Peterborough City 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

There was not always continuity in people’s care and treatment because services were not always flexible and joined-up. People’s care and treatment was not always delivered in a way that met their needs as services were not always coordinated and responsive. However, people received care and treatment from services that understood the diverse health and social care needs of their local communities.

People could mostly access care, treatment, and support when they needed it, including out of hours and in an emergency. Physical premises and equipment were accessible.

People did not experience discrimination and staff worked hard to provide equity in access to care and treatment. They made reasonable adjustments where required and listened to people’s concerns to improve the service.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Person-centred Care during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Some patients we spoke with did not always feel their care and treatment was delivered in a way that met their needs. For example, patients cared for in corridor beds told us their needs were not always being met by being in these beds, and that their care could be improved.

Medical staff told us that people’s care and treatment was, at times, disjointed. Teams were felt to work in silo and that the system was not flexible enough to ensure it was as coordinated and responsive as it could be. For example, a lack of therapists based on wards impacted on the communication and continuity for patients, as well as delays in internal discharge processes. Staff reported delays in dispensing of discharge medicines and arranging inpatient tests, which impacted on patient flow through the hospital and delayed discharges.

Staff told us there were problems with the flow of patients through the hospital, particularly with some specialty teams, and that there was a lack of adherence to internal professional standards. They said this was one reason why beds in short stay units were not available. Some areas had strict admission criteria to reduce the risk of patients not being able to be transferred out when the unit closed. However, staff in these units told us they often finished late because patients were not able to be discharged or transferred.

Staff told us that some patients were not able to receive dialysis close to their homes due to a lack of capacity. This meant patients were travelling over 2 hours to receive treatment. Staff told us they ringfenced 4 slots in order to support flow by offering dialysis to patients that were not able to access care in their local area. At the time of our assessment, we were told there were 3 patients that were being treated further away from their homes due to local outpatient availability. The service was looking to increase their staffing to offer a Sunday service to support the increased demand.

We saw examples where different groups of staff supported patients to return to bed or to reduce their distress when nursing staff were not available. For example, physiotherapists putting patients back to bed, and managing a patient who was confused, behaving aggressively who wanted hot drink.

The service considered the needs and preferences of different people. For example, staff could access interpreters in advance of appointments to support patients who had language barriers in order to ensure that care was coordinated. Staff could also support patients that spoke their native language. The service sought feedback from service users from a variety of sources such as a comments book, surveys and QR codes that could be scanned to allow for feedback. Staff felt supported to make suggestions on improvements based on feedback given.



There were delays to flow through the hospital, which were mainly caused by social care and medication delays. Other causes included delays in echocardiogram referrals, and occasional delays with portering and phlebotomy services.

There were also delays in discharges. Recent bed occupancy at Peterborough City Hospital (PCH) had been higher than the national average. Since late-March, general and acute bed occupancy has been mostly 97-99% at PCH when escalation beds were included, compared to 92-94% nationally, but over 100% for PCHs regular bed base, compared to approximately 95-97% nationally.

Capacity, such as availability of residential/nursing home or rehabilitation, and availability of resources was consistently the main contributor leading to patients remaining in hospital when they no longer met the criteria to reside.

Discharge notifications were either not submitted until medically fit for discharge or submitted early but then rejected. Discharges were not always pre-empted the day before planned discharge (TTOs, discharge letter). Patients deemed medically fit were kept in hospital until test results were at a level acceptable by a clinician.



The service had a patient discharge lounge for use by patients waiting for transport or medicines before going home. Staff told us that the lounge was usually well used in the afternoon, but was quite often quiet in the mornings.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Listening to and involving people during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People could generally access care, treatment, and support when they needed it, including out of hours and in an emergency. Most patients told us they were regularly updated automatically by staff on their care and treatment. They, along with their families, were able to discuss possible treatment.



People did not experience discrimination or inequality. Most people with additional needs did not feel they were disadvantaged. The service made reasonable adjustments for people with disabilities, those with communication difficulties or cognitive impairment. However, one patient reported being hard of hearing and that she felt she did not fully understand the medical plan.

People were listened to when they wanted to share their experience.

Staff worked hard to remove any barriers to access for patients. There was a strong culture to prevent discrimination and inequalities. The service worked closely with external organisations to identify barriers to patient experience and discuss improvements. Staff listened to people who had concerns or complaints and sought ways to improve the service.



However, patients did not always receive care, treatment and support in a timely manner. Staff told us that there was no pathway for acute physicians on the short stay medical wards to refer to speciality teams, as well as delays in speciality reviews for patients. This meant there were potential delays in patients accessing the care and treatment they needed. We were told this had been raised with senior leaders prior to the assessment.

Patients who were placed in other areas to their responsible consultant were allocated to a specific medical team each morning to reduce the risk of not being reviewed. However, 9% of patients were moved more than 4 times during their stay, with 3 of the 9% (13) as frequently as 11 and 15 times in July 2024. Over 250 patients were moved between 10pm and 7am, which may not provide optimum opportunity for healing due to disturbed sleep for these and other patients.

Staff told us that structured board rounds were used to identify priority reviews of patients based on their clinical need. One nurse told us that ward rounds did not always occur at scheduled times which impacted on timely decision making. We observed a consultant arriving 40 minutes late and the nurse informed us that this occurred on a regular basis.

Systems in place to provide therapy staff and pharmacy support at weekends and out of normal working hours. However, these were reduced services; therapy staff worked at weekends on a voluntary rota and they also covered urgent and emergency care. Patients were seen on a priority basis, although only 40-50% of patients referred to the team after emergency care patients were usually seen. The medical care division had submitted a request to have 2 therapy teams working at weekends to improve this.

The trust worked with regional partners, such as the Integrated Care Board (ICB) and the voluntary care sector, to develop alternative avenues for patient care. These included looking at patients’ length of stay, their flow through the hospital as part of the back on track programme, and whether these were in line with national targets. Three of the 8 medical wards looked at for length of stay did not meet their national targets, although 4 of the other 5 were ahead of their targets. The service had introduced a virtual ward programme as part of its work with the Integrated Care Board (ICB) across the East of England, which was estimated to have saved over 2,500 bed days and over £500,000. As part of its work with the voluntary care sector the trust introduced a single point of access for patients needing simple support and advice or bridging care.



The trust had a policy to guide staff when discharging patients that followed information and advice from the Department of Health, NHS Improvement and adult social care organisations. The policy included guidance for complex and delayed discharges. Despite actions taken by the trust to improve discharge pathways, there remained high numbers of patients waiting for discharge.

The service was in the process of introducing digital technology to enable patients to see their own records, monitor conditions such as atrial fibrillation or improve fast detection of strokes. The service was fully physically accessible throughout.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.