Royal Free London: Implementation of exceptional audit processes to improve patient experience

Patient experience at the heart of Royal Free London NHSFT

Royal Free London NHS Foundation Trust (RFL) is dedicated to delivering excellent patient outcomes and experiences. With over 1,000 healthcare and support staff, the trust cares for more than 1.6 million patients annually across three main hospitals.

• 1.6m Patients each year treated across three main hospitals

• 700%+ Improvement in areas achieving 90% score

• 14 Key self-inspection audits created to better understand patient care

Identifying Requirements Through Data

To enhance patient care and meet regulatory requirements, RFL launched 14 key self-inspection audits. These audits were designed to assess care quality across the organisation and identify actionable improvements at local, site and group levels – insights that were previously difficult to achieve.

The results, combined with external regulatory inspections, revealed a need for greater assurance in meeting regulatory standards and patient experience goals, particularly in historically challenging areas.

Approach

Model creation with Quality Improvement (QI) Methodology

To address these challenges, the Royal Free implemented a “Quality Inspection Walkabout”, a peer-to-peer inspection process underpinned by QI methodology. Using the “model for improvement” framework, the walkabout process included small tests of change to refine the approach before rolling it out broadly.

The governance team and quality leads developed this inspection framework on Tendable’s digital audit platform, enabling the trust to:

• Monitor and measure quality issues.

• Prioritise patient experience as a central focus.

• Provide evidence of compliance with regulatory standards.

Inspection results were triangulated with other compliance data, offering a comprehensive assurance of high-quality care across the organisation.

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Monthly Peer-To-Peer Inspections

With Tendable, inspection results became immediately accessible for analysis, eliminating the delays associated with paper-based or manual reporting. Post-inspection reviews allowed key learnings to be shared organisation-wide, which were used to improve care and quality in all aspects of care delivery. The real-time quality data highlighted themes for targeted improvement in the following month, ensuring a continuous quality improvement cycle. Areas which were struggling were supported to action plan and implement any required improvements.

Engaged Workforce

This peer-to-peer inspection process enabled greater engagement from nursing teams by highlighting areas for improvement and celebrating success. Monthly certificates of achievement and a “Trophy of the Month” award boosted morale and encouraged excellence.

Significant Quality Improvements

Since adopting Tendable and the Quality Inspection Walkabout framework, The Royal Free has seen substantial improvements in compliance scores. There was an increase in areas achieving a 90% compliance score from 6% to 43%, with several other areas nearing this target.

Looking Ahead

The Royal Free London NHS Foundation Trust continues to prioritise patient experience and care quality. By embedding Tendable into its quality improvement framework, The Royal Free is well-equipped to maintain high standards, meet regulatory requirements and deliver exceptional outcomes for its patients.