Nuffield Health York Hospital

Nuffield Health York Hospital is operated by Nuffield Health. The hospital has 40 beds and facilities include three operating theatres (two of which have laminar flow), a surgical unit for ambulatory care, radiology, outpatient and diagnostic facilities. The hospital provides surgery and outpatients with diagnostic imaging services and we inspected both of these services.

We inspected this hospital using our comprehensive inspection methodology. We carried out the announced part of the inspection on the 6th and 7th September 2016 with an unannounced visit to the hospital on 13th September 2016.

We rated both core services and the hospital as good overall.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so, we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate. Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

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 core service.

Services we rate

We rated this hospital as good overall because:

• There were systems and processes in place to promote practices that protected patients from the risk of harm. Openness and transparency about safety were encouraged. When something went wrong, people received an explanation, and a sincere and timely apology.
• There were sufficient and appropriately qualified and experienced staff working in all departments to meet the needs of patients. We saw that equipment in all areas was well maintained and kept clean to minimise the risk of infection. Staff were able to respond to signs of a deteriorating patient and medical emergencies.
• Patient feedback demonstrated that staff strived to make the patient experience as positive as possible. Staff recognised and responded to the individual needs of their patients throughout the patient journey.
• The hospital had systems in place to provide care and treatment in line with national guidance. There was effective multi-disciplinary working and good communication between teams within the hospital and with external healthcare partners.
• There was a stable leadership team who were highly regarded by staff. Staff felt proud to work within the hospital and were very positive about the culture and the quality of teamwork.
• There was a clear governance structure and a comprehensive reporting framework in place that provided timely information to the hospital board, medical advisory committee and to the corporate team.

We found areas of practice that required improvement in both surgery and outpatients services.

• We did not identify a clear mechanism to share learning from unplanned transfers and patient safety incidents with the Resident Medical; Officer. This was acted upon at the time of inspection and at the unannounced inspection, communication systems had been improved.

In surgery:

• None of the ten surgical case notes reviewed for consultant entries recorded daily consultant visits as per the requirements of practising privileges. Two sets of notes had documentation about the consultant’s visit from the nurse in charge of the patient’s care.
• Two patients receiving oxygen did not have oxygen prescribed on the medication record. This was raised at the time of inspection and immediately actioned.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Ellen Armistead

Deputy Chief Inspector of Hospitals (North Region)