Spire Murrayfield Hospital

Updated 21 July 2022

Spire Murrayfield Hospital is operated by Spire Healthcare Limited and located in Thingwall, Wirral. The hospital provides services for NHS, private and self-funding patients, over the age of 18 for outpatient, diagnostic, inpatient and day case surgical care. The specialities include general surgery, orthopaedic surgery, ear, nose and throat (ENT) surgery, vascular surgery, cardiology, gastroenterology, spinal surgery, urology and maxillo-facial surgery.

The hospital provides care and treatment to adults across Merseyside and beyond. The hospital offers NHS support for Wirral, West Cheshire and Liverpool clinical commissioning groups (CCGs).

The hospital has three operating theatres (two have laminar flow) that operate six days per week, three theatre sessions per day and two sessions on Saturdays. There is also a minor ops theatre located in the outpatient’s department. The hospital has capacity to accommodate 25 inpatients with ensuite single rooms and 17 day case patients and is open 24 hours per day, seven days a week.

The hospital has 16 consulting rooms across the site, including pre-op assessment rooms, breast care and outpatient consultations.

The outpatient department for adults offers a variety of specialist clinics, minor operations, physiotherapy and a private GP service.

The hospital provides day case endoscopy services and all endoscopy procedures are carried out in the main theatres by the existing theatre staff. Endoscopy procedures are undertaken typically six days per week.

The diagnostic imaging department at the hospital provides services such as ultrasound, general x-ray, digital mammography, mobile computerised tomography (CT) and on-site magnetic resonance imaging (MRI).

Other facilities include a three bedded extended recovery suite, a registered pharmacy, a specimen reception, a physiotherapy treatment area with dedicated gym and a sterile services department for the decontamination and sterilisation of theatre instruments. An independent provider British United Provident Association (BUPA) operate a health centre based within the hospital and offer private health assessments.

Spire Murrayfield Hospital has been registered with CQC since November 2010.

The hospital director has been the registered manager for the service for one year, although had been employed by the provider for twenty years in other roles.

The service is registered to provide the following regulated activities:

• Diagnostic and screening procedures

• Surgical procedures

• Family planning

• Treatment of disease, disorder or injury

• Management of supply of blood and blood derived products

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.

We previously inspected Spire Murrayfield Hospital during September 2016. The report was published April 2017. We rated the hospital as requires improvement overall, with a rating of requires improvement for surgery and a rating of good for the outpatient and diagnostic services.

Enforcement action was taken at that time with a warning notice issued for a specific concern about the lack of assurance around the robustness of investigations of incidences of venous thromboembolisms (VTE). A further unannounced inspection took place during August 2017 and was focused on the actions taken by the provider in response to the warning notice. We found that the provider had addressed the concerns in the warning notice and had processes in place for the management of thromboembolisms.

Updated 21 July 2022

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, 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, 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 well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

In Surgery;

• The World Health Organization (WHO) checklist did not have the safety checks documented for the ‘sign-out’ section in one of the patient records we looked at. Staff told us that there were occasions when surgeons did not stay for the final sign-out step.

In Outpatients;

• Staff did not know how to refer patients to appropriate services to support them with their mental health.
• Staff did not always receive all the information they needed about a patient from the medical records team.

In Diagnostic Imaging;

• The service did not have individual key card access to medicine stock cupboards (as in other areas of the hospital).
• The service did not have adapted chairs in the waiting room for patients with mobility issues or who may not be able to sit in lower chairs.
• The service did not have learning disability and dementia-friendly adjustments in the department, as seen in other areas of the hospital.

Updated 21 July 2022

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

This inspection was the first time we inspected medical care separately from other core services in the hospital.

We rated this service as good because it was safe, caring, responsive and well-led.

Updated 21 July 2022

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.

This inspection was the first time we inspected diagnostic imaging separately from other core services in the hospital.

We rated this service as good because it was safe, caring, responsive and well-led. We inspect but do not rate effective for diagnostic imaging.

Updated 21 July 2022

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.

This inspection was the first time we inspected the outpatients service separately from other core services in the hospital. We rated this service as good because it was safe, caring, responsive and well-led. We inspect but do not rate effective for outpatients.

Updated 21 July 2022

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.

Our rating of this service improved. We rated it as good because it was safe, effective, caring, responsive and well-led.

Updated 7 April 2017

The service is available to self–funding patients from the age of 18 years and no later than 14 weeks gestation. The service offered both medical and surgical terminations of pregnancy. There were processes in place to protect patients from avoidable harm and abuse; however, hand–written records were difficult to read and provide clarity about discussions and treatment of patients, including prescription charts. Patients accessed the service in a timely manner with access to screening, counselling and contraception if required.