HCA Healthcare UK The Harborne 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.

This is the first assessment for this service. We rated this key question as 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 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 made sure patients’ care and treatment was effective by thoroughly 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 told us about the comprehensive approach to assessing the needs of the patients. Staff were passionate about providing the best and most up to date evidence-based practice in line with national guidance to make sure patients had the best outcomes.

Risk assessments, nutritional needs and pain management was assessed daily, we saw evidence these were assessed and documented daily, this was in line with best practice.

We saw educational huddle cards to support staff looking after patients in ICU with specific conditions such as bowel surgery and head and neck surgery. Information including, post operative instructions, medication, monitoring and device management.

There was a SLA with the local trust to provide pathology and blood products. Blood products were stored in the theatre.

Physiotherapy staff attended the unit daily, specialist support such as dietitians and specialist nurses employed as bank staff were available when required.

Microbiology support was available; there was a weekly virtual ward round to provide support and advice on antibiotic use and infection control issues.

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, the Intensive Care Society and the Faculty of Intensive Care Medicine. Policies we reviewed were up to date and had been approved by the appropriate governance processes.

There were standard operating procedures and established pathways to support staff available on the organisation's intranet and staff knew how to access the documents. Policies were monitored at a corporate level to ensure they were updated, reviewed and consistent amongst each HCA hospital. There was an operational policy for ICU which included consent, safeguarding, critical care delivery, documentation and nursing and medical staff responsibilities.

Staff told us they had an annual appraisal and could raise any issues or learning needs or opportunities with their line manager. 100% of staff had received an appraisal within the last 12 months. There were a variety of online learning platforms that staff could use to develop their skills and experience to enhance their development.

Patients were assessed in line with national and best practice guidelines, and we saw evidence in the patient records that we reviewed.

There was a corporate audit programme with monthly, quarterly, biannual and annual audits scheduled. Results were benchmarked with other hospitals in the HCA group and discussed at monthly heads of department meetings and weekly Clinical Learning and Improvement Plan (CLIP).

The unit completed local audits quarterly such as catheter care, medicines management, VTE and environmental cleaning. We saw audit results were consistently between 80- 100% compliance. Action plans were in place when required and discussed with the individuals, team and at CLIP meetings.

The service always 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 ICU.

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 when patients were transferred back to the ward there was a verbal handover and written information. Nurses and the Resident Doctor (RD) from critical care would hand over to the RD working on the ward and nursing staff on the ward.

Every morning, there was a daily operational meeting attended by a representative from each department to discuss staffing levels, activity and capacity. Staff could raise concerns about staffing levels and patients care. They made staff aware of key roles for the day, including the fire warden and resuscitation team.

The ward and ICU staff had daily huddles to discuss patients care and those that may be transferred to the ward, they would agree suitable times for transfer and handover.

There were processes in place to ensure multidisciplinary working throughout the unit including regular multidisciplinary team meetings.

The unit had support from specialist teams such as physiotherapy, specialist nurses and dietitians.

The unit worked closely with the intensive care unit across the HCA group and with the local trust. Some staff worked at other HCA hospitals to provide support when required. Staff reported good working relationships across the intensive care units within the HCA group and local trust. The hospital was not part of the regional critical care network, however, they had good links with the local trust and the HCA critical care ICU services, benchmarked, monitor standards and standardise the clinical and operational policies.

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.

Patient information leaflets of a variety of conditions and post operative care were available in different languages.

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. Post discharge from the hospital patients were offered follow up appointments with the consultants. Patients were not routinely offered post discharge clinics from ICU admission as most patients did not meet the national criteria of ‘Adults who stayed in critical care for more than 4 days and were at risk of morbidity have a review 2 to 3 months after discharge from critical care’. However, leaders told us they could provide additional support and psychology support if the patient required this.

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.

Patient feedback about their care was positive. Results between April and September 2025 showed 100% of patients were satisfied with the overall experience including pain management, respect, dignity and being involved in decision making.

The unit completed local audits quarterly such as catheter care, medicines management, VTE and environmental cleaning. We saw audit results were consistently between 80- 100% compliance. Action plans were in place when required and discussed with the individuals, team and at CLIP meetings.

The hospital completed the Guidelines for the Provision of Intensive Care Services (GPICS) audit tool. The tool is used to plan and commission service and for services to benchmark with other providers. The tool kit includes the team structure, workforce, processes and elements of care. Following completion of the tool in August 2025 most areas were fully met, some areas were not applicable and some were partially met such as access to some allied health professionals and consultant led training. The hospital had implemented an action plan to review how these could be fully met.

The hospital had not submitted data to the Intensive Care National Audit & Research Centre (ICNARC), which is one of the GPICS recommendations, this was due to low numbers of patients using the ICU facilities. There were plans to commence submitting data in 2026.

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.

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.

Staff understood the Mental Capacity Act 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 and there were hospital policies in place to ensure that staff were aware how to request Deprivation of Liberty Safeguards for a patient.

We reviewed 4 consent forms and found they were all completed correctly and had the relevant details and risk identified.