Practice Plus Group Hospital - Emersons Green

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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

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.

At our last assessment this key question was not rated. At this assessment we rated it as good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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.

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.

We looked at 7 care records during assessment . Staff completed thorough health assessments of patients in a timely manner. Care plans were personalised and met patient needs identified during the detailed preoperative assessment process . Patients who attended for review for surgery were asked to complete health screening questionnaires and seen at outpatient appointments. Staff carried out a full set of medical tests to check patients’ fitness prior to attending for surgery. For example blood pressure, height, weight, blood tests and echocardiograms (ECGs) which were reviewed by anaesthetists. Patients with any additional needs or health concerns were discussed at a Multidisciplinary Team (MDT) meeting and additional support to enable patients to meet surgical inclusion criteria were assessed.

The physiotherapy team assessed patients before surgery with a preoperative phone call to discuss equipment and care needs . Some patients received advice on optimizing fitness before surgery. Mobility assessments were conducted at every point of the surgical pathway for patients and progressed appropriately in a timely manner to help reduce extended bed rest following surgery. Discharge needs for follow up therapist input were assessed before surgery and reviewed prior to discharge and care plans were updated when necessary. The nursing team contacted the physiotherapy team if there were any mobility concerns.

Patients told us their assessments were thorough and their care and treatment was clearly explained and they knew what to expect.

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 surgical team had access to a full multidisciplinary team of doctors, nurses, physiotherapy and support staff to meet the needs of patients receiving care in the service. Staff were qualified, experienced and had the appropriate skills to meet the needs of the patient group.

Managers identified the learning needs of staff and provided them with opportunities to develop their skills and knowledge. Staff had protected time to maintain and continue their professional development in line with best practice guidelines including clinical supervision and planned learning sessions. 95% of ward staff and 88% of medical staff had received an up to date appraisal in the last 12 months. However, only 66% of staff in theatres had an up to date appraisal recorded. The service had created an action plan to improve this. Managers ensured that staff had access to regular team meetings.

Staff assessed and met patients’ needs for food and drink in line with guidelines and catered for patients’ individual needs. Patients told us they had support from staff during their surgical experience and received pain relief quickly when required. Patients were provided with leaflets and a telephone number to call a 24 hour helpline for additional support following discharge if they had any concerns post operatively. All patients we spoke with knew their next steps for follow up care after discharge. Patients said they had been pleased with the reasonable length of wait time for their surgery from referral to the service. Patients said their care was in line with what they had been advised and what they expected and were involved in decisions about their care and treatment.

Staff were involved in quality improvement initiatives. There had been a project to improve patient discharge after some patient feedback regarding exercise information follow orthopaedic surgery.

Managers included staff in clinical audits to ensure care was delivered in line with best practice guidelines.

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.

Leaders described teamwork as strong across the ward, outpatients and physiotherapy departments. Most teams had effective working relationships. However, leaders and some staff told us there had been some examples of theatres team working in isolation from one another with some challenges around communication. Staff said theatre teams were less adept at working together effectively. There were processes and action plans to improve this and some staff told us team working in theatres was improving.

Staff held regular and effective multidisciplinary meetings. Staff from all teams attended, including nursing, physiotherapy, consultants, pharmacy and bookings. We observed the daily safety briefing which was attended by leaders and representatives of staff from all departments and from the service’s partner hospital. Huddles were well run and had clear purpose; staff introduced themselves and learning was discussed. We observed daily handover meetings in the wards and in theatres which were attended by all appropriate staff. Handovers were thorough and well-structured, with opportunities to ask questions and communicate effectively.

There were effective working relationships with other teams within the organisation including physiotherapy and the pre-assessment clinic.

Incidents were discussed at business review meetings with other locations within the organisation to review themes and trends across sites and to share learning.

The discharge process and information technology systems supported sharing of patients’ needs when they moved to external services after discharge, such as patients’ General Practitioners or the local NHS hospital. There was an admissions, discharges and transfers policy and transfer packs for any patients who needed to be moved to specialist care in case of an emergency. All staff knew where to find these and how to use them.

Weekly scheduling meetings were held involving theatre management, surgical teams, anaesthetists, ward staff, and booking coordinators. Theatre lists were planned in advance based on clinical priority, surgeon availability, theatre capacity, staffing levels, equipment requirements, and patient readiness for surgery. Meetings reviewed operating lists, identified potential risks and ensured efficient utilisation of theatre resources. Urgent cases were prioritised according to clinical need, with contingency arrangements made to minimise disruption to elective surgeries where possible. These meetings also reviewed the previous week’s activity and patient cancellation reasons to understand trends and identify actions for improvement.

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, reduced their future needs for care and support.

The service gave people information about the different types of surgery carried out at their location. This showed what patients could expect during their surgical experience and how patients should prepare for their surgery. Patients were sent videos ahead of surgery around optimising their lifestyle for long term recovery and health. This included nutritional advice for recovery and longer term healthier lives.

The hospital offered private general practitioner assessments which members of the public could access. There were a variety of assessments and price plans.

Patients could access joint care treatments to restore mobility and manage long term pain.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The hospital participated in national clinical audits such as the national joint registry (NJR). However, leaders told us this could be improved as consultants did not always participate. We asked for audit data relating to national guidelines. However, this did not include any information on NJR performance. Audit data for National Early Warning Signs (NEWS2) and Venous thromboembolism (VTE) shows 100% compliance with completion.

Quality and governance dashboards were used to review clinical outcome information for patients attending the service. Patients completed Patient Reported Outcome Measures (PROMs). These questionnaires were completed by patients to assess their health status, symptoms, and quality of life before and after procedures. This included tracking surgical recovery, monitoring clinical progress, and ensuring high care standards. Data provided for June 2026 showed a 75% response rate for patients undergoing eligible procedures. Outcome measures shows improvements in function, pain, overall health and quality of life. Physiotherapy outcome measures for June 2026 showed 70% of patients reported making progress towards their goals at their 6 week follow up appointments. We did not see evidence of an action plan intended to improve outcomes for patients.

Patients told us they were informed of their next steps for recovery and follow up care. The 24 hour patient help line supported patients with their clinical outcome following discharge. Patients spoke positively about the quality of care and treatment they received.

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 had an up to date consent policy and staff took all practical steps to enable patients to make their own decisions. Patients were given written information about the consent process before attending appointments and staff received training in consent. Staff were compliant with mandatory training in the Mental Capacity Act (2005) (MCA) and deprivation of liberty safeguards (DoLS). There were current policies to assess capacity and staff knew where to access these. Staff understood how and when to assess whether patients had capacity to make decisions about their care. The service had an up to date a restraint policy. However, this did not refer to the Mental Health Act (1983) (MHA) and we did not see evidence of a separate policy for the MHA. Staff and leaders told us patients detained under the MHA would be treated at their local NHS hospital rather than as part of the elective service offered at their location. This would be determined as part of the pre-operative assessment and multidisciplinary team meeting process.

The consent process was discussed during pre-operative assessment and on the day of surgery. The consultant surgeon met patients before surgery to discuss consent to procedures. Consent was confirmed as part of the world health organisation (WHO) checklist followed in theatres ahead of surgical procedures. Handovers were well documented through patients’ pathway within the service and consent was obtained and documented at every stage.

The consent process was audited to ensure consent was being completed by staff. Audits showed the service was compliant with the consent process.