Rivers 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 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 surgery outcomes and exploring best practice was part of their everyday work.

At our last assessment we rated this key question good. At this assessment under our new methodology the rating has remained good.

This meant people’s outcomes were consistently good, and people’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.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.
 

Patients told us staff asked questions to understand their needs. During pre-admission processes key information regarding medical history, allergies and physical needs were discussed. 
 

We reviewed 5 patient care records. All had completed pre-admission checks, including risk assessments for; skin integrity, blood clots and pain. On the day of admission these assessments were reviewed and updated if necessary. 
 

Physiotherapists reviewed patients following orthopaedic surgery, assessing their mobility and developing a therapy discharge plan. This included reviewing patients’ needs on returning home and determining whether additional support, such as mobility aids or care packages, were required. Patients were not discharged until all relevant assessments had been completed and the necessary support was in place. 
 

The care records we reviewed were personalised to each patient’s individual needs. Throughout the patient’s surgery care journey, regular health assessments were undertaken in accordance with their clinical needs. However, documentation did not always clearly demonstrate when risk assessments had been reviewed and updated during prolonged admission to the ward. Leaders had also identified inconsistent completion of risk assessments in patients’ records. They had taken action to implement refresher staff training, email reminders and spot check audits.
 

We scored the service as 3. 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. 
 

Patients were supported throughout their surgery care, this included support of their nutritional and hydration needs. Staff accommodated special dietary requirements, food intolerances and religious beliefs. 
 

Surgery staff participated in clinical audits that were monitored by department leads. Care record audits showed some areas of low compliance. Leaders were taking prompt action through supportive learning and close monitoring. The service also collected data relating to all surgery for organisational and national benchmarking. Rivers was performing within the expected range for patient orthopaedic surgery outcomes inline with national targets. 
 

The service used a national early warning score (NEWS) throughout the patients journey to monitor potential deterioration in theatre, recovery and post-operative care. Compliance was also monitored through audits. Data for Sept 2025 to April 2026 showed improved performance with April 2026 audit results at 92.2%. 
 

Patients were supported by a full range of specialists to meet their needs. This included consultant surgeons, anaesthetists and physiotherapists. Staff also worked with external agencies such as local authorities and general practitioners to ensure safe discharge and follow up care was achieved. 
 

Staff within surgery were experienced and qualified with the right skills and knowledge to support the variety of patients that received care. Leaders supported staff with specialised training for new procedures or protocols.

The hospital reported information to the Private Healthcare Information Network (PHIN). 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. Patient feedback, for PROMS was requested pre and post their surgery.

The surgery service was also registered with the National Joint Registry (NJR) for all joint replacement procedures. The NJR dashboard provided comparative data on patient outcomes against national benchmarks and peer organisations. Data reviewed for the period April 2024 to March 2025 showed that patients undergoing hip, knee or shoulder replacements at the Rivers hospital achieved outcomes that were in line with those expected nationally.

We scored the service as 3. 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.
 

Staff of all grades worked together across all departments to ensure the patients care journey was safe and good outcomes were achieved. 
 

We observed theatre teams taking a systematic approach to surgery preparation ensuring all staff involved were clear on the care plan and informed of any associated risks. Communication was clear and discussion documented within care records. 
 

Daily meetings and ward rounds took place to review current inpatients and those arriving for surgery. These meetings were multi-disciplinary with specialisms reviewing individuals’ surgery care pathways to ensure a joint approach to patients care and outcomes. 
 

Surgery leaders also met with the wider hospital departments each morning for a daily safety briefing. This was to discuss the hospital’s daily service provision, staffing numbers and escalate any risks to senior leaders. We observed a well-structured meeting that was attended by all departments including catering and maintenance staff.

The key focus was on the hospital being safe, having appropriately trained staff for emergencies and recognising staff achievements. 
 

In the operating theatres we observed effective and safe patient handovers between anaesthetists and recovery room staff. Staff of all grades were respectful and professional to each other and care was patient focused. 
 

Surgery leaders promoted effective teamwork and collaboration throughout the service. This was supported by specialty team meetings including breast, lung oncology, and urology. These meetings enabled complex cases to be discussed, and the areas activity would be monitored through audits and patient outcomes.
 

We scored the service as 3. 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.
 

Patients were supported throughout their surgery care with information about their condition, their treatment and how best to prepare for surgery. We observed staff while caring for patients pre and post-surgery. Staff held open and honest discussions with patients about the expected outcomes of their surgery, and any potential impact recovery may have on their daily activities. This included providing information on medication and post-operative risks such as surgical site infections. Patients were given clear guidance on the steps they could take at home to minimise these risks and support their recovery.

Patients had access to onsite physiotherapists both before and after their operations. This supported the prevention of falls and helped maintain mobility during inpatient stay. Patients were encouraged to mobilise as soon as it was clinically safe to do so, with the support of physiotherapists and appropriate walking aids, helping to promote recovery and reduce the risk of post-operative complications, including blood clots.

Patients’ menus were planned around their needs, offering a wide range of food options to support food allergies and sensitivities. This included healthier and lighter meals to support patients’ health and well-being choices. Catering staff also made efforts to ensure ingredients were sustainable and locally sourced where possible.

Patients were signposted to smoking cessation services. Staff discussed the perioperative care benefits of quitting smoking as early as possible before surgery and the direct positive impact it has on surgery outcomes. Patients were also signposted to the Royal College of Anaesthetists guidance on preparing for surgery ‘Fitter Better Sooner’ advice resource. Health advice and support was personalised and holistic.
 

We scored the service as 3. 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 ensured patient outcomes were monitored through audits and benchmarking dashboards. Information collected and reviewed included surgical site infections, joint replacement, cosmetic and cataract surgery outcomes.

The service submitted data to the National Joint Registry (NJR) following surgical joint replacements including hips, knees, shoulders, elbows and ankles. Rivers hospital had been awarded a NJR gold award in 2025 for its commitment to patient safety.

Surgery data was submitted to the Private Healthcare Information Network (PHIN) for a range of outcome measures. This included numbers and types of surgeries, whether NHS or self-funded and lengths of stay.

Where leaders identified areas for improvement, they took timely action to address them. For example, an increase in spinal surgical site infections was identified between April and June 2025. In response, additional staff training was delivered, and antimicrobial wash gloves were introduced for to assist patients following surgery to help reduce the risk of bacterial wound infection. These measures contributed to improved patient outcomes and a reduction in infection rates.

Patient-reported outcome measures (PROMs) were routinely monitored, with feedback collected from patients both before and after surgery. PROMs were used to assess the impact of surgery on patients, including changes in symptoms, levels of pain, and overall health-related quality of life. Patient complaints were also reviewed as part of outcome monitoring. At the time of our assessment, surgery services at the Rivers achieved a 97% positive patient rating.

Leaders also recognised the importance of patient feedback in evaluating the quality of care and patient outcomes. This was monitored through the Friends and Family Test. Survey results from January 2026 to February 2026 based on 33 patients, showed that 100% of respondents were satisfied with the care they received during their surgical treatment.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centered care and treatment.
 

Patients were supported by making informed decisions about their care and treatment through a 2-stage consent process. There were 2 stages to the consent process, the first Initial consent discussions took place during pre-admission assessment, with a further consent review conducted by the consultant on the day of surgery. This approach gave patients, and where appropriate their carers or parents, sufficient time to consider the information provided, ask questions and make an informed decision about their treatment. 
 

Patients were provided with information leaflets about the consent process, and staff explained consent to patients and, where appropriate, their carers or parents. For children undergoing surgery, parents and guardians were supported to understand the proposed procedure and were actively involved in the consent process. 
 

Staff could access translation and interpretation services if required to support patients in providing informed consent. This included the ability to arrange face to face British Sign Language (BSL) interpreters in advance of appointments where required to meet individual communication needs. 
 

During our assessment, we observed staff obtaining consent in line with national guidance. Staff demonstrated a clear understanding of how to support patients who lacked capacity to make decisions about their care or were experiencing mental ill health. This was supported by the services policies and procedures relating to consent and decision making. 
 

Staff understood their responsibilities in assessing a patient’s capacity to make decisions about their care and knew when such assessments were required. They followed organisational policies relating to consent, mental capacity, deprivation of liberty and restrictive practice, where relevant. Training on the Mental Capacity Act (MCA) and Deprivation of Liberties Safeguards (DoLS) formed part of the provider’s mandatory training programme. 
Leaders monitored consent processes through biannual audits, which demonstrated consistently high levels of compliance throughout the surgery service.