Updated 27 December 2019
The Saxon Clinic is operated by BMI Healthcare Limited. The hospital/service opened in 1985. It is a private hospital in Milton Keynes, Buckinghamshire. The hospital primarily serves the communities of Buckinghamshire. It also accepts patient referrals from outside this area.
The hospital has had a registered manager in post since 2013.
Updated 27 December 2019
The Saxon Clinic is operated by BMI Healthcare Limited. The hospital has 33 beds. Facilities include two operating theatres, endoscopy services, 12 outpatient consulting rooms and diagnostic facilities.
The hospital provides surgery, medical care, services for children and young people, and outpatients and diagnostic imaging for patients, either as outpatient appointments or inpatient admissions. The majority of patients are admitted for day case surgery, however, there is a portion of patients who require longer inpatient stays after more complex surgery. Specialities include orthopaedic surgery, urology, gastroenterology and general surgery. We inspected surgery, medicine, outpatients, diagnostic imaging and services for children and young people.
We inspected this service using our comprehensive inspection methodology. We carried out the short notice announced inspection on the 17 and 18 September 2019.
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 service level.
Services we rate
We last inspected this provider in September 2016 when we rated it as requires improvement.
Our rating of this hospital improved. We rated it as Good overall.
We found the following areas of good practice:
Staff were aware of their roles and responsibilities and completed training appropriate to their roles. This included safeguarding training. There was a robust process in place to ensure all staff, including consultants had completed training.
The hospital was visibly clean and tidy and there was evidence of a maintenance programme to ensure facilities were of a good standard.
There were enough numbers of staff to ensure that services ran smoothly. Skill mix was appropriate to clinical need and bank and agency staff were fully inducted to the service. Where possible, the same staff were used to improve consistency of care.
Services used safe processes for the storage, prescribing and administration of medicines and radiation.
Any incidents were reported and taken seriously. Staff investigated incidents and took steps to prevent reoccurrence and promote learning across the hospital.
The hospital used national guidance and policies to inform policies and promote best practice.
Patients were assessed and provided with nutrition and hydration across all services and staff ensured that patients pain was well managed. Fasting guidelines were in place to ensure patients were not starved for long periods whilst waiting for operations.
There were processes in place to ensure that patient outcomes were measured and staffs ability to complete their roles were continually assessed and monitored by leads. Teams worked collaboratively to ensure that services ran smoothly and ensure that patient pathways were robust.
Services were provided across six or seven days, although urgent services were provided 24 hours per day.
Patients were supported to make decisions about their care and were given advice on making health choices.
Patients, including adults and children were cared for respectfully and with kindness and compassion.
Services were planned to provide care in a way that met patients’ needs taking into consideration individuals needs and preferences. People could access services at times to suit them and admit, treat and discharge times were in line with national guidance.
Staff took any concerns or complaints seriously, investigating them and ensuring any learning was shared across the organisation.
Leaders were visible, approachable and had the right skills and abilities to manage the services. There was a clear vision and staff were involved with developing their local strategy and clinical areas.
Staff felt supported, valued and were proud to work at the hospital. Senior managers were engaging and collaborated with external partners.
There were robust processes in place to ensure effective governance and risk management. Staff used performance data to make decisions and improvements.
Staff development was encouraged, and services were continually learning and improving. Leaders promoted innovation.
However, we also found the following issues that the service provider needs to improve:
Within Surgery:
Non-clinical staff appraisal rate was below the hospital target.
Complaints were not responded to in line with the timeline outlined in the policy.
Consultants rarely attended governance meetings.
The hospital did not have a senior nurse at director of clinical services or ward manager position, who had oversight of the hospital activity.
Within Medicine:
Within endoscopy, the service environment did not always follow national guidance.
Endoscopy services were not utilising the full WHO five steps to safer surgery checklist.
Within endoscopy staff did not always address risk in a timely way. There was no standardised system in place to monitor and escalate deteriorating patients.
Endoscopy services did not always follow best practice guidance when gaining patients’ consent.
Within Children and Young People:
Within diagnostic imaging:
Not all radiation protection equipment was clearly labelled as being checked annually.
Some staff felt unsupported by the wider BMI corporate team.
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 requirements notice(s) that affected medicine. Details are at the end of the report.
Name of signatory
Heidi Smoult- Deputy Chief Inspector of Hospitals
Updated 27 December 2019
Medical care services were a small proportion of hospital activity. The main service was surgery. Where arrangements were the same, we have reported findings in the surgery section.
We rated this service as good for effective, caring, responsive and well led. Although we rated safe as requires improvement.
Updated 27 December 2019
Children and young people’s services were a small proportion of hospital activity. The main service was surgery. Where arrangements were the same, we have reported findings in the surgery section.
We rated this service as good because it was safe, effective, caring, responsive and well led.
Updated 27 December 2019
We rated this service as good because it was safe, effective, caring, responsive, and well led.
Updated 27 December 2019
We rated this service as good because it was safe, effective, caring, responsive, and well led.
Updated 27 December 2019
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.
We rated this service as good for safe, effective, caring and responsive. We rated well-led as requires improvement.