Nuffield Health Cheltenham Hospital

Updated 17 January 2023

Nuffield Hospital Cheltenham Hospital is operated by Nuffield Health and is one of the organisation’s 31 hospitals nationally.

The hospital offers a wide range of clinical specialties within surgery, outpatients, and diagnostic imaging to private and NHS patients. At the time of our inspection the mix of patients was 65% private and 45% NHS.

Surgery includes a dedicate pre-assessment unit, three theatres, a six-bedded recovery area and a 32-bedded inpatient ward. Specialties include gynaecology, urology, orthopaedics, ear, nose, and throat (ENT), and hips and knees. Around 65% of all surgery takes place on a day case basis.

Outpatients operates from a dedicated area of the building with consulting rooms, a minor operations theatre, phlebotomy facilities, a physiotherapy service, and well-equipped rehabilitation gym. The physiotherapy team offer specialist sports medicine services and a dedicated pelvic floor physiotherapist offers a highly specialised menopause service. The minor operations service includes dermatology, gynaecology, and flexible cystoscopy. The hospital has an endoscopy service on site.

Diagnostic imaging services include MRI, CT, DXA, mammography, ultrasound, and X-ray. The team also offers in-theatre radiography services.

We last inspected the service in March 2016. We rated the service good overall and good in each core service key question except for safe in surgery, which we rated requires improvement. At this inspection we found the hospital team had addressed all our previous areas of concern. At our last inspection, we inspected outpatients and diagnostic imaging as a combined service. Since then our methodology has changed and we inspect outpatients and diagnostic imaging as separate core services.

A registered manager is in post and the service is registered to carry out the following regulated activities:

• Diagnostic and screening procedures
• Surgical procedures
• Treatment of disease, disorder or injury
• Family planning

Where arrangements were the same across core services, such as mandatory training compliance, governance and senior leadership, we have reported findings in the surgery section.

We rated this service as good because it was safe and well led.

Updated 17 January 2023

Our rating of this location stayed the same. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

• Bank staff did not meet the provider’s minimum target for completion of mandatory training.
• The fabric in some parts of the building reduced infection control compliance and presented avoidable risks.
• The persistent use of agency nurses resulted was increasing delays to discharge, although risks around these were well managed.
• While standards of care record keeping were good, there were persistent challenges around consultant willingness to comply with provider standards in outpatients.
• Information governance in diagnostic imaging was a known trend in incidents and had not yet been fully resolved.

Updated 29 July 2016

We rated the services for children and young people as good overall because:

• Patient safety was important to the leadership team of the hospital. Children and young people’s services had been reviewed and actions taken to reduce risk.
• The hospital now offered an outpatient only service for young people aged between12 and 18 years of age.
• Managers ensured staff were competent to care for young people within the age group in the outpatient setting.
• Safeguarding children training had been attended by staff and plans were in place to offer further training at level two in line with guidance.
• Incident reporting, infection prevention and control and safety of equipment procedures were followed for all patients attending the hospital which included children and young people.
• Interactions we saw with young people and their parents were caring and appropriate for their age and understanding.
• Young people were assessed for their suitability to attend this hospital before an appointment was offered.
• Privacy and dignity of young people was respected and there were flexible waiting areas.
• Steps had been taken to provide leadership of the service but senior managers misunderstood Nuffield Group Policy about leadership of children’s services.
• Consultants managed their own patient record systems and we were told GPs received information in a timely way.

However:

• Consultants arranged for records to be available for patients who were attending their clinics. The patient notes were retained by the consultant and not usually available for outpatient nursing staff to view. This meant that records of consultations were not available for staff to reference if a patient should call the hospital outside of the consultation.

Updated 17 January 2023

We have not previously rated diagnostic imaging as a separate service. We rated it as good. Please see the main summary.

Where arrangements were the same for surgery and diagnostic imaging, we have reported our findings in the surgery section.

Updated 17 January 2023

Our rating of this service stayed the same. We rated it as good. Please see the main summary.

Where arrangements were the same for surgery and outpatients, we have reported our findings in the surgery section.

Updated 17 January 2023

We rated this service as good because it was safe and well led. Please see the main summary.