Wycombe Hospital

Updated 4 July 2022

Wycombe Hospital is situated in the centre of the historic town of High Wycombe and offers a wide range of surgical services and specialist medical care for stroke and heart conditions. The hospital also offers specialist cancer and urological services.

At Wycombe Hospital, we inspected the medical care (including older people’s care) and surgery.

Summary of our findings

• Medicines were stored correctly and disposed of safely. Staff kept accurate records of medicines.
• There were clear systems and processes to keep people safe and safeguarded from abuse.
• Most services had enough staff to care for patients and keep them safe.
• Staff had an induction that gave them the skills and confidence to carry out their role and responsibilities effectively.
• Staff gained consent and considered people’s capacity to make decisions. Where patients did not have the capacity to make decisions, staff followed best interest practices.
• Patients were treated with dignity, respect and kindness during all interactions with staff and relationships with staff were positive. Staff supported patients and their families and personal, cultural, social and religious needs were understood.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it.
• The needs and preferences of different patients were considered when delivering and coordinating services. Patients knew how to give feedback about their experiences, including how to raise any concerns or issues.
• Leaders were visible and approachable.

However:

• The service did not always control infection risk well and staff did not always follow infection prevention policies. Ward areas were not all clean and damage free. In some areas, the hospital did not keep the environment safe, secure and fit for purpose.
• Services did not always ensure products deemed as hazardous to health were stored securely.
• Services did not always manage medicines well or ensure emergency medicines were available. Medicines were out of date such as insulin and others were missing from emergency medicine kits.
• Staff did not always maintain care records safely in accordance with trust policy. On one ward records were loose and not kept bound and secure.
• Staff were not always able to effectively contribute to improvements and guidelines were not kept current.

Updated 4 July 2022

Updated 6 October 2014

Services for children and young people were good. Parents told us the staff were caring, and we saw that children and their parents and carers were treated with dignity, respect and compassion. The ward areas and equipment were clean. There were enough trained staff on duty to ensure that safe care could be delivered. Children were appropriately prepared for surgery and treatment and clinical outcomes were good.  

The service was responsive to the needs of children and young people and their families and carers. Staff were positive the service and children’s experiences were seen as the main priority. The service did not have a strategy but there were actions around improving the service. The trust long term plans for the service were not clear to staff.

Updated 6 October 2014

Patients we spoke with gave us examples of the good care they had received. Staff built up trusting relationships with patients and their relatives by working in an open, honest and supportive way. There was strong local leadership of the units. Openness and honesty was encouraged at all levels. The units had an annual clinical audit programme to monitor how guidance was adhered to. All staff, including student nurses, were involved in quality improvement projects and audit. There was good multidisciplinary team working. Patients were effectively monitored and clinical outcomes were good.

Updated 18 June 2019

Our rating of this service improved. We rated it as outstanding because:

• People are protected by a strong comprehensive safety system and a focus on openness, transparency and learning when things go wrong.
• People are able to transition seamlessly between services because there is advance planning and information sharing between teams.
• There is a genuine open culture in which all safety concerns raised by staff and people who use the service are highly valued as being integral to learning and improvement.
• The continuing development of the staff’s skills and knowledge is recognised as being integral to ensuring high quality care. Staff are proactively supported and encouraged to acquire new skills, use their transferable skills and share best practice. Chaplaincy volunteers re proactively recruited and supported in their role.
• There is a strong, visible person-centred culture. Staff are highly motivated and inspired to offer care that is kind and promotes peoples’ dignity. Relationships between people in the service, those close to them and staff are strong, caring respectful and supportive. These relationships are highly valued by staff and promoted by leaders.
• There is a proactive approach to understanding the needs and preferences of different groups of people and to delivering care in a way that meets these needs, which is accessible and promotes equality. This includes people with protected characteristics under the equality act, people who are approaching end of life and people in vulnerable circumstances who have complex needs.

There is compassionate inclusive and effective leadership at all levels. Leaders at all levels demonstrate the high levels of experience, capacity and capability needed to deliver excellent and sustainable care. There is a deeply embedded system of leadership development and succession planning, which aims to ensure that the leadership represents the diversity of the workforce.

Updated 6 October 2014

The ward areas were modern and clean. Women and their partners said that the staff were caring and friendly. Women were encouraged to discuss their plans and choices with their midwife and to be actively involved in the planning and decision making. Midwifery staffing levels were appropriate and there were always experienced staff on every shift to women and provide one to one care.

There was good multidisciplinary team working and learning throughout the service. Staff development and continuing professional development in general was a priority within the service. The head of midwifery and her team were well focused and fully engaged. The service did not have a strategy to develop its services and there were concerns about underused services at Wycombe Hospital and potential delays to transfer women who required urgent care to Stoke Mandeville Hospital. The service did have a strategy to manage operational and performance risks and risks were appropriately managed.

Updated 18 June 2019

Our rating of this service improved. We rated it as good because:

• People were protected from avoidable harm and abuse. The department was sufficiently staffed and most of the team had received up-to-date mandatory training, including safeguarding. Premises were visibly clean and tidy. Staff were pro-active in managing risk, and patient records were completed appropriately. Incidents were reported and investigated.
• Patients received effective care and treatment that met their needs. The trust had participated in a national benchmarking programme and was using the findings to make improvements to the service. Staff development was encouraged, and appraisals were up to date.
• People were supported, treated with dignity and respect, and were involved as partners in their care. Patient survey results were good, and patients we spoke with were happy with their care. Staff were compassionate and helpful in their interactions with patients.
• People’s needs were met through the way services were organised and delivered. The trust recognised where the service needed improving and was taking action to do so. People with particular needs were prioritised for appointment times and patients were told when appointment delays were longer than expected.
• The leadership, governance and culture promote the delivery of high-quality person-centred care. The team felt supported by managers and were supportive of each other. Systems were in place with appropriate escalation processes for governance, quality and performance. There was a focus on continuous learning and improvement throughout the service.

Updated 4 July 2022