The Princess Royal Hospital

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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 people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics.

This is the first assessment for this service since the combined inspection with outpatient’s department in 2014. This key question has been rated as good.

This meant people’s needs were met through good organisation and delivery.

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.

The service had systems to support patients with complex healthcare needs, sensory loss, mental health, learning disabilities and dementia. Staff were able to access support through trust wide support from other departments. Staff were trained in equality, diversity, inclusion and human rights and 96% of staff had received up to date training. There were 3 tiers of dementia awareness training, and staff were compliant at 99%, 87% and 82%, respectively. The e-learning element of the training around learning disability and autism was also mandatory for all staff, and 86% of staff were compliant with the training at the time of inspection. However, only 12% and 2% of staff had received Tier 1 and 2 training which were face to face sessions. Leaders explained that double appointments could be given to patients with additional needs. Ambient lighting could be used to make the environment more inviting for autistic patients and children

Managers made sure staff, and patients, families and carers could get help from interpreters or signers when needed.

Both the internal and external mobile scanners were accessible by wheelchair and step-free access was provided. The reception area and the waiting area had seating area and toilet facilities for patients and visitors. However, the service did not have a separate area for children and young people.

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 planned and provided care in ways which met the needs of local people, and the communities served. They worked with others in the wider system and local organisations to plan care where relevant.

The service had systems to help care for patients in need of additional support or specialist intervention. Facilities and premises were appropriate for the services being delivered. The environment was appropriate, and patient centred. It was clearly signposted and easy to find.

Staff made sure patients living with mental health problems, learning disabilities and dementia, received the necessary care to meet all their needs. Staff identified if a patient required additional support to meet their needs. Staff recorded this on the service’s patient management system. This meant all staff were aware of any additional needs to support their patients prior to attending the department.

Managers ensured that patients who did not attend appointments were contacted to make alternative arrangements.

The service operated scheduled appointments across several modalities, with extended opening hours of up to 8pm for routine elective activity. Out-of-hours arrangements were also in place to support patients requiring urgent assessment or intervention, including those presenting via the emergency department or receiving care on inpatient wards.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

A range of information was available to patients, including leaflets on various surgical procedures, investigations and advice for maximising their health. Information was also available on the services website. Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on.

Staff made notifications to external bodies as needed. Information governance systems included confidentiality of patient records.

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.

The service and staff made it easy for patients to share feedback and ideas or raise complaints about their care, treatment and support. Patients were involved in decisions about their care and were well informed about treatment plans. The hospital displayed the complaints process on their website and within the department for patients to access.

Leaders told us patients knew how to give feedback about their experiences of care and support, including how to raise any concerns or issues and could do so in a range of accessible ways. People, their family, and carers could feel confident that if they complained, they would be taken seriously and treated compassionately.

Complaints and concerns were investigated thoroughly; we reviewed examples of formal complaints and found these had been fully investigated and responded to, although not always within the timeframes set out in the local policy. Staff understood the complaints policy and process and were able to manage complaints appropriately. Patients were informed of escalation routes, including referral to a third-party organisation or the Parliamentary Ombudsman, and this information was readily available. Where improvements were identified, patients were given opportunities to be involved in shaping solutions and monitoring impact, and staff protected those raising concerns from discrimination or harassment.

Learning from complaints and concerns was seen as an opportunity for improvement and leaders could give examples of how they incorporated learning into daily practice, leaders identified themes and trends from investigating complaints and were able to demonstrate what was done to address them. During 2024/25, the Trust received 931 complaints, representing an increase in line with higher activity levels, with complaints equating to just over one in every 1,000 patients (1.03), higher than in previous years. Of the 955 complaints closed within the year, 26% were upheld, 64% partially upheld, and 10% not upheld, indicating that a significant proportion of complaints identified aspects of care requiring improvement.

During 2024/25, 1,386 compliments were recorded, indicating an improving trend; however, the trust recognised this underrepresents the true volume of positive feedback received and planned to increase awareness and recording of compliments to support more comprehensive capture.

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.

At the time of inspection, patients did not have 24 hour access to magnetic resonance imaging (MRI). This meant that if a patient presented with suspected cauda equina syndrome, a neurological emergency where nerve roots at the lower end of the spinal cord are severely compressed, out of hours, they may not receive an MRI within 4 hours of request. This is not in line with guidance from Getting it Right First Time. However, the service was in the process of moving to an overnight service, with a standard operating procedure written by staff.

The service staff managed the department usage and occupancy for patient flow well. The service had developed a “Radiology Roadmap” to improve oversight and prioritisation of service developments, addressing previously fragmented and informal processes. Plans included the introduction of a centralised system and formal request process to ensure all proposals were visible and trackable, with prioritisation based on clear evidence such as alignment with NICE guidance, Trust objectives, patient impact, and service delivery considerations. This aimed to support transparent decision-making, realistic timescales, and consistent management of service changes, although the final format was still in development.

Managers worked to keep the number of cancellations to a minimum. When patients had their appointments cancelled at the last minute, managers made sure they were rearranged as soon as possible and within guidance.

Managers and staff worked to make sure patients did not stay longer than they needed to.

Patients we spoke with during the inspection did not raise any concerns about the length of time they were kept waiting for their appointment. During our observation and speaking with patients, we did not see any delays or longs waits.

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 within the service and the wider organisation promoted a culture in which the patients using the service felt empowered to give their views.

The provider demonstrated a commitment to equality and inclusion by undertaking equality impact assessments of policies and procedures to ensure they did not disadvantage vulnerable patient or those with protected characteristics, and maintained a high level of compliance with equality, diversity, inclusion and human rights training, with 96% of staff having completed this. The service monitored patient access and outcomes to identify potential health inequalities. This information was used to inform service planning and delivery, for example certain cancers that were most common in the area. There were systems and processes for gathering feedback which enabled collection of information about equity of patient's experiences and outcomes, which we have included above in the report.

We scored the service as 3. The evidence showed a good standard. People were supported by planning for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Patients were provided with information about how they would receive results and from whom and any related follow up appointments. Patients were supported to make informed choices about their care and plan their future care, with the support and involvement of their family or carer if they wished.

Staff promoted healthy lifestyles as part of discharge and recovery planning following procedures. During observations within the ultrasound department, patients were provided with clear and appropriate instructions to support their recovery. Staff consistently reinforced key information and tailored advice in line with current best practice, ensuring patients were informed and supported following their care.