Salisbury District 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

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

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 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.

The service and its staff were committed to personalised care, enabling positive outcomes and a sense of empowerment for patients.

Care plans were designed to reflect the holistic requirements of patients, incorporating their personal circumstances and any protected characteristics under the Equality Act. Staff worked closely with patients to understand their needs and preferences, aligning care plans to these insights.

Patients reported understanding their conditions and the options available to them. They told us they valued their families, carers and close friends were regularly involved in care planning and decision-making processes. This fostered shared decision-making and ensured patients felt empowered to participate in their care.

Staff listened to patient concerns, answered questions, and provided comprehensive information, enabling informed and confident decision-making. Observations confirmed staff provided detailed explanations of surgical procedures and recovery plans, helping to ease patient concerns and ensure a clear understanding of their care.

The evidence showed a good 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.

The service demonstrated a coordinated approach to care provision, ensuring care and treatment were responsive to the health and social care needs of patients and the wider community.

Leaders demonstrated an understanding of local community requirements, tailoring the delivery of services to meet individual patient needs effectively. Continuity of care was a priority, with flexible and joined-up services enabling seamless transitions throughout patients' treatment journeys. Coordination between departments and external care providers helped minimise disruptions and delays, ensuring patients received timely and consistent care.

Staff were responsive and adaptable, adjusting care plans in line with changes in a patient’s condition or circumstances. We saw, and patient feedback confirmed, care was delivered impartially, with staff prioritising inclusivity and respect for each patient’s cultural, social, and medical needs.

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

The service made efforts to provide accurate, up-to-date information to patients, helping them understand their care, treatment options, and any changes to their treatment plans.

Patients had access to various information leaflets on topics such as patient rights, care processes, and post-operative care. Clinicians were observed taking time to answer patients’ questions and ensuring they understood the information provided.

Care plans reflected physical, mental, emotional, and social needs of patients including those related to protected characteristics under the Equality Act. Staff were responsive to changes in patients after their surgery. Staff took needed action when patient needs changed. For example, we reviewed records on the ward and saw pain assessments were adjusted during the first 24 hours on the ward.

Surgical pre-operative information was available to patients through the provider’s website which set out the different specialities available. Staff provided leaflets to patients which gave them information to consider before their visit. Post operative information was made available at the time of discharge. This included any onward recovery information and follow up appointments.

Information was provided and available in a range of community languages. Posters displayed around the hospital were predominantly in English. However, information was available in a range of different languages on the trust's website or by request.

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.

Information about how to give feedback about care and treatment was detailed on the trust website. This included compliments, concerns and complaints feedback processes. A trustwide complaints policy gave staff guidance about managing and responding to complaints.

The service had mechanisms to encourage feedback from patients, involving them in decision-making and responding to their concerns. Patients said they were aware of how to give feedback, including through the Patient Advice and Liaison Service (PALS), and there were various channels for raising complaints. Patients reported feeling comfortable and informed about how to raise concerns. They had multiple channels available for feedback, including PALS, email, telephone, and in-person discussions.

Staff were knowledgeable about the complaint-handling process and could articulate the steps taken to manage complaints. When concerns or complaints were raised, staff demonstrated a thorough and sensitive approach to handling them. Managers investigated complaints promptly, following the trust's policy, and worked to identify common themes or areas for improvement, with patients and their families actively involved in the investigation process.

Staff provided examples of how feedback was used to drive improvements. For example, a patient had provided feedback regarding the admission and discharge process. They had commented how the additional movement between different areas had caused increased stress and anxiety. The service reviewed the concerns using a structured improvement methodology. As a result they improved their communication protocols for patients, for example pro-actively discussing plans with patients or providing orientation visits to help alleviate any stress.

The service used the NHS Friends and Family Test (FFT) to gather patient feedback, and results were displayed prominently, showing transparency in how patient feedback was influencing practice and demonstrating an ongoing effort to improve care quality.

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.

Bed capacity on wards meant some patients remained in recovery longer than they needed to, some waited up to 4 hours for a ward bed. The surgical theatres reception area was utilised to admit and discharge patients for surgery. This impacted the effective flow of patients through the surgical service. However, the service reported minimal cancellations of procedures due to lack of bed capacity.

There were no overnight stays in recovery. Patients who needed to stay overnight for clinical reasons were transferred to wards for ongoing care and management.

As a result of poor flow through the surgical service, patients experienced delayed admission to surgical wards from the emergency department. Data provided by the trust showed patients frequently spent more than 4 hours in the emergency department after the decision to admit to a ward.

The NHS constitution directs that patients have the right to begin consultant-led treatment within a maximum of 18 weeks from the time they are referred by their GP. Patient waiting times for planned surgery were monitored and reviewed at governance meetings. The service carried out harm reviews to identify and act on harm patients were exposed to because of delayed surgery.

The service was working to reduce the number of patients waiting for treatment. Data provided by the service which related to surgical services showed significant reduction in the number of patients waiting over 65 weeks to be seen and treated. Despite the numbers of patients on the waiting lists, the service was improving its position.

The environment on wards supported people with dementia to have equal access to facilities. Toilet and shower rooms had dementia friendly labelling. Door frames and toilet seats were of a contrasting colour to the walls and floors to make them clearly visible for both patients with dementia and for patients who were visually impaired.

Staff took account of both the physical needs and cognitive needs of patients including specific fears and preferences associated with healthcare conditions. This included patients with a learning disability, autistic people and those who were neurodiverse. For example, staff in pre-assessment provided examples of when they had supported patients to visit departments, including day surgery, prior to attending for their procedure. They told us patients then felt less anxious on the actual day of their procedure because they were more familiar with their surroundings.

The evidence showed a good standard. 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.

Leaders and staff were aware of the potential for discrimination and inequality, striving to create a fair and inclusive environment for all patients. Efforts to promote equity included providing interpreter services, making cultural adjustments, and offering various dietary options.

Staff completed equality, diversity and inclusion training as part of their mandatory training. Staff highlighted to us the benefits of the Oliver McGowan mandatory training for Autism and Learning Disabilities which they felt was valued and encouraged reflection. Staff followed processes that supported them to deliver care and treatment that did not put patients with protected characteristics at disadvantage.

The service described how they had tailored plans to support patients with a learning disability to access the service and receive their care and treatment. For example, a patient and their sister, who was their advocate, attended outpatients. They subsequently required treatment for a condition that was restricting their voluntary work commitments. The service described how they worked with the patient and their advocate over time to enhance their understanding of the procedure. The ward provided extended time for the patient on the ward post-surgery. Discharge planning included provision of additional care support to allow the patient to remain as independent as possible.

The service's ability to provide equitable experiences and outcomes was sometimes hampered by systemic issues such as overcrowding, bed shortages, and staffing challenges. The trust taken a strategic decision at the beginning of the 2025/26 financial year to change one of their trust vision metrics from ‘increasing healthy life years’ to ‘reducing health inequalities’. The trust had commissioned a new internal operations group to help focus on health inequalities. At the time of this inspection there was no specific data or information to report. However, the surgical division confirmed that they would be feeding into this new operation group.

The evidence showed a good standard. 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.

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.

Staff in pre-assessment made a full assessment which focused on ensuring patients were well enough to have their chosen surgery. Staff told us part of this role was giving lifestyle advice if certain clinical readings were not suitable for safe surgery. For example, when surgery was not a viable option at that time due to poor cardiac health or other medical conditions. Staff told us they approached these conversations in a sensitive manner and wanted to support patients to feel as well as possible prior to their surgery.

Staff had access to the trust wide resuscitation policy and demonstrated a clear understanding of the trust do not attempt cardiopulmonary resuscitation (DNACPR) policy and ReSPECT documentation. The ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) process created personalised recommendations for a person’s clinical care and treatment in a future emergency in which they are unable to make or express choices. These recommendations were created through conversations between a person, their families, and their health and care professionals to understand what mattered to them and what was realistic in terms of their care and treatment. Care plans we reviewed accurately reflected patients advanced planning decisions.

The trust also carried out monthly audits on the accuracy of DNACPR and ReSPECT documentation. Data provided by the service demonstrated compliance of 100% for all wards.