The Royal Bournemouth Hospital

Ratings - Surgery

• Overall

  Requires improvement

• Safe

  Requires improvement

• Effective

  Good

• Caring

  Good

• Responsive

  Good

• Well-led

  Requires improvement

Our view of the service

We carried out this assessment on 28 and 29 January 2025.

We carried out this assessment as a responsive inspection, due to concerns we had about the service. We assessed 5 key questions: safe, effective, caring, responsive and well led. We rated surgery services as requires improvement overall because:

Safe

We found concerns in relation to keeping the environment safe, particularly regarding fire safety, the timely availability of emergency equipment and securing hazardous materials

While medicines management showed some effective practices, they were not always stored securely, and some were found to be out of date. Similarly, while infection prevention and control policies aligned with national guidelines, and some areas showed good practice, we observed some inconsistencies across the surgical services in cleanliness which was not always in line with these standards.

Effective

There was a clear emphasis on patient-centred care, evidence-based practices, and strong teamwork across various disciplines. Pro-active safety measures like surgical safety checklists, falls prevention strategies, and thorough pre-operative reviews indicated a commitment to maximising the effectiveness of care and treatment. The use of national guidelines, participation in audits showing positive outcomes in areas like cancer care, and the active monitoring of patient-reported outcomes for procedures like joint replacements, highlighted a dedication to delivering effective and evidence-based care. There was a pro-active approach to supporting healthier lifestyles for specific patient groups, such as those with vascular conditions.

Caring

There was commitment to caring for patients with kindness, compassion, and respect, as evidenced by positive patient feedback across various surgical areas. The service prioritised treating individuals holistically, considering their unique backgrounds and preferences to tailor care plans and actively involve patients in decision-making. While workforce well-being showed positive aspects like valuing staff and providing support networks, issues with break facilities and workload balance for some staff indicated areas for improvement to ensure the team was fully enabled to consistently deliver person-centred care.

Responsive

The service demonstrated a responsive approach to individual needs. People and communities were always at the centre of how care was planned and delivered. The health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. Care and treatment met people’s personal circumstances and protected equality characteristics. The service acted upon patient feedback and implemented changes based on what they were told.

Well Led

There were shortfalls in governance processes and how leaders identified and mitigated risks. The surgical leadership team did not do enough of their own checks (audits). This meant frontline staff did not always know the risks and leaders did not always have a clear picture of these risks. This led to safety problems like environmental hazards, timely emergency equipment availability, and basic safety mistakes. However, the service had a clear vision, capable leadership, a positive culture encouraging staff to speak up, and a commitment to equality, diversity, and inclusion.

The service was in breach of the legal regulations in relation to, safe care and treatment and good governance.

People's experience of this service

Overall, people's experiences of using/accessing surgical services at The Royal Bournemouth Hospital presented a generally positive picture regarding interactions with staff and involvement in their care. Patients consistently described feeling well-cared for by a team they perceived as kind, compassionate, and respectful. This positive feedback extended to feeling included in the planning of their care, with staff reported to be attentive to their individual needs and preferences, striving to deliver person-centred support. Information was accessible, catering to people with different communication needs. The service was responsive to patients' immediate needs. The outcome of call bell audits as actions taken as a result of feedback from patients demonstrated a patient centered approach which positively impacted on people’s experience.