Birmingham Children's 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

Caring is rated as good. This meant people always felt well-supported, cared for and or treated with dignity and respect.

Children and young people were treated with kindness, compassion and their privacy and dignity was respected. Staff understood the experience of how children and young people were treated and supported mattered. Children were treated as individuals and given choice and control where possible.

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

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.

The service treated children and young people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect. We observed caring and warm conversations with patients and their families or loved ones.

Children and young people felt they were treated with kindness, compassion and dignity. When speaking to children, young people, and family members, they all told us staff were kind and caring. Staff spoke compassionately about caring for their patients and they wanted to provide the best care and treatment for them.

Staff recognised the need to treat children and young people with dignity and making sure they were comfortable with who the staff were. When nurses or doctors needed to complete observations or care or treatment, curtains were pulled around the bed or side room doors were closed. We saw staff explaining to children and young people or their families and carers who they were and what they were proposing for the care and treatment.

Parents and carers we spoke with said they felt their children were safe. They told us that the team ‘are great and supportive’. There was evidence on noticeboards and in the friends and family survey of very positive feedback for all levels of staff.

Parents told us that surgeons and staff had been open and honest when a procedure had not been successful. They explained the reasons and any changes required to the plan of care. Risks were discussed and consent was sought throughout the treatment journey. Parents told us they felt comfortable to question decisions made for the care of their child without fear of repercussions.

Patients and their parents or carers told us that pain was managed well, and staff checked frequently that the child was comfortable.

Parents had also been offered support from mental health services and family liaison workers. For some families, especially where their children’s stay in hospital may be a long one, this can be both an emotionally and financially worrying time. Parents told us the service supported emotionally and considered the needs of parents too. There was some financial and practical support for families.

The service treated children and young people as individuals and worked to provide care, support and treatment that met their needs and preferences. Staff took account of children’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. The service used different forms of communication aids with children and young people to enable them to express their wants, needs and wishes.

Areas around children beds displayed information about the child for example likes and dislikes and ‘what’s important to me’. One parent also told us that, for times when she was unable to be with her young child, staff kept a diary for her to read when she returned to the hospital. She said she found this to be comforting.

Records identified multidisciplinary meetings had taken place with support from the local mental health service and social workers to meet children’s individual health and care needs.

Staff told us one of the things they were most proud of was the advocacy they provide for their patients and the innovative ways in which they try to make their stay in hospital better.

The service promoted people’s independence, so children and young people knew their rights and had choice and control where possible over their own care, treatment and wellbeing.

Children, young people, and families told us they were involved in care decisions. They told us this included difficult conversations relating to care and treatment. Staff took time to provide information. Children, young people, and families told us they felt they were able to ask nurses and doctors questions regarding their care and treatment, and staff took time to answer any questions they had.

Information was provided to parents through leaflets and posters. We observed information in the parent’s room on the complaints policy and how to contact the Patient Advice and Liaison Service (PALS), advocacy services and wellbeing support.

The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs promptly and acted to minimise any discomfort, concern, or distress. We saw children and young people had access to the call bells and staff answered them in a timely manner. Staff had a good understanding of the children and young people’s needs. There was good communication between departments.

The service had a deteriorating patient pathway known as the Observation, Monitoring and Escalation Policy. Staff were able to explain this pathway and demonstrated an understanding of how to escalate concerns when a patient’s condition deteriorated. The pathway also acknowledged that there were times when parents or carers had concerns or felt that something may have been missed in their child’s care, this explained the action to be taken to address these concerns and escalate, if necessary to senior staff or medical teams.

There was medical cover on-site 24-hour hours a day, 7 days a week. In addition to this, consultants were also available on an on-call basis out of hours. Staff told us they could call for support from consultants at any time and reported no delays in receiving this support.

Radiographers and physiotherapists were available 24 hours a day, 7 days a week. This meant diagnostic X-rays and respiratory physiotherapy could be completed promptly when required.

The child and adolescent mental health team was also accessible 24 hours a day, 7 days a week.

The service offered a chaperone for those patients who wanted one during physical examinations. There was a message displayed at the service reception explaining how to request one.

The service cared about and promoted the wellbeing of their staff. It supported and enabled staff to deliver person-centred care. There was a psychology led service where staff could access support. An emotional support framework was used to ensure healthcare staff could access appropriate, timely, and confidential emotional support. Staff told us they had accessed this support, but they also felt they were able seek guidance and support from their managers and clinical educators.

Nursing staff could contact a professional nurse advocate. These were senior registered nurses trained to provide confidential emotional and professional support to nurses, midwives, and the wider healthcare staff.

The service had awards to celebrate the skills, compassion and care of individuals. Nursing staff could nominate a nursing colleague for a daisy award. All staff in the surgical division could also be nominated for a spirit award.

During our inspection we talked to some staff who had been on the nursing apprenticeship scheme. One staff member told us they had enjoyed the working environment and felt supported.

The service had a Guardian of Safe Working. This is a statutory, independent role within NHS trusts that safeguards safe working hours, rest, and working conditions for doctors in training.

The service had an average range of sickness of 5%. There were peaks in winter months, but this was in line with average national trends. The trust actively monitored staff sickness and worked towards reducing this where possible.

Results from the 2024\25 staff survey showed that 47% of staff had responded, which was the highest response rate amongst the clinical divisions at the trust. The service scored well for being compassionate, inclusive and staff feeling passionate about their work. Staff were offered opportunities to have their voice heard and managers encouraged staff engagement. Results from the survey showed work was needed on developing the culture of civility and inclusivity, learning opportunities, quality of appraisals and supporting staff with competing demands of their role. The service leaders had actions plans for supporting staff which included workforce planning and consultations, an equality, diversity and inclusion group which was run monthly and a theatre staff council who met to discuss issues concerning staff and suggest improvements. Investment had been made in staff facilities, including the refurbishment of on-call rooms, which was a specific request from theatre staff.