HCA Healthcare UK The Harborne Hospital

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• 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

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

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

We scored the service as 3. 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 had a clear strategy and vision, which leaders communicated to staff through listening events and other engagement activities. Staff across the unit were passionate about their work and demonstrated a strong commitment to meeting people’s needs. The culture was centred on patient safety and high-quality care. Staff told us they had confidence in the leadership team and consistently reported feeling supported by both their managers and colleagues.

Further details about how the hospital shared direction and culture can be found in the medical care report.

We scored the service as 3. 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 integrity, openness and honesty.

Staff told us they felt well supported by their managers, who were regularly visible and actively engaged on the unit. Support mechanisms were also in place for staff who had been involved in emotionally challenging or difficult situations, helping to promote staff wellbeing and resilience.

Further details on capable, compassionate and inclusive leaders can be found in the medical care report.

We scored the service as 3. 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.

The hospital had designated Freedom to Speak Up champions on site whom staff could contact for advice and support. Freedom to Speak Up Guardians provide an independent route for staff to raise concerns safely and confidentially. Staff told us they were aware of the champions, understood their role, and felt confident they could approach them if needed.

Further details on freedom to speak up can be found in the medical care report.

We scored the service as 3. 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.

The service promoted equality, diversity and inclusion through clear policies and mandatory training, which helped set expectations for fair treatment and respect at work. Staff told us they felt comfortable being themselves and described a culture where colleagues treated each other fairly.

Further details on workforce equality, diversity and inclusion can be found in the medical care report.

We scored the service as 3. 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.

There were clear and effective governance, management and accountability arrangements in place, and staff demonstrated a good understanding of their roles and responsibilities.

The service operated within an integrated governance framework that included the Medical Advisory Committee (MAC), Clinical Learning and Improvement Plan (CLIP) meetings, and both corporate and local governance forums. The weekly CLIP meeting reviewed incidents, complaints, audit findings and activity data, ensuring that learning and improvement opportunities were identified and acted upon.

At a local level, governance processes were supported by daily safety huddles, where teams reviewed staffing levels, patient numbers and patient acuity. Information relating to risks, incidents, complaints and concerns was shared with staff each day, helping to maintain situational awareness and promote a consistent focus on safety. However, there was limited oversight and monitoring of booking processes and appointment management, which created gaps in assurance around how effectively these systems were functioning.

Further details on governance, management and sustainability can be found in the medical care report.

We scored the service as 3. 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.

Further details on partnership and communities can be found in the medical care report.

We scored the service as 3. 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.

Staff were encouraged to contribute ideas for improving the service and felt supported to share their views. One example of this was when a staff member attended external training and returned with the idea of creating premade, personalised care packs for patients. This initiative aimed to reduce delays the following day and minimise the time patients spent waiting after their appointments. Staff told us that leaders were receptive to the suggestion and encouraged them to trial the new approach, demonstrating a culture that values innovation and continuous improvement.

Further details on learning, improvement and innovation can be found in the medical care report.