Bath Clinic

Updated 18 May 2022

Bath Clinic is part of Circle Health Group Limited. In January 2020, Circle Health Holdings Limited (Circle) acquired the BMI Healthcare Limited group. The hospital is located in Bath and serves the local population treating privately funded patients and NHS patients. Surgery and medical services are provided for inpatients, day-case patients and outpatients and the hospital treats adults. The hospital did not provide services for children or young people. The hospital has 67 beds (24 bed inpatient ward and 43 day beds), three operating theatres, a dedicated endoscopy suite, diagnostic imaging department, day-case unit, oncology ward and outpatient department.

The provider is registered to provide four regulated activities:

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

During this inspection, we looked at the following services: surgery, medicine and outpatients. We inspected the hospital as part of our routine comprehensive inspection programme for independent healthcare services. We carried out a comprehensive unannounced inspection on 9 and 10 February 2022.

Hospital activity

The top three surgical procedures in the last 12 months for NHS patients were;

Cataract surgery for 276 patients

Hip replacement for 239 patients

Knee replacement for 194 patients.

The top three procedures in the last 12 months for private patients were;

Diagnostic colonoscopies (test to check the health of the bowel) for 189 patients

Cataract surgery for 157 patients

Injections or aspirations of joints, and cysts for 144 patients.

The oncology service provided 551 chemotherapy sessions from February 2021 to January 2022.

The endoscopy service provided 548 scope procedures between October 2020 and September 2021.

Track record on safety from March 2021 to February 2022

No never events were reported - A never event is a serious incident that is wholly preventable as guidance, or safety recommendations providing strong systemic protective barriers, are available at a national level, and should have been implemented by all providers. They have the potential to cause serious patient harm or death, has occurred in the past and is easily recognisable and clearly defined.

No external review or investigations have been undertaken.

There were no incidences of healthcare acquired infections.

The service received 24 formal complaints across surgery, medical care and outpatients.

No Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) reportable incidents have occurred.

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 18 May 2022

We carried out a focused inspection of Bath Clinic on 9 and 10 February 2022. The service was inspected in May 2016 and was rated as requires improvement in safe and well led with good in effective, caring and responsive. The service was rated as requires improvement overall. A follow up inspection of safe and well led was undertaken in May 2018 and these were found to be good. However, due to the guidance available at the time, the overall rating remained as requires improvement.

Bath Clinic provided the following services: surgery, medical care, outpatients and diagnostic imaging. We inspected surgery, medical care and outpatient services during this inspection. The inspection was short notice announced.

We rated safe as good in surgery and medical care. In outpatients it was rated as requires improvement. Effective was rated as good in surgery and medical care. We do not rate effective in outpatients. Caring was outstanding in medical care and in surgery and good in outpatients. Well led was rated good.

Our rating of this location improved. 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 and acted on them. 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, 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 health information. Key services were mostly 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 them to give feedback. Patients could access the service when they needed it.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Most 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 some community services to plan and manage services and all staff were committed to improving services continually.

However:

• During the recruitment of some staff, not all the required information was obtained prior to them starting work at the service.
• Observed practice as part of clinical supervision to monitor the skills and knowledge of qualified staff was not always documented to help them with their revalidation requirements for their regulatory body. Staff felt this would be useful to have this documented.
• Not all staff followed policy when completing care records.
• Although the hospital had a high standard of cleanliness there was a lack of oversight of some areas.

Updated 18 May 2022

Our rating of this service 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.
• 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, 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, 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.

Medical services are 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.

Updated 18 May 2022

We rated this service 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 and acted on them. 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.
• 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 with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

• Not all staff followed policy when completing care records.
• Although the hospital had a high standard of cleanliness there was a lack of oversight of some areas.

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 18 May 2022

Our rating of this service 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.
• 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 some 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:

• The service should consider as part of their clinical supervision documenting observed practice when qualified staff work together so it can be used for their revalidation as staff felt this would be useful.
• Not all staff had the required information obtained prior to them starting work at the service. Interview records were not always detailed about any gaps in staff employment history.