Fleetwood Hospital

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we did not rate this key question.

This key question has been rated good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

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

Staff completed further training to support patients with diverse needs. Staff had access to up‑to‑date clinical policies, to ensure that patient risk assessments were aligned with current guidance or agreed standards. The service audited patient care records to identify learning opportunities, or areas for improvement.

Staff described how they would support patient’s communication needs, particularly those with disabilities and with a sensory loss and how they would consider cultural needs when planning outpatient appointment.

We reviewed 10 patient records, which demonstrated that patient information was recorded clearly, accurately and contemporaneously by staff.

Staff had access to specialist nursing teams, including Admiral Nurses, and completed dementia and learning disability assessment documentation when appropriate to support people’s individual needs.

Staff supported and empowered people using the service to be involved in decisions about their own care. People who attended both nurse‑led and consultant‑led clinics told us they felt involved in decision‑making and that treatment options were discussed with them in a way they could understand.

We saw evidence of patient involvement within clinical documentation, including clinic outcome forms completed by clinic leads. These recorded follow‑up arrangements and General Practitioner (GP) correspondence, demonstrating that patients’ views and agreed care plans were reflected accurately in records and shared appropriately to support continuity of care.

Staff followed up-to-date policies to plan and deliver high quality care. All policies we looked at contained a creation and review date, and clear references to current professional guidelines and National Institute for Health and Care and Excellence (NICE) guidelines.

We looked at the pathway for patients who relied on the ambulance service to get them to and from appointments. There is good evidence that patients were transported on time to their prebooked appointments. Staff confirmed that they could easily access transport for patients home again.

There were suitable protocols available for children and other patient groups, such as those with a learning disability. Quieter waiting areas could be accessed for those who required it and drinks were available for patients.

We reviewed 10 patient records and found patient information was recorded clearly, accurately and contemporaneously by staff.

The outpatient department at Fleetwood Hospital was encouraged to be involved in changes to practice based on evidence‑based care. We saw evidence of this through governance updates shared with staff, which included information about changes in practice, learning, and service improvements.

Staff worked together as a team to benefit patients. They supported each other to provide good care and deliver a quality service, ensuring for example, they started clinics on time and planned liaison with other healthcare professionals, such as physiotherapists, to maximise the patients' time in the department.

Staff reported healthy working relations with internal and external organisations they came into regular contact with. For example, staff who held clinics at the service were always welcomed by staff who permanently worked there and nothing was too much trouble to support the delivery of patient care.

Staff took time to consider people’s individual needs, circumstances and ongoing care arrangements. Information was shared between teams and services to ensure continuity of care.

Permanent staff working within the community services on the upper floor told us they worked effectively with staff in the outpatient department located on the ground floor, particularly in the event of an emergency.

The outpatient department sister had oversight of both the upstairs and downstairs areas of the building however did not have line management responsibility for all staff or services. Staff told us that this arrangement worked well, especially when responding to incidents, and supported effective communication across the site.

We found good evidence of effective working relationships between the outpatient departments at Blackpool Victoria Hospital and Fleetwood Hospital. We saw evidence of shared learning between the two sites, including information shared through weekly updates. For example, when incidents occurred at Blackpool Victoria Hospital’s outpatient department, learning was shared with Fleetwood Hospital, and vice versa. This information was disseminated during morning handovers and shared with staff who used the building.

Information and data were shared appropriately between specialty teams and the outpatient department. We saw evidence of this collaborative approach when staff were involved in updating the chaperone policy. The policy had recently been amended to reflect the unique layout of the building at Fleetwood Hospital, demonstrating that services worked together to ensure policies were practical and responsive to local needs.

Health promotion information was displayed throughout the outpatient department at Fleetwood Hospital. This included posters and information relating to smoking cessation, domestic abuse, sepsis, and other signs and symptoms of illness. These materials were accompanied by details of who to contact within the trust and externally, for further information and support.

Notice boards containing relevant information relating to the clinics were displayed. For example, one board focused on heart conditions and how the condition could affect a person’s ability to maintain an active lifestyle. Types of suitable exercises were displayed, to help improve symptoms and their overall lifestyle.

Staff provided health promotion advice and information tailored to individual needs and signposted people to other internal services, external organisations, and charities when appropriate.

This approach reflected the Trust’s commitment to the ‘Making Every Contact Count’ initiative, which aimed to use every interaction between healthcare professionals and patients as an opportunity to support improved health and wellbeing. The trust provided specific training to support this approach, which was available to all staff.

Staff monitored the effectiveness of care and treatment through audit and benchmarking to compare with other similar services. The service used the findings to make improvements and achieved good outcomes related to getting patients to their treatment on time.

Improvements had been made because of Collaborative Organisational Accreditation System for Teams (COAST) audits, which were carried out regularly by senior nurses who did not work directly within the service to maintain independent review. Audit performance was at 92% which was above the trusts baseline score of 90%

The service had systems to monitor and improve outcomes. Managers reviewed and ensured the service met all their key performance indicators (KPIs) and targets. Wherever possible managers sought their commissioner’s performance data to monitor and improve patient outcomes.

The provider considered health inequalities and took steps to ensure outcomes across people with protected characteristics were in line with the wider community.

The service monitored and reacted to avoidable incidents of harm. Learning from investigations was shared with the aim of making improvements, for example, upgrades to the patient record system.

Staff completed Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) training as part of their mandatory training completion. Staff aimed to identify any potential capacity concerns prior to a patient attending the outpatient department.

Staff took all practicable steps to give people the appropriate information, support and time to make an informed decision in a way they could understand, including use of accessible communication formats. Staff followed national guidance to gain patients’ consent. Staff knew how to support patients who lacked capacity to make their own decisions or were experiencing mental ill health.

Staff understood how and when to assess whether a patient had the capacity to make decisions about their care. Staff followed the services policies related to consent, mental capacity, deprivation of liberty and restrictive practice, as relevant.

Patients reported being involved in decision making about their care. For example, we observed staff seeking verbal consent before completing a blood test or ECG.

Where specific requests had been made by patients, for a same sex health care professional this was discussed and provided whenever possible. Chaperones were provided if requested.

Interpreters were used to support patients to give informed consent, including for British Sign Language (BSL) and face to face interpreting when necessary.

Staff sought permission before sharing patient information with family or friends. Appointment letters included contact details for next of kin and care providers, enabling staff to gather relevant information before attendance where necessary. Staff told us that residents from care or nursing homes who required patient transport were routinely supported to attend outpatient appointments at Blackpool Victoria Hospital, where appropriate arrangements could be made to meet their needs.