Archived: The Chelmsford

Updated 16 January 2017

The Chelmsford is operated by Aspen Healthcare Limited. This private hospital is located in Chelmsford, Essex. The hospital first opened in February 2006 as Med-Tel. In 2009, it became The Chelmsford Medical Centre, a day surgery unit run by a group of practising consultants. In 2012 it was acquired by the Aspen Healthcare group and in 2013 it rebranded as The Chelmsford. In June 2015, Aspen Healthcare became a wholly owned subsidiary of Tenet Healthcare.

The hospital has had a registered manager in post since January 2009.

The hospital also offers cosmetic procedures. We did not rate these services.

Updated 16 January 2017

The Chelmsford is operated by Aspen Healthcare Limited. The hospital provides day surgery, and outpatients and diagnostic imaging. We inspected both these services. Surgery included cosmetic procedures which we do not have a legal duty to rate. Facilities include three general consulting rooms, two ophthalmology consulting rooms, and two physiotherapy consulting rooms. There is a theatre suite comprising a main theatre, procedure room, recovery stage one, and recovery stage two/discharge lounge. The recovery stage one area has five holding bays, and the discharge lounge has five recovery recliner chairs. Other facilities include general x -ray, an ultrasound room, outpatient treatment room, physiotherapy gym, administration offices and store rooms.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 19 September 2016, along with an unannounced visit to the hospital on 10 October 2016.

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.

We rated this hospital as good overall.

• There was a positive incident reporting culture, with good evidence of learning from incidents. Complaints were monitored and well managed. Infection control practices were observed to be embedded and used effectively.

• Safeguarding procedures for both adults and children were embedded and in accordance with best practice requirements.

• Policies and procedures followed best practice guidance. There were audits against these requirements with clear action plans to improve the service.

• Appraisal rates were 100%, and mandatory training rates were 100%.

• Feedback from Patients who use the service was consistently positive. People could receive care at the service without delay, there was no backlog of patients in any service.

• There were good leadership processes including good governance, risk management and quality assurance in place. Staff spoke positively about working at the service and of their local and hospital level leaders.

We found areas of good practice in surgery:

• There were robust incident reporting processes and infection control procedures in place. Complaints were monitored and well managed.

• There was a variety of relevant evidenced based policies and guidelines for staff. The hospital monitored patient outcomes and participated in relevant national audits.

• There was a robust process for staff appraisal. Practising privilege processes were well established, embedded and used effectively.

• Patients and their relatives reported that staff had been kind and compassionate when delivering care. The patient survey showed that 99% of patients would recommend the hospital to their friends and family.

• The management team were visible to staff and there was good engagement with patients and the wider multidisciplinary team.

We found good practice in relation to outpatient and diagnostic services:

• There were robust incident reporting processes and infection control procedures in place.

• Staff appraisal rates and mandatory training rates were 100%.

• People could access the service without delay, there are no backlogs or delays relating to outpatient services.

• The staff spoke highly about their local leaders and support from the management teams.

We do not currently have a legal duty to rate cosmetic surgery services or the regulated activities they provide but we highlight good practice and issues that service providers need to improve and take regulatory action as necessary.

However, we also found the following issues that the service provider needs to improve:

Following this inspection, we told the provider that it should make improvements regarding the completion of moving and handling assessments in surgery, and improve the quality and completion of patient records, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Professor Ted Baker

Deputy Chief Inspector of Hospitals

Updated 16 January 2017

The Chelmsford provided a range of specialist consultant clinics including cosmetics, GP services, gynaecology, ophthalmology, pain management, physiotherapy, and psychotherapy (cognitive behavioural therapy). The hospital offered diagnostic services, including onsite magnetic resonance imaging (MRI), x-ray and ultrasound. These services were available to insured, self-funding, NHS Choose and Book and NHS Spot contract patients.

During the reporting period from April 2015 to March 2016, there were 6640 outpatient attendances, which consisted of both NHS and private consultations. These comprised 37% (2434) new appointments and 63% (4206) follow-up appointments. NHS new and follow-up appointments represented 26% (1719/6640) of outpatient work for the reporting period. Outpatient services saw children and young people and adult patients.  Children and young people represented less than two per cent of outpatient work within the reporting period.

Updated 16 January 2017

Surgery was the main activity of the hospital. Where our findings on surgery also apply to other services, we do not repeat the information but cross-refer to the surgery section.

The hospital offered a range of surgical procedures under local and general anaesthetic to private and NHS patients over 18 years of age. The theatre suite comprised of a non-laminar flow theatre, one procedure room, five recovery bays and a patient lounge with five recliner chairs. Theatres were open Monday to Saturday from 7:30am to 5:30 pm for patient procedures.

There were 1,365 day case episodes of care recorded at the hospital in the reporting period April 2015 to March 2016. Of these 35% were NHS funded and 65% were other funded. No patients stayed overnight at the hospital during the same reporting period.

The service carried out the following procedures:

• 534 pain management procedures
• 320 cataract surgeries
• 286 podiatric fore foot surgeries
• 84 breast augmentations
• 70 venous endovascular laser treatments
• 33 breast procedures
• 22 ocular plastics