Spire Portsmouth Hospital

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• 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’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we inspected but did not rate this key question. At this assessment, the rating is good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

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

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

The service had a clear pathway that assessed whether people who accessed the service met the clinical risk criteria to be treated at the hospital. Those deemed too high risk would be referred to the NHS.

Staff maximised the effectiveness of people’s care by assessing and reviewing their health, wellbeing and communication needs with them. We reviewed 5 patient records which were completed to a good standard and information was easy to locate. Allergies, consent, observations, Malnutrition Universal Screening Tool (MUST) scores, moving and handling assessments, nutrition and hydration information and falls risk plans were documented where relevant.

The service had a pre-operative assessment policy for staff to follow. Staff roles and responsibilities were clearly outlined in the policy. It stated all pre-operative assessments must be undertaken by registered staff who have successfully completed relevant supervised practice. Staff used an electronic pre-operative assessment system to screen patients efficiently. The structured questionnaire and automated risk flags helped staff identify people who needed more detailed assessment. This system supported timely clinical decision making and ensured resources were used effectively.

Daily medical alerts ensured pharmacy, therapy teams and allied health professionals remained aware of new or emerging issues affecting patient care.

Staff attended weekly meetings, which allowed teams to review the full plan for the week ahead. This helped identify staffing needs, consider any emerging clinical issues and ensure safe preparation for each patient.

Staff used hospital passports to help them make reasonable adjustments for people with communication needs, autism and/or learning disabilities. A hearing loop was available, and staff said they were usually informed in advance when a patient with a learning disability attended.

Staff observed patients closely in waiting areas and raised concerns if communication needs appeared to affect safety or understanding.

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

Staff followed up to date policies to plan and deliver high quality care according to best practice and national guidance.

The hospital’s overarching policies were produced and reviewed centrally by the hospital group. Staff were able to access all policies on the hospital’s computer system. We sampled the policies and found them in date and evidenced based with references to key national documents.

Weekly meetings brought together the wider multidisciplinary team to plan staffing, coordinate equipment and review any changes in patients’ needs, such as new symptoms or medication adjustments. This consistent communication ensured patients had timely access to specialists throughout their care journey.

Clinicians worked within clearly defined scopes of practice, which were reviewed every 6 months as part of the practising‑privileges process. This included performance monitoring, documentation checks and external oversight when required.

Staff in outpatients engaged in clinical audit, benchmarking and quality improvement activity. Monthly audits covered medical device checks, point‑of‑care testing and national cleanliness standards. Quarterly audits assessed documentation, fire safety, health and safety, hand hygiene, infection control precautions, waste management and compliance with the surgical safety checklist. Outpatient audits generally achieved over 95% compliance. A small number fell slightly below the required standard, including fire safety. Action plans were developed to address areas requiring improvement.

The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The service worked collaboratively as a multidisciplinary team, the clinical service managers had regular heads of department meetings to share information. Heads of department then cascaded information to their teams. There was also information sharing at corporate level with staff able to join national conferences with the wider Spire group.

Staff told us the team worked together well to manage patient risk; the wider hospital clinical team met to discuss higher risk patients to decide whether they could safely be treated at the hospital.

Outpatient staff held a safety huddle each morning and afternoon. A noticeboard provided a clear overview of staff allocation, supporting visibility and accountability.

The organisation maintained strong relationships with local NHS trusts and other healthcare partners through Service Level Agreements.

Staff described strong communication across departments and said they felt confident raising concerns. Leaders responded quickly to issues, including equipment faults and delays with diagnostic tests, which supported safe teamwork.

Chaperones were routinely provided, and staff followed standard safety practices such as knocking before entering rooms and maintaining privacy.

Staff followed clear escalation processes, and Advanced Life Support trained staff and porters responded quickly to alarms.

The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

The service supported patients to manage their health and wellbeing, the pre-operative team assessed people’s fitness for surgery and referred any health concerns to the patient’s GP.

Staff promoted health and well-being through the pre-operative check and patient information booklet. Physiotherapy staff supported people through various interventions such as joint classes to manage pain and enable them to regain mobility.

Staff referred on to NHS services when people were interested in smoking cessation or mental health support.

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

Leaders routinely monitored safety and performance data to identify trends and improve outcomes. Staff monitored waiting times closely and tracked the first available appointment for each consultant and specialty. At the time of inspection, almost all specialties had waits of less than a week.

On clinic days, outpatient nurses monitored delays in real time. Along with the reception team, they kept patients updated and recorded significant waits on the incident system. Persistent late starts or overrunning clinics were escalated to the Director of Clinical for oversight and review.

The service monitored any adverse outcomes through their incident reporting system and had implemented actions where required.

Patients who had surgery were able to contact the outpatient department for advice following surgery. Staff had received wound management training. Patients were invited to return to a post-operative clinic for wound care. Patients could access their GP but we were told most preferred to come back to the hospital.

All patients who had joint replacement surgery received follow‑up assessments due to the complexity of their procedures. This enabled ongoing monitoring of recovery and early management of any concerns. The physiotherapy team had reduced the length of stay for patients through enabling early mobilisation following joint replacement surgery. They also had a joint replacement club where patients came after their surgery for exercise groups. This also provided ongoing support and advice from the physiotherapy department.

The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff had access to policies designed to protect patients, including a Deprivation of Liberty Safeguards policy. This policy explained how to keep people safe when they were unable to make decisions for themselves and required necessary restrictions for their care. A consent policy was available to ensure patients were given information and were able to give informed consent. All policies were in date and aligned with national guidance.

Staff in clinics obtained informed consent from patients, outlining the risks and benefits to the procedure. Patients told us they understood their care and treatment, however staff knew what to do if they were concerned about a patient’s capacity to consent.

Staff followed chaperone guidelines to make sure patients had the option of a trained chaperone during examinations. Chaperone posters were displayed in public areas, clinics had allocated chaperones, and all patients were verbally offered a chaperone.

We reviewed 5 care records and found consent had been clearly recorded in every case.