Archived: Withington Community Hospital

Updated 30 June 2016

We visited Withington Community Hospital on 11 February 2016, as part of our comprehensive inspection of University Hospital of South Manchester NHS Foundation Trust. Withington Hospital carries out a small range of pre-operative assessments and planned surgical services for adults, on a day case basis. These services include urology pre-operative assessment and day case surgery, plastics and orthopaedic day case surgery. Ear, nose and throat (ENT) day case surgery did take place at the treatment centre but had not taken place for the past four months, due to a vacant consultant surgeon post.

Procedures can be carried out using either local or general anaesthetic. The treatment centre also provides some colonoscopy services for a local trust.

Withington Community Hospital offers outpatient services for a range of specialities including dermatology, urology, ear, nose and throat (ENT), diabetes, podiatry, phlebotomy, audiology and therapies.

Withington Community hospital offers a range of diagnostic services to patients including general x-ray, ultrasound, mammography and urological investigations.

Updated 30 June 2016

Withington Hospital is one of two locations providing care as part of University Hospitals of South Manchester NHS Foundation Trust. It provides a range of hospital services in surgery and outpatient and diagnostic imaging services.

We carried out an announced inspection of Withington Hospital on 26-29 January 2016 as part of our comprehensive inspection of University Hospitals of South Manchester NHS Foundation Trust.

Overall, we rated Withington Hospital as ‘Good’. We found that services were provided by dedicated, caring staff and patients were treated with dignity and respect. However, improvements were needed to ensure that services were responsive to people’s needs.

Our key findings were as follows:

• The trust had infection prevention and control policies in place which were accessible to staff.

• We observed good practices in relation to hand hygiene and ‘bare below the elbow’ guidance and the appropriate use of personal protective equipment, such as gloves and aprons, while delivering care.

• Staff received training appropriate to their role however uptake of mandatory training could be improved within outpatients and diagnostic imaging.

• Staffing was good across surgical services but there was a high vacancy rate within the outpatients department.

• Care and treatment was delivered in line with evidence-based practice. Policies and procedures followed recognisable and approved guidelines such as the National Institute for Health and Care Excellence (NICE).

• Care was delivered with care and compassion by competent staff who worked together as a multi-disciplinary team to provide a comprehensive service to patients.

• Referral to treatment times across the trust for patients awaiting outpatient care was the same or better than the national standard with the exception of September 2015.

However, there were also areas of poor practice where the trust needs to make improvements.

In addition the trust should:

In Surgery:

• Offer staff opportunities to develop surgical nursing competency skills.

• Consider having data available to staff on performance at a local level including local audit activity.

• Increase senior management visibility at Withington treatment centre.

• Cascade to staff the local vision and strategy of the service.

• Provide patient feedback at a local level.

In Outpatient and Diagnostic Imaging Services:

• The trust should ensure access to IT (information technology) services is consistent and reliable to facilitate access to Local Rules and policies and procedures online and mandatory e-learning.

• The trust should ensure documentation relating to radiation faults and Medical Physics are accessible electronically.

• The trust should consider fitting a keypad lock to the clean utility room used to store Urografin in radiology.

• The trust should maintain a record of the maximum and minimum fridge temperatures for each medication fridge and action should be taken if temperatures fall out of the recommended range.

• Staff should have their learning needs identified through the trusts appraisal process.

• The trust should consistently obtain NHS Family and Friends data in the radiology department.

Professor Sir Mike Richards

Chief Inspector of Hospitals

Updated 30 June 2016

Cleanliness and hygiene was of a high standard throughout the hospital departments we visited and staff followed good practice guidance in relation to the control and prevention of infection.

Patients attending outpatients and diagnostic imaging departments received care and treatment that was evidence based and followed national guidance.

Care was delivered with care and compassion by competent staff who worked together as a multi-disciplinary team to provide a comprehensive service to patients.

Referral to treatment times across the trust for patients awaiting outpatient care was the same or better than the standard with the exception of September 2015.

Updated 30 June 2016

We found that the treatment centre at Withington hospital was delivering good surgical services to patients. Services were safe, with staff knowing the value of reporting incidents in improving patient safety. The assessment of risk was undertaken consistently and was managed by ensuring appropriate patient selection for procedures. There were very low rates of harm, for example, the treatment centre had no infections or pressure ulcers over the past year. The unit was well staffed, with one full-time vacancy. There was a system in place to manage the safe storage of medicines. The treatment centre was visibly clean and tidy in all areas. There was a safe system in place to ensure that all equipment was decontaminated in the appropriate manner and all equipment had been serviced and labelled.

The unit used National Institute for Clinical Excellence (NICE) guidelines to identify appropriate patients to be treated at the centre and adhered to trust policies when delivering care. The service was responsive to the needs of the population. It had considered the changing needs of its population by training members of staff to become dementia champions. It also adapted the way it delivered care to the needs of patients. If patients required extra support from relatives or carers during a procedure, staff supported this happening.

The interactions we observed between patients and staff were compassionate and caring. During interviews with staff, it was clear that staff gave considerable thought to how they could improve care to their patients and could give examples of where this had happened.

Staff morale was good and staff turnover was low. The leadership of the treatment centre was of high quality. However, there was no visible leadership beyond the level of the treatment centre level. Staff reported that they did not see senior clinical leaders or trust management at the centre. Staff also reported that they felt isolated from the rest of the trust and perceived there to be few development and learning opportunities for them.