Spire Portsmouth 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

At our last assessment we rated this key question as good. At this assessment the rating has remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted 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 shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of patient and their communities.

The service had a vision for what it wanted to achieve and a strategy to turn it into action. This vision reflected the overarching provider aims and objectives. Staff spoken with had awareness of how their work contributed to achieving targets. We heard how the values of the service were part of annual staff appraisals and interim reviews to support and promote a positive working culture. Staff were encouraged to review the values and reflect on how they could use their strength to achieve them or develop areas they felt they could be improved.

The culture of the service was centred on the needs and experience of people who used services and staff were focused on this. The service had an open culture where patients, their families and carers as well as staff could raise concerns without fear. Staff were proud to work in the organisation and spoke of how everything they did was for the benefit of the patient.

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

The service celebrated both team and individual staff achievements and ensured staff felt valued and appreciated for their work.

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 did so with integrity, openness and honesty.

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. There was a clear management structure with clear lines of responsibility and accountability. There was a clear leadership structure for the service. The senior leadership team consisted of the Hospital Director, Director of Clinical Services, Finance Director and Operations Director. Heads of department reported to senior leaders and met monthly. We saw ward and theatre staff working together effectively.

Senior leaders were visible and approachable in the service for patients and staff. Leaders attended the wards and departments to assess for themselves how the service was running. There was a process for leaders to meet and discuss issues and cascade information back down to the staff in the service. Minutes from governance meetings showed leaders were knowledgeable about their issues and priorities in their services. In theatres, staff praised local leaders for the support given to them. Ward staff told us they felt able to raise concerns and were confident that leaders acted with integrity.

Staff felt leaders supported them to develop their skills and take on more senior roles. The service had processes to ensure staff were recruited fairly and for roles they were competent in. Where new leaders were recruited, there were processes to ensure they were supported. We reviewed the succession planning document for the service which identified staff for development of their role and the ways they could support them to achieve this.

Leaders had taken incidents seriously and knew how to deal with concerns when raised which promoted a positive culture in the service. Staff and patient survey results were acted upon.

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

The service fostered a positive culture where staff felt empowered to speak up and knew their voices would be heard. Staff and leaders acted with openness, honesty and transparency. Staff were encouraged to raise concerns and offer ideas; the culture allowed staff to be confident their voices were heard. Staff told us they could raise valid concerns and felt confident they would be listened to and supported, without fear of detriment. When concerns were raised, leaders investigated them sensitively and confidentially.

The service had an appointed Freedom to Speak Up (FTSU) lead and a network of FTSU Guardians within the service. There was a freedom to speak up policy and a whistleblowing policy, and staff were aware of this. Staff could also report concerns anonymously through the hospital’s incident reporting system by selecting FTSU as the type of concern. There was also a dedicated phone number for the provider for FTSU reporting. FTSU concerns were reviewed by the FTSU lead or, where required, the provider.

The hospital director met monthly with the FTSU Guardians to discuss areas of concern. The FTSU felt supported by the hospital director and was given appropriate time to carry out duties. Staff completed speak up training as part of their mandatory training and induction. The service clearly displayed information about how to raise a concern. Monthly drop-in sessions were advertised to staff so concerns could be discussed face to face with the FTSU. We also saw FTSU information posters in staff areas.

The service valued diversity in their workforce. Staff work towards an inclusive and fair culture by improving equality and equity for everyone.

The service actively promoted equality, diversity and inclusion in everyday practice, while providing staff with meaningful opportunities for career development and progression. Leaders recognised and addressed disparities in the experiences of staff with protected characteristics, taking action to create a more equitable workplace.

Efforts were made to identify and remove bias from policies, processes and working practices, ensuring all staff had equal opportunities throughout their employment. Equality impact assessments were routinely incorporated into policies and procedures to help identify and mitigate any unintended adverse effects on individuals or groups.

The service demonstrated a strong commitment to preventing and addressing bullying, harassment and discrimination at all levels. Attention was given to supporting staff with protected characteristics under the Equality Act, as well as those from underrepresented or marginalised groups. Staff described the culture as fair and inclusive, and felt confident that any inappropriate behaviour, attitudes or concerns would be taken seriously and addressed.

The service had clear responsibilities, roles, systems of accountability and good governance. Staff used these to manage and deliver good quality, sustainable care, treatment and support. Staff act on information about risk, performance and outcomes, and shared this with others when appropriate.

The service had clear responsibilities, roles, systems of accountability and effective governance arrangements to support the delivery of good quality, sustainable care, treatment and support. Staff at all levels understood their roles and accountabilities, with clear job descriptions setting out expectations and responsibilities. Where senior staff held designated responsibilities for audit and quality monitoring, they demonstrated a good understanding of these requirements. Staff also contributed to decision-making processes to support service sustainability and improve the quality of care provided.

The service operated effective governance processes through a well-established governance framework and committee structure. This included the Medical Advisory Committee (MAC) and Clinical Quality and Safety meetings, supported by groups covering areas such as clinical leadership, infection prevention and control, medical devices, medicines management and risk forum meetings. Standard agenda items included clinical incidents, complaints, audits and risks. Minutes demonstrated sufficient challenge and discussion, with evidence of actions taken to improve compliance within the surgical service. Staff told us they received feedback from these meetings and were kept informed of outcomes and actions.

A range of operational systems supported the delivery of safe, high-quality care. These included daily management huddles and leadership walkarounds across clinical areas. Leaders monitored quality and operational performance through these activities and established reporting mechanisms, enabling them to identify areas requiring action and improvement.

The service used comprehensive audit and performance monitoring processes to support continuous improvement. A wide range of information was collected, analysed and communicated through committee structures and escalated to provider level where appropriate. Performance data was benchmarked across the provider organisation, and where improvements were identified at local level, action plans were developed, monitored and implemented. Audit findings were used to maximise the quality of services, and leaders ensured improvement plans resulted in positive changes. We reviewed several service-level and provider policies and found them to be up to date and easily accessible to staff.

Leaders ensured accurate information was discussed, shared and available to key staff. Staff could access the data they needed in user-friendly formats to understand performance, support decision-making and drive improvements. Information systems were integrated, secure and supported effective governance arrangements.

Risk management processes were well established. Risks were clearly identified, recorded on risk registers and regularly reviewed to ensure oversight and mitigation. Risk registers and management reports included analysis of trends over time and associated action plans. Staff acted on information relating to risks, performance and outcomes and shared this appropriately to support service improvement and patient safety.

The service demonstrated effective management of information and compliance requirements. Data and notifications were submitted to external organisations as required, and there had been no reported data breaches. Patient-identifiable information was handled appropriately, and systems were secure. The service also had arrangements to respond to unexpected events, including a business continuity plan and major incident plans.

The service clearly understood and carried out their duty to collaborate and work in partnership, and services worked seamlessly for people. They always share information and learning with partners and collaborate for improvement.

Staff and leaders at the service collaborated with relevant external stakeholders and agencies to improve care and treatment for patients using the service. Senior leaders were part of regional networks to understand the needs of the community and the provider ambitions. They also maintained regular and structured engagement with Integrated Care Boards (ICBs).

Leaders and staff actively and openly engaged with patients, staff, equality groups, the public and local organisations to plan and manage services. Patient and their families were invited to undertake the Patient-Led Assessments of the Care Environment (PLACE) audit. Patient-led assessments of the care environment (PLACE) help organisations understand how well they are meeting the needs of their patients and identify where improvements can be made.

Consultants provided educational updates to primary care healthcare professionals, including GPs, through webinars and face-to-face sessions delivered during lunchtime and evening events. The service told us this aimed to improve patient diagnosis and treatment by strengthening collaboration between primary, for example G. P’s, and secondary care services like themselves. This approach improved referral quality, helped identify serious symptoms earlier, and supported better patient care before and after surgery in the community. It also promoted shared decision-making and improved patient understanding of surgical options and recovery pathways. This contributed to improved patient outcomes and more effective use of healthcare resources.

The service told us these sessions aimed to improve patient diagnosis and treatment. Feedback was overwhelmingly positive, with 75% of attendees stating they were very satisfied. Attendees said the information presented was informative and had improved their knowledge in the subject area.

The hospital worked closely with an NHS trust outside the local area to provide capacity for patients who had been on NHS waiting lists for a significant amount of time. This included some patients who had been waiting more than 104 weeks. They also worked with other services within the provider network to improve referral to treatment times across the local region. The service had a partnership with an independent oncology service to support patients with rapid access to diagnostic services and essential radiotherapy planning imaging.

They worked in partnership with the local NHS trust to support clinical research programmes by providing diagnostic services. The hospital had participated in formal clinical governance and learning forums, including microbiology multidisciplinary meetings and National Joint Registry (NJR) data reviews to ensure shared learning, benchmarking, and continuous improvement in clinical outcomes and patient safety.

Leaders told us they were working to develop stronger links with their local acute NHS trust to support the local community and develop agreements for mutual aid. There was engagement meetings planned to discuss this.

Local staff events were arranged to support physical, emotional and mental wellbeing and help raise funds for local charities. Staff told us these were supported by the senior leadership team.

The service supported a mental health charity chosen by staff as its charity partner. This collaboration included fundraising initiatives, such as an annual “Mental Elf” 5k run which raised funds for the charity.

The service focused on continuous learning, innovation and improvement across the organisation and local system. Staff encouraged creative ways of delivering equality of experience, outcome and quality of life for patient. Staff actively contribute to safe, effective practice and research.

Staff demonstrated a strong commitment to continuous learning and service improvement. They were given protected time to develop their skills, engage in improvement initiatives, and pursue areas of professional interest. Several staff members we spoke with had a good understanding of quality improvement methodologies and had received relevant training. In addition, staff from the service had completed Driving Clinical Excellence training and certification, a programme designed to equip colleagues with the knowledge, skills, and confidence to deliver high-quality care and lead service improvements.

Across the service there was a shared commitment to excellence, with a focus on enhancing the patient experience. They worked collaboratively to identify opportunities for improvement and develop effective solutions. The service had been selected as a pilot site for the development of the Bowel Network for a multinational healthcare company. These specialised sites provide a fast-track diagnostic pathway, enabling patients to be assessed for bowel cancer more quickly and supporting earlier detection. Leaders told us the pilot had been highly successful, benefiting patients while also driving internal service developments, including the redesign of the bowel preparation issuing process.

The service made changes from safety alerts and incidents to improve practice. We saw evidence supporting how reviews of medicines errors resulted in steps to prevent recurrence. For example, patients requiring endoscopy preparation medicines were unable to obtain these in community pharmacies. This prompted a coordinated response between multiple departments to ensure all information and medicine required was supplied at patients’ consultation in a ‘one stop shop’ approach.

Students undertaking professional qualifications were well supported during placements within the service. Feedback from students was actively sought to help improve learning experiences and placement programmes. Students we spoke with were positive about their placement and described receiving good levels of support from staff throughout their time in the service.

There were effective systems to promote learning from incidents and share examples of good practice at both a local and national level. Each week, the service produced a ‘Friday Feedback’ poster, which was distributed across the hospital. The poster included learning from incidents, patient feedback, staff achievements, awareness events, and key organisational messages from the previous week. We saw these posters prominently displayed in staff areas. Leaders told us teams were encouraged to discuss the content during daily huddles, helping to promote communication, shared learning, and awareness across the service.