Archived: Manchester Private Hospital

Manchester Private Hospital is operated by Manchester Private Clinic Ltd and based in Salford. The hospital is located on the ground floor of premises shared with other businesses. Facilities include an operating theatre and recovery area, a six bedded ward, two individual ensuite rooms, patient changing rooms and two consultation rooms. There is a reception/waiting area, staff room, and staff and patient toilets.

The service provides cosmetic surgery procedures for adults only. It does not provided services for children.

Of the 165 surgical procedures carried out between July 2018 and June 2019, liposuction (78) and breast augmentation (50) accounted for the majority. The remaining procedures included breast uplifts, otoplasties, blepharoplasties, rhinoplasties, gynaecomastia and abdominoplasties.

We only regulate surgical procedures carried out by a healthcare professional for cosmetic purposes, where the procedure involves the use of instruments or equipment which are inserted into the body. We do not regulate – and therefore do not inspect - cosmetic procedures that do not involve cutting or inserting instruments or equipment into the body.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection on 28 and 29th January 2020.

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.

Services we rate

This is the first time we have rated the hospital. We rated it as Requires improvement overall because:

• Staff did not always complete and updated risk assessments for each patient to remove or minimise risks. NEWS scores had not always been completed.

• There was a lack of compliance with the surgical safety checklist, and records had not always been completed.

• The hospital did not have a comprehensive induction process for new employees.

• Patients were not discharged with a summary of their care and treatment, nor was this information shared with the patients’ GP.

• The service did not always managed patient safety incidents well. Staff did not always recognised and reported incidents and near misses.

• The outcomes of people’s care and treatment were not always monitored regularly or robustly.

• Participation in external audits and benchmarking was limited.

• The results of monitoring were not always used effectively to improve quality.

• The service did not have a strategy for what it wanted to achieve and by when.

• Leaders and teams did not used systems to manage performance effectively.

• The service did not always collect reliable data and analyse it to ensure the effectiveness of care and treatment. There was no oversight of the monitoring of patient outcome measures.

• Whilst issues with the surgical safety checklist had been identified, action to improve compliance had not been fully effective.

• The service had an audit plan but this had not been fully embedded and audits had not taken place as often as planned.

However:

• The service provided mandatory training in key skills to all staff and made sure everyone completed it.

• Staff understood how to protect patients from abuse.

• The service controlled infection risk well.

• The design, maintenance and use of facilities, premises and equipment kept people safe.

• The service had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment.

• Staff kept detailed records of patients’ care and treatment.

• The service used systems and processes to safely prescribe, administer, record and store medicines.

• The service provided care and treatment based on national guidance and evidence-based practice.

• Staff assessed and monitored patients regularly to see if they were in pain, and gave pain relief in a timely way.

• The service made sure staff were competent for their roles.

• Doctors, nurses and other healthcare professionals worked together as a team to benefit patients.

• Staff gave patients practical support and advice to lead healthier lives.

• Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to gain patients’ consent.

• Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.

• Staff provided emotional support to patients, families and carers to minimise their distress

• Staff supported and involved patients, families and carers to understand their condition and make decisions about their care and treatment.

• The service planned and provided care in a way that met the needs of local people.

• The service was inclusive and took account of patients’ individual needs and preferences.

• People could access the service when they needed it and received the right care promptly.

• It was easy for people to give feedback and raise concerns about care received. The service treated concerns and complaints seriously, investigated them and shared lessons learned with all staff.

• Leaders had the skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for patients and staff.

• Staff felt respected, supported and valued.

• Staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss and learn from the performance of the service.

• Staff identified and escalated relevant risks and issues and identified actions to reduce their impact. They had plans to cope with unexpected events.

• The information systems were integrated and secure. Data or notifications were consistently submitted to external organisations as required.

• All staff were committed to continually learning and improving services.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with two requirement notices that affected surgery. Details are at the end of the report.

Ann Ford

Deputy Chief Inspector of Hospitals (North of England)