Nuffield Health Bristol Hospital - The Chesterfield

On this page

• 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

We looked for evidence there was an inclusive and positive culture of continuous learning and improvement based on meeting the needs of people who used services and wider communities. We checked leaders proactively supported staff and collaborated with partners to deliver care that was safe, integrated, person-centred and sustainable, and to reduce inequalities.

At our last assessment we rated this key question good. At this assessment the rating remains good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care. However, the service was in breach of legal regulations as the provider did not always have effective governance processes for recruitment of staff and some policies were not aligned.

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.

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.

Staff demonstrated a clear understanding of the provider’s vision and values, and how these were embedded within day-to-day practice. The service actively promoted equality and diversity, supported ongoing staff development, and fostered an open and inclusive culture in which concerns could be raised without fear of reprisal.

Staff reported feeling valued and respected within their roles. They described positive working relationships, effective teamwork, and visible, approachable leadership. Leaders supported skills development and recognised staff contributions through regular feedback and structured daily team briefings.

The service utilised benchmarking processes to monitor performance, including monthly comparisons with other Nuffield hospitals. This enabled oversight of key metrics such as adverse events, and patient satisfaction, supporting continuous improvement.

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.

The service did not have dedicated leaders solely for children and young people’s services. However, leaders had the skills, knowledge and experience to perform their roles and understood the service provision for children and young people.

Staff reported they were well supported by senior leaders, who were described as visible, approachable, and responsive. Leaders demonstrated a commitment to acting on both staff and patient feedback, taking incidents seriously and responding to concerns. This approach contributed to the development and maintenance of a positive, open, and transparent culture within the service.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The service had 2 Freedom To Speak Up (FTSU) guardians, supported by a regional Freedom To Speak Up lead. Staff reported they were aware of the available channels to raise concerns, share feedback, and contribute ideas.

Staff received training in Freedom To Speak Up and records showed 97% compliance. They told us they received feedback and felt their views were listened to and valued.

The provider’s website detailed how people could raise concerns and how this was investigated. There were complaint escalation routes for private and NHS funded care. Staff were encouraged to respond to immediate concerns or complaints with a view to resolution. There were policies to support the complaints process.

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 provider maintained an up-to-date Equality, Diversity and Inclusion (EDI) policy, and leaders actively promoted an inclusive working environment. Equality of opportunity was supported through transparent access to development opportunities and staff told us they had benefited from this.

The service had arrangements to prevent and address bullying and harassment. These arrangements considered the needs of staff with protected characteristics and those from marginalised groups. Data showed staff were 95% compliant with harassment and bullying mandatory training. Reasonable adjustments were implemented where required to support staff with disabilities and ensure equitable working conditions.

The evidence showed some shortfalls in standard. The hospital did not always operate governance process to identify and mitigate risk. However, the service had clear responsibilities, roles, and systems of accountability. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The hospital did not always have effective governance processes to identify gaps in recruitment records and practicing privileges which we found during our assessment. Processes did not identify provider policies covering safeguarding training requirements were not aligned. The safeguarding policy stated all non-clinical staff, who have contact with children no matter how frequently, must be trained to level 2 for safeguarding children and young people. However, the, mandatory training policy stated health care assistants and support workers should be trained to level 1. Records showed healthcare assistants and support workers were trained to level 1.

The hospital had systems and processes to manage other aspects of safety and quality of care. The service had clearly defined governance structures and systems of accountability to support the effective delivery of services to include children and young people. An established meeting framework, alongside monthly quality reports, enabled senior leaders to monitor performance and maintain oversight. Monthly reports included updates in staffing, safeguarding and learning. Quarterly assurance quality reports included children and young people, referencing evidence of discussion throughout the governance network.

There was a clear framework of what required discussion at a ward, team or directorate level in team meetings to ensure essential information, such as learning from incidents and complaints, was shared and discussed.

The medical advisory committee met regularly to oversee patient safety, quality of care and regulatory compliance. It reviewed incidents and adverse events to identify areas for improvement and strengthen patient safety.

Governance policies reflected best practice and were accessible to staff, who told us updates were shared through meetings and safety huddles. Policies were available to staff on an online platform.

A risk register was maintained and regularly reviewed, with controls to mitigate identified risks. There were no risks recorded on the June 2026 register relating to children and young people.

The service had a business continuity plan which would be put into operation in the event of an unexpected disruption to the service, this included a short-term disruption plan. Should the hospital need to be evacuated there were printed up-to-date business continuity plans and information.

The provider had a sustainability plan with a target for each hospital to reduce energy consumption. Managers of the service were aware of this plan and were working on implementing energy reduction plans without impacting patient care.

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.

Staff and leaders worked collaboratively with external stakeholders and partner agencies to support improvements in patient care and outcomes. The hospital ran free of charge events where the public could attend presentations on a variety of health topics. This could be booked on the provider’s website.

The service demonstrated open and proactive engagement with patients, staff, equality groups, the public, and local organisations in the planning and delivery of services.

The provider’s gyms promoted healthier living by integrating traditional fitness facilities with fitness and wellbeing clubs. They had also produced a social impact report 2025 entitled building a healthier nation. This included improving the quality of life for people living with long-terms conditions and inclusive sport for young people.

The hospital contributed to the local community. For example, local primary schools have benefitted from education sessions, promoting hand hygiene and infection prevention among the children. They also collaborated with a local rugby club (under 15s to under 24s), providing players with advanced diagnostics, rapid specialist access and rehabilitation.

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 demonstrated a clear commitment to continuous learning and service improvement. The provider had structured processes to identify, review and share learning from incidents and examples of good practice, informed by both local and national themes.

Monthly quality reports supported effective oversight, enabling leaders to monitor trends, identify risks, and take timely action to reduce the likelihood of recurrence.

Staff contributions and achievements were recognised and celebrated within the service, which supported staff engagement and morale.