Nuffield Health Cheltenham Hospital

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating remains good. This meant people’s outcomes were consistently good and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

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

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing, and communication needs with them.

Daily morning huddles were held to review patient lists and share relevant information with staff. This supported forward planning and ensured staff were aware of any specific patient needs, including when children and young people were due to attend the service.

We reviewed 5 care records for children and young people who had attended outpatient appointments. All records were fully completed and demonstrated assessment and care planning in line with provider guidance.

Pre-admission assessments for young people aged 16 -17 who were referred for surgery were undertaken by a Registered Sick Children’s Nurse (RSCN) from another site, in line with established clinical pathways.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Care and treatment were planned and delivered in accordance with relevant legislation and evidence‑based guidance. Young people who underwent surgical procedures were managed in line with the adult surgical pathway.

Staff adhered to current policies and procedures, supported by monthly safety bulletins which provided updates on clinical practice and corporate matters. Updates to clinical guidelines were routinely reviewed and discussed through established governance arrangements.

The service maintained a programme of audit activity, including consent, hand hygiene and medicines management. This provided ongoing assurance that practice was monitored and aligned with required standards.

Please refer to surgery, outpatients and diagnostic and imaging reports for more information.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Doctors, nurses and allied health professionals worked collaboratively to meet the needs of children and young people.

Daily huddles, attended by senior staff, were used to identify when children and young people were due to attend the service and to highlight any specific needs or considerations to support their care.

Where required, consultants provided written communication to other services, including GPs, detailing diagnoses, treatment plans and prescribed medicines to support continuity of care.

Refer to outpatients, surgery and diagnostic imagining reports for more information.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice, and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

The service supported children, young people and their families to manage their health and wellbeing. Staff provided advice during outpatient appointments, and guidance relevant to the health condition. The service promoted healthier lifestyles and, where possible, helped reduce future care needs.

Please refer to surgery, outpatients, and diagnostic and imaging reports for more information.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff used recognised tools to identify and respond to clinical deterioration, supporting patient safety and outcomes. Younger people undergoing surgery were managed on the adult surgical pathway, with observations recorded using NEWS2.

Managers completed regular audits to review outcomes and drive improvements in care. Audit findings and outcome data, including activity for children and young people, was shared with staff, for example in staff meetings and monitored to ensure sustained improvement.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

There were no dedicated children’s staff at this location. Younger people who were referred for surgery were assessed by a RSCN from another location. Staff told us they assessed if the younger person was able to consent and understood the procedure.

Staff told us a child’s parents or guardian would consent to any treatment on their behalf.

Please refer to surgery, outpatients and diagnostic and imaging reports for more information.