Nuffield Health North Staffordshire 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 that 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 as good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We looked for evidence that people and communities had the best possible outcomes because their needs were assessed. We checked that people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

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

Staff assessed patients’ needs using a range of assessment tools to ensure their needs were identified and understood. Assessments considered patients’ health, care, wellbeing, and communication needs, to enable them to receive care or treatment that had the best possible outcomes.

If staff had not been told about a communication issue or other access needs prior to the appointment, they would endeavour to ensure the patient’s needs were met. For example, they would arrange for a telephone interpreter at short notice or see someone sooner in clinic if they struggled with long waits. The hospital also had an accessible information pack available to patients. Accessible information standards are legally binding and entitle patients to receive health information in alternative formats like easy read or large print.

All the patients we spoke with told us that their needs and care were discussed with them in detail, and in a manner that they were able to understand. Patients told us that they felt included in decisions that were made about their care and that their preferences were considered.

Staff reviewed pain relief medicines for maximum effect. Outpatients and pharmacy staff had worked on a pain management leaflet which was very informative, explaining which medications could be taken at the same time, and when to discontinue medications. Staff considered alternative pain relief medicines and advised patients on how to manage pain. Patients told us how they felt that their pain was managed well. One patient told us how they had tried various pain relief options and how staff had acted fast to support them in this.

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.

Staff followed up-to-date policies to plan and deliver high-quality care according to best practice and national guidance. Staff could easily access policies online or on their mobile telephones. All policies we looked at contained a review date and clear references to current national guidelines. There were systems to communicate changes in guidance through meetings, email updates and through a shared intranet page. Staff also had a mobile application which showed individual compliance with current or updated policies. Policies and processes took account of changes to the Royal Colleges guidelines and National Institute for Health and Care and Excellence (NICE) guidelines.

Staff were aware of data reported by surgery 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, infections and data submission levels.

Staff used a range of tools to assess and review people’s health needs. The tools were standardised, so staff understood how to use them. The type of tools used to record and monitor people’s health depended on the clinic being held, and the individual needs of the patient. For example, venous thromboembolism (VTE) assessment for patients who were being considered for surgery. We reviewed 8 care records and found all care plans and risk assessments were completed correctly on the hospital’s digital system.

One consultant we spoke to was full-time in the NHS but had been employed at Nuffield for many years. He said he had continued his role because he felt the hospital was responsive to newer treatments and ongoing research and development.

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 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 team working which was based on mutual respect and trust. Information was shared between teams and services to ensure continuity of care. Multidisciplinary meetings were held, for example, every Thursday there was a patient safety meeting which was usually led by a senior nurse or pharmacist. The meeting included representatives from all departments including outpatients. Patient safety meetings were held for patients who met Nuffield Health North Staffordshire's admission criteria but had been identified as having additional needs or specific co-morbidities, such as Parkinson's disease, that require enhanced pre-operative planning and multidisciplinary coordination. These meetings supported the safe management of patients whose needs could be accommodated within the hospital's capabilities. Patients who fell outside the established admission criteria were not considered suitable for surgery at Nuffield Health North Staffordshire and referred to a more appropriate setting for their care.

Senior staff spoke about monthly calls with other Nuffield outpatient leads where best practice is shared. A good example of this was seen with the introduction of hysteroscopies within the clinic, this led a standard operating procedure being written and shared with other hospitals that had not yet introduced it. Specialist training was provided for all levels of nursing staff. Consultants reported they were happy with the reduction in wait times since the introduction of this service.

We saw evidence of a national resuscitation team lead staff training, this was organised by the hospital's resuscitation lead. Staff also completed scenarios on a quarterly basis, recent scenarios included major haemorrhage, seizures and anaphylaxis. The provider running the scenarios rated the hospital, which had a low-risk score of 41/50 at its last assessment. Staff who missed this learning opportunity were offered another date where senior staff would copy the scenario internally.

Consultants working under practising privileges at Nuffield who were primarily working in the NHS could access NHS records. This was seen as a seamless way to access patient NHS records and refer patients into NHS services should that be required. This often meant transfers were seamless and reduced the time patients waited to be seen in the NHS as consultants could book patients into their own clinics. They also used their secretaries to type clinic letters.

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 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. For example, the pre-assessment team would look at health promotion topics including looking at body mass index and smoking cessation. They would offer patients information leaflets and support to reach these goals if required.

Staff delivered health checks, talks and screening events in partnership with local employers, schools, and community groups. These included highly visible and accessible places such as local supermarkets which gave people increased opportunities for engaging in health promotion. A consultant led presentation delivering on knee pain shared valuable insights into the causes of knee pain and explored the latest, evidence‑based non‑surgical treatment options available to patients.

The gym team also supported the local community, offering free health checks and sharing practical advice on simple ways to look after people's wellbeing. They recently visited a local school and teamed up with a local football club to support their men’s health event.

The provider offered staff free gym membership and a reduced membership fee for their families to join to promote good health and wellbeing. Staff had access to private health insurance.

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 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 achieve good outcomes for patients. The service participated in relevant national and provider led clinical audits, including using the National Early Warning Score (NEWS) tool to monitor patient observations when undertaking minor procedures in the department. We also saw a good example of this when observing a clinic appointment for a patient who had contacted the hospital that day with post-operative concerns. The NEWS score was recorded, and a comprehensive examination was undertaken, and appropriate information was recorded. When incidents happened, patient safety investigations were undertaken analysed for themes and after action reviews were completed and tracked. Leaders benchmarked the hospital against other Nuffield hospitals, and results were presented to staff in team meetings.

The service also supported continuous improvement through self-assessment and governance oversight. The service had been accredited under relevant clinical accreditation schemes. We saw accreditation in the National Joint Registry quality scheme gold award issued in 2025. Following submission to the Royal College of Physicians for annual review, the service met all the required standards in February this year and saw the hospital gain Joint Advisory Group accreditation for gastrointestinal endoscopy. Gold standard had also been attained in aseptic non touch technique accreditation for decontaminating equipment.

There was board oversight of waiting lists and outpatient clinic risk. The senior leadership team held monthly board meetings and discussed issues such as noncompliance. A recent audit of clinic letters showed not all patients were receiving clinic letters following an appointment. The audit trail detailed responses from consultants and comments from the auditor to demonstrate actions taken to resolve this. Monthly hospital quality reports assessed the Nuffield’s overall effectiveness, safety and experience of people using and working in the hospital. Recent reports identified there was room for improvement regarding effectiveness of the hospital, looking at increasing referrals and productivity. Safety, patient and staff data was generally positive.

Staff used technology to support patients effectively. Online digital systems streamlined patient treatment by having 1 central system for patient records including digital prescribing of medication. Systems were in place for medicines management, these included oversight for medicines security, where outpatients scored 100% in recent audits. National standards of healthcare cleanliness saw clinical and non clinical areas benchmarked, this included reviewing good housekeeping arrangements, outpatients scored 99% and exceeded targets.

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 patients subject to the Mental Health Act (1983) using outpatient services at the time of our inspection. However, all the staff we spoke with were able to explain what steps they would take to ensure patients subject to the Act were provided with safe and equitable care and treatment.

Staff took practical steps to enable patients to make their own decisions. Patients we spoke with told us they had been asked to consent to treatment where this was applicable, for example, patients who were going to undergo a surgical procedure and patients who had received surgery and in the department for follow up care. One patient told us, “I was fully informed around consent, I received written confirmation, given choices and options”. Patient records we reviewed confirmed all World Health Organisation checklists had been fully completed, and documentation for consent was fully considered and recorded. The audits used were designed for surgery and found not to be outpatient specific. The outpatient department audits were currently being developed specifically for the service to identify any areas that may need action to ensure high standards were maintained.

The consent process was robust and started at pre-assessment, following the patient journey to outpatients and subsequently theatre. Patients were also given a contact number should they have any questions about their planned treatment.

If a patient was identified as requiring an interpreter for a procedure, arrangements were put in place. The hospital had access to 24-hour interpretation services through a telephone service. The consultation or procedure would not go ahead until consent had been gained with the use of a translator. Staff did not use family or friends to translate when gaining consent for surgical procedures and interventions.

Chaperones were available to consultants performing intimate examinations on patients. There was a local process for outpatients and prompts in patient notes asking if a chaperone was required. Posters were visible around the department and in clinic rooms and a current policy in place to support this. A chaperone competency tool was used to train staff and record understanding of the role. A document tracker was also in use to ensure compliance.