Spire Thames Valley Hospital is operated by Spire Healthcare Limited. It opened in the 1960s initially as a nursing home, and its’ ownership has changed a number of times over the years. Spire Healthcare Limited took ownership in 2007.
The hospital treats patients from Buckinghamshire, Berkshire and Middlesex. Spire Thames Valley is a two-storey hospital with one ward that has 37 private ensuite rooms providing inpatient and day case care and a 2 bed extended recovery unit.
Current facilities include: nine consulting rooms, two pre-assessment rooms, one minor procedure treatment room, physiotherapy treatment room, two laminar flow theatres and one endoscopy unit and an in-house theatre sterile services department. Diagnostic imaging facilities include a digital mammography, ultrasound, x-ray and magnetic resonance imaging (MRI). Two days per month, a mobile computerised tomography (CT) service is on site.
Specialities at the hospital include: Bariatric (Obesity) surgery, Oncology, Breast surgery, Oral surgery, Cardiology, Orthopaedic surgery, Colorectal (bowel) surgery, Cosmetic surgery, Dermatology, Physiotherapy, Dietetics, Plastic & reconstructive surgery, Ear, Nose & Throat, Psychology, Endocrinology, Renal medicine, Fertility, Respiratory medicine, Foot & ankle surgery, Gastroenterology, General surgery, Hand & wrist surgery, Urology, Immunology & allergy testing, Vascular surgery, X-ray/MRI/Mammography, Gynaecology, Cardiac Stress Echocardiograms.
Children and young people were only seen in outpatients and diagnostic imaging. We inspected services for children and young people using the outpatient framework and have reported findings for children and young people in a separate section.
[Note the hospital ceased surgical services for patients below the age of 18 with effect from August 2019.]
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 an unannounced inspection on 6 and 7 November 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, governance or medical staffing – also apply to other services, we do not repeat the information but cross-refer to the surgery core service.
Services we rate
Our rating of this hospital stayed the same. 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 the following areas of outstanding practice
- The oncology service 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.
- Staff were extremely motivated to deliver care that was kind and compassionate. They anticipated the needs of their patients and ensured their needs were acknowledged and met. We saw how staff took the time to interact with people who used the services and those close to them in a respectful and considerate way in theatres and on the wards.
- Staff did not merely react to patient needs or requests, they consistently assessed their needs and strived to build personal relationships, so they could understand their patients’ needs and preferences. Staff demonstrated a genuine desire to enhance the patients’ experience and to ensure their needs were met and exceeded.
However, we also found the following issues that the service provider needs to improve:
- The provider should consider raising the awareness of risk and how to report it with all staff.
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.
Nigel Acheson
Deputy Chief Inspector of Hospitals