Buckshaw Hospital

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We found in the surgical service that an inclusive and positive culture promoted continuous learning and improvement. We assessed whether leaders focused on meeting the needs of patients and the wider community, and whether they supported staff to deliver safe, person-centred and sustainable care. We also considered how the service worked with partners to reduce inequalities and improve outcomes.

At this inspection, we found that leaders promoted a positive and inclusive culture within the service. There was evidence of continuous learning, and staff were supported to develop and contribute to improvements. Leaders worked collaboratively with staff and partner organisations to deliver care that was safe, coordinated and responsive to patients’ needs.

At our previous inspection, this key question was rated as good. At this inspection, the rating has remained good. This meant the service was well organised, and leadership supported the delivery of safe, effective and person-centred care.

We have not awarded this service a score for Well-led.

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

We scored the service as 3. The evidence showed a good standard. The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The service had a clear vision and strategy focused on delivering high-quality, patient-centred care. Leaders and staff understood and applied this in their work.

The provider, Ramsey Healthcare UK, had a shared vision and strategy known as ‘The Ramsay Way’, which focused on strong relationships, continuous improvement and sustainable growth. The organisation’s purpose was to create a positive work culture where patient care was central to all activity. At Buckshaw Hospital, this was supported by a clear 2-year clinical strategy for 2024 to 2026. Staff demonstrated an understanding of this strategy and how it related to their roles. Staff told us they were involved in shaping the service through strategy and vision days, where they contributed to discussions with the management team.

Staff were focused on delivering high-quality, patient-centred care and promoting equality and diversity in their daily work. The service had an open and inclusive culture where staff, patients and those close to them could raise concerns without fear. Staff told us they felt respected, supported and valued by leaders. They said concerns were listened to and acted upon, and they felt confident raising issues at all levels, particularly those relating to patient safety.

We observed positive working relationships between staff of all grades, with strong teamwork and collaboration. Staff described feeling motivated about the future of the service and told us they were proud to work at Buckshaw Hospital. Leaders recognised and celebrated staff achievements through team huddles and organisational events, where positive feedback and successes were shared and staff were thanked for their contributions.

We scored the service as 3. The evidence showed a good standard. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders had the skills, visibility and approachability to run the service effectively and support staff.

The management team at Buckshaw Hospital was visible and accessible. Staff told us that leaders regularly visited the ward and theatres to check on staff and understand how the service was operating. Staff received regular communication from the management team, including weekly updates from both the hospital and the wider organisation.

Leaders were described as friendly and approachable. Staff knew who the management team were and understood their roles and responsibilities. There was a strong professional relationship between staff and leaders, which supported open communication.

Staff told us that leaders supported their development and encouraged them to take on more senior roles. Staff described receiving appropriate support when progressing into leadership positions.

Leaders were also visible to patients. During the inspection, when there was a delay to the service, managers attended the ward to speak directly with patients and those close to them to explain the situation and provide reassurance.

Leaders demonstrated an effective approach to managing risks and concerns. Staff told us that incidents were taken seriously and addressed appropriately, which contributed to a positive and open culture within the service.

Leaders maintained oversight of the service through regular walkarounds and audits. Cross-site audits were undertaken by managers from other departments to provide independent review and avoid bias. Learning from these audits was shared across the management team to drive improvements.

The service participated in staff engagement surveys across Buckshaw Hospital and a Euxton Hall Hospital. Results from 2025 showed improvements compared to the previous year, indicating increased staff satisfaction. Engagement scores increased to 71% (up by 3%), wellbeing scores to 74% (up by 8%) and inclusion scores to 63% (up by 6%). Leaders told us they used this feedback to inform improvements to staff working environments.

We scored the service as 3. The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff and leaders acted with openness, honesty and transparency. Staff were encouraged to raise concerns and offer ideas; the culture allowed staff to be confident their voices were heard.

Staff we spoke with told us they felt empowered to speak up if they observed a concern about inappropriate behaviours.

There was a provider speak up for safety policy and process and a whistleblowing process. Speak up focused on human factors and stressed the importance for all health workers, particularly checkers, and the patient to effectively speak out.

Staff told us they felt confident to raise concerns and believed they would be supported without fear of negative consequences. When concerns were raised, leaders investigated sensitively and confidentially. The local senior leadership and provider level were made aware when whistleblowers had raised serious concerns.

Patients, their families and carers were provided with information to explain how they could raise a concern and how this would be investigated. Senior staff on ward areas responded to immediate concerns or complaints to resolve these.

We scored the service as 3. The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them.

Data relating to workforce race equality standard (WRES) was monitored, however; this was at provider level. The Workforce Race Equality Standard (WRES) is a mandatory NHS framework to measure and improve workplace race equality. Leaders took steps to remove bias from practices to ensure equality of opportunity and experience for the workforce within their place of work, and throughout their employment.

Staff told us they had opportunities to apply for project work, new roles and to undertake external studies through an open application process.

The hospital acted to prevent and address bullying and harassment at all levels and for all staff, with a clear focus on those with protected characteristics under the Equality Act and those from excluded and marginalised groups. Staff felt everyone was treated fairly and that they would be able to report behaviour or attitudes which were negative.

We scored the service as 3. The evidence showed a good standard. The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

Leaders operated effective governance processes to ensure the delivery of high-quality, sustainable care.

The service had clear responsibilities, roles and systems of accountability in place. These were used effectively to manage and deliver safe, effective and person-centred care. Leaders used a range of governance systems to monitor performance and risk, including medicines management, audit and effectiveness, and infection prevention and control committees.

Data relating to training compliance, audits, incidents and complaints was collected, monitored through dashboards and reviewed regularly in meetings. This information was benchmarked across the wider organisation, and where improvements were required, action plans were developed and monitored to support improvement.

The medical advisory committee (MAC) met quarterly and was chaired by hospital leadership, with representation from all specialties. This committee oversaw practising privileges, reviewed clinical outcomes and provided a forum to raise concerns. Meetings were documented and included key updates such as activity levels, consultant onboarding and identified risks.

Staff at all levels understood their roles and responsibilities. Job descriptions outlined expectations clearly, and staff involved in audit and quality monitoring processes were aware of their responsibilities.

Staff were able to access information in a timely and accessible format to support decision-making and service improvement. Information systems were integrated, secure and allowed appropriate sharing of information with external organisations where required.

Leaders ensured that accurate information was shared with staff through team meetings, electronic systems and internal communications. Risks were clearly identified and recorded on a formal risk register, which supported oversight and ensured mitigation plans were implemented or risks were escalated appropriately. Staff contributed to managing risks and were involved in decision-making to improve care quality and sustainability.

The highest identified risk for the service related to emergency preparedness, including the management of major bleeding. Leaders told us they had plans in place to address this through scenario-based training for staff of all roles.

Audit processes were used to monitor quality, and outcomes were reviewed at regular meetings. Where improvements were needed, leaders ensured action plans were developed and monitored to achieve positive change.

The service had arrangements in place to respond to unexpected events, including a business continuity plan and major incident plans. There had been no reported data breaches in the 12 months prior to inspection.

Patient information was handled securely, and information governance formed part of mandatory training, with compliance at 95%. Policies, including those relating to service level agreements and surgical services, were up to date and accessible to staff.

Leaders maintained oversight of policies to ensure they remained accurate, valid and aligned to current guidance. Robust recruitment processes were in place, including disclosure and barring service checks, to ensure staff were safe to work within the service.

We scored the service as 3. The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

Staff and leaders at Buckshaw Hospital collaborated with relevant external stakeholders and agencies to improve care and treatment for patients using the hospital such as the integrated care board and local GP’s.

We requested feedback from stakeholders about the service. Information we received was positive and they reported feeling assured about communication and the working relationship.

Some senior leaders were part of regional networks to understand the needs of the community and the provider ambitions.

Leaders and staff actively and openly engaged with patients, staff, equality groups, the public, using social media posts, and local organisations to plan and manage services.

Each year, the Buckshaw Hospital and Euxton Hall Hospital named a charity to support, and staff completed events such as marathons in aid of these charities and had donated used crutches and furniture to oversees charities. There was information for a local charity in the waiting room at the Buckshaw Hospital, with a collection box.

They supported health fairs in local GP’s and had visited local schools providing teaching sessions.

We scored the service as 3. The evidence showed a good standard. The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

Staff were committed to continually learning and improving services.

There were processes for learning when things went wrong or of good practice, either locally or nationally. We were provided with examples of learning from incidents.

Staff were supported to have the time to develop their skills around improvement and innovation and to pursue areas of interest in the service. Leaders encouraged innovation and participation in research.

Staff and leaders were committed to excellence that centred on the patient experience. Where they saw a need, they worked together to find a solution. Leaders shared examples of patient focused care experiences.

Administration staff had contributed to improvement work that was ongoing with an internal tracking system that monitored trends and themes within the booking system that may impact on utilisation figures. These could be escalated at daily huddles or other meetings planned.