City Health Campus

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• 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

This means we looked for evidence that the service met people’s needs.

At our last assessment we rated this key question Good. At this assessment the rating has 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.

We scored the service as 3. 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.

Staff made adjustments to accommodate people’s individual needs. We observed a patient with additional needs had 2 anaesthetists and a family member with them while undergoing anaesthesia and was given the first theatre slot of the day to minimise waiting time. Family members said that approaches differed depending on staff member, and some staff were more comfortable around communicating with their relative than others. It was not clear from conversations with staff if there was a link nurse for learning disabilities in the service. However, theatre staff had worked with the trust’s vulnerable adults team to optimise care for patients living with dementia, with 3 staff members as named dementia links.

Bariatric theatre beds were available in the service.

We scored the service as 3. 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 acknowledged that as they were a specialist centre, many of their patients travelled significant distances for treatment, and as such provided a ‘one stop service’ for cataract surgery pre-assessment a few days before procedures took place. We heard evidence of staff working in the community with a patient’s residential home to provide a flexible approach to their surgery.

However, some patients fed back that they found arriving for their surgery at 7:30am along with the rest of the morning cohort “a long day” and suggested that a more flexible approach such as staggering arrival times would provide a better experience.

We scored the service as 2. The evidence showed some shortfalls. The service did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Patients received letters for pre-operative and surgery appointments. One patient fed back that letters could provide more specific information about the location of appointments as they had difficulty navigating the site. Another patient had a failed appointment as they had not been informed that they were not to wear contact lenses for a period of time before the appointment. Staff agreed that information in letters was a common source of complaints and we saw that this issue was fed back into the Wayfinding Action group, a project in collaboration with Healthwatch.

Relatives we spoke with were kept informed about their loved ones’ progress in surgery.

The trust eye care liaison officers provided a wide range of information and support to users living with sight loss in person and by telephone. This included advice and practical support setting up accessibility tools and applications on digital devices, processing certificates of visual impairment, and signposting to advice on employment, benefits and to organisations teaching Braille. Leaflets in large print were available in the service, and information could be printed in patients’ preferred contrast.

We scored the service as 3. 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.

Patients we spoke with knew how they could raise concerns. We saw posters for the trust patient liaison and advice service, which included tear-off pieces of paper with their contact details.

There were 15 complaints regarding the surgical service and eye ward in the 12 months prior to the inspection. Themes included non-availability of equipment, failure in communication with patients and between clinicians, and delayed referral or treatment. Staff knew how to handle complaints and could give examples of where practice had changed because of patient feedback. For example, a staff member told us that patients had raised that they were unhappy travelling to the service and paying for parking for a short blood pressure test, and so if clinically suitable, patients could measure their blood pressure at home with their own equipment. We saw in minutes of monthly team meetings that complaints and resulting actions were discussed.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

The service was physically accessible to patients. A patient we spoke with who used a cane felt able to navigate the environment safely. We observed signage of a yellow background with black text which offered high contrast for people with certain visual impairments. We read in the latest minutes from the BMEC “Retained Estate” Regeneration and Wellbeing Working Group that there were plans to develop a digital application to assist wayfinding.

Staff planned for patients’ discharge including pre-booking a follow-up appointment for the day after surgery. However staff told us, and we saw in an incident report, that delays in the patient pathway occurred due to patients from outside prescribed postcodes not being eligible for patient transportation. For example, a patient was not able to be transported to another site for a scan. Service leads told us that they were previously able to book taxis, but this ability had been removed.

There was an emergency support team consisting of a resident doctor and 2 nurses who could provide emergency assistance and assess whether an emergency response through 999 was required.

We scored the service as 3. 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.

Staff were trained in equality, diversity, inclusion and human rights with 100% compliance of ward staff, and 95% of theatre staff. Policies were assessed in accordance with the trust Equality Impact Assessment Toolkit, the results of which were monitored centrally. However, it was not clear from conversations from staff whether there was a link nurse for learning disability.

We scored the service as 3. 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.

Staff created personalised care plans to account for patients’ individual needs. Staff could refer patients to eye care liaison officers (ECLOs) for support in helping to plan for a future with sight loss. Although they saw around 160 service users monthly across the service, they were aiming to become a mandatory part of the patient pathway for all, and hoped that working to change the mindset of clinicians to refer all service users would enable this