- NHS hospital
Great Western Hospital
Report from 6 February 2025 assessment
Contents
Ratings - Surgery
Our view of the service
On 18 and 19 March 2025 we carried out an inspection of surgical services at The Great Western Hospital NHS Foundation Trust. We inspected due to an increased number of reported incidents in the surgical service.
We inspected 31 quality statements across safe, effective, caring, responsive and well-led key questions. We have combined the scores for these areas with scores from the last inspection to give the rating.
There were improvements following the breaches reported in the previous inspection of surgery in 2020.
The trust’s Surgery, Women and Children’s Division manages the surgery core service at Great Western Hospital. The trust has 15 operating theatres, including day-case facilities, which provides care for people undergoing a range of surgical procedures not requiring an overnight stay.
We spoke with 17 patients and 2 relatives/carers. We reviewed a sample of patient records including nursing notes, prescription charts and theatre records. We spoke with more than 40 staff which included: consultants, surgeons, anaesthetists, resident doctors, nurses, physiotherapists, occupational therapists, senior leaders, healthcare assistants, administration staff, housekeeping staff and volunteers.
Safe:
The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. People were protected and kept safe. Staff understood and managed risks. The facilities and equipment did not always meet the needs of people. However, they were clean, well-maintained and any risks were mitigated. There were enough staff with the right skills, qualifications and experience. Managers made sure staff received training and regular appraisals to maintain high-quality care. Staff managed medicines well and involved people in planning any changes.
Effective:
People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice. People always had enough to eat and drink to stay healthy. Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions when moving services. They monitored people’s health to support healthy living. Staff made sure people understood their care and treatment to enable them to give informed consent.
Caring:
People were treated with kindness and compassion. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences. People had choice in their care and were encouraged to maintain relationships with family and friends. Staff responded to people in a timely way. The service supported staff wellbeing.
Responsive:
People were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. People were involved in planning their care and understood options around choosing to withdraw or not receive care.
Well-led:
Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. People with protected characteristics felt supported. Staff understood their roles and responsibilities. Managers worked with the local community to deliver the best possible care and were receptive to new ideas. There was a culture of continuous improvement with staff given time and resources to try new ideas.
People's experience of this service
Patients and their family members we spoke with were all positive about the staff treating them. Patients told us they were treated with warmth and kindness, and provided with everything they needed.
Records showed patients were given the tests they needed, and they felt staff were on hand if they needed them for help or support. People said they were involved in the planning of their care. They told us that the staff would listen to their individual needs and do their best to meet these. People said they did not feel anxious about raising concerns.