Derriford 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 people and communities were always at the centre of how care was planned and delivered. We checked the health and care needs of people and communities were understood, and they were actively involved in planning care met these needs. We also looked for evidence people could access care in ways that met their personal circumstances and protected equality characteristics.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. 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.

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.

Staff told us they took into account patients’ individual needs and undertook risk assessments to identify specific needs such as frailty or high risk of falls.

There was a dedicated room to assess patients with mental health needs designed for patients’ safety. Staff referred patients with acute mental health conditions to the psychiatric liaison team (PLT) (provided by a system partner) for psychiatric assessments. The service was available 24 hours a day 7 days a week. However, staff told us there could sometimes be delays of up to 12 hours for the team to respond due to staff availability. The provision of mental health support was on the risk register. There was a rapid tranquilisation policy and risk assessment to ensure staff understood the legal framework and guidance for patient safety. One patient who was waiting for review during our visit said staff had listened to their needs and they felt safe.

The emergency department worked with an end-of-life charity who provided health care assistants (HCAs) to support patients. There was a pathway to 12 specialist end of life beds at another of the trust’s hospitals, providing a more easily accessed and quieter space with dedicated side rooms for patient and their families.

The security guard team told us when staff requested their assistance they checked if there was any knowledge to assist them to provide person-centred care. They would interact with people taking into consideration if they were suffering from dementia, learning disabilities or autism.

Staff said there were various ways in which they provided information in a way people could understand including interpretation for people who did not speak English as a first language. They were also able to obtain support for people who were deaf and used British Sign Language. There was also an artificial intelligence telephone to interpret languages.

One patient said staff were very kind and they felt listened to though they were hard of hearing. Another described staff as “brilliant” and their treatment was “very positive”.

The service understood the diverse health and care needs of people and their local communities, so care was mostly joined-up, flexible and supported choice and continuity.

Staff articulated how their local communities had diverse health and care needs. There were processes to support staff to deliver joined-up care and treatment which did not put patients at a disadvantage. Staff said there were measures to support people living with mental health problems, learning disabilities, autism and dementia, to receive the necessary care to meet their needs. Staff could access support and guidance from specialist nursing teams, such as learning disability or dementia nurses and the psychiatric liaison team (from an external provider).

The trust was in partnership with a system partner to develop and improve services for people in their local communities and ensure equitable and fair access and outcomes.

The paediatric emergency department struggled to provide sufficient mental health support to patients. There was a risk of young patients absconding and harming other children and young people due to delays in mental health assessments which were provided by an external provider. There were also unsuitable mental health spaces in the new paediatric area and this was already on the risk register.

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

Staff knew how to make notifications to external bodies such as the local authority for safeguarding issues. Information governance systems included confidentiality of patient records. The service complied with the accessible information standard (AIS) and the trust’s patient information policy set out guidance on producing information.

There was a policy for providing patient information leaflets. These included advice and guidance about what to expect when visiting the department and injury/non-injury related conditions. Leaflets were also available on the trust website. Some were offered in large print, other formats (easy read) and available in different languages. The trust provided patients with a range of discharge information including contact details of external agencies. There were posters describing staff uniforms and their roles displayed in waiting areas.

Waiting times for the emergency department and Dartmoor urgent treatment centre (UTC) were available on the trust’s website (longest waiting time to see a doctor, current number of patients waiting to be seen and the total number of patients in the department).

The fundamentals of care audit 2024 to 2025 documented 150 out of 166 records audited stated patients were aware of their medical plans. Most patients we spoke with said staff kept them informed of their treatment plan and what they were waiting for next. However, one patient said they were transferred within the department without explanation and a relative had to seek out staff regarding next steps.

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.

The service made it easy for people to share feedback and ideas. Staff assisted patients to raise concerns and patients, carers and relatives could make complaints directly by visiting the trust’s patient advice and liaison service (PALS) or through the trust’s website by telephone, form or email.

The service received 95 complaints during the previous twelve months. The main themes were regarding waiting times in the ambulatory waiting room, general communication with patients regarding what was happening next. No complaints were referred by patients to the parliamentary and health service ombudsman during this period.

Complaints were taken seriously and used to improve care and treatment where possible. Staff knew how to handle complaints appropriately and offered to telephone people and arrange local resolution meetings with patients, relatives and carers.

Leaders told us they held weekly concerns and complaints meetings. Staff said they received feedback on the outcome of investigations and recognised complaints were opportunities for learning and making things better for patients. An example of learning from listening to patient feedback was the introduction of eye masks and ear defenders to help patients sleep in the majors treatment area.

A system partner shared feedback with us regarding people’s experiences of visiting the department over the 6 months prior to our visit. Staff were described as helpful, professional and caring. However, some feedback concerned long length of wait for triage or treatment. One patient who was waiting for a psychiatric review told us staff had listened to their needs and involved them in their care decisions. However, another patient said all staff had been lovely but they had been in the department for 5 hours, they were hungry and had no communication as to whether they were being admitted or discharged.

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

We found some inequity in access for patients dependent on how they entered the department. Patients who arrived and were clinically triaged to the medical receiving unit (MRU) were seen and clerked by the medical doctors quicker than patients who were seen by emergency department staff and identified as needing medical referral and clerking before transfer to a medical ward. This was due to long waits for medical reviews.

However, all children and young people attending the children’s emergency department were visually assessed by a doctor or nurse immediately upon arrival and clinical assessment undertaken within 15 minutes to determine priority category, pain score and full record of vital signs.

At our last visit we found there was a significant issue regarding the flow of patients through the emergency department which affected access. However, at this visit we found improvements had been made with more equitable access to services by directing patients to appropriate alternatives such as the new Dartmoor urgent treatment centre (UTC) (open 12 hours a day, 7 days a week). We observed patients attending the UTC were triaged promptly, tests were conducted and diagnosis and management plans were documented.

Also, the implementation of an x-ray car, staffed by specialist radiographers and imaging healthcare assistants, visited patients at home and saved patients from travelling to hospital. The GP gateway hub took calls from community services and gave advice for streaming patients and clinical advice prior to conveying patients to hospital.

There was a safe, validated, reliable and audited system to identify critically ill patients when accessing the department by ambulance. The hospital ambulance liaison officer (HALO) reception desk, staffed by the hospital, had good systems and processes to identify the severity and urgency of a patient's condition to prioritise care and inform staffing decisions.

The acute rule out waiting (AROW) area accommodated patients who were well enough to sit in chairs to wait for results or medication and then discharged.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The provider had undertaken an equality impact assessment on policies used by the service. A process to review policies to ensure vulnerable people or people with protected characteristics were not placed at a disadvantage. The trust’s equalities and human rights impact assessment guided staff for the collection of data to ensure risks for complying with their responsibilities for groups with protected characteristics were addressed. The equality, diversity and inclusion policy endeavoured to create a fair, diverse and inclusive workplace and healthcare service.

All staff received equality, diversity and human rights training as part of their mandatory training. However, not all staff were compliant with 74.48% of nursing staff having completed training (October 2025) which was below the trust target of 90%.

There were processes to support staff to deliver care and treatment and did not put patients with protected characteristics at a disadvantage. Staff said there were measures to support people living with mental health problems, learning disabilities, autism and dementia, to receive the necessary care to meet their needs. Staff could access support and guidance from specialist nursing teams, such as learning disability nurses, dementia nurses and the psychiatric liaison team provided by a system partner.

The restraints policy guided staff about the use of restraint and restriction to ensure they were not used inappropriately. This included the legal frameworks for restraint. There was a pharmacological policy for the use of rapid tranquilisation and restrictive interventions, to ensure staff understood the legal framework and guidance for patient safety.

Staff had a good understanding of take away packs (medications a patient is given to take home when they are discharged from hospital). However, transport was sometimes difficult to send patients home as the service covered an area where there were 3 different transport teams with different response times. We were told by staff patients returning to Cornwall experienced challenges.

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 service worked with commissioners to understand paediatric attendances and with community services to redirect and decrease paediatric attendances in the future using health visitors, midwives, 111, pharmacy, and an electronic application to provide advice and support to parents and carers regarding how to treat unwell children.

The service was working with an end-of-life charity who provided health care assistants (HCAs) to support patients who required end of life care in the department. Since August last year, the trust had embedded an end-of-life care pathway from the emergency department to specialist end of life beds at another of the trust’s hospitals, providing a more easily accessed and quieter space with dedicated side rooms for patient and their families.

We reviewed a selection of patient care records which were mostly completed in detail including mental and physical health needs, safeguarding checks, falls risk assessments, diagnosis and management plans. Staff developed care plans met patients’ needs identified during assessment.

The service followed the trust’s recording and filing of living wills and advance directives process. Living wills and advance directives indicated individuals’ wishes about future medical treatment. Compliance was monitored by regular audits.