Great Ormond Street Hospital

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We observed a strong culture of compassion, kindness, and patient-centred care, ensuring that children and families felt supported throughout their hospital journey. Staff interactions were consistently positive, gentle, and reassuring, with a clear emphasis on respecting patients’ dignity and emotional wellbeing.

The service was highly responsive to individual needs, adapting communication styles to reduce distress and ensure that patients understood what was happening to them.

Patient independence and choice were actively encouraged, with staff ensuring that young people had a voice in decisions about their care. While parents and guardians were consulted, conversations remained child-focused, promoting autonomy and engagement.

The workforce culture was supportive and inclusive, with staff feeling valued and proud to work for the trust

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

Staff demonstrated kindness, empathy, and compassion in their interactions with patients and families, ensuring that care was delivered sensitively and respectfully. We observed three instances of care in the recovery ward, where staff engaged in a positive and attentive manner, offering reassurance, comfort, and clear explanations to both patients and carers.

Staff were observed speaking gently and reassuringly to patients as they woke from anaesthesia, ensuring they understood what was happening and where they were. For one patient, visual aids were used to help them process their surroundings, while soft toys that had been brought into theatre were sealed for hygiene purposes and presented to the child upon waking, offering a familiar and comforting presence.

Where patients experienced distress on waking from surgery, staff acted swiftly to facilitate parental involvement, ensuring that parents could hold and comfort their child in a safe and controlled manner. Staff were attuned to the emotional needs of both patients and their families, taking active steps to minimise anxiety and provide support where needed.

Patients’ privacy and dignity were consistently respected. We observed staff drawing curtains around recovery bays when appropriate, ensuring that patients were given space and privacy during their immediate post-operative period. Staff were also observed communicating clearly with carers and patients, explaining each step of the recovery process.

Carer and family members spoken with during the assessment expressed satisfaction with their loved one’s care and treatment, highlighting the kindness and attentiveness of staff.

The service demonstrated a strong culture of compassionate, patient-centred care, with staff making every effort to maintain dignity, offer emotional support, and tailor their approach to meet individual needs. Staff interactions were gentle, considered, and responsive, ensuring that patients felt safe, valued, and reassured throughout their hospital experience.

We observed a strong commitment to person-centred care, ensuring that patients’ individual needs and preferences were understood and reflected in their treatment and support. Staff were observed adapting their communication approaches to engage with patients in a way that maximised their comfort and reduced anxiety.

We observed staff holding difficult conversations with patients and families in a compassionate and empathetic manner, ensuring that patients were prioritised in discussions and communicated with in ways they could understand. Staff demonstrated creative approaches to reducing patient distress, including one instance where a staff member engaged a nervous patient by discussing the sensations and smells of a face cream while administering oxygen. This distraction technique was seen to lower the patient’s visible anxiety level, illustrating how staff took individual needs into account to enhance the patient experience.

For patients who had difficulty communicating their needs, staff had developed a pain protocol that used visual, vocal, and physical response cues to assess discomfort. A pain protocol poster in the recovery area provided guidance on identifying various levels of pain through visual observations, ensuring that patients who were unable to verbally express their pain received appropriate and responsive care.

The service ensured that patients had as much independence as possible during their hospital stay, recognising the importance of choice, dignity, and personal control in the overall care experience. Staff demonstrated a patient-centred approach, ensuring that children and young people were given opportunities to express their needs and preferences, with support tailored to their individual circumstances.

Patients and their parents, guardians, or carers reported that staff were responsive to their needs, particularly in relation to pain management and dietary preferences. Families told us that pain relief was provided promptly upon request, ensuring that children remained as comfortable as possible. Staff were also accommodating when providing meals, ensuring that patients had access to food they wanted to eat, recognising the importance of nutrition in recovery.

Observations showed that staff engaged proactively with patients and their families, using appropriate communication tools and language to address concerns and provide reassurance. Staff ensured that patients’ voices were central to discussions, demonstrating respect for their opinions and individual preferences. We noted that while parents and guardians were involved in decision-making, the focus of conversations remained on the child or young person, ensuring they felt heard and had control over their experience.

The trust facilitated parental access to patients as soon as it was clinically safe to do so. We observed that parents were allowed into the recovery ward post-surgery, enabling them to comfort and support their child as they regained consciousness. This approach reinforced the importance of family involvement in the patient’s emotional wellbeing and recovery process.

Staff ensured that comfort, safety, and emotional wellbeing were prioritised. They were observed to be attentive, engaged, and highly responsive to patients waking from surgery, providing both medical and emotional support in the recovery ward.

To ensure that pain was managed effectively, even for patients who were unable to communicate verbally, staff had developed a structured pain protocol. This protocol was based on visual, vocal, and physical responses to pain, allowing staff to assess and address discomfort promptly. A pain protocol poster was displayed in the recovery area, providing clear guidance on recognising, and responding to different pain levels. This approach ensured that no patient’s discomfort was overlooked, particularly those who might struggle to express their needs.

Observations in the recovery ward showed that each patient was assigned two staff members, ensuring continuous monitoring and rapid response to any emerging needs. The recovery bays were organised around a central post, where the coordinator had a full view of all patients and staff, allowing for immediate oversight and quick intervention if required.

Staff were seen to monitor patients closely as they woke from anaesthesia, providing reassurance, comfort, and necessary medical interventions as needed. They engaged with patients in a calm and supportive manner, responding promptly to any distress and ensuring that patients felt safe and well cared for. Each recovery bay was fully equipped to meet patient needs, ensuring that staff had the tools and resources necessary to provide high-quality, responsive care.

Overall, the workforce wellbeing culture at the trust was positive, with staff reporting strong peer support and access to personal and professional development opportunities. Staff reported feeling valued and proud to work for the trust, with many expressing that they received good support for career progression and had access to personal support when needed. Staff described a positive culture where they felt confident to raise concerns, with the expectation that they would be listened to and taken seriously by leadership.

The hospital demonstrated a comprehensive approach to supporting staff wellbeing across all areas, including surgical services. A range of initiatives was in place to address emotional resilience, morale, and workplace stress. Notably, the “Thriving not just Surviving” programme was offered to individuals and teams, with participation from surgical wards such as Eagle Ward. This facilitated self-reflection and action planning to promote resilience and prevent burnout.

Staff had access to wellbeing walks, pop-up support sessions, and a dedicated wellbeing hub called "The Hive." Practical support was also available, such as a hardship fund for staff facing unexpected financial challenges. The trust also introduced a wellbeing e-learning module to help managers hold effective health and wellbeing conversations, aligning with the NHS People Plan. Despite the wide availability of wellbeing services, it was not always clear how effectively these initiatives were embedded or evaluated within surgical divisions specifically. Nevertheless, staff across clinical and non-clinical roles—including those in theatres and surgical wards—had access to resources designed to enhance wellbeing and reduce the risk of burnout.

While many staff felt supported, some raised concerns about limited opportunities for promotion, noting restricted pathways for career advancement. Despite this, staff spoke positively about training and development opportunities available to them, which helped them enhance their skills and professional growth.

The excessive cost of living and commuting to London was a recurring theme among staff, with several stating that these financial pressures contributed to staff turnover. Some staff told us that they adjusted their work routines to minimise travel costs, such as delaying their commute to take advantage of off-peak train fares.

The trust provided low-cost staff accommodation for those who required it, but some staff reported that the standard of these facilities was not high, which impacted its appeal as a long-term housing solution.

Staff told us that they were able to take regular breaks, and no staff spoken with during the assessment reported being dissatisfied with their working environment. Some staff also noted that they were able to work from home occasionally, which helped to improve work-life balance and flexibility in certain roles.