Archived: Brixton Clinic

Updated 19 December 2019

The Brixton Clinic is a clinic which provides circumcisions only, and is based in clinical rooms which are part of a pharmacy, based at 290 Brixton Road, London, SW9 6AG. It is located in the London Borough of Lambeth and provides solely private health services. The services offered were faith and non-faith based cultural circumcision services for all age groups. However, 99% of the patients of the service were under one year old. The patients seen at the practice are often seen for single treatments and as such the clinic does not keep a patient list. The service is open on Saturday mornings only, and approximately 100-120 patients utilise the service each year. At the time of the inspection the service was not operating while the owner of the building was making renovations and was due to re-open in the next month.

The service’s doctor is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The service had no employees other than the registered manager.

During the inspection we utilised a number of methods to support our judgement of the services provided. For example, we asked people using the service to record their views on comment cards, interviewed staff, and reviewed documents relating to the service/clinic.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 19 December 2019

This service is rated as Good overall. We had previously carried out an announced comprehensive inspection on 24 January 2018. At that time the service was judged to be meeting the standards for providing effective, caring, responsive and well led care and treatment and not providing a safe service. We carried out a further inspection on 6 April 2019. At that inspection we rated the service as requires improvement overall and for the safe and effective key questions, and good for caring, responsive and well led. At that inspection, warning notices were issued for the following:

• The service undertook ID checks for patients when they attended clinics. Mobile telephone numbers were recorded, but not the patient’s address. As a consequence of this when the service needed to make a safeguarding referral where it appeared that a circumcision had been badly attempted previously elsewhere, the service was not able to make the referral. The doctor did not also consider that such a referral was required.
• The service had a protocol that both parents would need to sign consent. However, in one case we noted that only a single parent had signed the consent form. The doctor said that they would have contacted the other parent, but there was no record of this.
• The doctor had not undertaken the requisite training in paediatric life support.

We also said that the service should:

• Develop a quality improvement program.
• Undertake proactive patient surveys.
• Provide further safety netting information in post-operative checklists that are given to patients.
• Implement more regular reviews of policies.

We carried out an announced comprehensive inspection at Brixton Clinic on 23 November 2019. Following this inspection the key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

At this inspection we found that the practice had addressed all of the issued from the previous inspections.

We found that:

• The service provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The service organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

The areas where the provider should make improvements are:

• Ensure that the website contains accurate service information.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care