Archived: Manchester Surgical Services Limited

Updated 16 May 2023

Manchester Surgical Services Limited is an independent health provider based in Manchester, Greater Manchester.

The service is commissioned to deliver services through an NHS standard contract to offer patients a choice and to assist with post pandemic long waits for patients across Greater Manchester and the wider North West region.

The service offers outpatient appointments, dressing clinics and day case surgical procedures to NHS funded adults over 18 years.

The service has a service level agreement with a host independent hospital to support the majority of outpatient and surgical procedures delivered by the service. The service also has a service level agreement with a primary care service for delivering outpatient clinics and 3 other NHS and independent healthcare providers and utilised their premises and / or equipment for delivering surgical procedures. The service also had a service level agreement with an additional NHS acute hospital for the provision of endoscopy services.

The service provided a range of elective day case surgical procedures, including general surgery, orthopaedic surgery, ear, nose and throat (ENT) surgery and non-surgical endoscopy procedures. The service also provided non-surgical outpatient consultation clinics for ENT and rheumatology. All other outpatient clinics were pre and post-operative consultations for NHS patients undergoing surgical procedures with the service.

During April 2022 and February 2023, the service carried out 4,294 outpatient clinics at the main host hospital location and 4,699 outpatient clinics at an external primary care service provider. The service carried out 850 day case surgical procedures at the main host hospital location and 93 day surgery procedures across three additional NHS and independent healthcare providers.

The main service provided by this hospital was surgery. Where our findings on surgery – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the surgery service.

The service carried out 147 endoscopy procedures during April 2022 and February 2023. The endoscopy procedures were carried out by gastroenterologists working under practicing privileges for the service utilising staff, premises and equipment of an NHS acute hospital under a service level agreement.

We did not have sufficient evidence to inspect and rate the endoscopy services as a separate core service because of the limited number of procedures carried out and the service utilised resources from a host hospital. Therefore, we have reported the endoscopy activity under surgery.

Manchester Surgical Services Limited has been registered with the Care Quality Commission (CQC) at its current location since July 2021. The service was previously registered under a different location. This is the first time we have inspected and rated the service at this location.

The service has had a registered manager for the service since its initial registration. The current registered manager has been registered with the CQC since November 2022.

The service is registered to provide the following regulated activities:

• Diagnostic and screening procedures
• Surgical procedures
• Treatment of disease, disorder or injury

Updated 16 May 2023

This is the first time we have rated this service. We rated it as good overall because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

• The service did not have an effective process for carrying out checks on company directors, in line with regulatory requirements for fit and proper persons; directors.
• Leaders did not always carry out relevant checks for employed or contracted staff as part of their recruitment and practicing privileges processes, such as checks for suitable references or periodic updates on disclosure and barring service checks.
• Leaders did not always have effective assurance processes in place relating to the premises, equipment or staff supplied by the host organisations used by the service. However, the service had planned actions to improve this.
• The majority of staff had not yet completed their annual appraisal for the current year.
• The number of patients that did not attend outpatient appointments was worse than the national standard.
• Staff had not completed specific training on learning disability and autism, in line with national guidelines.

Updated 16 May 2023

Outpatients is a small proportion of the provider’s activity. The main service was surgery. Where arrangements were the same, we have reported findings in the surgery section.

We rated this service as good overall. We rated safe, caring, and responsive as good. and well-led as requires improvement. We inspect but do not rate effective for outpatients.

Updated 16 May 2023

The main service provided by this service was surgery. Where our findings on surgery – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the surgery service.

We rated this service as good overall because it was safe, effective, caring and responsive. We rated well-led as requires improvement.