North East London NHS Foundation Trust

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

Responsive – this means we looked for evidence that the trust met people’s needs.

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.

People were supported to have choice and control over their own care and to make decisions about their care, treatment and wellbeing. Where, following hospital admission, people had lost confidence in self-administering their insulin, staff had supported them and their families in developing this skill.

Staff in specialist clinics had systems to follow up patients who did not attend. Deferred visits rarely happened.

The service displayed information leaflets in various languages, reflective of their local communities. Clinics had ‘welcome’ posters in various languages. Team bases had information displayed about chaperones and staff made sure patients were aware they could request a chaperone.

People experienced a person-centred approach, which promoted equity of experience. The trust listened to people who were most likely to experience inequity and aimed to develop services to address this. Patients were encouraged to feedback on services and engage in their development through local and trust wide engagement networks. People working in services reflected the diversity of the communities they worked in.

The service treated concerns and complaints seriously, investigated them and learned lessons. These were shared with the whole team and wider service. Patients, relatives and carers knew how to complain or raise concerns.

This service scored 82 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The trust 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 people we spoke with told us they felt involved in their care planning and decision making. The care plans we reviewed included patient views. Staff responded promptly to patient requests. For example, a patient felt a wound was getting worse and staff made arrangements to see them the same day.

People told us that staff focused on their individual needs. For example, where a patient was concerned about delays to hospital transport, the nurse had supported them to work through what they were worried about and plan ahead in case of this eventuality, for example, packing snacks in case they became hungry.

The trust understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People were supported to have choice and control over their own care and to make decisions about their care, treatment and wellbeing. Where, following hospital admission, people had lost confidence in self-administering their insulin, staff had supported them and their families in developing this skill.

Staff in specialist clinics had systems to follow up patients who did not attend (DNA) their appointment. Managers monitored missed appointments and ensured these were promptly followed up. DNA appointments and follow up procedures were regularly reviewed during team meetings.

Deferred visits rarely happened. Staff ensured any visits at risk of being deferred had been identified and arrangements made to make sure the patient would be seen on their due day. We saw that teams used appropriate tools to manage their day and plan their visits.

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

The service displayed information leaflets in English at all sites. Some teams had leaflets displayed for patients with other first languages including Turkish, Albanian, Portuguese, Bengali, Farsi, Polish, French, Tamil, Arabic, and Russian. Where leaflets were required in other languages, staff told us these could be obtained.

Clinics had ‘welcome’ posters in various languages. Leaflets subjects included struggling to cope with the financial effects of cancer, dental care and carer support services.

Team bases had information displayed about chaperones and staff made sure patients were aware they could request a chaperone.

The trust 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.

The service treated concerns and complaints seriously, investigated them and learned lessons. These were shared with the whole team and wider service.Patients, relatives and carers knew how to complain or raise concerns. Information about complaints was displayed in public areas at each site.

The trust had an ‘integrated patient and carer experience partnership’ group in each of the geographies where services were provided. Representatives made sure the patient voice was heard in the development of services. Representatives could also be involved in staff recruitment and a range of patient participation activities within their local area or the wider trust.

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

Staff followed standards such as the ‘alliance care of the dying person’ and ‘one chance to get it right.’ We saw that staff raised issues in relation to end of life care sensitively and allowed the patient to lead the discussion in ways they were comfortable.

Staff were concerned about the reliability of patient transport. This was provided by an external contractor, but teams had shared information locally and escalated the concerns to commissioners to follow up and address.

The diabetic clinic had responded to patient feedback by offering more flexible appointments that people could book themselves. Waiting times for people accessing diabetic clinics had improved.

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.

People experienced a person-centred approach, which promoted equity of experience. The trust listened to people who were most likely to experience inequity and aimed to develop services to address this. People working in services reflected the diversity of the communities they worked in. Staff worked hard to empower patients to make choices around their care and treatment.

Overall, staff had a clear and detailed understanding of the individual needs of their patients. Specialist teams delivered good quality care and worked collaboratively with district nursing teams to deliver joined up, holistic care.

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.

Care plans were holistic and included persons’ wishes. Peoples preferred place of death was clear for those receiving end of life care.

Staff used lessons learned from incidents to plan future care. For example, we saw staff discuss possible treatment pathways for end-of-life patients with complex presentations including extreme age, multiple pressure care issues and elevated MUST scores.

Managers supported staff to complete advance care planning (ACP). ACP supports patients to plan for their future care and support, including medical treatment, whilst they have the capacity to do so.