Manchester Orthopaedic Clinical Services

Updated 24 December 2021

Manchester Orthopaedic Clinical Services is an independent health service located in Manchester, Lancashire and provides a limited range of outpatient and diagnostic imaging services for privately funded adult patients.

The service has been registered since February 2014 and has a registered manager in place.

The service is registered to provide the following regulated activities:

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

The service was registered to provide surgical procedures but had not yet carried out any surgical activity since its initial registration.

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

The service provided three outpatient services for patients; spinal nerve block injection procedures, steroid (pain) injections and taking blood samples for patients travelling abroad. The service provided two diagnostic imaging services for patients; nerve conduction studies and X-ray imaging to support spinal nerve block injection procedures. These services were only provided to privately funded patients that had been referred by external organisations under service level agreements. The service did not have any commissioning arrangements for referral or treatment of NHS patients directly with the service. However the spinal nerve block injection procedures were carried out for NHS patients that had been referred by an external independent healthcare provider, who maintained clinical oversight and responsibility for these patients.

Service activity over past 12 months:

• The service had carried out 591 bloods appointments between March 2021 and October 2021.
• The service commenced spinal nerve block procedures since August 2021 and had undertaken treatment and X-ray scans for 13 patients.
• The service had undertaken steroid (pain treatment) injections for two patients during July and August 2021.
• The service had carried out 28 nerve conduction studies procedures between January 2021 and October 2021.

Updated 24 December 2021

This is the first time we have rated this service. 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. The service managed safety incidents well.
• 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.
• 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.
• 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.
• 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 to plan and manage services and all staff were committed to improving services continually.

However:

• Leaders did not operate effective governance processes for the management of staff recruitment and training. Not all policies and procedures reflected the processes in place. Whilst staff were clear about their roles and accountabilities, there was no formal documented process to demonstrate staff had regular opportunities to meet, discuss and learn from the performance of the service.
• Leaders did not have effective systems to manage risk, issues and performance effectively. Staff did not identify and escalate all relevant risks and issues or identify actions to reduce their impact. The service did not have effective systems in place for compliance monitoring and audit of key processes, such as for patient records or staff recruitment and training.
• Mandatory training for non-clinical staff was not always complete and up to date.
• Not all staff had completed the higher level of adult safeguarding training in line with national intercollegiate guidance.
• Records for national early warning scores were not always completed accurately by staff.
• Not all staff had completed their annual appraisals.
• Routine engagement with external stakeholders was not formally documented.

Updated 24 December 2021

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

We rated this service as good because it was safe, caring and responsive, although leadership requires improvement. We inspect but do not rate effective for diagnostic imaging services.

Updated 24 December 2021

The main service provided was outpatients.

We rated this service as good because it was safe, caring and responsive, although leadership requires improvement. We inspect but do not rate effective for outpatients.