Nuffield Health Derby 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 checked whether there was a welcoming, positive culture where staff keep learning and improving, focused on meeting the needs of patients and the wider community.

The service showed a strong, shared culture based on openness, fairness, inclusion, and respect for human rights. Staff followed the same values, worked well together, treated each other with respect, and were committed to providing high-quality, patient-focused care.

Leaders at all levels were visible, easy to approach, and inclusive, showing honesty and kindness in how they led. Staff said leaders listened to them, supported them, and helped them grow. Leaders encouraged development, recognised successes, and offered flexibility when needed. They also created a culture where staff and patients felt safe and confident to speak up about concerns.

Leaders had systems in place, with clear roles and good oversight of safety and performance. They used secure and reliable information to help make decisions. Leaders actively monitored risks, used audit results to improve services, and kept policies up to date and easy to access. However, we had significant concerns about governance arrangements within the pharmacy. We identified instances where pharmacy staff worked outside both local and central Nuffield policies relating to the management of controlled drugs.

The service actively focused on learning, improving, and trying new ways of working. Leaders encouraged staff to share ideas, take part in research, and tailor care to each person’s needs. Staff used lessons from incidents, feedback, and audits to improve both clinical care and day-to-day operations.

Teams worked well with NHS trusts, community providers, GPs, and universities to coordinate care. The service also connected with local communities, offering support and education tailored to different needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

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.

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 patient and their communities.

The service showed a clear, shared direction and a positive culture based on well-defined values. Staff could clearly describe these values and said teams worked well together across all roles and departments, treating each other with respect and sharing responsibility for delivering high-quality care.

Staff told us leaders maintained a visible and approachable presence and engaged actively in the service. They said leaders modelled the organisation’s values, supported open communication and encouraged collaborative working.

This approach created a strong, joined-up culture where staff felt well-informed, supported, and working together towards the same goals for patient care.

Staff focused on the needs of people receiving care. The service promoted equality and diversity in daily practice and offered opportunities for career development. Leaders fostered an open culture where patients, families, carers and staff could raise concerns without fear.

Staff told us they felt respected, supported and valued. They described the leadership culture as inclusive and said leaders consistently recognised and acknowledged their contributions. Staff at all grades reported positive working relationships.

Leaders recognised and celebrated both team and individual achievements. They thanked staff for their work and reinforced a culture of appreciation.

Leaders at all levels created an inclusive culture and understood the context in which staff delivered care. They led with openness, integrity and compassion.

Leaders maintained a visible presence in theatres and on the ward. Staff told us leaders were approachable and supportive. They said leaders understood the demands of the service and provided help when needed. Staff gave examples of managers making reasonable adjustments, offering flexibility and giving direct support during difficult personal or professional circumstances.

Staff told us leaders supported their development and celebrated their achievements.

Senior leaders demonstrated excellent understanding of the service and showed they had the skills, knowledge and experience to perform their roles effectively. They clearly valued their staff and invested in their development to strengthen the service for the future.

Managers on the ward and in theatres described how they maintained oversight of governance, safety and staffing, including training compliance, incident reporting and escalation processes. Staff told us leaders understood national guidance, safety alerts and local pathways and shared this information through briefings, meetings and day‑to‑day conversations.

Staff engagement data supported what staff told us. The 2025 staff survey showed strong engagement and positive scores for management support, peer relationships, organisational fit and autonomy. These results indicated that staff felt supported by their managers, aligned with organisational values and able to contribute to decisions about their work.

The service fostered a positive culture where patients felt they could speak up and their voice would be heard. Staff and leaders acted with openness, honesty and transparency, and the culture encouraged staff to raise concerns and share ideas confidently.

Staff told us they felt able to speak up without fear of repercussion and believed leaders would support them when they did so. They said leaders handled concerns sensitively and confidentially.

The service operated comprehensive Freedom to Speak Up governance processes, supported by regional and national leads. Staff had access to Freedom to Speak Up Guardians at the hospital and told us the initiative was well embedded across the service. Leaders described concerns that staff had escalated through this route and explained how they acted on them.

Patients, families and carers received clear information on how to raise a concern and how the service would investigate it. Senior ward staff responded to immediate concerns to achieve early resolution, and we saw examples where leaders addressed issues promptly before they escalated into formal complaints.

The service valued diversity in their workforce. Staff work towards an inclusive and fair culture by improving equality and equity for everyone.

The service promoted an inclusive culture and supported this through its equality, diversity and inclusion policies.

Staff told us managers engaged with them regularly and listened to any concerns they raised. They said they had not experienced unfair treatment, discrimination or harassment and felt confident the service would address any issues sensitively.

Staff received training in equality, diversity and human rights, and the provider embedded these principles within its recruitment policies and processes.

Managers told us they embedded equality, diversity and inclusion firmly within the service’s culture, and staff described a workplace where people were respected, valued and treated fairly.

Leaders told us the hospital actively supports colleagues who relocate from overseas, including helping them settle into accommodation and navigate required employment processes. Leaders described how these staff have become valued members of the clinical teams. The hospital also makes reasonable adjustments for staff with disabilities. For example, when a team member with hearing loss joined the service, managers worked with fire‑safety specialists to ensure appropriate alerts were in place, including visual signals in their work area and a personal vibrating device to notify them of any fire alarm activation.

Staff at Nuffield Health Derby Hospital work within the wider Nuffield Health organisation, which monitors fairness and equality through the Workforce Race Equality Standard. The latest results show that, across the organisation, staff from ethnic minority backgrounds are less represented in senior roles and are more likely to report negative experiences such as discrimination or bullying. Recruitment and disciplinary patterns also show some inequality. However, staff across all backgrounds have good access to training and development. These findings mean Derby, like other Nuffield sites, is focusing on improving representation, strengthening fair processes, and creating a more inclusive workplace for everyone.

The service had clear responsibilities, roles, systems of accountability and effective governance. Staff used these to manage and deliver high-quality, sustainable care, treatment and support. Staff always acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

Although we saw evidence of good practice throughout the hospital, we had significant concerns about governance arrangements within the pharmacy. We identified instances where pharmacy staff worked outside both local and central Nuffield policies relating to the management of controlled drugs.

The service mostly used clear and effective governance processes. Committees such as infection prevention, antimicrobial stewardship, tissue viability and the adverse event forum met regularly, and staff from different roles took part in these meetings.

Staff collected and monitored a wide range of information. They shared this at committee meetings and reported it to the provider. Leaders reviewed performance data across the organisation and created action plans when they identified areas needing improvement.

A medical advisory committee, led by a chair and supported by service leaders, oversaw practising privileges and checked the clinical outcomes of individual doctors. When concerns arose about a doctor’s performance, leaders followed set processes and shared information with professional bodies when required.

Staff at all levels understood their roles and responsibilities. Job descriptions set out expectations clearly, and senior staff who carried out audits or monitored quality understood their duties well.

Staff could easily access the data they needed to understand performance and make decisions. Information systems were secure and worked effectively together. The service sent required data and notifications to external organisations on time.

Leaders made sure staff received accurate information. They used email, noticeboards and face‑to‑face updates to keep staff informed.

The service kept a clear risk log. Leaders used it to monitor issues, plan actions and drive improvements. Staff contributed to decision‑making to support sustainability and improve the quality of care.

Leaders used audit results to check the quality of services. When audits showed the need for improvement, they created action plans and monitored progress until changes were complete.

The service reported no data breaches. Systems remained secure, and staff handled patient information correctly. Patient records were paper based and were stored securely to prevent any breaches of confidentiality.

We reviewed several service and provider policies. Leaders kept these policies up to date, ensured staff could access them easily and checked them regularly to maintain accuracy.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for patient. Staff share information and learning with partners and collaborate for improvement.

Staff coordinated care effectively within the hospital and with external partners to reduce gaps in people’s care. They worked closely with NHS trusts, ambulance services and community providers to support shared responsibility for patients’ treatment. The service maintained clear links with local GP surgeries and signposted patients to free courses on joint pain, long COVID, rheumatology and cardiology at their local Nuffield gym.

Staff and leaders also collaborated with external stakeholders to improve care. The service partnered with local universities, and student GPs completed four‑week surgical placements at the hospital. Senior leaders participated in regional networks to understand community needs and support the provider’s wider aims.

Leaders and staff engaged actively with patients, staff, equality groups, the public and local organisations to plan and shape services. They identified local needs through regular and proactive engagement. The service also hosted multi‑cultural menopause evenings, where a consultant gynaecologist provided education and support to the community.

The service focused on continuous learning, innovation and improvement across the organisation and local system. Staff encouraged creative ways of delivering equality of experience, outcome and quality of life for patient. Staff actively contribute to safe, effective practice and research.

The service demonstrated a continuous and consistent approach to improvement in both clinical and operational areas. Leaders invested in the service and fostered a culture across all staff levels that focused on improving outcomes and creating better experiences for patients.

Staff used systems that supported learning from incidents, complaints and feedback. They used audit and monitoring processes to identify areas for improvement.

Leaders encouraged staff to contribute to improvements in practice, and staff described a culture where teams valued ideas and feedback. Teams worked collaboratively to identify opportunities to improve patient experience and outcomes.

Staff told us leaders supported them to develop and progress their skills. The service offered training to all staff and shared good practice to continuously improve patient experience.

The service used a range of approaches to support equality of experience and responsive care. Staff described adapting care pathways and environments to meet individual needs, including for people with additional communication or sensory needs.