This was the first comprehensive inspection of Highgate Hospital, which was part of the CQC’s ongoing programme of comprehensive, independent healthcare acute hospital inspections.

Highgate Hospital is operated by Aspen Healthcare Group. The hospital provides surgery, medical care, and outpatients and diagnostic imaging. We also inspected the GP service that operates at this location and reported it as part of outpatients and diagnostic imaging service. Services are provided to insured, self-paying private patients and NHS patients via referrals from GPs, consultants and local contract systems.

The hospital has 43 en-suite single rooms mainly used for patients undergoing day case procedures. Facilities include four operating theatres, an endoscopy suite, seven bedded recovery bay, two-bed enhanced care unit, eleven consulting rooms and two treatment rooms. Other facilities include phlebotomy, pharmacy, X-ray, complex diagnostic investigations such as magnetic resonance imaging (MRI) and computerised tomography (CT) and other outpatient and diagnostic facilities.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 6, 7, 8 and 12 December 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.

Overall, we rated Highgate Hospital as good. We found surgery, medical care, outpatients and diagnostic imaging to be good, with well led rated as outstanding. We inspected but did not rate the key question of effective in outpatient and diagnostic imaging services.

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 surgical core service.

We rated this hospital as good overall.

• The hospital put a strong emphasis on providing safe, effective and quality care for patients and launched a number of initiatives to support staff in providing safe care. There was a good incident reporting culture, with a robust investigation and learning from incidents process.

• The hospital monitored patient safety on a day-to-day basis. Patients were appropriately risk assessed and their condition was monitored throughout their stay. There were appropriate procedures and protocols for responding to any deteriorating condition.

• There were effective and well embedded infection control procedures in place.

• Staffing levels and skills mix were planned using an acuity tool and there were enough staff on duty on every shift to ensure patient received safe care.

• Medicines were stored and managed appropriately.

• Treatment was always consultant led and used evidence based best practice from the World Health Organisation (WHO), the National Institute for Health and Care Excellence (NICE) and the Royal College guidelines. Most outcomes for patients were within the expected range.

• Staff were supported with opportunities for further professional development and underwent competency based assessment prior to working independently.

• Feedback from patients who use the service was consistently positive and people received care at the service without delay. The hospital understood the needs of the local population and services were planned to meet those needs.

• There was good multi-disciplinary working when managing patients with co-morbidities.

• Complaints were investigated within appropriate timescales, in line with the hospital policy and lessons were shared with staff.

• There was a clear statement of vision and values, driven by safety and quality. The hospital had a well defined strategy underpinned by the vision and values.

• The MAC was well represented and led on discussing and developing practice and ensuring patient safety.

• The hospital had a clear and robust governance structure. Governance focused on improving patient safety, learning from patients’ experience, improving clinical effectiveness and patient experience.

• We found the culture within the hospital to be one of openness, transparency and willingness to learn and improve. Staff reported they were happy and proud to work for the hospital.

Professor Edward Baker

Deputy Chief Inspector of Hospitals (area of responsibility)