Nuffield Health Chichester Hospital is an independent hospital which is part of Nuffield Health, a not for profit organisation. The hospital has six consulting rooms, 19 in-patient and 11 day-case beds and two laminar flow theatres. There is also an endoscopy suite and a dedicated gynaecology suite. It is situated in Chichester, West Sussex in a residential area.
The hospital provided a range of surgical services to private and NHS-funded patients from the local community. NHS patients accounted for an average of 40% of all patients.
We previously visited this hospital in July 2016 as part of our national programme to inspect and rate all independent healthcare providers. We inspected two core services at the hospital, which incorporated all the activity undertaken. These were surgery and outpatients, including diagnostic imaging.
Whilst we rated both core services and the hospital as ‘good’ overall, we found improvements were required to minimise risks and promote safety. We told the hospital it must:
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Ensure infection control policies and standard operating procedures (SOP) are adhered to within theatres.
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Ensure adequate availability of staff handwashing facilities in line with the Department of Health’s Health Building Note 00-09.
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Ensure the sinks in patient rooms are compliant with the Department of Health’s Health Building Note 00-09: Infection control in the built environment.
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Ensure compliance of record keeping in theatres relating to Misuse of Drugs Regulations 2001 and Safer Management of Controlled Drugs: a guide to good practice in secondary care (England).
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Standardise and improve compliance with the ‘five steps to safer surgery’ (WHO) checklist.
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Ensure that there is proper assurance of the safety, calibration, security and servicing of any privately owned clinical equipment brought into the hospital.
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Ensure patients’ privacy and dignity is maintained at all times in theatre.
The hospital was in breach of three regulatory requirements:
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Regulation 12 HSCA (RA) Regulations 2014 Cleanliness and infection control.
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Regulation 17 HSCA (RA) Regulations 2014 Good governance.
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Regulation 10 HSCA (RA) Regulations 2014 Dignity and respect.
We told the hospital that it must give us an action plan showing how it would bring services into line with the regulations. The hospital provided a comprehensive report on the actions it planned to take and updated us on progress, as the issues were resolved.
The purpose of the inspection on the 29th June 2017 was to see if the hospital had made the necessary changes outlined in the action plan provided. During this follow up inspection we focused on the action plan and the areas of concern which included some aspects of the surgery core service. We did not inspect any parts of the outpatient and diagnostic imaging core service.
We cannot re-rate these services due the time elapsed since the comprehensive inspection, therefore the rating for safe for surgery remains requires improvement. However, during this inspection we were assured that the hospital had met all the required improvements, recommendations and were no longer in breach of regulations.
The hospital had significantly improved and had taken action to comply fully with regulations and we found:
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The hospital had an internal quality audit review following our inspection and showed us evidence of changes as a result of this.
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The hospital had introduced a Standard Operating Procedure (SOP) for compliance with the uniform policy in theatres.
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A new infection prevention co-ordinator had been employed and infection prevention link nurses worked in each department.
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We saw evidence of plans to undertake refurbishments install handwashing facilities on wards to ensure adequate handwashing facilities for use by staff.
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Staff training in Aseptic Non Touch Technique (ANTT) had been implemented and 90% of staff had undertaken the training.
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Consultants were no longer bringing privately owned clinical equipment on site.
However:
We will continue to monitor the performance of this service and inspect it again, as part of our ongoing programme.
Professor Edward Baker
Chief Inspector of Hospitals