Nuffield Health Shrewsbury 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 had the best possible outcomes because their needs were assessed. We checked that patient’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring patient 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.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant patient’s outcomes were consistently good, and patient’s 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 usually made sure patient’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. 

Patients were involved in the assessment of their needs, and support was provided where appropriate to maximise their involvement. Staff ensured patients were able to share their individual needs when completing the pre-assessment and admission process. Staff told us during the initial contact patients with additional needs were highlighted such as English not being their first language or if living with dementia.

The weekly theatre scheduling meeting ensured all patients were discussed, their needs identified, and their care planned to include  identifying those patients with allergies or who may be diabetic.

Shift changes and handovers included all necessary key information to keep patients safe. 

Discharge plans were discussed during the patients pre assessment appointment as well as on admission to the ward. This ensured patients were aware of discharge dates and arrangements were in place so they were prepared to go home.

Staff assessed patients’ pain and used recognised tools to do so. Staff gave pain relief in line with individual needs and best practice and assessed how effective this was. Patients’ pain and ongoing prescribed pain relief was addressed before they left the operating theatre. 

Pain relief medicines were timed for maximum effect before painful procedures or to allow the patient to sleep at night. Patients told us they received pain relief soon after requesting it and felt their pain was well managed.

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. Staff were able to access policies, processes and guidance easily through the hospitals electronic system 

The service followed National Institute for Health and Care Excellence (NICE) guidelines. Policies were reviewed, were up to date and had been approved by the appropriate governance processes. Policies were monitored at corporate level to ensure they were updated, reviewed and consistent for each Nuffield Hospital. Policies and processes took account of changes to the Royal Colleges guidelines and NICE guidelines. 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. 

We looked at the pathway for people who were admitted for elective orthopaedic surgery and other procedures done through the NHS choices route. We also looked at care treatment for self-pay/insured patients having other surgical procedures. We reviewed 10 sets of patients medical and nursing notes and found they had a comprehensive health assessment of the patient soon after admission. Care plans were personalised and identified the patients’ needs and how staff could assist the patient. They were updated as necessary. Risk assessments, such as nutritional needs, falls and moving and handling, skin integrity and pain management were assessed daily and any updates recorded in line with best practice.

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. 

Staff used a nationally recognised screening tool to monitor patients at risk of malnutrition and used this to inform care planning and delivery. Patients requiring special diets for clinical reasons, were assessed and advice given. 

There was a corporate audit programme with monthly, quarterly, biannual, and annual audits scheduled. Results were benchmarked with other hospitals within Nuffield Health. Nuffield Health Shrewsbury performed similar to or better than other hospitals. Audits were discussed at incident investigation meetings known as SWARM, senior management meeting and reported to the Medical Advisory Committee. Any audits out of range had action plans and would be repeated more frequently. 

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.

Staff had access to the information they needed to appropriately assess, plan and deliver patients’ care, treatment and support. Staff within all department worked collaboratively to make sure patients' healthcare needs were met.

Teams worked effectively together with the daily hospital wide safety huddle sharing key information between departments around activity and mitigation against any immediate risks for example staff sickness and moving staff when needed.

There was a staff handover at the beginning of every shift which discussed every patient including discharge plans, observations and medication. Staff were allocated patients to care for and tasks to carry out.

There was a weekly theatre meeting during which every patient scheduled to have surgery in the next 7 days was discussed. 

When patients were transferred back to the ward staff were given verbal and written information on the operation and ongoing care needs.

Staff held regular and effective multidisciplinary meetings, to discuss treatment options for individual patients and improve their care. Consultants told us they frequently did this alongside their colleagues in the NHS to consider all treatment options.

The physiotherapy staff visited patients on the ward throughout the day. We saw physiotherapists and nursing staff discussing patient care needs, mobilisation and ongoing plans

During our onsite inspection, we observed staff within theatres working effectively together with clear direction from the lead surgeon and scrub nurse and clear communication with each other.

Plans for discharge considered people’s individual needs, circumstances, ongoing care arrangements and expected outcomes. For example, patients were aware there must be another adult with them when they were at home. Discharges were planned at an early stage to ensure they were safe and appropriate for the person’s needs. 

Patients’ 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.  

When patients were due to move between services, all necessary staff, teams and services participated in assessing their needs to maintain continuity of care. Written and electronic information was shared with other care providers such as the patients GP.

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.

Patients were empowered and supported to manage their own health, care and wellbeing by staff who understood their needs and preferences.

Patients had access to physiotherapy services and other support services to promote people to maximise their wellbeing and independence.

Patients undergoing elective operations had access to information about their condition, their treatment and how best to prepare for surgery. Patient information leaflets of a variety of conditions and post-operative care were available in different languages. There was lots of health information on the organisation's website. These included topics such as menopause, weight loss and men's and women's health. 

Staff told us how they had been to an agricultural show and had a stand. Thy told us they offered free health checks such as blood pressure. As a result, over 500 people had health checks.  

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 monitored the effectiveness of care and treatment through audit and benchmarking to compare performance 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 National Joint Registry (NJR), Private Healthcare Information Network (PHIN) and Patient Related Outcome Measures (PROMS) to benchmark performance against national standards. Outcomes for patients who used services were consistently better than expected, when compared with other similar services. 97% of people said their experience at the hospital was either very good or good (3127 patients).

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. In addition, it also included complaints data received from private insurers. In the PROMS survey, patients were asked whether they felt better or worse after receiving the following operations hip replacements knee replacements. (PROMs) demonstrated strong clinical outcomes across key surgical specialities. Hip replacement patients achieved a health gain of 21.5 points and knee replacement patients achieved a health gain of 15.7 points, both consistent with published UK national benchmarks. Cataract surgery patients demonstrated significant improvement in visual function. The results, covered 913 patients over the last 24 months across NHS and private activity, provided evidence of sustained clinical effectiveness and improved patient quality of life following treatment. 

Average length of stay was 1.22 days across all specialities, indicating a predominantly short stay, elective model of care. This demonstrated the hospital had rapid recovery pathways to support faster and effective patient recovery.   

The service had a low number of readmissions for patients having elective care and the return to theatre rate was 0.3%.

There had been 11 surgical site infections between January and September 2026 3 identified whilst they were an inpatient and 8 identified following discharge. This is an infection rate of 0.28% of all patients who had a surgical procedure.

The service had been accredited under relevant clinical accreditation schemes. Such as the hospital had achieved gold accreditation for Aseptic Non-Touch Technique valid from December 2025 to December 2028.  

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 service monitored and reacted to avoidable deaths and harms. Hospital adverse events meetings were held weekly with information about deaths and avoidable harms then reviewed during the quarterly Quality and safety meetings. Learning from these meetings was shared with staff with the aim of making improvements. 

The service had a transfer policy for any patient that required transferring to an NHS hospital for ongoing treatment. In the last 12 months there had been 5 patients transferred. All transfers were reported as incidents and reviewed by the MAC chair, consultant and anaesthetist involved in the care. 

The service told patient 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. Staff followed the services policies related to consent, mental capacity, deprivation of liberty and restrictive practice, as relevant.

Where possible, staff gained consent from patients for their care and treatment in line with legislation and guidance. Consent for surgery was sought by the most appropriate doctor and included discussion about the benefits of the treatment, potential complications, the risks and alternative options. Patient consent was checked at various points before they went to the operating room and immediately prior to surgery. Consent audits for March identified 97% compliance and for June 89% compliance. The results of the audits was 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. Relatives said they were kept informed about the care and treatment of their family member when they lacked capacity to consent to surgery.

We observed staff seeking verbal consent before providing care or treatment. People were involved in decision making at all levels. Housekeeping staff asked patients what they wanted to eat and drink.

Where specific requests had been made by patients, for a same sex health care professional or theatre team, this was discussed and provided whenever possible. Chaperones were provided if requested. 

Interpreters were used to support patients to give informed consent, including for BSL and face to face interpreting when necessary. 

Staff sought permission before sharing patient information with family or friends.