Great Bridge Kidney Treatment Centre

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

Leaders demonstrated a structured approach to governance, with systems in place to support oversight, risk management and improvement. Regular governance and staff meetings, risk registers and daily handovers enabled leaders to monitor performance, identify risks and take action. The service promoted a culture of learning and improvement, with patient and staff feedback, audit findings and incident data used to inform actions and shared learning.

The service collaborated well and had systems and processes in place, but was not always consistent and clear in measuring and demonstrating the long-term impact of it’s improvements

This demonstrated that the service was consistently managed and leaders promoted a culture that supported high-quality, person-centred care.

At our last assessment we rated this key question as requires improvement. At this assessment, the rating has improved too good.

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 evidence showed a good standard. 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 people and their communities.

The service regularly reviewed patient survey data to monitor experience and identify areas for improvement. Survey results highlighted areas such as transport and pain related to needling, which were recognised by the service and informed improvement actions.

This demonstrated a structured approach to using patient feedback to drive learning and service development.

The provider had a clear organisational vision to deliver life-enhancing renal care and to be a trusted provider to the NHS, underpinned by values including competence, compassion and patient-centred care. Staff were aware of the service’s values and vision.

We observed positive interactions between staff at all levels, with clear evidence that staff worked collaboratively to meet the needs of patients during the inspection.

Staff told us they felt supported by local and wider managers and described a clear focus on delivering appropriate care and treatment for patients attending the service. Staff reported that there was a positive culture and told us they enjoyed working at the service.

The evidence showed a good standard. 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 openness, and honesty.

Staff told us that leaders were visible and approachable within the service and described them as supportive.

Leaders had the skills, knowledge and experience to perform their roles. They demonstrated a good understanding of the service they managed and were able to clearly explain how teams worked together to deliver safe and effective care. Leaders were aware of the challenges within the service and described actions in place to maintain and improve the quality of care provided.

Leadership development opportunities were available, including opportunities for staff to develop their skills and progress within the organisation, supporting the delivery of safe and effective care.

The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Leaders were open and transparent and reviewed staff feedback to identify learning and implement changes. This supported ongoing improvement in the quality of care and treatment provided to patients using the service. Staff told us, “We feel able to speak up about any concerns we have with managers”.

The service used patient survey feedback to identify areas for improvement and developed a structured action plan in response, with actions identified to address these issues, including referral pathways and liaison with external providers. Positive feedback about staff was also recognised and reflected in actions to support and value the workforce. This demonstrated that patient feedback was reviewed and used to inform service improvement and learning.

The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Leaders promoted equality, diversity and inclusion within the workforce, and staff demonstrated an understanding of these principles in their day-to-day roles. Staff described a culture where people’s differences were respected and valued, and where they felt able to raise concerns or speak up without fear of negative consequences. Feedback from staff surveys indicated that most staff felt their ideas and opinions were valued and there was equal access to opportunities. However, some responses identified opportunities for ensuring all staff were aware of and able to access development opportunities. The service had recognised this and included within its action plans.

The service reviewed staff feedback from the ‘My Opinion Counts’ survey and developed a structured action plan to address identified themes, including communication, training and development, and access to opportunities. Leaders had identified clear actions, including improving communication practices, supporting staff development and engaging with staff through one-to-one and team meetings. This demonstrated a commitment to using staff feedback to inform improvement. Actions were ongoing at the time of inspection, meaning the full impact of these changes was not yet seen.

The evidence showed a good standard. The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment, and support. They act on the best information about risk, performance, and outcomes, and share this securely with others when appropriate.

The service had a structured governance and management framework, with leadership at board, regional and clinic levels supporting day-to-day service delivery.

The service provided governance meeting data for January to March 2026, which demonstrated that meetings were held regularly. These meetings had a clear structure, including a defined agenda and an associated action plan. The action plans identified required actions, named responsible individuals, recorded completion dates and included updates on progress where relevant, supporting oversight and accountability within the service’s governance processes.

The service submitted notifications to relevant external organisations where required, including statutory notifications to the Care Quality Commission in line with legal requirements. This demonstrated an understanding of and compliance with regulatory responsibilities.

The service’s risk register covered key risks to safety and operations, including missed or shortened treatments, falls, infection control and environmental issues.

Risks were clearly described with associated impacts and were supported by documented control measures, mitigation actions and named leads responsible for oversight.

The risk register demonstrated regular review, with updates provided to reflect changes in risk levels and ongoing actions, including escalation to relevant forums and multidisciplinary discussion where appropriate. Managers were able to tell us of their top risks identified on the risk register.

The service used daily nurse handover sheets to support safe transition of care and effective communication, including key information on staffing, patient activity, risks and issues, enabling timely oversight and escalation.

The service held regular staff meetings with structured agendas and minutes, covering key areas including risk, audits, incidents, training and patient feedback. Actions were identified and monitored, supporting communication, oversight and shared learning. However, it was not always clear how the impact of actions was evaluated.

The service had business continuity plans in place for a range of risks including staffing shortages and utility failures. These outlined clear actions, escalation processes and recovery arrangements. Site-specific contingency plans, including alternative evacuation routes, were also in place, demonstrating oversight of risks and continuity planning. In addition, there was an absence of data for 2025, and available information indicated challenges with embedding the pathway in practice, including uncertainty among staff and limited use of the protocol.

Documentation supporting the pathway was not consistently dated, and it was not clear whether planned multidisciplinary reviews had been undertaken. There was limited evidence to confirm that the pathway, including the pre-prescribing of antibiotics for red flag sepsis, had been formally reviewed or approved through appropriate governance structures such as the Antimicrobial Stewardship Group or Sepsis Steering Group.

Information did not clearly define protocols for antibiotic use, including prescribing authority or guidance when a doctor was unavailable. Although reviewed by the Sepsis Steering Group, there was no evidence of outcomes or actions.

Oversight was limited, with minimal audit activity and insufficient analysis to support assurance or improvement in medicines management for sepsis care.

A quality improvement project was introduced following a serious incident, but it was unclear how the red flag sepsis prescribing pathway was governed, approved, or used in practice.

The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

The service worked collaboratively with external partners to support the delivery of care and the continuity of services. This included working with NHS trust consultants, transport providers and specialist teams, such as vascular access services, to support patient care and treatment. Processes were in place to communicate effectively with partner organisations, including sharing information, escalating concerns and coordinating care where required.

Business continuity plans also demonstrated established links with external partners, including arrangements to transfer patients to alternative units and liaise with trust colleagues during service disruption.

Overall, partnership working supported the coordination of care and helped to maintain service delivery, although the effectiveness of some arrangements, such as transport, remained variable and required ongoing monitoring and collaboration with external providers.

The evidence showed a good standard. The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome, and quality of life for people. They actively contribute to safe, effective practice and research.

The service demonstrated a structured approach to learning and continuous improvement. Patient and staff feedback was routinely collected and reviewed, with outcomes used to inform action plans and service changes. Leaders demonstrated a commitment to acting on feedback, including through organisational surveys and local discussions, with actions identified to improve areas such as communication and access to development opportunities.

A programme of auditing was in place to monitor the quality and safety of care. Audit data showed high levels of compliance across key areas, including infection prevention and control, dialysis records and prescription delivery. Where gaps were identified, actions were taken and shared with staff to support improvement.

Incident reporting systems were used to identify trends and themes, including missed and shortened treatments, falls and access-related complications. These were reviewed through governance processes and staff meetings, enabling learning to be shared and embedded into practice.

Leaders used governance systems to monitor performance and improvement activity, including reviewing audit results, incident data and feedback. This supported a culture of continuous learning. However, while systems were in place to identify and act on learning, it was not always clear how the impact of changes was formally evaluated over time.