Buckshaw Hospital

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Endoscopy services were safe, with leaders promoting a culture of openness, transparency and teamwork.

Safe systems were in place to identify and respond to deteriorating patients throughout their endoscopy journey.

Staff took appropriate action to minimise risks, including falls, pressure damage and venous thromboembolism (VTE), and completed safety checks to ensure patients received the correct procedure.

Staffing levels were safe and changed if required.

Medicines were managed safely and safeguarding processes were well understood.

At our previous assessment, this key question was not rated. At this inspection, we rated safe as good. Patients were protected from avoidable harm and received safe care.

We have not awarded this service a score for Safe.

Find out about when we will not publish a key question score and what we look at when we assess Safe.

We scored the service as 3. The evidence showed a good standard. The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

We reviewed a specific incident within the endoscopy service and saw evidence of appropriate management. Duty of candour was applied, and meetings were held with the patient and their family to explain what had happened and share learning. Learning from this incident was shared through safety briefings, displayed in staff areas and incorporated into training sessions. This approach was consistent for all patient safety incidents.

The endoscopy service had no 'Never Events' in the last year.

For additional findings please refer to the surgery report.

We scored the service as 3. The evidence showed a good standard. The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

There was a clearly defined endoscopy pathway in place, outlining the patient journey from initial appointment through to discharge. This supported a structured and consistent approach to care delivery. Clear admission criteria were established for both NHS and private patients, ensuring patients were appropriately selected for the service.

Staff demonstrated a good understanding of the endoscopy pathway and admission requirements. Feedback from both staff and patients did not raise any concerns regarding access to, or delivery of, the service. On the day of inspection, there was a delay to the endoscopy list due to issues with the computer system. However, this was communicated clearly to patients at the time. Patients told us they understood the reasons for the delay and felt kept informed, which helped to manage expectations and maintain a positive experience.

For additional findings please refer to the surgery report.

We scored the service as 3. The evidence showed a good standard. The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.

For our main findings please refer to the surgery report.

We scored the service as 3. The evidence showed a good standard. The service worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Staff informed us that patients receiving an endoscopy procedure did not receive a phone call to check their recovery. However, patients were able to ring the triage phone if they experienced post-procedure complications. Patients could re-attend the hospital if necessary to be reviewed.

For additional findings please refer to the surgery report.

We scored the service as 3. The evidence showed a good standard. The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Patients undergoing endoscopy procedures were cared for within the same environment used for surgical services. One of the operating theatres was also utilised as an endoscopy procedure room. Staff told us this supported efficient use of facilities while ensuring patients had access to appropriate equipment and clinical support. The environment was suitable for the procedures undertaken and enabled the service to respond flexibly to patient demand.

For additional findings please refer to the surgery report.

We scored the service as 3. The evidence showed a good standard. The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

In the endoscopy service, staff had received the appropriate training and were assessed as competent to deliver care safely and effectively. Several staff worked across both endoscopy and surgical services, providing flexibility in workforce deployment and supporting service continuity. The ward at Buckshaw Hospital cared for a mixed patient group, including both surgical and medical patients.

Staffing arrangements reflected the range of skills and competencies required to meet patients' needs throughout the patient pathway. Staffing levels for endoscopy procedures typically included a consultant endoscopist, a consultant anaesthetist where required, an endoscopy practitioner (either a registered nurse or operating department practitioner), an airway practitioner, two endoscopy decontamination assistants, and a healthcare assistant. This multidisciplinary team approach ensured patients received appropriate clinical support during procedures while maintaining effective decontamination processes for endoscopy equipment.

The recovery area was usually staffed by two recovery practitioners who monitored and cared for patients following their procedure. Ward staffing generally consisted of three registered nurses and one healthcare assistant, providing an appropriate skill mix to support patients' ongoing care and recovery.

Staffing levels were adjusted in line with activity and patient acuity, including the size and complexity of procedure lists. Review of staffing rotas demonstrated there were no significant staffing gaps, and staffing levels were sufficient to support the delivery of safe and effective care. Staff told us there were enough suitably skilled and experienced staff available to meet patients' needs.

For additional findings please refer to the surgery report.

We scored the service as 3. The evidence showed a good standard. The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

For our main findings please refer to the surgery report.

We scored the service as 3. The evidence showed a good standard. The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

For our main findings please refer to the surgery report.