HCA Healthcare UK at the Wilmslow Hospital

Updated 21 February 2022

HCA Healthcare UK at The Wilmslow Hospital is a private hospital in Cheshire, England, owned and operated by 52 Alderley Road LLP. The hospital opened in May 2014, and provides outpatients, diagnostics and day case surgical services for both self-paying and insured patients. The hospital accepts adults and children under 18 years of age in their outpatient and diagnostic services and treats adults and children aged 16 and over in the surgical service.

The hospital has had a registered manager in post since opening in 2014 and carries out the following types of regulated activity:

• Family planning services
• Treatment of disease, disorder or injury
• Surgical procedures
• Diagnostic and screening procedures

The hospital operates across three floors, offering patients a full range of treatments including; dermatology, ENT surgery, gynaecology, interventional radiology, minor procedures, non-invasive cardiology, orthopaedics: upper limb and lower limb, oncology (Including SARCOMA), pain management, plastic surgery (reconstructive), plastic surgery, upper and lower gastro intestinal surgery, urology, anaesthetics, breast surgery, general surgery, dermatology, ophthalmology and Insertion and removal of coil.

The hospital includes an outpatient suite, imaging department and theatre day unit. Additionally, there are two laminar flow operating theatres, eight post-operative pods (five with en-suite), twelve consultation rooms, a dedicated women’s health suite and an on-site pharmacy.

The diagnostic imaging service included magnetic resonance imaging (MRI), mammography, ultrasound scanning, x-ray and fluoroscopy for both self-paying and insured patients.

For the period of January to October 2021, the hospital carried out:

• 2,007 surgery procedures
• 12,360 outpatient attendances
• 7,208 imaging procedures.

We inspected HCA Healthcare UK at the Wilmslow Hospital previously from December 2018 to February 2019 and we rated the service as good overall. During our last inspection we did not identify any breaches of regulations and we did not carry out any enforcement action.

The main service provided by the hospital was surgery. Where our findings on surgery – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the surgery service.

Updated 21 February 2022

Our rating of this location improved. We rated it as outstanding because:

• The service had enough staff to care for patients and keep them safe by utilising strong and comprehensive safety systems with a focus on openness, transparency and learning, Staff had comprehensive training in key skills and competencies which meant they understood how to protect and promote individual safeguards. The service controlled infection risk very well. Staff proactively assessed risks to patients and acted on them to lessen risk and promote patient wellbeing and outcomes. They managed medicines well in line with best practice with a focus on patient safety and monitored adherence to guidance routinely. The service reviewed and managed safety incidents in a robust manner, with a view to learning lessons and embedding these within hospital wide practice. Staff collected safety performance information through a variety of ways, with the aim of encouraging as much participation as possible. The information gathered was reflected upon and used to improve the service for the benefit of both staff and patients. The services consistently updated safety goals with the aim of ensuring a zero-harm culture.
• Staff provided attentive and respectful care and treatment to a high standard. The hospital provided patients with enough to eat and drink and altered the menu where required. Pain relief was proactively reviewed by staff and provided to patients when they needed it. Managers monitored the effectiveness of the service, compared to other healthcare providers, with a view to ensure optimal performance. The service made sure staff were highly competent and confident to carry out their roles. Staff worked well together and displayed a collaborative pride in their work for the benefit of overall patient care. Patients were advised on how to lead healthier lives and supported them to make decisions about their care, with an emphasis on maximising their health outcomes. Services were available in line with patients wishes and could be accommodated at extremely short notice for patient convenience and treatment speed.
• Staff treated patients with compassion and kindness, with a strong person-centred approach to minimise patient discomfort or worry. Patients were recognised as individuals and staff took time to respect their privacy, dignity and circumstances accordingly. Emotional support to patients, families and carers, was provided at several different stages, to account for the capacity restrictions of COVID-19.
• The service tailored care to meet the needs of local people by taking account of patients’ individual needs and being aware of wider health issues and trends in the local community. The service encouraged a variety of ways for people to give feedback, so that it could be fed into the service and drive improvement. People were provided with a high degree of choice of when to access the service when they needed it and could often be seen at very short notice.
• Leaders focused on running innovative and an exceptional standard of services using patient centric information systems. The hospital’s reputation for excellent care had led to people from outside of the UK regularly using their services. Its reputation in the area for sports injuries meant that many high level sportsmen and women used their services. Leaders actively supported staff to develop their skills and provide career development opportunities at every level. Staff understood and were proud to be aligned with the service’s vision and values. Staff felt respected, supported and valued and were unafraid to speak up to drive change and improvement. Leaders were focused on the needs of patients receiving care when considering any aspect of the service’s strategic vision. The hospital invested in new technology to improve patient outcomes. Staff were clear about their roles and accountabilities. The service engaged well with patients in a variety of ways and all staff were committed to improving services continually, by reviewing current processes and encouraging innovation and suggestion about patient treatment and experience.

Updated 21 February 2022

Our rating of this service improved. We rated it as outstanding because:

• The service had enough staff to care for patients and keep them safe. Staff had comprehensive and relevant training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff robustly assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and embedded learned lessons from them within the local department and wider hospital. Staff collected comprehensive safety information and used it to improve the service.
• Staff provided good care to patients. Managers monitored the effectiveness of the service and made sure staff were competent and took steps to improve where necessary. Staff worked well together for the benefit of patients in a highly time efficient manner and advised them on how to lead healthier lives. Staff supported patients to make informed and knowledgeable decisions about their care, and where appropriate made procedurally correct best interests decisions for patients who lacked capacity. Key services were available in a highly flexible manner for patients.
• Staff treated patients with compassion and kindness, respected their privacy and dignity. Staff actively sought and took account of their individual needs to helped them understand their conditions and provide holistic support to maximise patient comfort and experience. They provided emotional support to patients, families and carers.
• The service model was planned to progressively meet the needs of the patient group. Individual patient needs were assessed and where needed adapted, to improve patient specific outcomes. The service continually sought feedback from patients and attempted to find innovative ways for people to provide it. People could access the service at a time convenient for them and processes were in place, for diagnosis and treatment to start on the same day.
• Leaders ran services to a high standard using reliable information systems and encouraged innovative practices. Staff were supported to develop their skills and careers with a mixture of training opportunities, job progression and leadership programs. Staff had a clear understanding of, and could articulate well the service’s vision and values. Staff felt respected, supported and demonstrated a high level of pride in their work. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. There was comprehensive knowledge about whistleblowing and duty of candour, if things went wrong. The service sought excellent engagement with local NHS acute and specialist trusts to plan and manage services and all staff were committed to improving services continually.

Updated 21 February 2022

Our rating of this service stayed the same. We rated it as outstanding because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
• The patients we spoke with were exceptionally complimentary about the staff and the manner in which care and treatment were provided. Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• Leaders ran services well using a suite of reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

Updated 21 February 2022

Our rating of this service improved. We rated it as outstanding because:

• The service had enough highly skilled staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service effectively controlled infection risk. The service had a robust system for assessing patients at risk and staff completed and updated risk assessments for each patient in a timely manner. Staff kept comprehensive care records. They managed medicines well. The service managed safety incidents effectively and learned lessons from them. They routinely collected safety information, shared learning with staff and proactively used it to improve the service. The service had effective systems in place to manage emergency procedures.
• Staff provided excellent care and treatment, gave patients enough to eat and drink, taking account of their personal, religious and cultural requirements, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. The service had an exemplary record of mandatory training compliance.
• Staff demonstrated professionalism and competence in their roles. Patients told us they were very confident in the staff looking after them. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to key information. Key services were available six days a week with emergency support available outside of working hours.
• Staff treated patients with visible compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs and choices. People could access the service when they needed it and did not have to wait long for treatment.
• There was a well integrated and proactive senior management team. Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. There was a strong person centred culture within the service. Staff were clear about their roles and accountabilities.
• The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually. The service made it easy for people to give feedback. Feedback from patients was continually positive. Staff demonstrated a proactive approach to continuous learning from feedback, complaints and concerns. There was an obvious drive to keep improving and developing and to provide the highest possible standard of care.
• The hospital had a well established and effective governance structure. They improved service quality and ensured high standards of care by creating a workplace where excellent clinical care was helped to succeed.