Independent Health Group Limited

Updated 8 September 2022

The Independent Health Group Limited delivers surgical and outpatient services. The name of the provider and the registered location are the same.

The service was registered to provide regulated activities in 2018 and this was our first inspection. There was a registered manager in place.

The service provides clinical care to NHS patients from rented clinical space in 12 GP practices across England. The organisation provides staff, records, and some equipment. Each clinical site has its own arrangements with the building operator with regards to areas such as cleaning, storage, and emergency procedures.

The organisation provides both surgical and outpatient services for hernia, cataracts, vasectomy, hand, and podiatric surgery

In the 12 months leading to our inspection, the provider carried out 10,570 spells of patient care. This included pre-assessments, operations, outpatient visits, and follow-ups.

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

Updated 8 September 2022

We have not previously inspected this service. We rated it as outstanding because:

• The service had enough staff to provide innovative, holistic care for patients that kept them safe and promoted wellbeing beyond their clinical need. Staff had extensive 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 care and treatment that went above and beyond expectations and that was holistic by nature.
• Managers monitored the effectiveness of the service through a programme of continual, ambitious auditing and benchmarking. They made sure staff were competent by providing an extensive programme of continual professional development.
• Staff worked well together for the benefit of patients and used a wide range of multidisciplinary opportunities to explore opportunities for improved care. Staff advised patients 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 and staff sought an expansion of some services where this would improve patient outcomes.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. This approach was fully embedded in all aspects of care. Staff provided individualised emotional support to patients, families and carers and adapted care delivery based on individual needs.
• The service planned care to meet the needs of people, took account of patients’ individual needs, and made it easy for people to give feedback. The service aimed to reduce waiting times for NHS patients and prioritised those who had already exceeded national maximum waiting times.
• Leaders ran services well using reliable information systems and supported staff to develop their skills through a programme of engagement. Staff understood the service’s vision and values, applied them in their work, and used provider standards to challenge the status quo. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care and creating a working environment that promoted innovation and development. Staff were clear about their roles and accountabilities. The service engaged meaningfully with patients and the community to plan and manage services and all staff were committed to improving services through research and exploration of new evidence-based practice.

Updated 8 September 2022

We have not previously inspected this service.

We rated it as outstanding because:

• There was a strong culture of safety and staff worked within least-risk care frameworks.
• Care and minor procedures reduced waiting times for patients and meant they could be seen at convenient community locations.
• Patient outcome monitoring was embedded in the service and demonstrated consistently good outcomes for patients.
• Outpatients operated in a culture of learning and multidisciplinary working that meant patients received care from professionals with up to date experience.
• The average referral to treatment time was 4.8 weeks and no patients had breached the maximum 12 week wait.
• Staff openly engaged with patients and it was common practice to use feedback for changes and improvements.
• Care was compassionate and individualised, and staff took the time to listen to patients.

However:

• A variety of factors meant there had been delays to issuing clinic letters within the provider’s seven day standard.

Outpatients operated separately from surgery but shared governance, leadership, and elements of other core processes. Where arrangements were the same, we have reported findings in the surgery section.

Updated 8 September 2022

We had not previously inspected this service.

We rated it as outstanding because:

• Staff demonstrated a good track record of infection prevention and control standards, including low rates of surgical site infections.
• Safeguarding processes were comprehensive and reflected the geographically-spread nature of the service.
• Safety systems and operating procedures were appropriate to the nature of the service, such as providing clinic care from rented premises of other providers. Patients received safe care as a result.
• Medicines management focused on ensuring essential items were always available, including during a national shortage.
• Care was demonstrably evidence-based, and the service actively monitored changes in national standards and guidance to ensure practice was up to date.
• The service performed well in relation to access and flow. Unplanned readmission rates were consistently low, cancellation rates were very low, and staff offered flexibility to meet individual needs. Capacity planning was focused on reducing waiting times for patients.
• Staff adapted the service to meet the needs of people living with mental health challenges, including learning disabilities.
• Clinical governance processes were tailored to the service and the needs of patients. The senior team was integrated, collaborative, and worked with colleagues across health economies to coordinate care.