The New Foscote 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

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.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

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 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 they included patients throughout their whole patient journey. Each patient attended an appointment with a consultant prior to any investigation. At this appointment the consultant undertook a comprehensive health assessment; this included a medical history, mental health history, communication needs, and any potential risks. The consultant discussed and explained treatment options and, together with the patient, decided on the best option.

On the day of the endoscopy appointment, patients underwent pre procedure checks to ensure the procedure could continue. Staff cancelled procedures if they identified any risk factors; for example, if a patient forgot to fast as required, staff cancelled and rescheduled the procedure.

Staff ensured patients had clear treatment plans so they knew what would happen on the day of their procedure.

We observed a pre procedure appointment and staff ensured patients understood their care plan. Staff recorded discussions and treatment plans on the electronic patient record system. We reviewed records and found them to be comprehensive and reflective of what had been discussed. We spoke with a patient who said staff had “been very thorough and given clear advice and explaining everything and been very patient – there has been no jargon everything has been pitched in a way that is easy to understand”.

Where appropriate, staff included carers or family members in discussions. We spoke to a patient’s relative who said “they were brilliant and amazing, can’t fault them. All explanations have been clear, and they are so calm which makes you feel calm”.

Staff ensured they communicated with patients before, during and after a procedure. This ensured they kept people up to date throughout the procedure.

We scored the service as 3. The service planned and delivered people’s care and treatment and did this in line with legislation and current evidence-based good practice and standards.

The service participated in local and national audits and had a clear audit framework. This outlined the type of audit, the frequency, key metrics and actions. Audits ranged from duty of candour reporting, patient reported outcome measures, to post procedure complications. The provider reported into the Private Healthcare Information Network (PHIN), which is an independent, government-mandated organisation publishing performance and fees information about private consultants and hospitals.

The service used audits to benchmark themselves and analysed data to drive service improvements and patient care. A clear governance structure indicated which committee was responsible for each audit; for example, the clinical governance team overlooked PHIN and duty of candour, the IPC committee reviewed surgical site infection data.

The provider had a benchmarking framework document which applied to all services. In endoscopy, benchmarking aligned with standards from JAG and staff monitored specific key performance indicators, for example, procedure cancellation and post-procedure complication rates. The service collected, analysed and reviewed data from audits and benchmarking activities. The undertook improvement plans when performance fell below the expected standard.

We reviewed KPIs in the endoscopy service for July 2025 and all had met or exceeded the provider target. For example, the target for procedure cancellation was 5% and the service had 4.8% cancellations. The KPI target for post-procedure complications set at less than 1% and the service’s actual percentage was 0.6%. We did not have more recent data to review.

Staff followed up-to-date policies to plan and deliver high quality care according to best practice and national guidance from the Royal Colleges and from the National Institute for Health and Care Excellence.

We scored the service as 3. 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 ensured they had a representative at a variety of huddles every working day. Each morning leaders from The New Foscote Hospital and their sister site met to discuss the day ahead. This included patient lists, staffing, project work and any other business. The endoscopy lead attended these daily huddles. In addition, the endoscopy team had a morning and end of list huddle where they discussed only endoscopy related business.

The provider had a service level agreement with the local NHS trust for the transfer of critically unwell patients who required a higher level of care. As part of this agreement the 2 parties had clear processes relating to the handover of patients to ensure seamless continuity of care. This included provision of full patient records, all observations, and information on infection status.

We scored the service as 3. The service supported people to manage their health and wellbeing. The service signposted people to get information on living healthier lives.

The service signposted patients to other services or websites following investigations and diagnoses. They provided literature and leaflets containing patient information. For example, if a patient was diagnosed with a stomach infection, the service signposted them to their GP or to a website containing information on the infection.

We scored the service as 3. 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 service adhered to the World Health Organization (WHO) checklist for every procedure. This ensured team communication and avoidance of any errors or complications.

The team used a process called endoscopic tattooing or spot marking appropriately (this is a technique used during endoscopy to mark the precise location of a lesion, polyp, or tumour on the inner wall of the digestive tract, allowing clinicians to easily identify the site). This process ensured the clinician removed a lesion from the correct area. We spoke with a patient and observed a procedure and found staff kept patients up to date throughout.

The endoscopy team monitored patients carefully during and after any procedure. After the procedure patients received observations at regular intervals. The consultant ensured they spoke with patients after the procedure to determine whether a patient was fit to be discharged.

Consultants discussed initial findings with patients immediately after the procedure, once the patient was fully alert. If people had to wait for a formal diagnosis, for example, the results of a biopsy, staff ensured they explained this to them.

The endoscopy service at The New Foscote Hospital did not carry out therapeutic endoscopy (this meant they did not treat gastrointestinal conditions but only diagnosed them). Although therapeutic endoscopy could be performed in a private hospital, they should ideally be JAG-accredited. The provider had not yet reached full accreditation.

Staff referred patients to an NHS trust if they identified a polyp larger than 25 millimetres. This was because the service did not have access to immediate emergency care if something went wrong. Due to a higher risk of bleeding or perforation these procedures should be carried out by specialists with access to emergency care.

We scored the service as 3. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

The consultant explained investigative options with patients in their first assessment appointment. They ensured patients had all the information they needed to make their own decisions. Every assessment included questions around mental health and communication abilities to ensure people’s needs could be met and patients could give consent independently.

Staff ensured they gained consent from patients prior to any procedure. The consent form was comprehensive and included prompts for staff; for example, to use language which is understood by the patient. Patients could withdraw their consent at any stage, even immediately before the procedure and the consent form contained a section for this situation.

If a patient did not have capacity, staff could use appropriate carers/family with the right to consent on the patient’s behalf. The service had a separate consent form for adults who lacked the capacity to consent. We heard the endoscopy service had never experienced a situation when a patient could not consent independently.

The provider had changed from written to electronic patient records in the autumn of 2025. At the time of the inspection, they continued to complete consent forms manually and scanned them onto the system. The provider was in the process of uploading all forms to the electronic system.

Staff received training specific to the Mental Capacity Act and all endoscopy staff were compliant with this training. In addition, staff received training in autistic spectrum disorders, disability awareness and learning disability awareness. Endoscopy staff were compliant with these modules.