George Eliot NHS 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

We reviewed the person-centred care, care provision integration, and continuity, care provision, integration, and continuity, providing Information, listening to and involving people, equity in access and planning for the future as part of the responsive key question. We found responsive remained good. The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Planning for service delivery was made in conjunction with a number of other external providers, commissioners and local authorities to meet the needs of local people. There was a multi-faith chaplaincy service available on site. An on-call service was available 24 hours a day, seven days a week. The chaplaincy team provided pastoral, spiritual, and religious care to patients, visitors, and staff. There was a room available for relatives who were with patients that were in a critical condition.

Leaders worked closely with commissioners and other external providers to increase the provision of critical care facilities to meet the needs of the local population. Senior managers recognised that the facilities needed improvement to meet the needs of the local people. There were plans in place for a refurbishment of the department. Domestic staff served meals to patients who were able to eat.

The service moved patients only when there was a clear medical reason or in their best interest. All documentation was paper based. We found patient records to be detailed and fit for purpose. They included multidisciplinary input and evidence of personalised care. We looked at 4 medical records and found daily documentation from nursing and medical staff about ward rounds, results, patients’ progress and family discussions. All records included details of allergies, daily treatment plan and evidence of daily consultant reviews. Paper records were stored safely in trolleys at patients’ bed spaces.

The critical care services were responsive to the needs of patients and their relatives. Patients were admitted to the unit within standard times and appropriately discharged to the wards with support from the critical care team. Support for patients with physical and learning disabilities was available if needed. The unit would transfer patients to a neighbouring trust if they required critical care and there were no available beds.

Staff told us they understood and respected patients’ personal, cultural, social and religious needs. Services were generally planned and delivered in a way that took the needs of different patients into account. Physiotherapists and senior therapy assistants provided rehabilitation to patients who required a higher level of monitoring and medical care of all clinical specialities on the critical care unit. There was a recovery area within theatres, which had equipment to safely monitor and care for critically ill patients; however, this was intended for short term and not for prolonged patient support. It was mostly used for supporting patients whilst a bed was made available for them in the main intensive therapy unit. There were no incident reports relating to patients remaining in recovery inappropriately or for prolonged periods.

There were processes in place to ensure care provision took into account the diverse health and social care needs of the local population. All care was provided in line with the guidelines for the provision of intensive care services and took into account the needs and preferences of different people. Multidisciplinary teams worked together to ensure treatment was co-ordinated and joined up.

A relative told us they felt listened to and felt staff provided great care. They had been given time to ask nurses and doctors questions. Translation services were available for people whose first language was not English. Staff knew how to access the service but told us they did not need to use it regularly.

We observed on-going care information was shared appropriately at handovers during our assessment. Staff could contact the NHS interpretation service by phone, or request interpreters to visit the unit. Managers strongly encouraged the use of professional interpreters as opposed to dependence on family members or acquaintances for translation purposes.

The service had policies and processes in place to ensure the information which patients received met their needs and where adjustments were required, these were made. We saw information during our onsite assessment which confirmed staff implemented these policies and processes where patients needs identified it was required (for example patients requiring translation and interpretation services, information provided to patients which met the Accessible Information Standard. In addition to this, there were processes in place to ensure all patient information was kept in a way which complied with data protection and legal requirements.

The hospital and staff recognised the importance of the views of patients and the public. Using surveys and questionnaires to gather information to enable service improvement. There were leaflets available on the unit to advise patients, visitors and family on how to make complaints. A relative told us they knew how to make a complaint if they wished to.

The service had not received any complaints in the last 6 months prior to our assessment. Staff were aware of the policy for managing concerns and complaints and knew how to access it. Managers told us that staff were encouraged to try to resolve complaints on the ward as they occurred. These complaints were still passed onto the Patient Advice and Liaison Service. Complaints were recorded on the electronic incident reporting system and reviewed in incident meetings. Information on patient experience was reported alongside other performance data. This information was used to make informed decisions about the service. All staff we spoke with were focused on and committed to providing a high standard of safe care and were proud of the services that they provided.

There were policies and processes in place to support patients who wanted to raise concerns and complaints about their care and treatment. The policy in place was comprehensive and in date until January 2025. During the onsite assessment, evidence was seen of posters and leaflets which informed patients on how they could raise their concerns. There was also information available on how patients could provide their feedback outside of formal complaints (for example the Friends and Family Test). Processes were in place where complaints were reviewed themes identified and lessons from the complaints identified and shared with others. The report for the Quality and Safety Governance Report evidenced where complaints and learning was identified. We requested information on the recent complaints received, however the service informed us there were no complaints received recently.

Staff told us they worked to make sure patients did not stay longer than they needed to. People could access the service when they needed it. Waiting times from treatment were in line with guidance and arrangements to admit, treat and discharge patients, were in line with good practice. Managers monitored waiting times and made sure patients and their families could access services when needed and received treatment within agreed timeframes and national targets. Data provided by the trust following our assessment showed there had been 44 (10%) delayed admissions between 1 to 4 hours and 45 (10.2%) delayed admissions over 4 hours. This was much lower than similar units and the national. The reasons for delay in admission was due to no ward beds available to move patients. Staff reported the situation had improved overtime and they prioritised admissions of high-risk critically ill patients into the unit.

There were process and policies in place to ensure that people were able to access care and treatment when they needed it and in a way that promoted equality. The service maintained a multi activity report which recorded the number of admissions each month. Between March 2023 and February 2024 there were 37 admissions on average each month. At the time of the inspection, the service were full. Information provided at the time indicated the service usually had minimal availability and at times had to use the theatre recovery for additional capacity. The multiactivity report also recorded the number of readmissions into the service. Between March 2023 and February 2024 there were 20 readmissions of which 6 of these were within the first 48 hours after discharge. The service monitored their discharges and the delays in transferring the patients out of the service. The standard expected time for a patient to be transferred from the service is 4 hours. Between March 2023 and February 2024 there were 206 delayed discharges from the service. The majority of delayed discharges (144) were recorded between 4 hours and 7 hours 59 minutes. During this time, there was 1 delayed discharge recorded over 72 hours.

The critical care outreach team, physiotherapist, and clinicians ran follow up clinics. A band 7 critical care outreach nurse had protected time for follow up clinics and linked with neighbouring hospitals via team meetings. All patients who had been in-patients for 72 hours were offered a follow up appointment.

The processes and policies in place within the service ensured patients were treated in line with requirements under legal and human rights. The trust met the needs of patients where reasonable adjustments were required. Policies and processes in place had an equality impact assessment completed on them to ensure they met the needs of people. The processes in place ensured patients were not discriminated against and where unable to speak up for themselves ensures care and treatment was equitable for all.

Staff had access to relevant information to assist them to provide effective care to patients admitted to the unit. There were ward clerks who coordinated the provision and requests for medical records. Staff said they had good access to patient related information and records whenever required.

The critical care outreach team, physiotherapist, and clinicians ran follow up clinics. A band 7 critical care outreach nurse had protected time for follow up clinics and linked with neighbouring hospitals via team meetings. All patients who had been in-patients for 72 hours were offered a follow up appointment.

The processes and policies in place within the service ensured patients were treated in line with requirements under legal and human rights. The trust met the needs of patients where reasonable adjustments were required. Policies and processes in place had an equality impact assessment completed on them to ensure they met the needs of people. The processes in place ensured patients were not discriminated against and where unable to speak up for themselves ensures care and treatment was equitable for all.