Huddersfield Royal Infirmary

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 remained good. This meant 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 and communities were understood, and they were actively involved in planning care which met these needs. We also looked for evidence people could access care in ways which met their personal circumstances and protected equality characteristics.

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.

Some OPD environments and services were designed to meet the needs of patients living with dementia. Staff took a structured approach to identifying and supporting people with dementia, mental health conditions, or learning disabilities. They completed bespoke proforma from the point of referral.

Staff flagged specific needs early where possible during the referral process to ensure appropriate planning and support. We heard about a patient with a learning disability who did not like crowded spaces. Staff held a best interest meeting with the family for informed decision making. This helped them escort the patient from their car straight to the clinic room.

Hospital and department leads were committed to inclusive care. They had policies for patients who needed additional support to access information and services.

Staff identified and documented any communication and physical support needs patients had. They used the electronic patient records (EPRs) database to flag any alerts or special requirements patients had at the booking stage. Breast clinic outpatients completed a confidential questionnaire. This ensured their discussions with nurses were personalised and considered their needs.

Managers ensured staff, patients, loved ones and carers could get help from interpreters when needed. Outpatients could translate self check-in screens and relevant appointment information into 28 different languages. We also saw the Royal College of Anaesthetists (RCoA) patient information resources were available in 23 languages.

Staff could provide interpreter services, large print or braille materials. They also supported accessibility for patients through a hearing loop system. This was available at reception to support patients with hearing aids. Signage was in place, and staff were encouraged to proactively offer this support.

We heard about some encouraging service initiatives and development work to better meet the needs of people with a learning disability (LD).

The trust had a lead learning disability nurse consultant who led improvements in provision and supported OPD staff in implementing reasonable adjustments for this patient cohort. They held monthly lunch and learn sessions for staff to attend. They also visited clinics to raise staff awareness, share advice and examples. Several clinics across the service had appointed THINK LD champions to provide support to patients. They wore a corresponding visible badge, were well known and available to colleagues.

Staff could use several patient passports the trust had co-designed with service users and carers to support the delivery of person-centred care. This included a passport available for children and young people (CYP) with chronic, long-term and complex conditions. It provided clear, accessible information which supported personalised, family-centred care. This helped ensure individual needs, preferences, communication requirements and reasonable adjustments were recognised and consistently met across OPD services.

Staff could also access autism passports for CYP, as well as VIP passports for young people and adults with learning disabilities to promote inclusive, person-centred care. Staff could help people or their carers complete these. They uploaded completed passports to the patient’s electronic record.

Passports ensured all OPD staff could access key information in real time for people with specific needs. This supported continuity, safety and a consistent approach to care delivery across the pathway.

Staff met the information and communication needs of patients with a disability or sensory loss. OPDs had specific pathways in place for people with disabilities, dementia, mental health conditions, and sensory impairments. During our assessment 98.4% of divisional staff had completed the Oliver McGowan statutory training online e-learning module for learning disability and autism. This met trust’s target compliance of 95%. This divisional data could not be broken down to location specific information. This meant staff had the basic knowledge and skills to care for this patient group.

However, clinical staff did not meet the trust’s target compliance of 95% for tier 2. Latest compliance for the full day face to face seminar was 42.7%. Some OPD clinic teams, including the Child Development Service and ENT, demonstrated very low compliance with this module. The manager confirmed they hoped to achieve 50% by the end of March 2026.

The directorate was on target to achieve Tier 2 compliance over the next 2 years aligned to the organisational trajectory. We heard about some encouraging service initiatives and development work to better meet the needs of people with autism or a learning disability (LD).

OPD staff also received bespoke training sessions around LD and autism. This formed part of their induction and preceptorship programs. Staff also covered this topic during learning disability week and with the trust-wide network of learning disability champions.

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.

Some pre-planned, elective and drop-in clinics could not increase capacity to meet extra demand. The service’s clinics did not always run on time and could keep patients waiting. During our assessment, some OPD clinic waiting times stretched to 1 to 2 hours such as the drop-in phlebotomy or blood service, and eye clinics. Administrative staff told us blood clinic waits could extend to three hours. This clinic had plans in place to reduce waiting times such as reinstating a ticket system.

We observed some consultant clinics running late and behind schedule. We heard surgical outpatient vascular clinics often finished late. A few general outpatient patients we spoke to had waited two hours for their appointment. Some only received treatment after escalating to staff; for example, a macular patient had to remind staff before they administered their injection. Drop-in blood clinic arrivals had a one to two hour wait.

Patients in most clinics were prompted to remind receptionists if they had been waiting over 15-30 minutes. However, most clinics running late did not display waiting times. Consultants told us they could sometimes be delayed by needing extra time with a more complex patient.

The OPD followed a communication and escalation process for clinic delays. This entailed four stages staff should follow for between 15 and 90 minute delays; identify, inform, update and reassure. However, we saw staff did not always follow this process in practice.

Some consultants needed extra time with their patients, as their specialty area was complex and more unpredictable. Reception staff would ring later patients on the list to adjust times or reschedule if needed.

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

Staff talked with patients, families and carers in a way they could understand. They used communication aids where necessary. Displays showed OPD staff’s different coloured uniforms for easier recognition.

For example, orthopaedic OPD staff gave their outpatients leaflets with relevant aftercare instructions from their local anaesthetic steroid injections. Patients we asked in the eye clinic said they were always given useful information and were encouraged to ask questions.

Other patient information leaflets stored online could be tailored or personalised to meet people’s needs.

Staff communicated all outpatient appointments using a digital-first approach. Patients could choose appointment letters in their preferred format. The trust had guidance on how patients could change their preferences as well as how to access and read digital letters. Their patient portal and the NHS App provided clear ways for patients to access appointment information. Step‑by‑step user guides were available to help patients navigate the portal. This ensured timely and accessible delivery of information.

The trust had information to support people with managing their care and communication needs online, as well as links into GP practices. Appointment letters advised patients of their outpatient clinic location. Staff, volunteers and clear signage supported people to find their way around. All outpatient signage was designed to be easy to follow, using bold text and colour‑coding to support clear navigation. For example, in ophthalmology areas eye clinic signs and information leaflets were printed with black text on a yellow background. This was easier to read and supported patients with visual impairment.

Staff consistently recorded outpatient’s communication needs within their Electronic Patient Record (EPR). Once recorded, these needs, such as large print materials, or hearing loop access, were automatically visible to all colleagues across departments. This meant teams could prepare appropriately before appointments and provide patients with information in their chosen accessible format. Communication methods and tools were included as part of the trust’s VIP hospital passport for people with specific needs.

Clinic waiting areas across the service provided relevant information for outpatients to take away. For example, ophthalmology clinics had Parkinson’s UK charity and Macmillan cancer support leaflets.

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.

12 outpatients and their loved ones we spoke with were very positive, satisfied and complimentary about the service.

Patients gave positive feedback about the service. They could recognise individual staff members for delivering compassionate care. Leads told us feedback gained was valuable. We saw examples of recent thank you cards and positive online reviews.

OPD staff collected patient feedback through digital surveys and the NHS Friends and Family Test (FFT) results. We saw a summary of the department’s survey feedback for the last 12 months.

Results were fairly high, with multiple months achieving over 85% satisfaction. The women’s health unit’s latest FFT results from January 2026 showed 87% of patients would recommend the service to family and friends. Gynaecology outpatients’ latest FFT results recommendation score from January 2026 was 87%. Only 6% of respondents would not recommend the service.

Patient’s qualitative comments offered valuable insight into their positive experience. FFT feedback showed outpatients felt respected, listened to, and treated with kindness. Feedback consistently highlighted compassionate interactions and care delivered with dignity.

We saw specific examples of changes as a result of patient feedback. This divisional data was not broken down to location specific information. For example, some patients found the department’s webpages difficult to navigate. They did not always contain the information they needed. As a result, IT support reviewed pages in collaboration with expert panel members. This ensured information was accessible, consistent, and easier to understand for people with different communication needs.

In children’s outpatients, some people highlighted the lack of sensory equipment. In response staff purchased a sensory box available for use both in the waiting and clinic rooms. Other people highlighted the lack of a disabled toilet for children attending the clinic. Staff would instead escort children to the toilets on the children’s ward. Signage was installed to make these arrangements clear to patients and their carers.

Patients, relatives and carers told us they knew how to complain or raise concerns. The service clearly displayed information on how to do this in patient areas.

The department could evidence learning from recent complaints. We reviewed 3 of the department’s recent complaints and their responses across both sites. One concerned the Acre Mills drop-in blood clinic in September 2025 for an outpatient with hearing loss. Staff did not make any reasonable adjustments when calling her name and stood out of sight. This meant the patient waited for over 90 minutes. Leads would review the feasibility of name calling screens as part of their learning from this complaint.

The Outpatient management team were responsible for the oversight and management of complaint responses. They aimed to proactively prevent complaints through visible and responsive leadership. All formal OPD complaints were received through the complaints team. They were formally acknowledged within three days, aligned to NHS England complaint standards and trust local policy.

Patients and their families could give service feedback. Staff supported them to do this. The service had a Ray of Sunshine campaign which aimed to brighten the care and experience of babies, children and young people and their families in hospital and the community. This helped staff meet their individual needs, reduce avoidable distress and trauma.

The OPD directorate was included in the trust’s patient experience and involvement group’s (PEIG) annual work plan. Key areas of work during 2025/26 included orthopaedic outpatient insight, hand splinting service relocation and specific ‘waiting well’ insight activities aligned to NHS England’s reforming elective care plan.

Patient experience leads supported OPD teams to undertake their own insight‑gathering activities aimed at improving patient experience. They encouraged greater use of patient experience data through quality improvement programmes. Staff used an approach developed specifically for the Outpatient User Group Programme (OPUG). For example, by using this approach the trust had initiated a major overhaul of outpatient bookings. It addressed fragmented processes, inconsistent practices, and the significant backlog of new referrals and overdue follow‑up appointments. This created a safer, efficient, and more consistent system.

OPD had examples of service user (OPUG) and patient participation groups. We heard these were well attended and aimed to support ongoing service improvement. The colorectal service was running a project with patients, carers and staff to design the best possible care experience.

However, some patients told us that appointment letters often contained only high‑level information and did not consistently include sufficient detail about the clinical team or the purpose of the appointment. As a result, some patients reported needing to contact the hospital for clarification. In addition, appointment letters did not routinely include maps or clear directions, referring only to a building or hospital site.

After our onsite assessment, trust leads took prompt action to address appointment letter issues. The trust had reviewed its appointment letters in line with its elective transformation programme over the previous few months. Patient experience groups, operational and clinical colleagues were reviewing draft designs of a new letter format. These designs included easy-read formats, considered readability tools and local population reading ages. This would inform the production of a co-designed letter to ensure information was clear and accessible.

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

Clinics were accessible and adaptable to meet patient needs. We reviewed the OPD’s latest referral to treatment times, underlying issues and actions. The department met the trust’s RTT target of 73%. Their RTT performance showed sustained improvement throughout the year. OPD remained on track to meet the improvement trajectory submitted to NHS England.

Performance improved steadily each month because the service planned appointments more effectively and took action to reduce long waiting times. This meant patients were able to access consultations and appointments more easily.

RTT performance was monitored each month. Staff had treatment plans in place for all patients breaching the 52-week waiting time. Across all specialties (except ENT) 2025/26 plans included achieving 18-week compliance for all first to be seen appointments.

Some clinics had reduced RTT times and their waiting lists. For example, ENT had improved significantly by 15 % from August 2025 to January 2026. However, 4 other specialties were still below the January 2026 target. OPD had seen higher appointment slot issues in ENT and Gynaecology. In response leads planned ongoing work to reduce appointment slot issue wait times down to 14 weeks by March 2026.

The OPD managers and head of planned access had a project underway to centralise all their division’s appointment bookings through a hub and spoke model to improve governance and oversight. This work sought to capture patient’s person-centred needs and requirements using business intelligence tools.

OPD had safe discharge processes in place. All clinical staff decisions, including completion of treatment, discharge, or transfer back to GP, were communicated clearly in writing and stored on the electronic patient record (EPR). They kept GPs or referrers informed at each stage of the outpatient’s journey. Discharge only occurred after clinical review. This ensured decisions were safe and in line with the patient’s best interests.

Outpatients were never discharged solely due to capacity issues or administrative factors. Administrative staff had systems for contacting absent patients. For example, they made multiple attempts and liaised with GPs. OPD staff referred to the trust’s VIP passports to confirm patients needs when leaving hospital.

The OPD complied with the trust’s Accessible Information Standard (AIS) and Equality Act 2010. The trust had strengthened its AIS delivery through an updated accessible information policy. This helped to ensure every patient attending outpatient services received meaningful and understandable information tailored to their personal communication preferences. Processes were in place to support compliance. Staff ensured equitable access for patients with language needs. They identified any interpreter needs patients had during referral, registration, or through the patient health questionnaire. Staff recorded these in the patient record.

A reader’s panel reviewed all patient leaflets available in OPDs to ensure they met accessibility requirements. Digital accessibility was strengthened through the patient portal. This offered patients and carers access to outpatient letters and communication preferences. The portal also linked to the minimum provider standards for patient experience in the NHS England’s Elective Care reform guidance.

The department had ongoing work to make the outpatient environment easier to navigate and more responsive to different communication needs. This included exploring the Royal National Institute of Blind people’s (RNIB) wayfinding lens technology in ophthalmology. This is a smartphone app designed specifically to help blind and partially sighted people interact with the world around them. Leads were also enhancing communication boards for people with hearing or visual impairments.

OPD leads supported wider access to treatment within the local healthcare community and in collaboration with other acute trusts, independent providers and their regional NHS ambulance service. They offered some community-based services such as the Rainbow centre for paediatric outpatients. During our assessment ophthalmic staff were organising a low vision roadshow. This was an annual event for patients with related needs.

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.

The provider’s waiting list and access policy ensured outpatients had transparent and equitable access to NHS treatment. Leads proactively oversaw the elective waiting list. They applied protocols for did not attend (DNA) management, active monitoring, and inter-provider transfers in accordance with organisational policy.

OPD leads tracked how often patients did not attend (DNA) using the trust’s integrated performance report. DNA figures were reviewed every quarter, with a focus on fairness and equity across the trust. Staff used the inequalities flag on the EPR system in maternity, paediatrics, outpatients and elective services to help make sure all patient groups were treated equally and no one was disadvantaged.

The Learning Disabilities Group undertook annual audits of patients not brought to their appointment. This divisional data was not broken down to location specific information. We reviewed the latest audit from September 2025. This covered 154 episodes across all specialities. Improvements were noted since the previous year’s audit with no actions needed.

Leads reported any issues identified into the Health Equity Group and the Safeguarding Committee. The Nurse Consultant for Learning Disabilities rectified issues identified promptly from the audit and gathered intelligence to address themes. This included mortality data and learning reviews to help inform the national learning disability mortality review (LeDeR).

The Outpatient User Group tracked DNA rates across 25 speciality areas for new and follow up appointments. Previous audit findings of DNA rates informed the OPUG’s approach. The project’s key priority was to reduce DNA rates. The group led on trust-wide initiatives to reduce DNA rates and improve utilisation.

We reviewed a urology speciality tracker from April to December 2025. This divisional data was not broken down to location specific information. During this period, DNA rates stayed within the 7% target, although the overall urology DNA rate increased slightly by 0.5%. In September 2025, DNA rates for patients with learning disabilities, those in the most deprived groups (IMD 1 and 2), and people from minority ethnic backgrounds were slightly higher than the trust average of 6%.

DNA rates were shown on clinic dashboards and were mostly between 5–6%. The highest rate was in ophthalmology at 8%, slightly above the trust target.

Managers monitored and took action to minimise missed appointments. They ensured patients who did not attend appointments were contacted. Staff followed the hospital’s DNA process for patients who DNA their outpatient appointment.

The gynaecology and breast clinic service collected equality monitoring information from patients and carers such as age, gender, ethnicity, postcode and if they had a disability. This helped them understand the needs and experiences of individuals.

OPD staff and services followed the trust’s health equity strategy.

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 supported patients to make informed decisions about their care. We heard about examples of person-centred advanced care planning in surgical outpatients. The planning facilitator saw a frail patient outside their usual OPD setting to discuss their care and complete a ReSPECT plan.

The division had established a new paediatric gynaecology service. This was in response to patient feedback and an incidents review. Previously there was no dedicated service for people under (the age of) 14. This ensured young patients received appropriate, safe, and age‑sensitive care in an appropriate environment.

The review highlighted the need for a dedicated and structured pathway for patients under this age, aligned with safeguarding and paediatric governance standards. The new clinic would run alongside paediatric outpatients. This ensured access to specialist facilities, appropriately trained staff, and safeguarding support. A gynaecology consultant led these clinics working in collaboration with the paediatric team. They provided joint care and expertise as required.