were available on the trust website providing information before and after surgery. Some included how to “Keep fit and healthy” prior to surgery and recovery exercises and support contact details post surgery.

People said they were provided with the information they required. People were positive about access to physiotherapists, dietitians and occupational therapy support.

The service routinely monitored people's care and treatment to continuously improve it. Staff ensured outcomes were positive and consistent, and they met both clinical expectations and the expectations of people themselves.

The trust had processes to monitor outcomes of people using the service and was working with partner organisations to look at improving the discharge process. The trust participated in relevant national clinical audits and outcomes for people were mainly positive and mostly met expectations.

The service used a system called Patient Reported Outcome Measures (PROMs) to monitor progress and improve care. Patients' overall experience (2023/2024) following hip or knee replacements was good.

The European Association for the Study of Obesity (EASO) commended the team for high quality bariatric surgery service and post-operative follow-up programme.

The National Hip Fracture Database (NHFD) showed the trust performed highly admitting patients to orthopaedic wards within 4 hours. However, the trust performed less well for the proportion of arthroplasties (joint replacement surgery) which were cemented.

The trust said investigations informed, assured and supported quality improvement for people at end of life. Morbidity and Mortality (M&M) review meeting minutes were more standardised since the last assessment and showed the trust monitored surgery mortality outcomes. To identify where care could be improved, the trust participated in a national study, the National Confidential Enquiry into Patient Outcome and Death (NCEPOD), focusing specifically on rehabilitation following critical illness.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff understood the relevant consent and decision-making requirements of legislation, including the Mental Health Act (MHA), and knew who to contact for advice. The trust’s Mental Capacity Act policy (MCA) guided staff about when and how to apply it for vulnerable people. The policy included the Deprivation of Liberty Safeguards (DoLS) to protect the interests of vulnerable persons who lacked capacity to keep them safe from harm. If a person lacked capacity to make their own decisions, staff would carry out an assessment as part of the initial consultation process. Staff were required to complete MHA, MCA and DoLS training.

The service reviewed consent in their March 2025 Care Group Round Up report. People reported being well-informed and satisfied with the consent process. However, the audit found documentation often lacked detailed records of risks and benefits discussed. The trust had begun to standardise the consent process with a digital consent form, to improve efficiency and accuracy in recording consent. This would be further supported by implementation of a new trust wide electronic system.

People said they felt involved in the decision-making process. One person said staff had taken time to explain the risks of surgery and had given consent many times throughout the whole process. One person in an anaesthetic room confirmed they had consented prior to surgery and again at the time of surgery.

We observed staff assisting a person in theatres who required an interpreter to provide consent and explain the procedure. An interpreter was provided via telephone.