Spire Little Aston Hospital

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Leaders and staff knew the service’s vision, aims and objectives and understood how their service aligned with this. There was an inclusive, culturally sensitive and non-discriminatory person-centred approach was engrained in the values of the service and was evident in everyday interactions with staff, people who used the service and the public. People felt respected, listened to and safe, and services were designed around what matters most to communities served.

Leadership was collaborative, supportive and people-focused, with leaders at all levels empowered to act and work together to deliver excellent and sustainable care.

Leaders were proactively visible, accessible and responsive. They embodied integrity, honesty and openness, and built strong, respectful relationships with staff, people and local communities through inclusive and transparent engagement. This results in demonstrable improvements in people’s access to care, and their experience and outcomes.

Staff were proud of the service and consistently reported high levels of engagement, pride and trust in leadership. They reported that the service was an inclusive, supportive and empowering place to work. Staff felt alignment with and ownership of the service’s culture, vision and values.

Governance arrangements were clear, coherent and continuously tested, enabling effective decision making, accountability and delivery of the organisational strategy. Governance systems were proactively reviewed to ensure they remained fit for purpose, proportionate and responsive to emerging risks, system changes and population needs. Leaders were assured of service performance through analysis of quantitative data, qualitative insight, audit, lived experience and external assurance. Focus was on patterns, trends and root causes, rather than isolated metrics, and this intelligence was used to challenge, learn and improve.

The service worked well in partnership with others, sharing accurate and timely data in a transparent and accessible way, with the aim to improve care outcomes and experiences, and to make a positive difference to the local community and environment. The service openly shared good practice and learning across the local system, at neighbourhood level, regionally and nationally.

Staff with protected characteristics felt supported.

There was a fully embedded and systematic approach to continuous quality improvement, which leaders understood was key to delivering high-quality care.

Learning was a continuous process, embedded through reflection, collective problem-solving, and sharing both mistakes and good practice. Learning was systemically shared internally and with other organisations to support measurable improvement in the system and innovation.

At our last assessment we rated this key question as Good. This key question has improved to Outstanding. This meant service leadership was exceptional and distinctive. Leaders and the service culture they created drove and improved high-quality, person-centred care.

We have not awarded this service a score for Well-led.

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

The service had a clear shared vision, strategy and culture that built on the organisational vision and strategy. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of patients and their communities.

The service had a vision and objectives for what it wanted to achieve and turn it into action. The hospitals' purpose was to make a positive difference in people's lives through outstanding personalised care. There was also a clinical strategy which included patient experience, quality improvement, and innovation.

Leaders supported the wider health economy in ways such as increasing community-based engagement and supporting other organisations including a local hospice through fundraising. They also maintained regular engagement with the Integrated Care Board to ensure services were aligned with local health priorities and population needs. Additionally, the hospital had GP liaison officers who worked with GPs to build relationships, facilitate communication, and support collaborative pathways of care.

Staff were focused on the needs of patients receiving care. The service promoted equality and diversity in daily work and provided opportunities for career development. We heard several examples of staff who had been promoted into more senior roles.

The service had a diversity champion; they told us how they had arranged events such as liaising with the restaurant to offer staff the opportunity to taste food from other cultures. They had also produced a diversity calendar for staff with different dates and decorated the hospital with flags. They kept staff up to date with any new events via an email and were supported in their role by senior leaders.

The service had an open culture where patients, their families, and carers as well as staff could raise concerns without fear.

Staff felt respected, supported, and valued. Staff reported that the leadership culture was inclusive, and they felt valued and respected. Relationships between staff of all grades were positive, with strong teamwork and collaboration.

Leaders held staff forums every 3 months where they could feed back to staff and staff could just go along and have a chat about anything. Leaders told us how they had glass doors to their offices so staff would feel it easier to approach them.

Team and individual staff achievement and success was recognised and celebrated. Staff were thanked for their work. For example, we saw a staff member had gone above and beyond during a charity fundraising event. They had visited local businesses whilst on annual leave to obtain gift vouchers and cards to give away to add to the in-house raffle for a local children’s hospice. This had been celebrated and the staff member given recognition. Staff who had their achievement recognised were displayed on poster of a tree providing information on how the person had made a difference to care provided,

Staff felt motivated about the future and planned changes for the service.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They always did so with integrity, openness and honesty and understood the impact their behaviours and leadership had on patient outcomes and experience.

Leaders had a range of experience, skills and abilities to run the service, and they understood and managed the priorities and issues the service faced. Leaders were visible and approachable in the service for patients and staff. Staff felt the leaders supported them to develop their skills and take on more senior roles. Staff told us the interim hospital director and other managers visited clinical areas at the start of the day to check on staff wellbeing and offer support where required. Staff told us leaders were approachable and accessible.

Staff said they felt supported respected and valued. Staff said they were proud to work for the service.

There was strong collaboration, team-working and support and a common focus on improving the quality and sustainability of care and patients’ experiences. The culture of the service centred on the needs and experience of the patients who used services. Staff were passionate about delivering high quality care and treatment for patients requiring it as well as their loved ones.

Leaders had taken incidents seriously and knew how to deal with concerns when raised which promoted a positive culture in the service. Leaders attended the wards and departments to assess for themselves how the service was running.

The Spire Healthcare Annual Report 2025 explicitly identified Little Aston Hospital as an example of effective operational delivery within the hospitals business. The report stated that Little Aston Hospital had achieved sustained growth despite full theatres by reallocating low‑complexity procedures to minor theatres, redesigning clinical pathways, reducing length of stay and changing theatre lists using data‑driven review, all without major capital investment.

In addition to mandatory, statutory and role-specific training requirements, Spire Little Aston Hospital leaders demonstrated a strong commitment to workforce development, leadership capability, quality improvement and professional excellence through a wide range of additional training, education and development opportunities available across all departments.

The provider had a Leadership and Management Development programme which included a New Managers Programme (NMP). The programme was an in-house Spire Healthcare development initiative designed to equip new managers with the essential skills, knowledge and behaviours needed to excel in their roles and lead successful teams. The programme was specifically aimed at colleagues with six months or less people management experience and included: managers and team leaders. The course consisted of a two-day residential course and 1-day virtual follow-up session

To reinforce learning, participants attended locally delivered Mastering Management sessions. The Mastering Management Programme 2026 included sessions on handling difficult conversations, communicating and listening in a pressurised environment, developing great relationships, developing others and maximising growth, delegating effectively and maximising time and being a consciously inclusive manager. Spire Healthcare also offered an Advanced Managers Programme for experienced leaders, 90% of Heads of Department at Little Aston Hospital had attended either the New Managers Programme or the Advanced Managers Programme, reflecting the hospital's commitment to developing effective clinical and operational leadership.

The service fostered a positive culture where patients felt they could speak up and their voice would be heard.

Staff and leaders acted with openness, honesty and transparency. Staff were encouraged raise concerns and offer ideas; the culture allowed staff to be confident their voices were heard.

Staff were able to raise concerns through the Freedom to Speak Up Guardian and were aware they could do this and who they were. There was also 2 Freedom to Speak up ambassadors and a Freedom to Speak Up consultant in the hospital.

Staff were able to enter concerns on the electronic incident recording system and select the category Freedom to Speak Up. They could leave their name if they wished or raise the concerns anonymously. Staff told us when they had raised valid concerns or felt they would be able to, were or would be supported, without fear of detriment. When concerns were raised, leaders investigated sensitively and confidentially.

Staff told us when they had raised valid concerns or felt they would be able to, were or would be supported, without fear of detriment. When concerns were raised, leaders investigated sensitively and confidentially. The local senior leadership and provider level were made aware when whistleblowers had raised serious concerns.

Patients, their families and carers were provided with information to explain how they could raise a concern and how this would be investigated. Senior staff on ward areas were encouraged to respond to immediate concerns or complaints with a view to resolution. There were policies to support the complaints process.

The service valued diversity in their workforce. It had an inclusive and fair culture which had improved equality and equity for staff.

The mission of the hospital was to champion equity, dignity and diversity both within the staff teams and in the care provided to patients. The hospital monitored disclosed ethnicity with 12.77% identifying as a minoritised ethnic group, 14.66% preferring not to make a disclosure and 72.5% of the total workforce at Spire Little Aston Hospital identifying as white.

They also monitored disclosed disability with 2.36% reporting a disability and 16.54% not stating a response, they as such recognised there were additional colleagues who had chosen not to disclose this. The disclosure of ethnicity and ethnicity was voluntary; staff could also decide to disclose this later via systems in place.

The hospital provided access to occupational health for colleagues who required workplace adjustments, advice on health and wellbeing, support with mobility or long-term conditions or guidance on area such as stress, menopause or other health related needs.

To ensure staff had the knowledge and skills to help build an inclusive, respectful culture mandatory training such as equality, diversity and inclusion, compassion in practice, learning disability training had been put into place. An equality diversity and inclusion board was provided staff with support, guidance and details of staff networks.

Any incident, concern or allegation relating to discrimination or inequality was required to be reported through the electronic reporting system. Once logged this was reviewed by the local management team or clinical governance, any safety, cultural or raining themes. The hospital monitored potential inequalities through the annual colleague survey which included questions such as confidence in raising concerns and inclusion and respect in the workplace.

Staff had opportunities to apply for project work, new roles and to undertake external studies. They felt everyone was treated fairly and that they would be able to report negative behaviour or attitudes.

Staff were offered reasonable adjustments to support them to carry out their roles well. For example, we heard how staff hours had been adjusted to support a staff member when it was needed. Leaders told us how arrangements could be made to work flexibly if needed. They gave examples of when staff had been able to do specific shifts to meet their needs and how there were a range of shifts available such as long and short days.

The hospital had an equality and inclusion strategy which included how they were hoping to achieve it and how they were going to deliver it. These were placed under headings such as Encourage, Celebrate, Educate, and Equip and Adapt and Approach.

There was a hospital diversity including LGBTQ+ champion. They had also established colleague network groups such as LGBTQ+, race equality, and Mental Health First Aiders. There were 3 mental first aiders in post whose role was to act as a point of contact and reassurance for those experiencing mental health issues and emotional distress.

Leaders also promoted a comprehensive calendar of events and initiatives that celebrated different cultures and traditions. These had included Race Equality Week and International Women’s Day, with others planned for the year ahead. The hospital had also hosted LGBTQ+ educational events such as lunch and learn speaker sessions, and a podcast had been introduced to promote a more inclusive workforce.

Leaders acted to improve where there were any disparities in the experience of staff with protected equality characteristics.

The service acted to prevent and address bullying and harassment at all levels and for all staff, with a clear focus on those with protected characteristics under the Equality Act and those from excluded and marginalised groups. Staff felt everyone was treated fairly and that they would be able to report behaviour or attitudes which were negative in style.

The service had clear responsibilities, roles, systems of accountability and effective governance. Staff used these to manage and deliver high-quality, sustainable care, treatment and support. Staff always acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The hospital had an integrated quality governance and assurance structure that had been developed to provide guidance and support for all meetings taking place across the group from ward to board. The structure included various meetings and committees. These included a quarterly Hospital Safety, Quality and Risk Committee, Quarterly Health and Safety Committee and a Quarterly Medical Advisory Committee.

There was also a health and safety subcommittee with various subgroups as well as a Patient Safety Sub Committee, a quarterly patient experience group, bi-monthly head of department meetings and a quarterly departmental team meeting. There was also a whole hospital weekly rapid response meeting. Minutes from all meeting were shared at the local medical advisory committee (MAC).

There were systems and processes in place relating to practicing privileges. The hospital had a medical governance co-ordinator who ensured these systems were implemented effectively with oversight from the interim hospital director.

The hospital MAC ensured new consultants were only granted practising privileges if deemed competent and safe to practice. All consultants carried out procedures within their scope of practice within their substantive post in the NHS. This was monitored centrally and any consultant whose practice showed an increase or decrease in activity would be reviewed. Any outlier for incidents such as returns to theatre, infection rates and unplanned readmissions would be reviewed with the consultant. We reviewed minutes from the MAC meetings and found these followed a standard agenda.

Oversight of waiting lists and outpatient clinic risk was provided by twice weekly monitoring to track demand and capacity. This was then reviewed at a weekly capacity meeting and forecasting meeting which was attended by the senior management team.

The wards and theatres had team meetings which included topics such as risk, safety, complaints, incidents, learning, complaints and audit results and actions. We reviewed the minutes from the most recent Hospital Quarterly Safety, Quality and Risk Committee meetings and saw topics that were discussed included mandatory training, risk, incidents, and audit.

Key performance indicators relating to area such as clinical incidents, safeguarding and complaints were monitored through the hospital’s Excellence in Care Delivery and Safety Dashboard and Dashboard meetings.

There was a programme of audits in place with compliance above 94% over the last 3 audits. All audits except for the sharps audit achieved the required target. Actions had been put into place such as reminding staff to put sharps in the correct bins and putting notices above the sharp's bins.

The hospital had a risk register which included identified risks for wards and theatres. The risks were colour coded and had recently been reviewed. Top risks related to transitioning to a new electronic learning platform, the risk of being unable to fully comply with Spire’s data retention policy and the risk of delays in transferring acutely unwell patients to an NHS provider due to pressures on the ambulance service. Top risks were discussed in team meetings.

We reviewed the last 3 senior management team meetings and noted topics discussed included quality improvement, training, complaints, service level agreements, waste and carbon and quarterly fire updates from the engineer.

There was a mapping consultant performance concerns policy. Leaders told us how soft intelligence was regularly discussed. They were able to give an example of when staff had raised a concern about a consultant and how they had led to a positive outcome.

The hospital operated a succession planning framework since 2021 incorporating talent mapping, contingency planning, and leadership development. This was reviewed every 6 to 12 months to maintain workforce resilience.

We noted that the hospital had implemented various initiatives one of which had resulted in in a saving of 2018 kg of C02, equivalent to approximately 7 trees planted annually, one car removed from the road, or 1 house powered for a year.

Leaders made sure that accurate information was discussed and shared with key staff. For example, information was shared via huddles, team meetings, drop ins and emails.

Risks were clearly identified and a formal log of these was used to keep oversight and manage mitigations and/or bring to resolution. Staff contributed to decision-making to help improve sustainability and improve quality of care.

Audit processes and the outcomes were used to ensure quality of services was maximised. Where improvements were required, leaders ensured action plans and the monitoring of these led to positive changes.

The service had plans to cope with unexpected events and had a business continuity plan which included major incident plans.

We reviewed several service level and provider policies and found these were up to date and readily available to staff. There was leadership oversight of the accuracy and validity of each policy.

There were governance procedures for managing and monitoring any service level agreements with third parties. For example, they had a register of all standard operating procedures, service level agreements, and contractual arrangements with third parties. All third party standard operating procedures and service level agreements underwent a formal annual review through the senior manager team meetings. This ensured regular scrutiny of third-party performance as well as escalation of risks or gaps through governance processes.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for patient. Staff share information and learning with partners and collaborate for improvement.

The hospital had several service level agreements (SLA) in place with local trusts and organisations to support the services offered at the hospital. We saw SLA for transfer of patients to local NHS trusts and intensive care units when required.

The hospital carried out GP master classes to inform GPs of the services provided and how they could refer both private and NHS patients for treatments. They also carried out mixed speciality master classes which included a variety of consultants providing training and education on specific topics.

We saw the hospital engaged with local cancer services, private health insurance companies, local NHS trusts and other private hospitals to share information.

They held regular meetings with the local ICB to review performance, quality assurance and the ongoing contracts.

Leaders and staff actively and openly engaged with patients, staff, equality groups, the public and local organisations to plan and manage services.

The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. Staff were encouraged creative ways of delivering equality of experience, outcome and quality of life for patient.

There was an established, significant and sustained culture of continuous and creative learning, innovation and improvement based on evidence and local need. This delivered improved outcomes, equality of access, and quality care for patients.

Staff were committed to continually learning and improving services. There were processes for learning when things went wrong or of good practice, either locally or nationally. Staff were supported to have the time to develop their skills and leaders encouraged innovation.

Staff participated in quality improvement initiatives. For example, in response to a patient experience of treatment outcomes a quality improvement project in physiotherapy led to the adoption of an alternative orthotic device for patients with foot drop. Reduced the average length of stay for hip and knee replacements from 2.5 days to 1.5 days (Spire National average was 1.7 days). Average length of staff for hysterectomy had improved to 1 day with the Spire average 1.6 days.

Quality improvement projects were embedded practice and staff we spoke with had a good understanding of quality improvement methods and had been trained in this area of work. We were told about some of the areas of quality improvement projects in the last 12 months work included, early mobilisation – ‘need the loo, stand them too!’”, early introduction of diet and fluids, early removal of urinary catheter (at 6am), prescribing of medicines to take home theatre, reducing theatre cancellations due to loan kit unavailability. The success of this initiative had been recognised across the wider organisation and has been highlighted within Spire Healthcare as an example of good practice. The approach had subsequently informed a national Spire priority for 2026, demonstrating the project's contribution to service improvement beyond the local site.

The effective use of point of care test (POCT) blood testing was undertaken as a quality improvement project (QIP). The use of POCT had positively impacted patient flow, discharge efficiency and overall patient experience. The project successfully reduced unnecessary blood testing, improved the timeliness of results, enhanced patient experience and supported more efficient discharge processes. The initiative was recognised as an example of good practice across Spire Healthcare nationally.

Spire Little Aston Hospital was selected as one of only three pilot hospitals to implement the new electronic observations system. The system went live at the end of March 2026 and represented a significant step in the digital transformation of patient care. Prior to implementation, patient observations, blood glucose monitoring, and fluid balance charts were recorded on paper-based documentation. This created potential challenges with accessibility, timeliness, legibility, and real-time visibility of patient data across multidisciplinary teams.

Reducing clinical waste to lower costs and carbon emissions was a quality improvement plan initiated within theatre department. The volume of clinical waste had been reduced by improving waste segregation, while maintaining high standards of infection prevention and patient safety and overall efficiency.

The Spire Eye Centre “Less Delay, Better Day” quality improvement project had reduced patient waiting times and increased patient satisfaction. This had been undertaken by streamlining processes and identification of inefficiencies to provide a more responsive and patient-centred service.