Nuffield Health Derby Hospital

On this page

• 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

We looked for evidence that patients and communities achieved the best possible outcomes because staff assessed their needs effectively. The service ensured staff completed and regularly reviewed comprehensive assessments throughout each patient’s pathway so patients received effective surgical care. Patients told us they felt well‑informed and supported, and staff carried out consistent post‑operative checks and responded promptly when patients deteriorated. Staff completed routine safety and risk assessments, gave clear advice on when to seek help, and addressed communication needs appropriately.

Staff delivered care in line with national evidence‑based guidance, and leaders kept policies current and communicated them well.

Staff used multidisciplinary working, huddles and handovers. They coordinated complex patient care effectively.

Staff helped patients prepare for surgery and recovery by holding health‑promotion discussions and signposting them to additional support. Leaders monitored outcomes through audits, benchmarking and national reporting, which supported continuous improvement and helped the service maintain exemplar status in orthopaedics. This demonstrated that the service consistently met nationally recognised standards of high‑quality care, robust governance, and reliable data submission.

Staff followed consent processes in line with national standards to support informed decision making.

At our last assessment, we rated this key question as good. At this assessment, we maintained the good rating because patients continued to experience consistently positive outcomes, and their 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.

The service made sure patient’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them

The service assessed patients’ care and treatment by reviewing their health, surgical needs, wellbeing and communication requirements. Staff worked with patients to understand their needs before surgery and continued to review these throughout their stay on the ward.

We reviewed patient records on the ward. They showed staff had completed comprehensive assessments. These included patients’ medical history, diagnostic results, surgical plans, comorbidities, mobility levels, nutritional status and social circumstances. Staff told us these assessments were reviewed again at key points, such as pre‑operative checks, post‑operative handovers and whenever a patient’s condition changed.

Patients consistently told us they were given time to discuss their needs and understand their planned surgery.

Staff carried out post‑operative observations, pain assessments and wound checks regularly. Staff responded promptly to changes in patients’ condition by escalating concerns, adjusting pain management, or seeking review. Patients told us staff were responsive to changes in their condition and regularly checked on their comfort and recovery.

Staff assessed safety and risk as part of routine care. Staff gave patients clear verbal and written advice about when to seek help.

Staff gave verbal and written information to help people monitor wounds, recognise infection and know when to return.

Staff considered patients’ communication and additional needs and interpreters where used where required.

The service planned and delivered patient’s care and treatment with them, including what was important and mattered to them.

Staff followed up-to-date policies to plan and deliver high quality care according to best practice and national guidance. All policies we looked at contained a creation and review date, and clear references to current national guidelines. There were systems to communicate changes in guidance through meetings and management newsletters. We saw notice boards displaying up to date guidance to staff. The service used National Institute for Care and Excellence (NICE) guidelines to ensure care was evidence-based.

Staff ensured patients waiting for operations were not ‘nil by mouth’ for longer than necessary. The hospital followed the ‘Sip till Send’ protocol which allowed patients to sip small amounts of clear fluids up until the time that they were taken to the operating theatre. This reduced hunger, thirst, anxiety and dehydration related issues without increasing the risk of fluid entering airways or lungs when patients were under general anaesthetic.

All new policies were communicated with staff through face to face meetings, email and on noticeboards throughout the hospital. There was a process in place to record all implants, such as hip implants. Theatre staff completed the paperwork at the time they inserted the implant. This was documented on the National Joint Register (NJR) by theatre staff.

Staff used surgical pathways which were in line with national guidance. National Safety Standards for Invasive Procedures (NatSSIPS) were available in the theatre department. NatSSIPS provide a framework to produce Local Safety Standards for Invasive Procedures (LocSSIPS). The Nuffield Health group created a LocSSIP for safe invasive procedures which had been updated in line with the most recent guidelines. This ensured standardised practice, reducing variation and ensuring staff followed the safest, evidence‑based steps for every procedure.

The service had received exemplar status accreditation from the Getting it Right First Time programme in orthopaedic (including spinal) surgery. This means that they had demonstrated best practice in efficiency, patient care, and clinical pathways.

The service worked well across teams and services to support patient. Staff made sure patients only needed to tell their story once by sharing their assessment of needs when patient moved between different services.

Staff told us that they worked well together as a team. Staff took part in regular multidisciplinary working practices throughout theatres and the ward. This included daily safety huddles, structured handovers and patient safety meetings. Nurses, consultants and allied health professionals worked closely together to review patient needs and plan ongoing care. Effective handover processes ensured staff were able to share important information between teams. Clear pathways supported nursing staff to involve senior clinicians appropriately and provide all relevant information to help inform decisions around patient care.

The teams worked together to prepare patients for what to expect post-operatively and when they returned home. Nursing staff told us that staff at all levels were comfortable with seeking advice and support from consultants and anaesthetists when required. Staff survey results from 2025 reinforced this and indicated that teams across all services worked well together.

Governance structures within the hospital reinforced information sharing and coordination. Multidisciplinary governance meetings, including adverse event forums, clinical governance committees and the Medical Advisory Committee (MAC), brought together staff from different services to review incidents, risks and outcomes. Staff shared learning and agreed actions across departments, which supported joined‑up working and consistent practice.

Staff also worked together to support patients with additional or complex needs. We were provided with examples of how teams worked together to support patients with additional needs.

The service worked closely with local partners, maintaining strong relationships with the Integrated Care Board and the local NHS Trust through quarterly meetings that support joint planning and discussion of local healthcare needs. Because most consultants hold practising privileges with Nuffield while also working at the local NHS Trust, the service benefits from a collaborative relationship between the Trust’s theatre team and the Nuffield Health theatre team, helping ensure safe and consistent perioperative pathways.

The service had a healthcare account manager (HAM) who engaged regularly with local GP practices, promoting new services and gathering feedback to ensure referral pathways remained responsive. The HAM also coordinates GP education events, where specialist consultants delivered sessions on topics such as Orthopaedics, Spinal care, Gynaecology, Menopause and Dizziness. These activities strengthen relationships with primary care and support high‑quality, well‑informed referrals.

The service supported patients to manage their health and wellbeing to maximise their independence, choice and control. The service supported patients to live healthier lives and where possible, reduce their future needs for care and support.

Patients undergoing elective operations had access to information about their condition, their treatment and how best to prepare for surgery and recovery. Patients told us that staff spoke with them about how best to optimise their recovery.

Staff delivered an established Enhanced Recovery Programme that supports safe and timely postoperative recovery through a structured, evidence‑based pathway. They promote early mobilisation, optimise pain management, and work collaboratively across multidisciplinary teams to improve outcomes. Clinicians provide comprehensive pre‑operative education and create individualised postoperative plans that help patients understand their procedure and actively participate in their recovery.

Staff included health promotion and lifestyle discussions as part of routine care. This included discussing the impact of smoking, alcohol use, diet and physical activity on surgical outcomes. Staff provided patients with relevant health information materials, such as leaflets on smoking cessation and alcohol reduction, and signposted them to local support services. Staff referred patients needing additional support to other healthcare professionals, including dietitians, to ensure patients received tailored advice that promoted long term health and wellbeing.

The service monitored patient’s care and treatment to continuously improve it. Staff ensured outcomes were positive and consistent, and they met both clinical expectations and the expectations of patient themselves.

Staff routinely monitored clinical outcomes and collected patient outcome data to support improvement through the hospital’s governance framework. Leaders reviewed quality, safety and effectiveness data regularly at the quality and safety committee, clinical governance committee and adverse event forums. They examined performance dashboards, audit results, incident data, harm grading and learning outcomes at these meetings. Leaders told us they tracked outcomes using scorecards, benchmarking and national standards to identify trends and areas requiring action.

Staff monitored the effectiveness of care and treatment through audit and benchmarking against similar services. These audits included infection prevention and control, surgical site infection surveillance, medicines management, consent and clinical pathways. Staff used the findings to make improvements when needed. The hospital also took part in relevant national and provider‑led clinical audits, including Getting It Right First Time.

The service reported information to the Private Healthcare Information Network (PHIN). These reports contained data on PHIN’s existing performance measures, including; patient activity volumes, length of stay, never events, Patient Reported Outcome Measures (PROMs), infections and also data submission levels. Data submitted showed that the service was performing in line with or higher than other local Nuffield hospitals.

The service told patients about their rights around consent and respected these when delivering person-centred care and treatment.

Staff understood the legal requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). They supported patients to make informed decisions about their care and treatment and followed national guidance when discussing consent. Staff supported patients who lacked capacity or were experiencing mental ill health in line with clear procedures. However, the service did not routinely refer patients who were unable to consent for treatment.

Staff explained how and when they should assess a patient’s capacity. They obtained and recorded consent to share information with the patient’s GP and other health professionals.

Staff obtained consent for surgery after explaining the benefits, risks, possible complications and alternative options. They checked consent at several points before the patient went to the operating room and again immediately before surgery. Patients told us they were involved in decisions about their care and treatment and could describe the risks and benefits staff had explained.

Staff requested verbal consent before providing care or treatment. They involved patients in decisions at all levels; for example, the ward hostesses asked patients what they wanted to eat and drink.

Staff used interpreters, including British Sign Language and face‑to‑face interpreting, to support patients to give informed consent. Consent forms showed staff had discussed risks and benefits with patients, ensured patients signed the forms and provided them with a copy.

The provider’s consent policy gave staff clear guidance on how to obtain consent, and staff told us they sought advice when they needed additional support. Staff also sought permission before sharing patient information with family or friends.

When patients were responsible for paying for their care or treatment, staff provided a written statement outlining the terms and conditions of the service, including the amount and method of payment.