Spire Parkway Hospital

Spire Parkway Hospital opened in 1982 and is operated by Spire Healthcare. The hospital was previously run by an independent hospital group until Spire Healthcare acquired the hospital group in 2007.Spire Parkway Hospital provides medical and surgical care to the residents of Solihull, Birmingham, Warwickshire and further afield, with over 600 GP surgeries referring patients to the hospital in a range of specialities including: orthopaedics, general surgery, ear, nose and throat (ENT), plastics, ophthalmology, urology, gynaecology and cosmetics.

The hospital has 43 beds and facilities include five operating theatres, one specifically for endoscopy cases, an extended recovery unit, two in-patient wards, a day care unit, a specialist cancer centre, and an endoscopy suite. We inspected all services provided including surgery, endoscopy, oncology services, services for children and young people, outpatients and diagnostic imaging facilities.

Services were provided to patients who were self-funding, those covered by private medical insurance and to NHS patients who had been referred by their GP or who had booked via the NHS “choose and book” service. Chemotherapy and children and young people services was not provided to NHS patients.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 17 and 18 September 2019, along with an announced visit to the hospital on 26 September 2019.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? 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 surgery – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the surgery service report.

Services we rate

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

We found good practice within the services:

• The hospital 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 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 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 hospital 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 hospital engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

We found areas of outstanding practice

• The hospital had a multi faith resource box. This included a prayer mat, various religious texts and scriptures. There was a specific room that could be used as a ‘quiet room’ for patients and relatives to use when needed.
• Radiology staff had completed home visits for patients with additional needs alongside the Occupational Therapist to describe the process to the patients and their families so they were fully informed, prepared and aware of the procedure to be undertaken.
• A broad range of age appropriate information had been developed for CYP and their families. This included a range of activities, the use of pictorial cards to enhance understanding, information about bullying, safeguarding and supporting CYP with learning disabilities.
• Pharmacy staff had developed personalised leaflets for patients regarding their medicines following joint surgery and for oncology patients.
• Pharmacy staff had robust systems in place to safely manage and comply with medicines in the oncology service which was in line with national best practice.
• A broad range of age appropriate information had been developed for CYP and their families. This included a range of activities, the use of pictorial cards to enhance understanding, information about bullying, safeguarding and supporting CYP with learning disabilities.
• There was a proactive approach to understanding the needs and preferences of different groups of people and to delivering care in a way that meets those needs, which was accessible and promoted equality.
• The hospital had a comprehensive audit and risk management structure which ensured the service had a transparent approach to the management of risk and the assurance of safety.
• The hospital had gained and held national accreditations such as: ISO accreditation for pathology (ISO certification is a seal of approval from an external body whereby a company complies to one of the internationally recognised ISO management systems), British United Provident Association (BUPA) accreditation for breast care, bowel care, prostate care, and the cancer survivorship programme. The specialist care centre (oncology unit) had been awarded a Macmillan Mark of Quality Environment (MQEM) for achievements in quality for cancer care environment.
• The oncology service was awarded an Exemplar award by the provider’s group clinical director and had been recognised for excellent care and service for cancer patients in 2018.

However, we also found the following issues that the service provider needs to improve:

• The service was not carrying out face to face pre-operative assessment appointments for all children and young people, this was not on the hospital risk register.
• Not all records in oncology had a recording of the time they were signed.
• There had been instability in the chemotherapy leadership team during 2019 and an interim manager was in post at the time of our inspection. The culture within the oncology service was variable due to leadership changes and some staff felt unsettled and unsupported.

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

Heidi Smoult

Deputy Chief Inspector of Hospitals

Spire Parkway Hospital is operated by Spire Healthcare. The hospital has 59 beds. Facilities include five operating theatres, a recovery unit, two in-patient wards, a day care unit, a specialist cancer centre, endoscopy and ambulatory care unit. The hospital provides surgery, oncology services, services for children and young people, and outpatients and diagnostic imaging.

We carried out an inspection of the hospital on 26 November 2018. We announced the inspection because we needed to make sure staff and patients would be available to speak with us when we visited. We inspected the surgical service using our focused inspection methodology. The inspection was prompted by concerns we received about surgery staff being bullied and an unsafe theatre environment. We did not find any evidence to support these concerns. We did not inspect any other core services. Although surgery was provided to children and young people under sixteen years old we did not look at this aspect of the service.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? 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.

Services we rate

Our rating of this core service improved. We rated it as Good overall. Although we re-rated the surgery core service, our overall aggregated for the service has not changed.

• The service provided mandatory training in key skills to all staff and made sure everyone completed it.

• Staff understood how to protect patients from abuse.

• The service controlled infection risk well.

• The service had suitable premises and equipment and looked after them well.

• Staff completed and updated risk assessments for each patient.

• The service had enough staff including nursing and medical with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.

• Staff kept detailed records of patients’ care and treatment.

• The service followed best practice when prescribing, giving, recording and storing medicines.

• The service managed patient safety incidents well.

• The service used safety monitoring results well.

• The service provided care and treatment based on national guidance and evidence of its effectiveness.

• Staff gave patients enough food and drink to meet their needs and improve their health.

• Staff assessed and monitored patients regularly to see if they were in pain.

• Managers monitored the effectiveness of care and treatment and used the findings to improve them.

• The service made sure staff were competent for their roles.

• Staff of different kinds worked together as a team to benefit patients. Doctors, nurses and other healthcare professionals supported each other to provide good care.

• The service offered seven-day services to ensure surgery patients would receive consistent care and outcomes.

• People were provided with information which enabled them to make informed decisions about their life style choices and how they could improve the quality of their lives and outcomes.

• Staff understood how and when to assess whether a patient had the capacity to make decisions about their care. They followed the service policy and procedures when a patient could not give consent.

• Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.

• Staff cared for patients with compassion.

• Staff provided emotional support to patients to minimise their distress.

• Staff involved patients and those close to them in decisions about their care and treatment.

• The service planned and provided services in a way that met the needs of local people.

• The service took account of patients’ individual needs.

• People could access the service when they needed it.

• The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.

• Managers at all levels in the service had the right skills and abilities to run a service providing high-quality sustainable care.

• The service had a vision for what it wanted to achieve and workable plans to turn it into action, which it developed with staff, patients, and local community groups.

• Managers across the service promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.

• The service systematically improved service quality and safeguarded high standards of care by creating an environment for excellent clinical care to flourish.

• The service had good systems to identify risks, plan to eliminate or reduce them, and cope with both the expected and unexpected.

• The service collected, analysed, managed and used information well to support all its activities, using secure electronic systems with security safeguards.

• The service engaged well with patients, staff, the public and local organisations to plan and manage appropriate services, and collaborated with partner organisations effectively.

• The service was committed to improving services by learning from when things went well or wrong, promoting training, research and innovation.

We found areas of outstanding practice in surgery:

• Staff identified innovate ways to providing integrated person-centred pathways of care for people with learning disabilities and those living with dementia to manage their anxieties at all stages of their treatment. This included providing care in environments where people felt safe, identifying how to make their admission to the hospital as reassuring as possible and providing continuous care and support from staff and people they were familiar with and trusted.

However, the service should:

Seek to improve the response rate to the family and friends test (a measure of patient satisfaction).

Professor Sir Mike Richards

Chief Inspector of Hospitals