Birmingham Children's 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

Responsive is rated as Good. This meant children and young people’s needs were met through good organisation and delivery. 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 were understood, and they were actively involved in planning care to meet these needs. We also looked for evidence people could access care in ways met their personal circumstances and protected equality characteristics.

The service made sure children, and young people were at the centre of their care and treatment choices. Staff understood the diverse health and care needs of their patients and their local communities, so care was joined-up, flexible and supported choice and continuity. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment, and support. Staff involved children and young people in decisions about their care. The service made sure people could access the care, support, and treatment they needed when they needed it.

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 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 children, and young people were at the centre of their care and treatment choices. They decided, in partnership with patients and their families, how to respond to any relevant changes in children’s needs. The service had a learning and disability lead nurse and a learning and disability liaison worker who worked with patients and their families to discuss support needs and make reasonable adjustments.

There were facilities for families so they could spend time with their children. The service had onsite accommodation which was compromised of 14 rooms, 3 bath and shower rooms, a sitting area, kitchen and laundry facilities. This area was not available to all parents, there was a criteria for accommodating parents who needed this support.

A parents’ room was available with facilities to prepare hot drinks, comfortable seating, and access to shower facilities on the ward. The wards had specially designed playrooms equipped with age‑appropriate toys and activities, which were cleaned daily. Both playrooms provided suitable resources for different age groups and had access to outdoor spaces, which were undergoing further development.

Children and young people were able to access support from play and recreation workers and a play specialist. There were 10 play and recreation workers and a play specialist. These staff supported children to understand procedures and treatments in an age‑appropriate way and provided emotional and psychological support to promote their mental and emotional wellbeing.

The play and recreation workers and the play specialist talked to patients about the specific procedures they may be having and used interactive toy models to demonstrate these procedures. This helped patients understand what will happen, reduce anxiety, and gave them the opportunity to ask any questions they may have.

The service offered emotional support to siblings through play and activities, some of which involved the child and parent taking part together. This helped support siblings who may feel anxious and gave parents and children the opportunity to spend some positive, one‑to‑one time together.

Play and recreation workers told us that they felt the service had been recognised for its good and effective work, which had led to an increase in referrals for their support.

Patients with kidney disease who were awaiting a transplant were supported through home visits.

Multidisciplinary meetings were held to review the needs of patients with mental health conditions, autism and learning disabilities, including any reasonable adjustments made to support them. These meetings also included a review of support arrangements for parents with learning disabilities, ensuring that appropriate measures were in place.

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 worked closely with a range of healthcare and social care partners, including local specialist NHS hospitals, community health teams, mental health services, social care, and wider health and support services. Staff described good working relationships with partner organisations.

Local mental health services worked closely with ward and clinical staff to support children and young people with additional emotional or psychological needs. The service also maintained close working relationships with the local authority.

Multi‑agency meetings were held when required, with attendance from social care and other relevant agencies, particularly where decisions were needed regarding community support arrangements or safeguarding matters, such as for looked‑after children.

The service had appropriate, accurate and up-to-date information in formats which were tailored to individual needs. They had implemented a new electronic patient record (EPR) system in May 2025. Staff felt the implementation had gone well, they had been supported with training and could see the benefits of the system.

All patient records were stored on the EPR system which was used by all departments within the surgical service. Staff were able to locate information easily and praised the integration of the system, the training and the positive impact on patient safety. The system also highlighted involvement from other support services for the patient. For example, the local authority or other speciality services.

Children, young people and their families’ needs around interpretation and translation were met. There was access to translation services and information in different languages via a hospital web-based application using a QR code.

The service held a Leaflet Amnesty Week to raise awareness of the importance of up-to-date information. They collected over 100 leaflets that were out of date or didn’t contain the most recent information.

Patients, families and carers could access an application called ‘MyChart’ on their mobile phones. This enabled them to manage appointments, access health information, and communicate with the medical team. Staff at the service supported people to access the My Chart app and showed them how to navigate it.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment, and support. Staff involved people in decisions about their care and told them what had changed as a result.

Children, young people, their parents and carers had a good understanding of how to complain if they were unhappy with the care and treatment given. Staff said that talking as much as possible with children, young people and their families had helped understand if they were unhappy with anything and dealt with any concerns quickly. Staff encouraged families to raise concerns or complaints if they felt it was necessary.

The service monitored complaints and the outcomes and involved people in how complaints were resolved. Main themes included waiting lists and appointment pathways. The service had plans for addressing these concerns. For example, increased communications around the appointment booking process and ongoing work on waiting lists.

We reviewed 3 complaints including, the trust responses and actions taken. Responses were comprehensive and clearly explained the investigations. Actions included reinforcing the need for staff to escalate complex concerns, sharing learning across teams, and improving communication, particularly where delays occurred.

The service also conducted interviews with parents for patient stories and experiences. Feedback from parents was shared with staff for learning and development and used as opportunities to make improvements.

There was a strong patient-focused culture and learning from feedback to make improvements. Patient feedback was sought through the trust-wide NHS Friends and Family Test survey. The service received 1784 completed questionnaires in the survey from June 2025 to November 2025. Recommendations from the survey included themes around estates management (maintaining building and facilities), heating and temperature in patient areas, communication and food and drinks. Actions from the survey included updates to the MyChart application where patient and their families and carers could access information and feedback surveys collected on food to inform the nutrition & hydration group.

The service had a Community Engagement Council (CEC), which met regularly to support the exchange of ideas, feedback, and initiatives with community partners. There was a commitment to strengthening working with local communities and the service was keen to learn from partner case studies and shared experiences.

The service mostly made sure people could access the care, support, and treatment they needed when they needed it.

During our inspection, a significant number of medical staff told us that theatre cancellations were increasing. Medics felt this was due to a lack of registered nursing staff filling uncovered shifts due to changes in pay rates for bank staff. This was recognised as a national issue. We were unable to ascertain from the information provided by the trust if this issue was impacting the waiting lists which were high in some areas. Cancellation data provided showed that cancellations due to unavailable staff accounted for 10% of the cancellations which was high in comparison to other areas.

Staff told us that, following the cancellation of a procedure, the service manager would attend the ward or unit and explain this to the patients, families or carers. Reasons for cancellation were provided, and procedures would be rebooked, usually within 2 weeks, depending on clinical urgency.

Children and young people were not always able to access care and treatment when it was needed. Some waiting lists were long. However, children who needed urgent or emergency treatment were accommodated based on their clinical need.

The service had recently increased its interventional radiology staffing team to meet the demand and help reduce waiting lists.

The service provided evidence that they continued to make steady progress on reducing waiting lists. They remained on track against national targets to reduce long waits for treatment, fewer than 1% of patients waited over 52 weeks which was ahead of the national deadline of March 2026. The service explained that staff teams were actively working through mitigation plans and engaging closely with system partners to support improvements.

Staff explained that to reduce waiting lists, high intensity theatre (HITT) lists were used. This allowed specialised weekend surgical events which maximised the number of patients treated. Most staff felt this worked well.

The service undertook a wide variety of surgical procedures each day, including ear, nose and throat (ENT) and dental surgery. While some theatres were utilised between 9am and 5pm, the service also regularly operated extended surgical lists. In addition, some theatre sessions were rostered to operate 6 days a to maximise capacity and support patient access.

Theatre lists reviewed during the inspection demonstrated that theatres were being used for planned surgical activity and were not being utilised for alternative services, such as a high dependency unit or intensive care unit.

Reasonable adjustments were made for people with disabilities and premises were accessible for anyone to use safely. Children and young people were supported by staff skilled in more social aspects of care and in liaison work. There were learning disability champions who worked in wards and theatres. All new staff completed learning disability and autism training as part of their induction. Staff were able to describe times when they had made reasonable adjustments for children, for example, a child who was autistic and did not communicate verbally. Staff had done desensitisation work with a young person, this was a planned visit to the ward for them to experience the environments, sounds and activities. This helped the person reduce distress or anxiety. This was organised as part of the pre-operative assessment process.

The chapel and multifaith rooms were open 24 hours a day, this was a quiet space for anyone to use. Other faith leaders could be contacted as required.

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.

Children and young people and those who supported them were able to give their views of their experience and outcomes. Staff took these views into account in seeking to give all patients the best outcome. If there was discrimination or inequality recognised, this was addressed to improve care and mitigate the risk of poor outcomes. The service had protocols and policies to comply with legal equality and human rights legislation.

Staff had a good understanding of the diversity within the local and wider community. They worked closely with outside agencies to be able to provide a service to meet the diverse needs of the local community and provide equity in experience and outcomes for patients.

Bed allocation for transgender non-binary, or children and young people questioning their gender would reflect the young person’s gender identity and privacy needs. Where clinical risk assessment indicated a need for an alternative arrangement, the service would discuss the options available.

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.

Children, young people, and their families said they felt staff gave them good information about planning for their future when they left hospital. They could make informed choices and say what mattered to them. The service worked closely with other health and social care professionals, including GPs, community care teams, and social services to help them and their family plan.