Nuffield Health Shrewsbury Hospital

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We looked for evidence that safety was a priority for everyone, and leaders embedded a culture of openness and collaboration. Leaders had systems for identifying and responding to deteriorating patients. Medicines were managed safely. Patients were safe from neglect, abuse, and discrimination. Patient’s gave informed consent prior to procedures and where they were unable to consent, those close to them were involved in decisions made in their best interests.  

At our last assessment alongside diagnostic imaging, we rated this key question as good. At this assessment, the rating has remained good. This meant patients were safe and protected from avoidable harm.

We have not awarded this service a score for Safe.

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

The service had a strong proactive and positive culture of safety, based on openness and complete honesty. Staff and leaders actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Learning was shared widely across the service and more widely with the other provider locations, where appropriate.  

The service managed patient safety incidents well. Staff recognised and reported incidents and near misses. Leaders investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave patients honest information and suitable support. Leaders ensured actions from patient safety alerts were addressed and progress was monitored.  

There was an electronic system for managing incidents. We were given examples of how practice had changed because of an incident. All staff were able to discuss this incident with us and share the learning identified. Mandatory training included managing and investigating an adverse event, there was 100% compliance with this module.  

Staff were able to identify and report risks, secure in the knowledge these would be addressed. SWARM meetings were held as soon as possible after incidents. SWARMS were completed to identify learning, enabling insight and reflections to be quickly sought and to generate prompt learning.  

We reviewed some team meeting minutes and saw incidents from July 2025 to January 2026 were an agenda item and included details of the event and any actions taken. We saw leaders audited if staff could articulate learning from incidents in their own department and other departments and results since July 2026 showed that they could. Incidents were discussed in various meetings and embedded within the governance of the hospital. 

We observed a weekly whole hospital meeting to discuss all open incidents; we heard staff discussing incidents including levels of harm. They also spent time discussing any open complaints. Leaders used changes in national guidance, incidents, safeguarding and appraisals to identify gaps in learning. 

The service worked with patients and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Staff made sure there was continuity of care, including when responsibility for patient care moved between different areas of a service and between providers. 

The hospital saw 27,134 patients between the 1 September 2025 to the 31 August 2026. We reviewed the data for all specialities and found the shortest wait for an appointment to be 2 days and the longest was 26 days. 

Patients requiring tests and investigations were given enough information to enable them to understand the procedure. Patient records were electronic and were kept securely. There had been some IT issues at the hospital prior to our inspection however this appeared to have been managed appropriately to reduce any impact. Escalation was carried out as needed and it was discussed in the daily huddle.  

Care and support were planned and organised with people, together with partners and communities in ways which ensured continuity. Patient survey results showed that 99% of patients said hospital staff told them who to contact if they had any concerns after leaving hospital. 

The service worked with patients and healthcare partners where required, to understand how best to keep people safe, what it meant for individuals and the best way to achieve that. Staff concentrated on protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm, and neglect. The service shared concerns quickly and appropriately. 

Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff completed mandatory training in safeguarding adults and children and young people, compliance was 100%. There were current safeguarding policies, and these reflected the national guidance.  

Staff knew how to make a safeguarding referral and who to inform if they had concerns. Safeguarding advice was available to support staff; staff knew how to contact them. There was information on display in the toilets on safeguarding topics such as female genital mutilation and what to do if they experienced abuse. The matron was the service lead for safeguarding.  

There were audits at the hospital in relation to safeguarding. For example, leaders tested staff knowledge in relation to this. For example, if the staff member could describe what they would do if they had a safeguarding concern and who they would contact.  

Safeguarding concerns were considered when an incident occurred and a referral or further advice sought, when necessary. There were links to external agencies and staff knew what happened when they raised concerns. We reviewed the team meeting minutes and saw safeguarding was an agenda item.

The service worked with patients to understand and manage risks. Treatment and care met patients' needs in a way which was safe and supportive and enabled them to do the things that mattered to them. The hospital team came together daily to discuss any risks such as patients with high National Early Warning Score, supply and equipment issues impacting delivery and any hospital risks.  

We observed part of a consultation prior to a procedure and observed the consultant clearly describing the risks of the procedure they were going to perform in addition to the different options and the risks these entailed such as bleeding, pain, infection and small nerve damage. The nurse also completed a surgical safety checklist.  

A hypoglycaemia kit was available and checked monthly. The kit contained the required treatment items including glucose gel to support the management of patients experiencing low blood sugar levels. Staff told us although outpatients did not supply meals to patients, if the patient had diabetes or had travelled a long way there was the option to order them a sandwich/snack if needed.  

Staff were able to verbalise the actions they would take if a patient deteriorated in the waiting area such as contacting the onsite resuscitation team, calling the resident doctor, or calling the emergency services. Staff training included topics such as pressure ulcer prevention, diabetes and insulin management, falls prevention and National Early Warning Scoring (NEWS2). 

The service detected and controlled potential risks in the care environment. Leaders and  staff took steps to make sure equipment, facilities and technology supported the delivery of safe care. Where they were unable to do so, they mitigated the risks.  

The design, maintenance and use of facilities, premises and equipment kept people safe. The hospital had its own engineer on site who also attended the daily whole hospital huddle. There was a local water safety forum attended by the infection control nurse, engineers, the pathology lead and the health and safety co ordinator alongside other key staff. We also saw sampling had been completed for Legionella.  

Fire safety equipment was available and had been serviced. Fire exits were clear and free from obstruction; they also had fire inspections. There were weekly fire alarm tests and staff received training in fire safety  

We checked the resuscitation trolley and associated records and found all contents were complete and in date. The trolley was also tagged and the oxygen in date and secured. There were also various flow charts and algorithm for staff from the Resuscitation Council UK such as information on choking, anaphylaxis, and the treatment of hypokalaemia in cardiac arrest. A grab bag was located in the main reception area for use in car park or areas that may be difficult to reach with the resuscitation trolley. 

Leaders maintained oversight of equipment to ensure it was safe and ready to use. There were effective means of ensuring repair of replacement of broken or missing equipment. Electrical equipment was labelled to show it had been tested for safety. Equipment was an agenda item in the daily whole hospital huddle. 

The service had suitable facilities to meet the needs of patients’ families when necessary.  

Staff disposed of clinical waste safely, both inside and outside the building. Waste was segregated and labelled in accordance with Nuffield Health policy. The risk of sharps injuries was minimised because of the safe management of sharp implements. We saw there was a folder in the clinic room in case of needle stick injuries. The box contained information on the management of sharps and splash injuries, a monthly checklist and examples of a completed blood form. All staff had completed training on managing splash and sharps injuries. Hazardous substances were stored safely in line with Control of Substances Hazardous to Health.  

The service made sure there were adequate numbers of qualified, skilled and experienced staff, who received effective support, supervision, and development. Staff worked together well to provide safe care, which met patient’s individual needs. 

The service had enough clinical staff including nursing and support staff with the right qualifications, skills, training, and experience to keep patients safe from avoidable harm and to provide the right care and treatment. It was identified that additional administrative capacity was required to support the outpatient's manager role, Therefore, to provide the outpatients manager with sufficient protected managerial time the hospital had recruited 0.6 whole time equivalent staff nurse into the department. This resource supported clinical services delivery enabling the outpatient's manager to dedicate appropriate time to leadership, operational and administrative responsibilities.  

Staff were made aware of their shifts in advance and could make requests. The hospital used a Nuffield Health developed staffing tool which supported leaders to ensure the correct staffing levels.  

We reviewed several staff files and found safe recruitment practices to make sure all staff were suitably experienced, competent and able to carry out their role. We reviewed 3 staff records and found recruitment processes were in line with schedule 3 of the HSCA (RA) Regs 2014. Nursing staff had completed their Nursing and Midwifery Council revalidation and had up to date disclosure and barring checks.  

We reviewed a copy of the Nuffield Health Shrewsbury Hospital induction and introduction session slides. The induction included topics such as an introduction to the senior leadership team, organisational structure the purpose of the hospital, strategy, the Freedom to Speak Up guardians and key policies.  

Leaders supported staff to develop through constructive recorded, annual appraisals and constructive clinical supervision of their work. Outpatient staff completed competencies such as medical devices, phlebotomy, chaperone, and venepuncture. 

Leaders reviewed the number and grade of clinical staff, healthcare assistants and other key roles, needed for each shift. Leaders could adjust staffing levels daily according to the needs of patients.  

The service had low sickness rates. This was 4.46% over the last 12 months.  

Leaders limited their use of bank and agency staff and requested staff familiar with the service. Nursing bank hours for June were 53 hours, 67 hours in July and 53 hours in August 2026.  

Patients felt their needs were met in a timely way. We saw patients were attended to in a kind and supportive way.  

The service supported the learning and development needs of staff and made sure staff received any specialist training for their role. Leaders identified any training needs their staff had and gave them the time and opportunity to develop their skills and knowledge. For example, leaders made sure staff received regular appraisals to maintain high-quality care. Within their appraisals staff were encouraged to set objectives, examples seen included to assist with patients who were undergoing osteoporosis treatment and carrying out courses. 

The overall completion rate for mandatory training in the outpatient's department was 98.4%. 100% of nursing staff had completed their immediate life support training.  

Leaders ensured staff attended relevant meetings or had access to the information shared when they could not attend. We saw notes from meetings and other general information shared on notice boards. 

Allied healthcare professionals such as physiotherapists formed an integral part of the patient care and treatment pathway and promoted recovery and rehabilitation. The service had formal arrangements for a resident doctor to be on-site when patients were receiving treatment and care. Consultant surgeons and anaesthetists were subject to a full assessment through the practice privilege process. They were required to provide evidence of appraisal and re-validation.  

The service assessed and managed the risk of infection. Staff detected and controlled the risk of it spreading by following policies. Infection and prevention and control data was collected and reviewed. Where required, actions were taken to improve shortcomings.  

A team of housekeepers cleaned the outpatient's department in the evenings. Outpatients' areas were visibly clean and free from clutter; furnishings were visibly clean and well-maintained. Disposable curtains were changed and the date recorded. We noted that the department had been awarded a 5-star cleanliness rating in August 2026. The hospital had also achieved a cleanliness score of 100% in its patient led assessment of the care environment scores for outpatient areas in 2025. 

Leaders completed infection prevention control audits. We reviewed the results from January 2026 to August 2026 and found they scored 99% and above in all months.  

There was a provider infection and prevention and control policy and supporting guidance that was accessible to staff. Staff had access to expertise in infection control as needed. Hand hygiene audits showed good compliance achieving 98% in June 2026.  

Sharps bins were not overfilled and were dated. Staff cleaned equipment after patient contact, an outside contractor collected any clinical waste. We noted bins contained coloured bags to show it was hazardous waste and these were emptied regularly. 

Staff used records and data to identify how well the service prevented infections. There were processes to enable staff to respond to infection prevention and control risks such as transmittable infections. For example, there was an infection prevention expert advisory group. We reviewed the presentation from the meeting July 2026 and noted topics discussed included infections, infection incidents by hospital including any trends, anti-microbial stewardship, and cleaning reports. 

Staff were following infection control principles including compliant handwashing and the use of personal protective equipment (PPE) as outlined in the services PPE standard operating procedure. There were dispensers with hand sanitizers in public areas so staff and patients could decontaminate their hands.  

Staff supported infection prevention and control measures by following the uniform policy. Nail varnish and jewellery was not worn, and staff in clinical areas were bare below their elbows to allow for full hand decontamination.  

All staff had completed training in relation to infection prevention and control and 87.5% of staff had completed infection prevention control clinical; this was not at 100% due to staff sickness.  

The service made sure that medicines and treatments were safe and met patient’s needs, capacities and preferences. Staff involved patients in planning, including when changes happened. 

The service used systems and processes to safely prescribe, administer, record and store medicines. Fridge temperatures were monitored by an external company. We noted there had been some IT issues which had affected some parts of the building. This was discussed in daily huddles and was being managed appropriately. This had not had any impact on outpatient services. There was oversight of medicines optimisation for staff from a pharmacist. 

Weekly stock checks and ordering were completed via the in-house pharmacy. Consultants used the electronic system for any prescribing.  

There was effective governance of medicines, for example, there was a hospitals medicines management and medical gases meeting. We reviewed the notes from July 2026 and found areas discussed included medicines management updates, regulatory compliance internal quality assurance review in addition to reviews of themes, trends and lessons learnt. 

We reviewed the latest departmental medicines security audit from April 2026. The audit results showed a compliance rate of 95%. The audit included if out of date medicines were stored securely until they were returned to pharmacy, if emergency medicines resuscitation trolleys/anaphylaxis kits were tamper proof and if all IV fluids were in a lockable cupboard or with restrictive access. The audit identified there was no standard operating procedure for key management. At the time of the inspection this action was still in progress and high priority on the latest Integrated Quality Assurance Review.