Combine OpCo Limited, trading as The Hospital Group-Abbey Pines, operated three independent hospitals and approximately 20 clinics across the country, including The Hospital Group-Abbey Pines. Pines Hospital is a dedicated cosmetic surgery hospital providing facilities for The Hospital Group and another cosmetic surgery provider which owns the building and most of the equipment. The two providers have different clinical pathways and are different legal entities registered separately with CQC. We inspected and rated the services provided only by The Hospital Group-Abbey Pines, based at Pines Hospital.

Pines Hospital is a three storey hospital based in South Manchester. It had 22 inpatient beds across two wards (one ward was an overflow ward), two operating theatres, and recovery unit with four beds – these were based on the second floor. Some administrative functions were based on the first floor. The pre-operative consultation and pre-assessment outpatient clinics are based on the ground floors, as were the head office functions. The Hospital Group-Abbey Pines provided various cosmetic procedures, including breast augmentation, facial surgery, fat removal, abdominoplasty and other breast procedures, to patients aged 18 and over. In the Pines, The Hospital Group-Abbey Pines outpatient clinic provided pre-operative surgeon consultation, postoperative wound care, gastric band adjustments and dietician consultations.

The Hospital Group-Abbey Pines has service level and contractual agreements in place to secure provision of services, equipment, facilities and staff from the other cosmetic surgery provider co-located at Pines Hospital. This included a service level agreement to facilitate care of The Hospital Group-Abbey Pines patients by the responsible medical officer service.

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 all aspects of The Hospital Group-Abbey Pines services that were within our remit using our comprehensive methodology. We carried out an unannounced inspection on 26 September 2018.

The main service provided by this The Hospital Group-Abbey Pines at Pines 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

This is the first time that we have rated The Hospital Group–Abbey Pines. We rated it as good overall.

We rated The Hospital Group–Abbey Pines was good because:

• All staff had completed mandatory training and knew how to protect patients from harm or abuse.

• Staff understood their roles and responsibilities in relation to consent and the mental health act.

• Staff treated patients with care and compassion.

• There were high patient satisfaction scores.

• Staff supported and met the needs of individuals.

• Waiting times were managed effectively.

• There was a positive culture and staff engagement was good.

• There was a clear governance structure.

• We saw evidence of a comprehensive audit programme that was used to drive improvements and provide assurance.

  However, we also found the following issues that the service provider needs to improve:

• The Hospital Group-Abbey Pines did not monitor or report clinical outcomes effectively, nor was it taking sufficient steps to ensure it could submit data to the Breast and Cosmetic Implant Registry.

• There was a lack of a clear vision or set of values for the organisation.

• Due to the manual processes involved in monitoring and analysing incidents and complaints, there was a risk that trends could be missed.

• The Hospital Group-Abbey Pines had several policies that were beyond their review date.

  Following this inspection, we told the provider that it should make some improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

  Ellen Armistead

  Deputy Chief Inspector of Hospitals (North Region)