Nuffield Health Bristol Hospital - The Chesterfield

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that patients and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of patients and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that patients could access care in ways which met their personal circumstances and protected equality characteristics.

At our last assessment, we rated this key question good. At this assessment, the rating has remained good. This meant people’s needs were met through good organisation and delivery.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Patients told us they were involved in their care and treatment choices and their needs and preferences were taken into account. Patients were able to provide feedback at various stages of their care. All patients received a patient survey when they were discharged and leaders used this to improve services.

The service was able to make reasonable adjustments to support patients with complex healthcare needs, learning disabilities and dementia. Staff were able to explain what adjustments they could make if a patient had dementia. The service had a dedicated room that could be made dementia friendly with appropriate sensory items, signage and space to allow carers or family to stay with them. Leaders told us they could allocate additional staff for 1 to 1 support. We saw evidence that staff had completed mandatory training on learning disabilities. This helped ensure they had the knowledge and skills required to support and meet the needs of patients with learning disabilities, promoting person-centred and inclusive care.

The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service planned and provided care to meet the needs of local people. They worked with the wider system and local organisations to reduce long waiting lists at local hospitals and provided NHS treatment for Orthopaedics and Spinal surgery. Leaders had recently started a weight management service in response to growing demand in the local community.

There was effective continuity of care from the start of treatment to discharge. Staff planned discharge prior to surgery to ensure all necessary healthcare professionals and care equipment was ready for discharge. This ensured patients had a smooth discharge and recovery. Patients told us they were aware of their discharge plans and what to expect once discharged, including follow up appointments and physiotherapy.

Organisations worked collaboratively to provide safe joined up care. The hospital had a clear agreement and processes with an NHS trust to support the care of a patient whose condition was deteriorating.

Discharge summaries were sent to the patients GP following surgery.

The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Patients were provided with a range of information including leaflets, online videos and the opportunity to ask staff any questions. Patients told us they were provided with enough information prior to surgery and to support their discharge.

Staff told us that not all information was available in different languages or easy read formats. Staff told us patients have access to an online physiotherapy system to access exercises. This was not available in other languages. However, there were options to increase image size to view exercises or add subtitles to videos. Staff told us that some leaflets could be enlarged and they would do whatever possible to ensure patients received all necessary information available to them.

The service used an online patient record system. Any paper records were stored securely. Staff received training in information security and data protection. 97% of staff had completed the training.

At discharge, patients were provided with information relating to medication, exercise plans and contact details if they required additional support.

The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

Staff promoted a culture in which patients were able to give their views. Patients told us they would speak to a staff member if they had any concerns or wanted to make a complaint and felt comfortable doing so.

In the 12 months prior to our assessment, there were 16 complaints. Of which, 5 were upheld and 4 partially upheld. No complaints were referred to the ombudsman or Independent Sector Complaints Adjudication Service (ISCAS).

Clear and up-to-date complaints and feedback policies outlined how the service responded to feedback. Staff knew how to investigate and manage complaints. There was a clear process for recording, investigating, and responding to complaints, with timescales to ensure complaints were managed and responded to promptly. We saw evidence of correspondence following complaints investigations. All complaints were responded to and addressed the concerns and questions raised by the complainant.

Staff told us they received feedback and learning following complaints. This was cascaded via heads of departments and through daily huddles.

Incidents and complaints were investigated and responded to appropriately. Staff told us they received feedback and learning from incidents. However, this was not consistently embedded across all departments. Some incidents recurred due to learning and process changes not being consistently implemented across departments.

The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

The hospital provided services for private and NHS patients. Patients were booked chronologically for surgery unless consultants indicated clinical urgency. Patients could choose when they wanted to be seen to suit their personal needs There were no long waits. Consultants booked theatre schedules up to 6 months in advance.

There were 65 patient operations cancelled on the day, in the 12 months prior to our inspection. Most were due to patient related cancellations, such as infections, admission criteria issues or patient choice cancellations.

The ward had adequate medical cover 24 hours a day, with a Resident Doctor on duty and consultants available on call for escalation.

The service had a discharge policy that details discharge plans, medications and advice for carers including contact telephone numbers for support. There was also a post discharge call policy. All patients received a check up call several days after their discharge date.

Discharges were pre-planned and prompt following surgery. Patients were informed of their discharge date in advance, which was only amended if medical concerns or clinical needs arose.

The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

There was evidence that staff had undertaken equality, diversity and inclusion (EDI) training as part of their mandatory bullying and harassment training. Records showed 95% had completed the training.

The provider participated in Patient-Led Assessment of the Care Environment, which is a review of the care environment from patients and staff. In 2025 the hospital scored higher than the national and provider average for dementia and disability care.

The provider completed equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage. Protected characteristics are defined in the Equality Act 2010, this includes: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race and ethnicity, religion or belief, sex, and sexual orientation.

The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Patients were actively involved in care planning from an early stage, with family members involved where appropriate and with consent. Staff demonstrated awareness of patients’ preferences, including decisions on patients wishes for resuscitation.

Staff worked with patients before surgery to ensure all necessary equipment and resources were available. Staff told us they involved relevant healthcare professionals in discharge plans to ensure the correct support was provided.

Patients told us they were aware of future appointments and who to contact if they needed support once discharged. Patients were provided with online and paper resources to follow physiotherapy exercise programmes.