Nuffield Health Tees Hospital

Updated 19 April 2022

The hospital is commissioned locally to provide elective services to NHS patients as well as private elective treatment in orthopaedics, general surgery, endoscopy, plastics, urology, gynaecology, ENT, dermatology, rheumatology and ophthalmology.

The hospital had 30 overnight beds but did not admit emergency patients. It has previously provided some services for young people between the age of 16 and 18 years who had been risk assessed to ensure they could be nursed in an adult setting, however, patients in this age range were not currently being seen.

Nuffield Health Tees Hospital is registered to provide the following regulated activities:

• Diagnostic and screening procedures

• Family Planning

• Surgical Procedures

• Treatment of disease, disorder or injury

The senior leadership team comprises of the Hospital Director who was also interim registered manager, Matron, and Sales and Services Manager. A newly appointed registered manager was due to start in January 2022.

The hospital was last inspected in 2017 and was rated as ‘outstanding’ and no requirement notices were served following that inspection. There has been no enforcement action taken against this provider.

The main service provided by this hospital was surgery. Where our findings on surgery for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the surgery service.

Updated 19 April 2022

Our rating of this location went down. We rated it as good because:

• The service had enough staff to care for patients and keep them safe.
• The service controlled infection risk well. Staff used equipment and control measures to protect patients, themselves and others from infection. They kept equipment and the premises visibly clean.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions.
• 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.
• Leaders ran services well using reliable information systems and supported staff to develop their skills.
• 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.

Updated 19 April 2022

• 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 and managed medicines. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, supported them to make decisions about their care, and had access to good information. Outcomes for patients was good.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand the patient pathways for scans. They provided emotional support to patients.
• 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

• The service should ensure that staff have access to up to date national guidance in relation to policies and procedures in the department to meet Ionising radiation regulations 2017 (IRR 17).

Diagnostic imaging is a small proportion of hospital activity. The main service was surgery. Where arrangements were the same, we have reported findings in the surgery section.

Updated 19 April 2022

• The service had enough nursing staff to care for patients and keep them safe. Nursing staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Nursing 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. Staff collected safety information and used it to improve the service.
• Staff provided good care and treatment and gave patients pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available six days a week.
• Nursing staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• 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 or a consultation.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Nursing staff understood the service’s vision and values, and how to apply them in their work. Nursing staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Nursing staff were clear about their roles and accountabilities.

However;

• The service did not have a system to record and systematically monitor did not attend patient appointments.

Outpatients is a small proportion of hospital activity. The main service was surgery. Where arrangements were the same, we have reported findings in the surgery section.

Updated 19 April 2022

• 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.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• 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.
• 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:

• Staff did not always record consent in accordance with national standards.
• The service should ensure that all ward areas have the appropriate flooring.
• The service should ensure that the medicines policy is consistently followed in relation to the prescribing of maximum doses.
• The service should consider routinely referring to patients’ psychological and emotional needs of patients, their relatives and carers.
• The service should consider auditing patient preoperative fasting times to ensure these are not excessive.
• The service should consider how it can innovate to enable continuous improvement.
• The service should consider how it can improve at a local level utilising information and data beyond the standard performance data reported at a national level.
• The medicines policy was not always followed in relation to the prescribing of maximum doses.
• We saw no evidence of innovation from senior leaders.