Bespoke Healthcare Limited

Updated 1 December 2021

The service is located in a building at a Preston business park occupying two floors with secure intercom access. No patients are seen at the location which only houses the head office of the business.

The service provides diagnostic and screening procedures (neuro physiological investigations) which are non-invasive. These are provided to patients in both the NHS and independent hospitals throughout the UK where the treating hospital does not provide the service. This supports the hospitals to meet referral to treatment targets. Patients remain under the care of the client hospital or NHS trust.

The neuro physiological investigations undertaken are nerve conduction studies (NCS) or electromyogram (EMG); electroencephalogram (EEG); sleep-deprived EEG and ambulatory EEG.

These services can be variable, dependent on the needs of the client trust or hospital. For example, in some trusts they provide a full service where they receive the referral from the referring clinician, manage the appointment process, onsite clinic provision with chaperone, physiologist and/or consultant and provide the report. In other services they may only provide a physiologist who conducts the tests. Tests may also be conducted on inpatients, for example, patients in critical care.

The service also undertakes intra-operative monitoring (IOM) mainly for spinal surgery. A physiologist, employed by the service, works in operating theatres with surgical teams to manage nerve reactions during spinal, and occasionally, vascular surgery.

The service provides diagnostic and screening procedures for children at two NHS trusts in the south of England, though children only make up a small proportion of the total patients seen.

From September 2020 to August 2021, the service carried out 11,759 nerve conduction studies (NCS), electromyogram (EMG) and electroencephalogram (EEG) procedures at 19 locations. Of these, 375 (3.2%) were carried out on children and young people at two locations.

During the same period, the service also participated in 586 surgical procedures carrying out intra-operative measurements at 24 locations.

The service has a Care Quality Commission registered manager and nominated individual.

We have not inspected this location before.

The main service provided by this hospital was diagnostic and screening. Where our findings on diagnostic and screening – for example, management arrangements – also apply to other services (children and young people), we do not repeat the information but cross-refer to the diagnostic and screening service.

Updated 1 December 2021

Our rating of this location. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
• Staff treated patients with compassion and kindness, took account of their individual needs, and helped them understand their conditions.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for a diagnostic procedure.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the public to plan and manage services and all staff were committed to improving services continually.

However:

• The service did not always ensure that all staff underwent appropriate checks as required by Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
• The service did not always indicate which risks were accepted risks with no further actions to take to minimise those risks.

Updated 1 December 2021

We have not inspected this service before. We rated it as good. See the summary above for details.

Children and young people was a small proportion of the provider activity. The main service was diagnostics and screening. Where arrangements were the same, we have reported findings in the diagnostics and screening section.

We rated this service as good because it was safe, effective, caring, responsive and well-led.