Archived: BMI Gisburne Park Hospital

Overall we found services good at BMI Gisburne.

We inspected the core services of surgery and outpatients and diagnostic imaging.

• Incidents were reported by staff through effective systems. Lessons were learnt and investigation findings and improvements made were fed back to staff. There were systems in place to keep people safe and staff were aware of how to ensure patients were safeguarded from abuse.
• Medicines were stored safely and given to patients in a timely manner. The staffing levels and skills mix was sufficient to meet patients’ needs.
• Equipment was maintained, appropriately checked and visibly clean. Medical equipment was checked and maintained by an independent company.
• Patient records were stored securely and access was limited to those who needed to use them.
• There were defects in the carpet on the ward corridor and we found floors in three patient bathrooms which were dirty in the corners and grouting on the tiles were not as clean as they should have been. We found that this had been addressed at our unannounced visit.
• Staff assessed and responded to patients’ risks and used recognised assessments but these were not always fully completed.
• The majority of staff had completed their mandatory training.
• Senior staff were aware of their responsibilities relating to the duty of candour legislation and they were able to give us examples of when this had been implemented. The hospital had a duty of candour process in place to ensure that people had been appropriately informed of an incident and the actions that had been taken to prevent recurrence.
• Surgical procedures were carried out by a team of consultant surgeons and anaesthetists who were mainly employed by other organisations (such as in the NHS) in substantive posts and had practising privileges with the hospital.
• The consultants and anaesthetists were responsible for their individual patients during their hospital stay.
• Resident registered medical officers (RMOs) were employed to provide medical cover when the consultant was not available.

• Patients received care and treatment according to national guidelines such as National Institute for Health and Care Excellence (NICE) and the Royal Colleges of Nursing and Surgeons. Surgery services participated in national audits. Findings from performance reported outcomes measures (PROMs) and the National Joint Registry showed the majority of patients had a positive outcome following their care and treatment.
• The hospital monitored patient outcomes through surveys to ensure that patients were satisfied with the service they received.
• BMI corporate policies were based on National Institute for Health and Care Excellence (NICE), national and royal college guidelines were available to staff on the intranet.
• The rate of unplanned readmissions following surgery was within expected levels when compared to other independent hospitals.
• Care and treatment was provided by suitably trained, competent staff that worked well as part of a multidisciplinary team. The majority of staff had completed their appraisals.
• Procedures were in place to ensure that consultants holding practicing privileges were valid to practice. There were procedures in place to ensure all consultant requests to practice were reviewed by the Medical Advisory Committee (MAC).
• Staff sought consent from patients prior to delivering care and treatment and understood what actions to take if a patient lacked the capacity to make their own decisions.

• Without exception, patients spoke positively about their care and treatment. Staff treated patients with dignity and respect and patients were kept involved in their care. Patient feedback from the NHS Friends and Family test and patient satisfaction surveys showed most patients were positive about recommending services to their friends and family.

• There was daily planning by staff to ensure patients were admitted and discharged in a timely manner. There was sufficient capacity in the ward and theatres so patients could be seen promptly and receive the right level of care before and after surgery.
• There were systems in place to support vulnerable patients. Complaints about the services were resolved in a timely manner and information about complaints was shared with staff to aid learning.
• The department accessed translation services for those patients whose first language was not English, and information was available to patients in differing formats, if required. A hearing loop was available for those patients who were hard of hearing.
• The hospital had not implemented recognised schemes to help meet the individual needs of patients living with dementia.

• There were governance structures in place which included a risk register. The hospital’s vision and values had been cascaded across the services and staff had a clear understanding of what these involved. There was clearly visible leadership within the services. Staff were positive about the culture within the services and the level of support they received. There was routine public and staff engagement. All staff were committed to delivering good, compassionate care and were motivated to work at the hospital.