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

The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. People were protected and kept safe. Staff understood and managed risks. The facilities and equipment met the needs of people, were clean and well-maintained and any risks mitigated. There were enough staff with the right skills, qualifications and experience.

However, we were not assured that the service leaders had a clear oversight of medicines for children and young people as there was no dedicated pharmacist. Pharmacy audit information requested following our inspection was not provided.

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 reported them through an electronic system, and managers were alerted immediately. Incidents and complaints were reviewed daily at staff huddles and fully investigated. Lessons were learnt to continually identify and embed good practice.

Between November 2025 and April 2026 there had been 30 incidents reported. All incidents had been reported with no harm. Most incidents were errors in documentation and treatment booking errors. There was 1 medication incident reported. Each incident was investigated, actions taken and lessons learnt to continually identify and embed good practice. There had been no serious incidents involving children or young people.

The service held a shared learning session each month where staff were given feedback on lessons learned from incidents. They also discussed provider wide incidents and safety alerts.

Staff were able to explain and give examples of instances of applying duty of candour, this is the responsibility to be open and honest with patients and their families when things went wrong. Staff had a good understanding of when this duty needed to be applied.

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 the 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.

Children and young people were assessed at preoperative assessment, and consultants and nursing staff discussed the care of the patient throughout their stay. Prior to admission, each patient was discussed weekly at the multidisciplinary theatre scheduling meeting. The service saw children over the age of 3 years old and above 14kgs of weight. Assessments for children and young people were done face to face or only in exceptional circumstances by video link.

Patients’ care was discussed with the multidisciplinary team and planned to ensure all needs were met. The patient’s procedure was discussed, and information shared such as allergies, past medical history and any protected characteristics to ensure that all staff were aware and plans could be adapted to meet the patients’ needs.

We checked the pre and post-operative notes for 3 children or young people undergoing a surgical procedure on the day of our inspection. Notes demonstrated that the anaesthetic chart had been completed, operation notes were documented, and post-operative observations had been undertaken and recorded, fluid balance charts had been checked. The consultant surgeon and anaesthetist reviewed the child or young person following the procedure to ensure they were fit for discharge. A final set of observations was completed before discharge.

We observed that in the recovery area the anaesthetist remained with the child or young person (CYP) until they had had completely recovered from their procedure.

Nursing staff completed a discharge summary, copies were kept in the patient record and provided to the child or young person and their parent or carer. Families were also given a copy to share with their GP, together with a school nurse letter where appropriate. Pain relief advice and post-operative information were provided.

The child or young person received a hospital stay information pack containing post-operative instructions and relevant contact details. Staff told us that, on discharge, a nurse accompanied the child or young person to the main reception area and ensured the discharge process was completed, including updating the patient administration system.

The hospital's Paediatric Lead Group worked across each site to oversee and support the safe delivery of services for children and young people.

The Paediatric Lead Group also reviewed requests from consultants seeking approval to perform a procedure at the Spire Parkway location that would not normally be undertaken there but could provide quicker access to treatment for a child or young person, avoiding the need to travel to another location where the procedure was routinely performed. This supported timelier access to care and helped achieve treatment goals.

As part of this process, the group considered the proposed procedure, the competencies of staff, the availability of appropriate equipment and resources, and any specific risks associated with the patient group. The Paediatric Lead Group assessed whether the necessary safeguards were in place and sought assurance that the procedure could be delivered safely before approving the request. This oversight supported consistency and helped ensure that children and young people received safe, effective care across all provider locations.

Staff were supported by a resident medical officer (RMO) if a patient’s health deteriorated. The RMO was on duty 24 hours a day and was available on site to attend any emergencies. Staff could contact consultants by telephone 24 hours a day for advice or to raise concerns about patient care. The RMO and staff told us consultants were responsive and supportive.

The service had a transfer policy which laid out guidance in the event a child or young person required transferring to a local NHS hospital for urgent and non-urgent treatment. The possibility of non-urgent transfer was discussed with children, young people and their parents or cares at admission as part of the preparation process. The procedure explained non-urgent transfers could be where: The patient had or was likely to exceed the planned length of stay, the children’s nurse became ill during their shift, and safe staffing levels could not be achieved or children and young people in outpatients who were assessed as acutely unwell.

The procedure referred to urgent transfers in situations where the patient’s PEWS score remained elevated following all possible management by consultant, anaesthetist and paediatrician, the child or young person suffered a respiratory/cardio-respiratory arrest, significant bleeding or active bleeding, or a post anaphylaxis event.

In the last 12 months there had been 1 patient transferred to a local NHS hospital. Service leaders had a process for reviewing any transfers. Which were reported as incidents and reviewed by the medical advisory committee (MAC) chair, consultant and anaesthetist involved in the care.

The service worked with children and young people, their parents 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 had to act to ensure patients were kept safe.

Staff demonstrated a good understanding of safeguarding procedures and different forms of abuse. They could easily identify the service safeguarding leads and teams, how to get support and report a concern. There was evidence of actions taken to safeguard children and keep them safe from harm. There had been no safeguarding incidents reported in the 12 months prior to our inspection.

On patient admission to the service, staff completed a safeguarding checklist which included any safeguarding information from GP surgeries. All admissions of children or young people were discussed at the morning daily huddle.

The lead for CYP attended the Solihull Safeguarding Children’s Partnership faculty learning group. These were dedicated to safeguarding practice reviews and discussions around guidelines.

Staff received mandatory safeguarding children and adults training. All staff were trained to level 3 safeguarding. The DOCS and CYP lead nurse 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 children level 3 training compliance was recorded at 100%. Staff were also trained in safeguarding adults level 3 with a compliance rate of 100%. Staff completion rates for Prevent Level 3 training, on recognising the threat of terrorism and extremism, was 100%.

The service monitored appointments missed by children and young people, they were followed up and a reason for non-attendance noted and if there were concerns for a child or young person the service had processes for follow up for example contacting the school or GP.

Quarterly safeguarding reports presented to the board included details on safeguarding alerts, significant safeguarding issues, and any changes to organisational or national safeguarding policies, processes, and procedures. The Quarter 1 2026 report, for example, highlighted a policy review undertaken to align safeguarding procedures with national developments and to ensure clearer, more consistent terminology across all safeguarding documentation.

Patients were supported to understand their rights, including their human rights, their rights under acute services, the Mental Capacity Act 2005 and 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.

We viewed 3 staff files. 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 children, people and their parents 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 surgery all children and young people, their parents and carers completed a health questionnaire that was assessed by the POA team. Each patient was triaged and the patients age, procedure and medical history would be taken into consideration to determine the preoperative actions. Following the triage, patients had telephone call assessments, face-to-face appointments and tests taken. Staff told us they had identified patients through their assessments who required further reviews with medical staff. There were 2 anaesthetic-led clinics each week for children and young people. These clinics enabled anaesthetists to undertake detailed pre-operative assessments, review individual risk factors and plan care accordingly.

Staff demonstrated a proactive approach to risk management. For example, they recognised the known risks associated with tonsillectomy procedures, including the risk of bleeding. Records showed that staff identified potential complications in advance and developed appropriate plans to manage them should they arise. This helped ensure children and young people received safe care that was tailored to their individual needs and level of risk.

All female patients over the age of 12 years were asked to provide a urine sample for pregnancy testing. Test results were checked by two registered children's nurses. The test was undertaken with consent, and the reasons for the test were explained. Positive pregnancy results, disclosures of sexual activity, or any safeguarding concerns identified during the assessment were escalated in line with the service's safeguarding policy. The policy stated that an immediate referral would be made to the police and local authority safeguarding team for any child under the age of 13 who was sexually active. For children aged 13 to 16 years, safeguarding procedures were followed in accordance with Fraser and Gillick guidelines, with risk assessments and referrals made where appropriate.

Preoperative nurses told us they could contact the anaesthetist for advice and support at any time. We followed a patient journey. Preassessment paperwork was correctly and accurately completed. Anaesthetic review forms were completed correctly and evidence that risks had been discussed with patients and their parents and carers.

Staff used a nationally recognised tool to identify deteriorating patients and escalated them appropriately. Clinical notes demonstrated the use of the Paediatric Early Warning Score (PEWS) as a recognised tool for monitoring children’s health status, supporting the early detection of clinical deterioration and ensuring timely intervention and escalation in line with local procedures. We reviewed 5 sets of patient records and found observations were completed according to the frequency required for the patient and escalated according to policy. The service audited their compliance with escalating PEWS scores as part of a clinical file audit. Audits showed 98% compliance.

There was a service level agreement with the local children’s acute hospital to support staff when they identified a patient who deteriorated.

There was good compliance with safety checks in the operating theatres. During our observations, staff completed the World Health Organisation (WHO) Surgical Safety Checklist, and all members of the theatre team were actively involved in the process. Although audits were not completed specifically for procedures undertaken on children and young people, the overall service WHO checklist audit for January to March 2026 showed a compliance rate of 98%.

Theatre had a difficult airway trolley, and a chest drain trolley and haemorrhage trolley set ready to use in an emergency.

Staff demonstrated a good understanding of Martha’s Rule, a patient safety initiative that enabled patients, families, carers, and staff to request a rapid review by a critical care outreach team when there were concerns about a patient’s condition. Signs in corridors explained to staff and people using the service how to use the initiative.

The service did not provide overnight accommodation for children under 16 years of age. However, where clinically appropriate, young people aged 16 and 17 years could be admitted to the adult ward following completion of a formal risk assessment. The service had a Young Person Assessment for Adult Services (16–17 years) policy and process to support decision-making and ensure safe care.

Staff explained that young people aged 16–18 years who were assessed as suitable for management through the adult pathway would follow adult policies, procedures, and clinical monitoring arrangements, including the use of the National Early Warning Score (NEWS). These young people were considered appropriate for care by adult nursing staff and did not require direct involvement from children's nurses in their ongoing care.

Young people accepted onto the adult pathway were referred to the adult POA team for assessment before admission and for subsequent care planning and management. This approach ensured that the individual needs, risks, and safety of each young person were considered before care was provided within the adult service.

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 children and young people, there was a welcoming atmosphere in the children’s surgical area. The area was brightly decorated and appropriate for children. The ward was visibly clean and tidy with appropriate equipment available to maintain safe levels of care.

Fire extinguishers were within date service checks, fire exits were signposted throughout the hospital. There were dedicated fire wardens on duty daily.

Equipment in rooms and bays such as oxygen and suction facilities were in working order and had been appropriately checked and maintained.

Consultation rooms in the outpatient department were clean, tidy, and free from clutter. The physiotherapy and diagnostic imaging areas were also clean and well maintained. Equipment in these areas had been appropriately decontaminated for the use of the next patient, was in good condition, and appeared well maintained.

The hospital had 1 paediatric day case ward of 6 bays which was used prior to a surgical procedure and as a recovery area. Access to the day case ward was by security pass only and there was a reception desk immediately in front of the doors where staff check who was attending the ward. There were 2 accessible toilets and handwashing facilities. The service did not accommodate children or young people overnight.

Sharps bins were available and labelled correctly and not overfilled. Disposable curtains were used, dated and changed in line with guidance. Medical equipment in the ward area had been appropriately tested and was within date. Sterile equipment was stored off the floor on appropriate shelving, all equipment was in date. The linen room, storeroom and dirty utility room were all visibly clean and tidy and equipment was stored correctly.

Substances deemed hazardous to health were stored in locked cupboards in the housekeeper’s room. This meant people using the service did not have access to substances which could damage their health.

Resuscitation trolleys were well maintained and in good condition. Equipment was within its expiry date, and daily checks had been completed. Staff had access to appropriate paediatric emergency medicines, which were readily available in the event of an emergency.

There was adequate car parking directly outside the building.

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. 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.

There were 3 full time children’s nurses which included the CYP lead. The service used bank staff when required. Between November 2025 to April 2026, an average of 2.8% of hours had been covered by bank staff. The CYP service had no vacancies. Managers told us they continually reviewed staffing levels and could flex staffing according to need.

Staff in other areas were also trained in European Paediatric Advanced Life Support (EPALS), a training course for healthcare professionals that teaches the recognition and management of seriously ill children and paediatric emergencies, including cardiac arrest. Meaning, these staff members could also work in children and young people’s services if needed.

All consultants worked under practising privileges and were not directly employed by the service. 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 3 staff files consultants and found recruitment processes were in line with employment guidelines. Nursing staff had completed their Nursing and Midwifery Council re-validation checks and updates to develop their competencies. 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 also 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. We reviewed 3 consultant files and found they were all up to date with relevant information including up to date DBS checks, appraisals and training. 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 resident medical officers (RMOs), doctors. They worked on a week on week off rota and were available 24 hours a day.

Staffing levels were reviewed daily for each department and staff worked across departments to support each other. There was a senior manager on-call every day and out of hours, they would be on-call for a week at a time. There was a duty manager on site between 9am to 4pm every day. Theatre teams had an on-call anaesthetist, operating department practitioner and scrub nurse. Physiotherapy staff were on-call out of hours and over the weekend.

Staff sickness rate between October 2025 to March 2026 was 5.6% for children and young people’s services. This was slightly above the Spire group average for sickness of 5.3%.

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 inspection all 3 of the staff in the children and young people’s team had received an appraisal. 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 were provided 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 across all departments of the location showed 80% of all staff had completed their mandatory training, with a target to complete all training by the end of May.

We found that 100% of staff working with children and young people had completed European Paediatric Advanced Life Support (EPALS) and Paediatric Immediate Life Support (PILS) training. These courses provide healthcare professionals with the skills to recognise and manage a seriously ill or deteriorating infant or child, including delivering emergency treatment and resuscitation prior to the arrival of a specialist resuscitation team.

Medical staff received and kept up to date with their mandatory training, this was completed through their employing NHS trust, and this was checked and updated by the hospital. Records of mandatory training for visiting consultants were held on site. 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, EPALS, blood transfusion, infection prevention and control, safeguarding children level 3.

Staff we spoke with were aware of how to recognise sepsis and how and when to raise concerns. All staff had completed sepsis training, there was a policy for recognition and management of sepsis and septic shock. In the last 12 months there had been no cases of sepsis reported.

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 completed a 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. Equipment was clearly labelled with an ‘I am clean’ sticker, with a date to show when it had last been cleaned.

There was a schedule for cleaning toys which were provided in child friendly areas.

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.

Audits were completed for the children and young people areas within the wider audits for the service. 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 telephone microbiology support 24 hours a day 7 days a week.

The hospital had a decontamination and sterilising department in the theatre environment. The department had a one way flow for dirty and clean equipment. We saw staff wearing appropriate protective clothing.

The evidence showed some shortfalls. We were not assured that the service had clear oversight of medicines for children and young people as there was no dedicated pharmacist. Staff told us there had previously been a dedicated pharmacist and this had worked well. On the day of inspection, the pharmacy manager was covering all areas and was very stretched and it was difficult to see how oversight would be maintained at peak times. There had been 1 medicine incident reported in the between January and March 2026, a 15-year-old child was prescribed a medication not licenced for children under the age of 16 which the CYP nursing team had reported. The error had not been identified before the patient was discharged. However, no harm to the child was reported. Pharmacy audit information that we requested following our inspection was not provided.

Medicines were stored safely and securely in this area. Staff working in this area had achieved a 100% compliance rate with training on use of controlled drugs and demonstrated a good awareness at ward level on the appropriate use of these. Controlled drugs are medicines or substances that are regulated by law because they can be harmful if misused, abused, or diverted for illegal use. No controlled medications were used in the treatment of children and young people.

Thorough pre-surgical assessments were taken for people including a medical history and assessment of venous thromboembolism risk. Allergies were recorded in medicine care records.

Pharmacy staff were available to counsel people on changes to their medicine prior to discharge. Take home medicines were prepared in advance of people’s discharge to prevent delays in them going home.

Pharmacy staff completed medicine histories for people admitted to the ward and supported people with counselling on discharge. Every take home prescription was clinically reviewed by a pharmacist and staff on the ward proactively worked with people to reduce medicines costs on discharge. This would include informing them in advance of their option to buy pain medicines over the counter at an alternative pharmacy.

Surgical theatres were well equipped with medicines for a range of surgeries and medicines storage areas were well maintained. Medicines, including CDs, were kept securely and there was information available outside theatres on their appropriate use and destruction. Record keeping for CDs in theatres was completed according to national guidance. Medicines being used in theatres were prepared and labelled clearly as per local guidance.