Nuffield Health Newcastle-upon-Tyne 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

Patients, and where appropriate those close to them, were involved in assessments of their needs. Staff reviewed assessments taking account of patient’s physical emotional, communication and personal care needs. Care and treatment was based on latest evidence and good practice guidance. Patient outcomes met expectations, and harm free care was the norm. Patients’ pain was quickly identified and well managed.

This was the first rated assessment for this service since 2016. This key question has been rated good.

This meant staff assessed patients nutritional and hydration needs, made sure patients had sufficient to eat and drink or alternatives as needed. Staff made sure patients understood their care and treatment to enable them to give informed consent.

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

Staff shared key information to keep patients safe when handing over their care to others. During pre–assessment an anaesthetist reviewed higher risk patients and liaised with the specific anaesthetist for that list. We observed weekly patient safety meetings which reviewed patients against the service inclusion criteria, and those with personal needs. Following these we saw the service made adaptations based on each patient’s individual need such as a special mattress, and pharmacy had been made aware of patients with a low body mass index (BMI) who required medication adjustments. Further examples were arrangements made for patients who needed extended stays, those with complex onward social care needs, and dementia patients needing one-to-one nursing, and patients with autism who had additional needs.

We saw policies and procedures followed for the management of emergency medicines in the anaesthetic environment, surgical first assistant and dual role, safe transfer of a patient between the ward and theatre, changes to the order of the operating list, venous thromboembolism assessment (VTE) and risk reduction, and reconciliation of items. These were complemented by ‘prep stop block’, safe standards for invasive procedures, and the management of anaemia in the peri-operative pathway protocols. The service had recently introduced pre-assessment optimisation following a decision to treat a patient through the completion of a health questionnaire, blood and electro-cardiogram tests.

A theatre department safety huddle was held each morning, attended by all theatre staff to discuss staffing issues, lists, implants and alerts. Daily checks were completed of all equipment. Shift changes and handovers included all necessary key information to keep patients safe.

The service also supported an extensive programme of guides, strategies and research aimed at improving the mental, physical, financial and social wellbeing of the population developed by Nuffield Health. These provided ‘…a detailed review of all aspects of the nation’s physical and mental health’. This had identified ongoing impacts of the global pandemic on people’s physical and mental health, and identified lifestyle changes to support their health. An example was support to help people become more active with programmes, tips and advice.

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

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.

Polices and processes took account of changes to the Royal Colleges guidelines and National Institute for Health and Care and Excellence (NICE) guidelines. The service had a management of external guidance, guidelines and reports procedure in place.

We reviewed care records for evidence of completion of care plans and risks assessment of patients and found these were completed appropriately. Pre-operative assessment audits identified learning and improvements where necessary. Patients waiting to have surgery were not left ‘nil by mouth’ for longer than necessary. Intravenous fluids were used to ensure pre-operative optimisation for emergency surgery, when necessary. Staff fully and accurately completed patients’ fluid and nutrition charts where needed. The information was used to inform care planning and delivery.

The discharge needs of the patient were discussed at pre-assessment and if they needed to see a physiotherapist this was arranged as well as any needs requiring social services input. The nutrition needs of patients were assessed using nationally recognised tools and special diets for clinical reasons arranged, and advice given. All patients for hip and knee replacements were seen at pre-operative assessment.

The service reported information to the Private Healthcare Information Network (PHIN). Intelligence reports were reviewed by service leaders. 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.

We scored the service as 3. The service usually worked well across teams and services to support patient. Staff made sure patient only needed to tell their story once by sharing their assessment of needs when patient moved between different services.

All staff, including doctors, nurses, and other healthcare professionals worked together as a team to benefit patients. They supported each other to provide good care. Staff reported healthy working relations across staff groups including between medical and nursing teams. We saw and heard examples of effective teamworking which was based on mutual respect and trust.

Plans for discharge considered individual needs, circumstances, ongoing care arrangements and expected outcomes. Discharges were planned at an early stage, pre-assessment, to ensure they were safe and appropriate for the person’s needs using a health screening questionnaire. We saw an example where the service had requested specialist equipment from the local council for delivery to the patient’s home when required. Peoples’ records showed there was input from a range of clinicians and that they shared information to ensure a consistent approach to care and treatment pathways.

Staff held regular and effective multidisciplinary meetings to discuss treatment options for individual patients and improve their care. Patients identified as having complex needs were reviewed at weekly patient safety meeting attended by staff from pre-assessment, wards, theatre, pharmacy, physiotherapy, the director of clinical services, and an anaesthetist. These reviewed patient needs and agreed appropriate care plans, including decisions regarding extended length of stay, the need for social services input, and the suitability of respite care. The service had developed a ‘pre-habilitation’ guide for patients.

We saw recent examples when this approach had been applied, for example a patient with autism where reasonable adjustments were discussed, patients with reduced mobility, and arranging community nursing support for a patient requiring ongoing compression stocking management. We saw this approach ensured proactive planning, effective risk management, and coordinated care tailored to individual patient needs.

We scored the service as 3. The service generally 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.

The service supported people to manage their health and wellbeing so they could maximise their independence, choice and control. Staff supported them to live healthier lives and where possible reduce their future needs for care and support. For example, the service had developed protocols for the identification and treatment of anaemia, and weight loss to prepare for surgery.

Clinical review to assess surgical readiness and pathway suitability was designed to screen and guide patients early in their surgical journey. Guidelines for the management of patients classified as unsuitable for surgery were used, and achieved through baseline pre-operative tests (blood pressure, body mass index and blood tests).

Patients undergoing elective operations had access to information about their condition, their treatment and how best to prepare for surgery. Patient videos had been created for hip and knee procedures, as well as an orthopaedic toolkit, total knee replacement information, and swelling and pain management.

Staff spoke with them about how best to optimise their outcomes after surgery and how to modify their choices to ensure better health. The service recognised one of the most common complaints after joint replacement is difficulty sleeping due to pain and in response had developed booklets explaining the importance of sleep for recovery, pain and weight management.

We scored the service as 3. 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 patients themselves.

Staff monitored the effectiveness of care and treatment through audit and benchmarking to compare with other similar services. The service used the findings to make improvements and achieved good outcomes for patients.

The service participated in relevant national and provider led clinical audits, including internal quality and safety meetings. Quality data from the National Joint Register and patient reported outcome measures (PROMS) were discussed at regular meetings and reported by speciality and consultant.

The PROMS outcomes were discussed at the monthly hospital board meeting, the quarterly quality and safety meeting and the quarterly medical advisory committee meeting. PROMS data from the National Joint Registry (NJR) were reviewed to benchmark performance against national standards. We saw data demonstrated the hospital was performing at a high level compared to peer organisations, with outcomes ranking within the top 10 nationally for knee replacements and top 20 for hip replacements (out of 198 providers).

The service had a low number of readmissions (1) for patients who had received elective surgery and there had been 1 unplanned return to theatre reported in the quarter 1 hospital quality report (January to March 2026), this also showed there had been 3 surgical site infections in 2026 (quarter 1).

The service had been accredited under relevant clinical accreditation schemes, by the Association for Safe Aseptic Practice, the National Joint Registry Quality Data (provider gold award) and Joint Advisory Group (JAG) accreditation.

The provider considered health inequalities and took steps to ensure that outcomes across people with protected characteristics were in line with the wider community.

The provider monitored and reacted to avoidable deaths and harms. Mortality and morbidity meetings were held every quarter. These involved a multidisciplinary review of all deaths to identify good practice, and cases which warranted further review for key safety actions.

We scored the service as 3. The service told patients about their rights around consent and respected these when delivering person-centred care and treatment.

Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to gain patients’ consent. Staff knew how to support patients who lacked capacity to make their own decisions or were experiencing mental ill health. The service had developed a consent to examination or treatment manual which outlined a decision making and consent process for a procedure.

Staff understood how and when to assess whether a patient had the capacity to make decisions about their care. Staff followed the services policies related to consent, mental capacity, deprivation of liberty and restrictive practice.

We saw compliance through staff training (95%), the carrying of Mental Capacity Act prompt cards, posters and flow charts displayed throughout the hospital. These were supported by legal checks, and mental and cognitive tests.

Staff always gained consent from patients for their care and treatment in line with legislation and guidance. We saw consent for surgery was sought by the most appropriate doctor and included discussion about the benefits, potential complications, the risks and alternative options. Patient consent was checked at various points before they went to theatre and immediately prior to surgery. There were consent audits completed, and outcomes and learning shared with staff.

Patients said they were involved in decision making about their care and treatment. They could describe the risks and benefits they were told about prior to surgery. Information on specific procedures was provided to patients before signing their consent form, and this was provided in different languages and formats.

We observed staff seeking verbal consent before providing care or treatment. People were involved in decision making at all levels. The service had a consent policy which included guidance for a ‘cooling off period’ (at least 14 days).