Spire Parkway 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 outcomes and exploring best practice was part of their everyday work.

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 Effective.

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

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 were involved in the assessment of their needs, and support was provided where appropriate to maximise their involvement.

Staff ensured patients were able to share their individual needs when completing the pre-assessment and admission process. Staff told us about the comprehensive approach to assessing the needs of the patients.

The weekly theatre scheduling meeting ensured all patients were discussed and their needs identified and care planned such as those with allergies and diabetic patients.

We reviewed 9 sets of patients medical and nursing notes and found these they had a comprehensive health assessment of the patient soon after admission. Care plans described the needs of the patient and how staff could assist the patient. Care plans were personalised and holistic. They were updated as necessary. Risk assessments, such as nutritional needs, falls, skin integrity and pain management was assessed daily, we saw evidence these were assessed and documented daily, this was in line with best practice. Patients’ mobility was rated red, amber, green and displayed in the patients bedroom for all staff to see.

Discharge plans were discussed at the POA appointment as well as on admission to the ward. This ensured patients were aware of discharge dates and prepared at home. Patients with mobility issues and any patient that had orthopaedic surgery, physiotherapy staff would visit patient prior to discharge to ensure they were safe and had appropriate mobility aids.

Staff were supported by an RMO (resident medical officer) 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. In an emergency, staff would request an ambulance to transfer the patient to the local acute NHS emergency department.

The service had a transfer policy for any patient that required transferring to an NHS hospital for ongoing treatment. In the last 12 months there had been 15 patients transferred. All transfers were reported as incidents and reviewed by the MAC chair, consultant and anaesthetist involved in the care.

There was a pathology laboratory on site to carry out blood test, swabs and some specimens. Some tests and swabs would be sent to another Spire hospital to be tested. Blood products were stored in the theatre.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. Staff did this in line with legislation and current evidence-based good practice and standards.

Staff followed up-to-date policies to plan and deliver high quality care according to best practice and national guidance. The service followed National Institute for Health and Care Excellence (NICE) guidelines. Policies we reviewed were up to date and had been approved by the appropriate governance processes. Staff were able to access policies, processes and guidance easily through the hospitals electronic system.

Policies were monitored at a corporate level to ensure they were updated, reviewed and consistent amongst each Spire hospital.

Patients were assessed in line with national and best practice guidelines, and we saw evidence in the patient records that we reviewed. Patients waiting to have surgery were not left nil by mouth for long periods of time. Staff provided patients with information about the requirements for being nil by mouth (which means nothing to eat or drink) prior to their surgery. This was in line with national guidance and was checked as part of the ward checks and perioperative checks prior to surgery.

There was a corporate audit programme with monthly, quarterly, biannual and annual audits scheduled. Results were benchmarked with other hospitals within Spire. These were discussed at the weekly Rapid Response meeting, monthly senior management meeting and reported to MAC. Any audits out of range would have action plans and be repeated more frequently.

The hospital completed local audits quarterly such as catheter care, medicines management, VTE and environmental cleaning. We saw audit results were consistently between 85%-100% compliance. Action plans were in place when required and discussed with the individuals, team and at the Quality and Risk Committee.

The service worked well across teams and services to support people. Staff shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

Staff prided themselves on good teamwork and communication throughout the multidisciplinary team. We observed this throughout all areas of the whole hospital and the within surgery.

There was a daily huddle attended by a representative from each department to discuss staffing levels, activity and capacity. Staff could raise concerns about staffing levels, patients care and equipment. They discussed staff working from home and any visitors on site. They also discussed any safeguarding concerns, incidents complaints and staff sickness. Information was entered onto a spreadsheet that all staff could access.

We observed a ward handover, each patient was discussed including care plans, physiotherapy needs, discharge plans, observations and medication. Staff were allocated patients to care for and tasks to carry out.

The RMO did not attend ward handover or ward huddle, however, they visited the wards throughout the day and reviewed patients as required. We saw the RMO discuss discharge plans and medication with patients and staff. Following our inspection, we were informed that the RMO would attend the ward handover, ward huddle and the daily safety dependant on activity on the ward.

We saw and heard examples of staff supporting each other, this included collecting patients from theatre, sharing information about equipment maintenance and moving staff to other departments to support safer staffing levels.

Staff had access to the information they needed to appropriately assess, plan and deliver patients’ care, treatment and support. Patients were assessed at preoperative assessment and reviewed at the weekly theatre scheduling meeting prior to admission. When patients were transferred back to the ward staff were given verbal and written information on the operations and ongoing care needs.

The physiotherapy staff visited patients on the wards. We saw physiotherapists and nursing staff discussing patient care needs, mobilisation and ongoing plans.

The ward displayed staffing levels, the nurse in charge and nurses with staff competencies for blood transfusions, intermediate life support and advanced life support.

During our onsite inspection, we observed staff within theatres working effectively together with clear direction from the lead surgeon and scrub nurse and clear communication with each other.

The hospital had support from specialist teams such as specialist nurses and dietitians.

Staff told us that patients care and ongoing treatment needs could be discussed at the consultants practicing NHS MDT (multi-disciplinary team) meeting. This included patients with complex care needs and cancer diagnosis. The hospital had an SLA with local trusts to provide MDT services.

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 service supported people to manage their health and wellbeing to maximise their independence, choice and control.

Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Patients had access to physiotherapy services, a dietician and other support services to promote people to maximise their wellbeing and independence.

Patients were involved in planning their treatment and care and were able to choose options for care and treatment with the advice of the consultant and the hospital team.

Information leaflets were available in hard copies and online which included weight management, smoking cessation, mobility and avoiding falls. Patient information leaflets of a variety of conditions and post-operative care were available in different languages. These included hernia repair, knee surgery and wound care.

The service routinely monitored people’s care and treatment to continuously improve it. Staff ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

There was participation in relevant local and national clinical audits and other monitoring activities such as reviews of services and benchmarking.

The hospital completed local audits weekly, monthly and quarterly such as catheter care, medicines management, VTE and environmental cleaning. We saw audit results were consistently between 85%-100% compliance. Action plans were in place when required and discussed with the individuals, teams and at weekly Rapid Response meeting, monthly senior management meeting, Quality and Risk Committee and reported to MAC. Any audits out of range would have action plans and be repeated more frequently.

The hospital submitted data to Private Healthcare Information Network (PHIN) which collects data on performance, outcomes and adverse events of private patients. The latest published data from 2024-2025 showed the hospital scored a rate less than 1 per 1000 discharges for mortality, readmissions, returns to theatre and readmissions. This was better than the average performances.

The hospital submitted Patient Related Outcome Measures (PROMS), which helped the NHS measure and improve the quality of care that patients experienced during and after elective surgery. In the PROMS survey, patients were asked whether they felt better or worse after receiving the following operations hip replacements knee replacements. The PROMS data showed that the hospital was not an outlier and overall, most patients reported an improvement in how they felt after their hip and knee surgery. The hospital planned to collect data for additional procedures including carpal tunnel release, nasal septoplasty, shoulder replacement, transurethral resection of the prostate and abdominoplasty.

The service submitted data to the National Joint Registry (NJR) which records, monitors, analyses and reports on performance outcomes in joint replacement. The hospital was awarded the NJR’s “Gold” Quality Data Provider Certificate in 2025, for submitting high data quality data and was 100% compliance.

The hospital reported surgical site infections (SSI) for hip and knee surgery. Between January and December 2025, the data showed 0.2% SSI for knees from 443 patients and 0.3% SSI for hips from 364 patients. This was below the England national average.

In the last 12 months 11 patient returned to theatre, 5 patients returned to theatre within the same admission and 6 patients of return to theatre following a readmission. 1 patient was admitted to the NHS and returned to theatre. All returns to theatre were reported as incidents under the NHS Patient Safety Incident Framework (PSIRF). Each incident was reviewed with staff and any lessons learnt shared.

Managers monitored waiting times and made sure patients could access services when needed and received treatment within agreed timeframes and national targets. The service kept a detailed spreadsheet of all NHS patients and their 18-week breach deadline. However, due to Spire Parkway over preforming on the NHS agreed contract the ICB requested they stop operating on NHS patients during February and March 2026. This affected 118 NHS patients that had surgery rebooked based on clinical needs when the new contact commenced. Each patient had a harms proforma completed and review between the DOCS and MAC Chair.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment. Patients understood their rights around consent to the care and treatment they were offered.

There were systems and practices to ensure patients understood the care and treatment being recommended. This helped them make an informed decision about their treatment.

Staff gained written consent from patients for their care and treatment in line with legislation and guidance. Staff made sure patients consented to treatment based on all the information available. Patients received information about care and treatment in a way they could understand and had appropriate support and time to make decisions. Patients we spoke with told us they received enough information to give their consent for procedures.

Staff understood the Mental Capacity Act (MCA) and their responsibilities when assessing capacity to consent. Staff recognised that a patients’ capacity changed regularly due to the nature of treatment and their clinical condition, so they ensured that capacity was assessed at each interaction.

Staff understood their responsibilities around Deprivation of Liberty Safeguards (DoLS)and there were hospital policies in place to ensure that staff were aware how to request DoLS for a patient.

Staff compliance of MCA and DoLS training reached 81%, this was planned to be 100% by the end of May.

We reviewed 9 consent forms and found they were all completed correctly and had the relevant details and risk identified.