Springfield Hospital

Updated 9 February 2021

Springfield Hospital is operated by Ramsay Health Care UK Operations Limited. The hospital has 64 overnight beds. Facilities include five operating theatres, a three-bed observational unit, and X-ray, outpatient and diagnostic facilities. The hospital provides surgery, medical care and outpatients and diagnostic imaging services.

We received information from anonymous whistle blowers raising concerns about staffing and the safety of the services provided with the diagnostic imaging department. We previously inspected diagnostic imaging and outpatient services together in October 2016. The subsequent report rated these services as good overall – with safe, effective, caring, responsive all rated good and well led rated requires improvement. On 02 December 2020 we conducted a focused inspection of diagnostic imaging services within the radiology department at Springfield Hospital in Chelmsford.

This inspection focused on the diagnostic imaging service, which did not include outpatients’ services. The report includes what we found on inspection in relation to the diagnostic imaging service only, we did not rate the service. Therefore, the published rating reflects the previously applied rating for when this service which was inspected as outpatients and diagnostic imaging October 2016.

Our focused inspection was unannounced, so staff did not know we were coming, to observe routine activities within the department. The focused inspection of diagnostic imaging services was related to specific concerns of the service, so we did not include all the key lines of enquiry. We inspected key lines of enquiry in safe, effective and well led.

The diagnostic imaging department was located on the ground floor and provided magnetic resonance imaging (MRI), computed tomography (CT) scan, ultrasound scan (USS), x-ray and digital mammography services.

The service has had a registered manager in post since August 2019 and is currently registered for the following regulated activities:

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

Updated 9 February 2021

Springfield Hospital is operated by Ramsay Healthcare UK Operations Limited . The hospital has 64 beds. Facilities include six operating theatres, a three-bed close observation unit, and x-ray, outpatient and diagnostic facilities.

The hospital provides surgery, medical care, services for children and young people, and outpatients and diagnostic imaging.

We carried out a focussed follow up inspection to inspect the core services which we had rated as requires improvement during our previous inspection (October 2016). We inspected surgery services and children and young people’s services.

To get to the heart of patients’ experiences of care and treatment, we asked the questions; are they safe and well led for surgery services and are they effective and well led for services for children and young people. We asked only these questions because, during our previous inspection (October 2016), these were the areas we rated as requires improvement. Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

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

Services we rate

Our rating of this hospital improved. We rated it as Good overall.

We found good practice in relation to surgery services:

• Ward staff were 84% compliant with mandatory training and theatre staff were 86% compliant. This was an improvement on our previous inspection.

• Environmental cleanliness audits showed 94% compliance in theatres and 94% compliance in the ward area. This was an improvement on our previous inspection where overall compliance was 87%.

• Staff stored equipment appropriately in the clean utility rooms and the medical devices room. This was an improvement on our previous inspection.

• Theatre staff could easily access the difficult airway trolley and the latest difficult airway guidelines were also on the trolley for staff to refer to. This was an improvement on our previous inspection.

• Staff did not pre draw up drugs for use in theatre, control drugs (CD) cupboards were locked and the fluid store was tidy and organised. This was an improvement on our previous inspection.

• Medical advisory committee meetings (MAC) were now well attended and the hospital risk register had been improved to be more specific. This was an improvement on our previous inspection.

We found good practice in relation to services for children and young people:

• There were comprehensive plans in place relating to service improvement and auditing which was an improvement from our previous inspection.

• Frequent resuscitation scenario training took place in theatres to ensure that staff were competent in their paediatric life support skills.

• There was a good understanding of Gillick competence and this was well recorded as part of the paediatric day case pathway.

• There was service representation throughout the hospital, from a service specific meeting, to the clinical governance and medical advisory committees.

We found areas of practice that require improvement in services for children and young people

• Nursing leadership for the service was still being recruited to, which meant that other staff were providing leadership in the interim.

We found areas of practice that require improvement in surgery services

• The theatre audit schedule was not up to date due to a lack of a permanent theatre manager.

• Forty nine percent of theatre staff had not completed appraisals due to lack of a permanent theatre manager.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Amanda Stanford

Deputy Chief Inspector of Hospitals on Behalf of the Chief Inspector of Hospitals

Updated 18 January 2017

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

The medical service comprised of an oncology day service and an endoscopy service. The oncology unit provided a range of chemotherapy treatments for patients. The service was also able to admit patients to the inpatient ward area if they were unwell. The hospital worked closely with another provider in the oncology centre who provided radiotherapy. The oncology unit at Springfield Hospital is the largest private chemotherapy provider in Essex.

Updated 17 January 2019

Children and young people’s services were a small proportion of hospital activity. The main service was surgery. Where arrangements were the same, we have reported findings in the surgery section.

We rated this service as good because it was safe, effective, caring and responsive, and well led although nursing leadership required strengthening.

The hospital had addressed our previous concerns around the effectiveness and the well led aspect of the service. There were now comprehensive improvement and auditing plans in place which were well managed and had oversight from the senior management team, as well as the clinical governance and medical advisory committees.

Gillick competence was now well recorded as part of the paediatric day case pathway. There was an understanding of risk and risk assessment, and service risks were noted on the hospital’s risk register. The service was also well represented and received oversight at the Medical Advisory Committee.

Although the most recent staff survey results were poor, the hospital had responded and made changes to the senior leadership team which we felt had a positive impact when we inspected.

Updated 9 February 2021

We did not rate this service as part of this focused inspection.

Updated 18 January 2017

Outpatient and diagnostic imaging services were separate departments and led by two different managers. Between July 2015 and June 2016 there were 63,967 total outpatient attendances, of which 43% were NHS funded and 57% other funded.

The outpatient department was spread over the ground and first floor, and consisted of 21 consulting rooms, and four treatment rooms, which were used for minor procedures, phlebotomy and pre-admission. A range of outpatient specialities were available including trauma and orthopaedic (22%), general surgery (10%), urology (9%), and ears, nose and throat (8%). The diagnostic imaging department was located on the ground floor and provided x-ray, ultrasound scan (USS), computed tomography (CT) scan, Magnetic resonance imaging (MRI) and digital mammography services.

Updated 17 January 2019

Surgery was the main activity of the hospital. Where our findings on surgery also apply to other services, we do not repeat the information but cross-refer to the surgery section. Surgical services included a theatre department with six theatres, of which four had laminar airflow, six anaesthetic rooms and a six-bedded recovery area. There was also an inpatient ward consisting of 58 single bedrooms, three double bedrooms and a three-bedded close observation unit. From January 2018 to December 2018 there were 10637 inpatient and day case episodes of care recorded at the hospital; of these 60% (6419) were NHS-funded and 40% (4218) other funded.

We rated this service as good because it was safe, effective, caring, responsive and well led. The hospital had addressed all the concerns which we raised during our previous inspection (October 2016). Data provided by the hospital showed ward staff were 84% compliant with mandatory training and theatre staff were 86% compliant. Environmental cleanliness audits showed 94% compliance in theatres and 94% compliance in the ward area. Staff stored equipment appropriately in the clean utility rooms and the medical devices room. Theatre staff could easily access the difficult airway trolley and the latest difficult airway guidelines were also on the trolley for staff to refer to. Staff did not pre draw up drugs for use in theatre, control drugs (CD) cupboards were locked and the fluid store was tidy and organised. Medical advisory committee meetings (MAC) were now well attended and the hospital risk register had been improved to be more specific. However, The theatre audit schedule was not up to date due to a lack of a permanent theatre manager. Forty nine percent of theatre staff had not completed appraisals due to lack of a permanent theatre manager.