Spire Parkway 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

Leaders had created a positive and proactive culture of safety-based openness and honesty. Concerns about safety were fully investigated. Managers’ ensured lessons were learnt to identify and embed good practices. There was a very positive learning culture with staff managing incidents and safeguarding patients well. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. Staff assessed risks to patients, acted on them and kept good care records. There were processes to ensure the service had enough staff with the right training, skills and qualifications to keep patients safe.

At our last inspection we rated this key question as good. At this inspection the rating has remained the same. 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. Staff knew how to raise incidents and concerns and they were reported on an electronic system and managers were alerted immediately. Incidents and complaints were reviewed daily at the staff huddles and fully investigated. Lessons were learnt to continually identify and embed good practice. This included sharing lessons across the whole of Spire and adopting changes from incidents that occurred in other Spire hospitals.

Leaders had implemented the NHS Patient Safety Incident Framework (PSIRF) to develop effective systems and processes to respond, learn and improve from patient safety incidents. Incidents were comprehensively investigated and there was clear analysis of incident data and trends with comparison to previous reporting periods. Incidents were discussed at the hospital clinical governance meetings, to review trends and lessons learnt. There was a rapid review of incidents that needed immediate investigation.

Staff understood the duty of candour and applied this wherever necessary.

Between November 2025 and April 2026 there had been 38 incidents reported specific to medical care which included oncology and endoscopy. All incidents were reported with no or low harm. Themes included documentation issues and clinic cancellations. Each incident was investigated, actions taken and lessons learnt to continually identify and embed good practice.

Patient deaths were reported, including those within 30 days of systemic anti-cancer therapy (SACT) in line with national guidance. The service had a mortality review process where all patient deaths were reviewed to identify learning. There had been 4 deaths reported between November 2025 and April 2026 and no specific learning identified as care was within multidisciplinary team recommendations.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Staff made sure there was continuity of care, including when people moved between different services.

Safety and continuity of care was a priority throughout patients’ care journey. This happened through a collaborative, joined-up approach to safety that involved patients along with staff and other partners in their care.

Within the cancer centre we saw there were daily huddles. These included attendance from chemotherapy nurses, clinical nurse specialists, pharmacy and physiotherapy. Patient care was discussed with the multidisciplinary team and planned to ensure all needs were met. We saw there were clear schedules and plans for patients attending the centre for treatment on the day.

There were patient pathways for breast, prostate and colorectal services. Pathways were clearly defined, with specialist roles identified and well-structured steps that included referral, assessment, investigations and treatment decisions. Spire Parkway was a specialist centre for prostate cancer. Patients were referred to the clinical nurse specialist who undertook a triage assessment under consultant supervision. Patients were then booked for a scan and biopsy, with results reviewed and treatment commenced following MDT discussion and decision.

Patients attending for endoscopy included those with a suspected colorectal malignancy. There was a pathway that included urgent pathology services, multidisciplinary team meetings and decision making, investigations, and specialist input into discussions about treatments plans and escalation.

When patients attended for endoscopy staff checked the patient name, date of birth, and consent form prior to administering any medication.

Staff told us there were strong links with both internal and external partners. This enabled any transitions and continuity of care to be managed in a safe and effective way. This included care in partnership with another private provider around prostate cancer.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.

Staff understood their safeguarding responsibilities and knew how to take appropriate action when necessary. The provider had a clear safeguarding policy which was available for staff to access. Staff told us they rarely had the need to raise any safeguarding concerns themselves, however, were able to share examples of when they acted to ensure patients were kept safe.

Staff received mandatory safeguarding children and adults training. All staff were trained to level 3 safeguarding adults and level 3 children. Service managers were trained to level 3 safeguarding. Senior hospital leads had level 4 safeguarding training and staff knew to report any concerns directly to senior staff. They supported staff in escalating concerns and supported referral processes to the relevant local authorities.

Safeguarding adult level 3 training compliance and safeguarding children level 2 training for oncology and endoscopy staff was recorded at 100%, exceeding the hospital 95% target.

Patients were supported to understand their rights, including their human rights, rights under Acute services the Mental Capacity Act 2005 and their rights under the Equality Act 2010. Staff understood the importance of supporting equality and diversity and ensured care and treatment was in accordance with the Act. Staff gave examples which demonstrated their understanding and showed how they had considered the needs of patients with protected characteristics.

There had been no safeguarding incidents reported in the 12 months prior to our inspection.

Recruitment pathways and procedures were in place to ensure relevant recruitment checks had been completed for all staff. These included a disclosure and barring service (DBS) check, occupational health clearance, references and qualification and professional registration checks. The human resources team checked these monthly and prompted staff that required renewals.

The service worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Safety was a priority that involved everyone, including staff as well as people using the service. Staff made sure that people understood the care and treatment that was being provided.

Prior to endoscopy, all patients completed a health questionnaire and there was an assessment of their suitability for treatment. There was a clear inclusion criteria that focused on medically stable patients. The service did not have provision for bariatric patients, although staff could refer patients to other Spire endoscopy services that did have bariatric provision. There was a vetting process for all patients referred for endoscopy, where the endoscopist and endoscopy staff were responsible for identifying risks and deciding if the service could meet their needs safely.

Staff used a nationally recognised tool to identify deteriorating patients and escalated them appropriately. The service used the National Early Warning Score 2 (NEWS2) for the detection and response of deteriorating patients. We reviewed six complete sets of patient records and found that observations were completed at the frequency required for each patient and escalated appropriately in line with policy

There was a service level agreement with the local acute hospital to support staff when they identified a patient who deteriorated. Staff told us of a recent endoscopy case where there was a concern a patient had a perforation and was bleeding. A decision was taken to transfer them to the local acute hospital by emergency ambulance.

Staff we spoke with were aware of how to recognise sepsis and how and when to raise concerns. They completed sepsis screening using a recognised ‘sepsis 6’ national screening tool. We saw protocols relating to neutropenic sepsis, where patients receiving or immediately following chemotherapy were at greater risk due an increased risk of infection. Staff described where a patient who had received chemotherapy a few days prior had called in unwell. They were brought into the service and screened using the ‘sepsis 6’ screening tool, antibiotics were administered within an hour of contact and an emergency ambulance called, in line with the service policy.

Risks were assessed and people and staff understood them. Staff completed risk assessments for each patient within the oncology center and in endoscopy. Staff used recognised tools, and reviewed these regularly, including after any incidents. These risk assessments included, but were not limited to, a patient’s risk of skin damage, malnutrition risks, manual handling, venous thromboembolism (VTE) (blood clots) risk, and falls risk.

We reviewed the risk assessments completed for 6 patients and found all risk assessments were completed within the expected timeframe and where action was required, staff had taken this. The service audited the compliance with VTE risk assessments monthly, with consistently high scores.

There was good compliance with safety checks in endoscopy. Staff completed the World Health Organisation safety checklist, all staff were engaged in the process. Audits completed between September 2025 and March 2026 showed there was consistently 100% compliance.

Emergency trolleys were available at the cancer center and within endoscopy. These included appropriate emergency medicines and equipment for use in an emergency, for example in the event of any sudden patient deterioration. There were ‘bleed boxes’ in endoscopy for use in the event of gastrointestinal bleeding.

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

The service had suitable facilities to meet the needs of patients. The hospital was purpose built and the cancer center was in a separate unit, a short walk from the main hospital building through the car park. There was adequate car parking directly outside the building. The cancer center had 6 ‘pod spaces’ (individual bays with reclining chairs) for patients receiving chemotherapy and other treatments. Within endoscopy there was a waiting area, endoscopy suite and recovery area, plus a decontamination room.

The cancer centre and endoscopy department were visibly clean and tidy with appropriate equipment available to maintain safe levels of care. For example, within the cancer centre we saw that patients had wide, reclining appropriately furnished chairs to sit in while having treatment. Call bells were within reach, and patients were able to charge phones and had space to store personal items while receiving treatment. All treatment pods were visible from the nurse's station.

Water outlets and sinks were flushed to reduce the risk of legionella build-up in line with Health and Safety Executive guidance. Risk assessments and audits had been carried out by external companies.

Fire extinguishers had service checks which were within date and there were signs pointing out fire exits throughout the service. There were dedicated fire wardens on duty daily. Fire doors were on the hospital risk register due to some noncompliance. Action plans were in place to replace some fire doors in May 2026 and carry out maintenance of other fire doors in May and June to ensure compliance. Actions to mitigate the risks included fire marshals for each department, additional training, evacuation plans and tabletop exercises.

All clinical areas within the cancer centre and endoscopy were equipped with wipeable furnishings. There were oxygen and suction ports within endoscopy. Specific equipment within the cancer center included a machine for reducing the risk of chemotherapy leaking out into tissue surrounding the vein and scalp cooling systems to help minimise hair loss.

The hospital had a decontamination and Sterile Services Department in the theatre/endoscopy environment and carried out decontamination of all equipment, including endoscopic equipment. The department had a one way flow for dirty and clean equipment and there were traceability processes in place to keep track of all equipment. We saw staff wearing appropriate protective clothing when decontaminating.

We viewed an endoscopy ventilation report from a review that had been carried out in June 2025. The report stated that air change rates in endoscopy met national recommendations.

Sharps bins were available and labelled correctly. These were correctly colour coded and included purple bins for cytotoxic waste. Disposable curtains were used, these were dated and changed in line with guidance. Medical equipment had been appropriately tested and was within date. Sterile equipment was stored off the floor on appropriate shelving and when we checked expiry dates, all equipment was in date.

Substances deemed hazardous to health were kept in locked cupboards. This meant people using the service did not have access to substances which could damage their health. There were spill kits available, including for the spillage of cytotoxic medicines. As part of their ongoing training, staff participated in spill scenarios so they were up to date on the actions to take. We saw there was a dedicated shower for staff use in the event of a spill.

Staff carried out daily safety checks of specialist equipment, such as the resuscitation trolley. Resuscitation equipment was easily accessible and located in the cancer center and in endoscopy. Resuscitation equipment had been checked daily and an up-to-date checklist confirmed all equipment was ready for use.

There was a process to manage the safety, maintenance and repair of facilities, premises and equipment.

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

The service had enough staff to keep patients safe. The service employed permanent and bank staff. At the time of our assessment there were no staffing vacancies within oncology or endoscopy. Sickness absence rates were below the 5.3% Spire group average at 2.9% for oncology and 3.2% for endoscopy.

Managers limited their use of bank staff and used regular staff familiar with the service. All staff had a period of induction, and supervision on commencing work at the service. They would use bank staff when required. Between February to April 2026, 4.4% of shifts had been covered by bank staff within theatres and endoscopy, with no agency staff used. For the same time period 9.4% of shifts were covered by bank staff within oncology and no agency staff used.

There were robust and safe recruitment practices to make sure all staff were suitably experienced, competent and able to carry out their role. We reviewed 5 staff files and found recruitment processes were in line with schedule 3 of the HSCA (RA) Regs 2014. Nursing staff had completed their Nursing and Midwifery Council re-validation checks and updates to develop their competencies.

Consultants led and delivered the medical care service at the hospital under practicing privileges. There was a robust system for onboarding new consultants and ensuring their practice and behaviours were in line with the services values and vision. The granting of practising privileges is a well-established process within independent healthcare whereby a medical practitioner is granted permission to work in an independent hospital or clinic, in independent private practice, or within the provision of community services. Practising privileges were overseen and approved by the medical director (MD) and medical advisory committee (MAC). Consultants lived within a 45 minute radius of the hospital. Consultants would only carry out agreed procedures that they carried out in their NHS roles. Any new procedures would be reviewed by the MAC and specialist for that area. The medical governance and risk lead ensured consultants records were updated annually, including training and appraisals. They would raise any concerns or out of date data directly to the MD. We reviewed 5 consultant files as part of our assessment of surgery. We found they were all up to date with relevant information including up to date DBS checks, appraisals and training In addition, we reviewed a further consultant file as part of this assessment of medical care services. There were copies of appraisals carried out in the NHS for consultants who worked in the NHS. Consultants that worked in private practice only arranged their own appraisals and could access Spire central revalidation team to carry out appraisals.

Day to day medical cover was delivered by the resident doctors who were employed by the service. They worked on a week on week off rota and were available 24 hours a day.

Every morning, the hospital leads recorded safe staffing levels for each department. Each department gave staffing levels for that day and the next day including sickness, bank usage and any gaps. Discussions included staff working across departments to support each other.

There was a senior manager on call every day and out of hours, the same manager would be on call for a week. There was a duty manager on site between 9am to 4pm every day. Physiotherapy staff were on call out of hours and over the weekend.

Specialist nurses were available such as oncology, urology and breast clinical nurse specialists (CNS). There was a dietician that attended the hospital and could offer advice.

All staff received an annual appraisal with a mid-year review, which included objective setting. Staff could raise any issues or learning needs or opportunities with their line manager. At the time of our assessment, we saw that 100% of staff in oncology and endoscopy had received an appraisal in the last 12 months. There were a variety of online learning platforms that staff could use to develop their skills and experience to enhance their development.

Staff received training appropriate and relevant to their role. All staff had an induction, and supervision as needed. Staff could access mandatory training online and some face to face sessions. Managers received a monthly report to show compliance with mandatory training. Training compliance data for all staff showed 93% of all staff had completed their mandatory training, with a target of 95% to complete all training by the end of May 2026. Mandatory training subjects included resuscitation, fire safety, moving and manual handling and infection prevention and control.

Within oncology nurses completed the systemic anti-cancer therapy (SACT) competency passport and annual competency refreshers. We viewed up to date passports on the online system and saw these were complete or in progress. The oncology services manager was a practice assessor and competencies were signed off by the advanced clinical practitioner. All nursing staff had completed or were in the process of completing the administration of cancer therapies modules at a local university.

Medical staff received and kept up to date with their mandatory training, this was completed via their employing NHS trust, this was checked and updated by the hospital. Records of mandatory training for visiting consultants were held on site. Resident medical officers (RMOs) completed mandatory and yearly update training with their agency. The hospital received training certificates that verified RMOs training status. This included advanced life support (ALS), European paediatric advanced life support (EPALS), blood transfusion, infection prevention and control, safeguarding children level 3.

All staff had completed sepsis training; there was a policy for recognition and management of sepsis and sepsis shock. Staff we spoke with were aware of how to recognise sepsis and how and when to raise concerns.

Staff we spoke with told us there were good opportunities for development and completing training relevant to their role.

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

All areas were visibly clean, tidy and had suitable furnishings which were well-maintained. There were adequate storage facilities, no items were stored on the floor. Storage areas were tidy and free from clutter.

The service had an up-to-date corporate infection prevention and control policy which included information on roles and responsibilities, monitoring, training and the Infection Control Committee.

The environmental cleaning was provided by housekeeping staff who had enough equipment and daily checklist. Staff carried out daily cleaning of the equipment and environment, this was documented daily. We saw cleaning and alcohol wipes were available throughout the service.

Staff followed infection control principles including hand hygiene, cleaning, personal protective equipment (PPE), waste, and decontamination. Hand-washing and sanitising facilities were available for staff and visitors. We saw gloves and aprons in dispensers on the walls outside patients rooms. We observed staff using hand sanitising gel and PPE appropriately during the inspection.

The service performed consistently to a high standard for infection prevention and control, hand hygiene, waste, and sharps management. Audits were completed and consistently 100% compliance for environmental cleaning and hand hygiene.

There was an infection prevention and control nurse who worked across 3 Spire hospitals and visited Spire Parkway Hospital once or twice a week. They provided advice and support to staff, carried out some spot checks and monitored any infections. There was microbiology support 24 hours a day 7 days a week, via the telephone.

There had been no infections such as MRSA, E Coli or C. Difficile at the hospital in the last 12 months.

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 happened.

The oncology team provided person-centred care, ensuring people received medicines support that met their individual needs. There were joint service agreements to support the safe administration and monitoring of chemotherapy, medicines that treat cancer, from the point of initiation. This provided assurance that people received chemotherapy safely with consideration of potential side effects and had access to emergency medical care if issues were to arise. The service reported good relationships with local emergency departments and had processes in place to manage medical emergencies on the unit.

Medicines were stored safely and securely in this area. There were additional disposal systems in place to safely manage cytotoxic waste, waste that may cause harm in direct contact. The unit also had cytotoxic spill kits available in case of emergency. Chemotherapy treatment was planned, ordered and produced in advance of people’s clinic appointments. If treatment was not required, then processes were in place to reallocate treatments to other units to reduce wastage. The unit had seen a 27% decrease in avoidable chemotherapy wastage in the last year because of these workflows. All medicines we checked were in date and there were additional systems to monitor storage and use of short-dated medicines.

Paper private prescriptions were used on cancer unit, but record keeping was not consistent and this meant that some private prescriptions could not be accounted for. However, the service was working on improvements in this area and had processes in place to investigate missing records. Paper private prescriptions were used on this unit if people needed additional medicines at the point of their care. Record keeping accounting for the dispensing of private prescriptions had not been completed in full but the unit had identified this as an area of concern. Missing records were escalated at local safety meetings and investigated locally. A new system has since been introduced to support accountability.

People were reviewed in clinic before every cycle, where they received monitoring to ensure chemotherapy was safely prescribed. All the care records we inspected showed that people had received their monitoring on time and this was used to support their ongoing care.

The electronic care records displayed local guidance which supported the safe clinical review, prescribing and administration of specific chemotherapy regimens. Chemotherapy was prescribed according to local guidance and regimens were ordered in advance of clinic appointments where possible. If treatment regimens required re-prescribing following dose adjustments and medicine delivery delays were anticipated, staff worked collaboratively with patients to ensure they were comfortable receiving chemotherapy at an alternative appointment time. This ensured treatment remained aligned with planned chemotherapy cycles while accommodating patients' individual needs and preferences.

The unit had access to pharmacy support, but this was inconsistent due to staffing. The pharmacy service had recognised a need to strengthen their oncology pharmacy service within their annual strategy and were recruiting to posts within the team. The pharmacy team ensured that every person had a detailed medicine history taken and were counselled on their chemotherapy regime. People received detailed medical information relevant to their care and there was positive feedback from people in relation to their consultant and pharmacy team.

The unit was supported by different prescribers including a dedicated nurse non-medical prescriber. There were systems to support non-medical prescribers to practice within their scope and ensure medical prescribers had effective oversight.

Staff in this area had completed national competencies for administration of systemic anti-cancer therapy (SACT). They were supportive of people receiving chemotherapy, checking on them regularly during treatment administration. Staff had also introduced a new machine for reducing extravasation risk (where medicine that should go into a vein leak out), which is a significant risk during chemotherapy administration.