Boston West 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

The service had systems and process to provide good care for patients. Leaders investigated incidents and shared lessons learned with the whole team.

Leaders encouraged a positive culture of safety based on honesty. Staff understood how to protect patients from abuse and recognised incidents and reported them appropriately. Leaders made sure there were enough competent staff to keep patients safe. The environment was clean, and infection risks were well managed. The service had effective systems for to handle medicines safely.

At our last assessment we rated this key question 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 proactive and positive culture of safety based on openness and honesty. Safety events were investigated and reported thoroughly with lessons learned to identify and embed good practices.

The service had reporting processes to ensure managers had oversight of incidents and submitted statutory notifications appropriately. Staff told us there was a positive reporting culture, which encouraged shared learning and helped to manage risks.

Local leaders conducted regular audits of surgical practice and where issues were noted, learning was shared. Incidents were reviewed through the service governance processes and learning shared through safety alerts, emails and in team meetings. Consultants attended regular medical advisory committee meetings, where they discussed clinical incidents and the latest service and group-wide information. They also checked for national guidance updates and implemented the appropriate changes to practice.

Staff and patients felt the service was safe but if they felt unsure, they could raise safety concerns with leaders.

The service worked with people and their partners to establish and maintain systems of care where safety is managed, monitored and assured. They also ensured continuity of care within the service and when people were referred to different services.

The service worked with patients and their families to establish comprehensive individual transition plans. They did this before the patients moved between services to eliminate any risks and to ensure the patient received continuity of care.

The service also worked closely with local GPs and other practitioners in the local area to offer day care procedures. Referrers used systems to ensure that appropriate patient information was shared with relevant services. We saw appropriate checks and handovers conducted between teams. We checked electronic patient records in surgery and found these to be correct and up to date.

The service had guidelines around transferring patients to NHS hospitals in an emergency, which included providing a comprehensive handover to ambulance staff and contact with the local hospital to discuss the situation. Leaders told us there had been only 1 incident of a patient deteriorating and requiring a transfer to an NHS hospital in 2025.

Staff always checked patients’ names and dates of birth to ensure the patient would receive the correct treatment. Patients’ welfare was checked regularly throughout the procedure and during the recovery period. Patients received phone calls 24 hours after their procedure, to check on their wellbeing and arrange any follow up appointments or onward referrals.

The service worked with people to improving their health while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Staff made sure they shared any concerns quickly and appropriately.

Leaders and staff understood the importance of safeguarding in promoting and delivering safe care. There was up to date guidance in place, including safeguarding policies, flowcharts and contact lists. This meant staff could report concerns and ensure appropriate actions were taken quickly. Data from October 2025 showed 100% of staff had completed Level 3 safeguarding training for both adults and children.

Staff knew how to recognise and report concerns. They could explain the process to raise a safeguarding referral and were confident that the right action would be taken. One staff member told us about a safeguarding concern which was raised about a patient by a colleague. The information was shared with their GP, which meant that appropriate care was put in place.

Staff understood the service’s processes for gaining patient consent and how to support people who may not be able to provide consent. They followed guidance under the Mental Capacity Act (2005). This helped ensure patients were not inappropriately restrained or unlawfully deprived of their liberty.

Patients told us they felt safe within the service and found staff approachable and caring.

The service worked with people to understand and manage risks by providing care in a way that was safe and supportive and enabled them to do the things that matter to them.

Staff conducted clinical risk assessments to maximise patient safety during treatment. We saw staff completed NEWS checklist and conduct the 5 steps to safer surgery checks. We checked 3 patient records and saw that risk assessments had been completed in all of these.

The service used tools such as the venous thromboembolisms (VTE), Malnutrition Universal Screening Tool (MUST), and the Screening Tool of Older Persons' Prescriptions (STOPP). The records also showed that staff checked for any specific care needs for patients with dementia, any need for bed rails in the recovery area, falls risks and any specific plans around moving and handling.

There was always a resident medical officer (RMO) on site during surgery hours, and all have advanced life support (ALS) training. Consultants and surgeons followed a prescribed on-call operative or post-operative processes, and surgery teams conducted regular training scenarios around deteriorating patients and how to manage complications.

Patients told us the procedures were well explained, and the risks and benefits were discussed. They said they felt confident they could ask further questions and make informed decisions about their treatment. One patient told us that due to complications in their surgery, the next procedure was put on hold until they had arranged a further appointment with the consultant to discuss alternatives in their ongoing treatment.

The service identified and controlled potential risks in the care environment and made sure that the equipment, facilities and technology supported the delivery of safe care.

Staff could access appropriate emergency equipment as needed. We saw that a resuscitation trolley was positioned in an easily accessible place in the corridor between the theatre and the recovery area. We checked the trolley, and all items were in date. We saw evidence that staff conducted daily and weekly checks and these corresponded with records in the audit book.

Staff were clear about their responsibilities regarding premises and equipment. The right equipment was available and used to deliver care and treatment that was suitable for the intended purpose. We saw that equipment was stored securely and used properly to support people to stay safe and minimise risk. Supplies and consumables were stored appropriately and were within their use by dates

Staff told us that specialist equipment was available to deliver the best care during surgeries, and they were trained to use any new equipment. We saw equipment was regularly checked for serviceability and PAT testing of electrical equipment was up to date. Fridge temperatures were checked regularly. Fire exits were clearly marked, and staff knew the correct procedures to follow in an emergency.

A recent re-design of the premises enabled a new pathway for the removal of contaminated items to minimise the risk of infection.

Staff told us they could raise any concerns about the site or equipment at daily meetings or report issues directly to managers who would address these promptly. Patients told us they thought the location was very clean and observed staff washed their hands before touching them.

The service conducted annual audits of the environment under Patient-Led Assessments of the Care Environment (PLACE). The assessment team is made up of staff and patients but must be made up of at least 50% patients or members of the public. The most recent audit, conducted in October 2024, indicated that the service achieved 100% in areas including cleanliness and the condition of the premises.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

There were robust recruitment processes which followed Ramsay group guidelines, to make sure that all staff were suitably experienced and competent and able to carry out their role. Leaders ensured recruitment, disciplinary and ongoing review processes were safe, fair and were regularly checked to ensure there was no disadvantage based on any specific protected equality characteristic.

The service had a full surgical team, including consultants, theatre specialists and nursing staff. At the time of the inspection there were no vacancies within the surgical service.

Staff told us staffing levels were appropriate and people had the right qualifications and experience. Staff members could be flexible with their working hours. This meant staff could arrange a better work/life balance. Nursing staff sickness in theatres in the six months prior to the inspection was 1.5% whilst doctor sickness absence was 0.6% over the same period.

Data from October 2025 showed an overall 97% completion of mandatory training by theatre staff.

Managers ensured all staff received regular appraisals of their work, and staff received opportunity to develop clinical skills. Managers made sure staff refreshed their training at regular intervals to maintain knowledge and skills in line with best practice.

Patients noted that there were lots of staff around to provide care and answer questions. They told us they felt confident in the skills and experience of the staff.

The service assessed and managed the risk of infection. They detected any infections and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service had up to date infection prevention and control policies and audit processes. We saw evidence audits were conducted regularly to manage risks of infection. In the three months prior to the inspection overall compliance with the infection prevention control (IPC) audits was 99.2%. Action plans were in place to make improvements in any areas outside compliance.

A dedicated housekeeping team cleaned the entire hospital at the end of each day, with managers carrying out regular audits of the tasks and environments. We saw evidence that theatres achieved 100% compliance in the twice monthly 50 steps cleaning audits

Theatre areas were visibly clean and tidy, and staff checked equipment regularly. We saw that staff labelled sharps bins in line with national guidance and disposed of these safely. Posters reminded staff and patients to wash their hands and hand gel dispensers were readily available in all areas.

Leaders told us there was a local infection control and prevention (IPC) lead who inspected the service regularly. The service also liaised with external experts regarding microbiology management and kept up to date with changes in IPC guidance.

Staff followed processes to reduce the risk of infection. House-keeping staff used "I am clean" stickers on equipment and areas of patient contact to show which items were now ready for use. Staff were bare below the elbow and washed their hands at appropriate time. They had access to, and used, appropriate personal protective equipment (PPE). Hand sanitisers were available and there were adequate handwashing facilities. Staff were aware of the latest IPC guidance and could escalate concerns about infection control in daily meetings or raise them with the IPC lead.

In 2023, theatre sterilisation services unit moved off-site. This meant that surgical equipment was still cleaned onsite, but decontamination was carried out off the premises. The recent renovations to the building enabled staff to set up a new pathway for contaminated equipment handling. Staff used traceability stickers on endoscopes and followed a strict process and physical pathway to keep clean and contaminated items separate. This helped maintain strong infection prevention and control for all surgical equipment.

The service had no surgical site infections in the 12 months prior to the inspection.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happen.

Medicines, including controlled drugs, were stored securely and safely. Staff monitored room and refrigerator temperatures daily in areas where medicines were stored. Medicines were stored within the correct temperature ranges. We reviewed a sample of medicines in the emergency trolley, theatre and in the medicine cabinet. All were stored correctly and within expiry dates.

Staff followed comprehensive policies and guidance around medicines, including controlled drugs. The service's medicines policy also included guidance on managing patients' own medication. A pharmacy lead oversaw clinical governance in medicines.

Staff audited management of controlled drugs, which are medicines controlled under the Misuse of Drugs legislation (and subsequent amendments). Staff completed monthly audits. We identified that generally compliance to national standards was 100% from March to September 2025. There was one minor documentation issue in June 2025 which was corrected and learning shared.

A Home Office inspection of controlled drugs was conducted in March 2025 which confirmed full compliance with no actions.

Staff reviewed each patient’s medicines prior to surgery as part of the safety brief and explained to patients what they would be given and any potential side effects. Staff gave them advice on their medicines when they were discharged. Consultants advised patients they could contact them after procedures for further information or if they required more medicines.