Boston West 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

The service ensured patients’ care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

Staff enabled patients to have the most positive outcomes because their needs were assessed promptly and effectively. We saw that patients’ care and treatment reflected these needs and that staff provided evidenced based treatment. Staff monitored patients’ outcomes and worked together to encourage patients in their ongoing recovery.

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 Effective.

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

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

Staff used appropriate tools to effectively support the assessment of patients’ needs or maximise their involvement. Staff involved all patients who underwent surgery in a holistic assessment of needs.

Where appropriate the service involved families, carers and other stakeholders in the assessment of patients’ needs. Staff reviewed patients before their surgical procedure to ensure previously completed assessments were still relevant. Staff members continued to check on patients' wellbeing during and after surgery. Any changes were documented on their clinical records.

Patients told us staff regularly checked on how they were, if they required pain relief, and offered food or drink, if appropriate. One patient described how staff would check in every 5 or 10 minutes whilst they were in recovery to make sure they had everything they needed.

Where patients may not fit the criteria for surgery, the service considered their case at an MDT meeting. In the best interests of the patient, the service may consider conducting the procedure despite certain criteria being evident. If so, this was clearly documented in the patient record, noting any risk identified and signed by all parties involved in the decision-making process.

If a patient was considered unfit for surgery, the service instructed staff to document the reason in the patient’s care record, along with a copy of the decision in the patient’s notes. These patients would then be referred to their GP or the operating consultant to discuss further options.

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 kept up to date with the most recent evidence-based practice. Managers shared updates to national guidance and corporate policies with the relevant heads of the department. These were then cascaded down to staff through team meetings.

Staff were encouraged to review local policies and consider all available methods to improve patient care. Staff noted concerns about patients being de-hydrated before procedures as part of a nutrition and hydration audit. As a result of this issue being raised, the service rolled out a “sip ‘til send” initiative. This encouraged patients to sip one 170ml glass of water per hour before going to theatre to prevent pre-surgical oral fluid deprivation. Staff spoke to patients and displayed posters to help them understand the new process and how it would help them to be in the best condition for their surgery.

The service leads attended regular meetings of the medical advisory committee (MAC) and the clinical effectiveness group where updates in clinical practice and guidance were routinely discussed. All staff could easily access updates on the service's intranet.

The service was actively pursuing accreditation in several national schemes, including the Association for Perioperative Practice (AfPP) and the Anaesthesia Clinical Services Accreditation (ACSA). The service had attained silver in the Association for Safe Aseptic Practice (ANTT) and recently renewed their Joint Advisory Group (JAG) accreditation for endoscopy.

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.

Staff worked together to enable patients to have an easy journey through the service. We saw evidence of "hospital passports". These were documents which enabled patients to share their wellbeing and communication needs in a simple way. They ensured that all teams were aware of the patient's wishes and that people only had to give their details once. We saw staff conduct handovers concisely and thoroughly.

We observed a daily multi-disciplinary meeting with location colleagues and those at the hospital in Peterborough. The meeting covered aspects of safety, care and planning for the day. The team members checked in with each other and shared good news and praise for individuals as well as formal updates.

Staff told us the nurses, surgeons and anaesthetists shared information freely and there was no ‘us and them’. Consultants agreed that there was good communication across the theatre team. All staff we spoke with felt they could challenge clinical teams and managers if they were worried about a patient or had queries about a process or action taken.

Leaders said that teams at the hospital in Peterborough collaborated well with staff at Boston West, particularly when patients received care across both locations. Theatre staff told us they had built good networks with their peers across the group of hospitals but also worked closely with the wider team in the local service.

Staff liaised regularly with local GPs, opticians and the local NHS Trust and had built good relationships with them. This helped to enable a prompt and effective response from other services.

Staff 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.

Staff gave patients information about services that offered health promotion support, such as giving up smoking and vaping. The service provided leaflets about a local initiative which supported people to take up more exercise and eat well.

Staff provided patients with post-procedure guidance on monitoring blood pressure and eating well. They also offered follow up services in the local area and handed out information leaflets to help patients continue their rehabilitation and recovery. Staff providing post operative care helped patients understand what the underlying issue was and how their rehabilitation could help the recovery process. If appropriate the service offered follow up physiotherapy appointments to help patients with post-operative rehabilitation.

Leaders described the prescribed pathways for recovery. To ensure the best outcome, the service’s patients usually had up to 4 post-operative follow up appointments. Ophthalmology patients received a multidisciplinary approach to their post procedure care, involving the consultant, their GP and their optician.

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 used standardised tools to record patients’ progress before and after procedures. Endoscopy patients were sent surveys after their procedures. From January to June 2025, overall results from 106 patients’ feedback showed that 93% rated the service as excellent and 7% very good. In September 2025, of 16 responses received, only 1 patient raised concerns about their comfort during the procedure.

The service was signed up to the private healthcare information network (PHIN), which provides information for stakeholders about a private healthcare service. This website outlined information about the service’s private and NHS admission numbers, incident reporting and that the service collected and reported PROMs (Patient Reported Outcome Measures) feedback for cataract surgery. PROMs assess the quality of care delivered to NHS patients from the patient perspective. We saw evidence of the PROMs results for cataract procedures, which showed on a rolling 12-month basis that patients had reported a 23.4% improvement in their eye health. Those who had carpal tunnel surgery indicated a 33.5% improvement in their hands after their operation.

We spoke to 2 patients who had undergone surgery some time ago, and they confirmed they were very happy with the outcome.

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.

Staff followed policies on patient consent and on specific measures to accommodate those with extra requirements, including people with a physical and/ or mental health disability. There was also guidance on gaining consent from those who might need assistance with communication.

We observed staff request consent just before a procedure, to check that patients were still comfortable in going ahead. Staff assessed and recorded patients’ capacity to consent appropriately. When patients lacked capacity, staff included family members as appropriate to make sure that any decisions about a patient was in their best interest. They also aimed to consider that person’s wishes, culture and history in planning their treatment.

A review of an audit of the consent process in June 2025, indicated that although the process had been completed correctly, there were a few cases where a copy of the consent form had not been given to the patient. The audit noted that a reminder should be sent to staff and consultants to ensure that this was done in all future consent processes.