HCA Healthcare UK The Harborne 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

This means 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.

This is the first assessment for this outpatient service. This key question has been rated 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.

We scored the service as 3. 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 ensured that people’s care and treatment were effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

During daily safety huddles, staff reviewed the list of patients due to attend and identified any additional needs, ensuring that reasonable adjustments could be planned in advance. For example, this included arranging extra nurse support for wheelchair users or booking interpretation services where required. Staff told us that if a patient attended with mental health needs or a learning disability, they would make reasonable adjustments, such as offering a quiet room to support the patient’s comfort and wellbeing.

When access or communication needs had not been identified beforehand, staff made efforts to respond on the day, including arranging interpreters at short notice.

We scored the service as 3. 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.

The service provided care and treatment in line with current legislation, national standards and evidence-based guidance. Clinical policies were developed and reviewed centrally by the hospital group to ensure they reflected up-to-date best practice, including guidance from National Institute for Health and Care Excellence. Staff were able to access policies easily through the hospital’s electronic systems and told us they were kept informed of changes through email updates. Managers also discussed significant updates at team meetings to support consistent application in practice.

We found that departmental pathways and processes reflected national guidance and supported evidence-based decision-making. Staff demonstrated a good understanding of relevant policies and applied them appropriately when delivering care.

During our observations of consultations, clinicians explained treatment options clearly and involved patients in decisions about their care. Risks, benefits and expected outcomes were discussed, and individual circumstances were taken into account. For example, during one consultation a patient was offered several suitable treatment options. The consultant considered the patient’s work commitments and, together with the patient, agreed a treatment plan that met clinical needs while remaining in line with best practice guidance.

We scored the service as 3. 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 demonstrated effective collaboration with wider hospital teams. The clinical service manager held regular heads-of-department meetings to share information, which was then cascaded to staff. Team members confirmed they attended monthly meetings where updates, learning and key messages were communicated, supporting good engagement and continuity across the service.

Staff described a flexible, supportive approach to teamwork and said they worked collaboratively with other HCA hospitals, particularly when seeking opportunities to gain experience in different services. They were encouraged to undertake shadowing at other HCA sites, including those in London, to broaden their skills and knowledge. Senior leaders also highlighted positive partnership working with University Hospitals Birmingham (UHB), which supplied the resuscitation trolleys used within the service and supported with auditing and restocking them when required. When patients were discharged, they were given a copy of their discharge letter, and a copy was also sent to their GP.

We scored the service as 3. 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, reduce their future needs for care and support.

Outpatient staff told us they offered health advice where appropriate. For example, if a patient who smoked attended for wound care and their wound was not healing as expected, staff explained the impact of smoking on recovery and the increased time wounds can take to heal in people who smoke. During one consultation we observed, a consultant also provided a health awareness leaflet to a patient who reported high caffeine consumption, using the discussion as an opportunity to offer lifestyle advice.

The service promoted wider health education through public engagement events, such as the Wellness and Wisdom – Women’s Health Coffee Morning. These events included guest speakers who shared information on specialist topics, giving the public opportunities to learn about specific conditions, preventative care and broader wellbeing. Such initiatives supported the hospital’s aim to encourage proactive health management within the community.

Patients receive health information on an individual basis according to their personal circumstances. During initial consultations, nurses and/or doctors complete a comprehensive patient history, including lifestyle factors, and provide advice where appropriate, such as on smoking cessation or alcohol use. Clinical staff have access to an online repository containing a wide range of information on medical conditions and health education topics, which can be printed or shared electronically with patients. QR codes are also available, allowing patients to download relevant information directly. This approach ensures patients receive tailored advice and access to relevant health education materials.

However, there were no noticeboards or health promotion leaflets available within the outpatient department. This limited opportunities to promote wider health awareness or to provide patients with discreet access to information they could take home and review independently. As a result, while personalised information was available during consultations, the lack of visible educational materials reduced opportunities for broader, self-directed learning and wider health promotion.

We scored the service as 2. The evidence showed some shortfalls. The service did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

The service undertook a range of audits to support improvement within the outpatient department, and we observed that patients were able to provide feedback with ease. However, several important areas remained unaudited, particularly those relating to appointments and booking processes. Following the assessment, the provider submitted its outpatient complaint log for the previous 12 months, which showed seven recorded complaints, two of which related to booking issues. During the assessment, two patients experienced problems with their appointment times. Because no audit processes were in place to monitor booking accuracy or delays, leaders are unable to identify the underlying causes, trends or implement targeted improvements.

Further details about how the hospital monitored and improved outcomes for patients can be found in the medical care report.

We scored the service as 3. 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.

The service informed people of their rights around consent and respected these when providing person-centred care and treatment. We reviewed patient records and found that consent was appropriately documented. In addition, we observed staff obtaining informed consent during patient interactions. For example, in one consultation, the consultant sought the patient’s permission before carrying out a brief examination, confirmed whether a chaperone was required and explained each step clearly to ensure the patient understood what was happening. Privacy was maintained by pulling the curtains across during the examination.