Cleveland Clinic Portland Place Outpatient Centre

Updated 28 February 2023

Portland Place Outpatient Centre is operated by Cleveland Clinic London Limited. The clinic has been registered with CQC since September 2021. The clinic offers GP services, diagnostic services, and outpatient services to both insured and self-paying private patients. Services are consultant led and are supported by registered nurses and health care assistants. The service does not offer any NHS funded services.

Portland Place Outpatient Centre has a diagnostic suite located on the ground floor that provides a range of services such as general X-ray imaging, interventional and diagnostic ultrasound, computerised tomography (CT) and magnetic resonance imaging (MRI). The service operates from Monday to Friday from 8am to 8pm and Saturdays from 8am to 2pm. The service treats patients who are 18 years old and above.

The outpatient department consists of 17 consulting rooms located over two floors. The service offers both in-person and remote consultations. Specialties include Heart and Vascular, Cardiology, Digestive Diseases, Colorectal Gastroenterology, Hepatobiliary, General Medicine, Gynaecology, Urology, Orthopaedics and Rheumatology. In the 12 months prior to our inspection the service held 34,676 outpatient appointments. The service operates from Monday to Friday from 8am to 8pm and Saturdays from 8am to 2pm. The service treats patients who are 18 years old and above.

The care of children is limited to the GP Service. GP services cover all family health needs for adults and children and, with a registered paediatric nurse available to support child specific services. The GP service was inspected by a GP specialist inspection team and has not been included in this report. A separate report has been produced for the GP service.

Portland Place Outpatient Centre is registered with the Care Quality Commission to provide the following regulated activities:

• Treatment of disease, disorder or injury
• Diagnostic and screening procedures
• Family planning service

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.

Updated 28 February 2023

This service is rated as Good overall.

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

We carried out an unannounced comprehensive inspection of the Portland Place Outpatient Centre, Cleveland Clinic London as part of our inspection programme. The Portland Place Outpatient Centre provides outpatient services; diagnostic services including radiology; and a GP service. The Portland Place Outpatient Centre has not previously been inspected.

This report focuses on our findings in relation to the GP service at Portland Place Outpatient Centre. The GP service is a primary care medical service, open to patients of any age.

Our key findings were:

• The service had clear systems in place to safeguard patients identified as being at risk of abuse or neglect. However, systems for checking parental authority were not consistently in place and were not formalised.
• Patients’ immediate and ongoing needs were fully assessed.
• The GPs were able to readily refer patients for further diagnostic testing and specialist consultation as required on the same site or through the provider’s nearby hospital service.
• Care records were generally written and managed in a way that kept patients safe. However, the GPs did not always clearly record the ‘safety netting’ advice provided to patients or clarify the presence or absence of ‘red flag’ symptoms (that is, symptoms that might indicate a more serious illness). Safety-netting refers to the advice given to a patient about the actions to take if their condition fails to improve or deteriorates after the consultation.
• Patients were treated with compassion, kindness, dignity and respect.
• We saw evidence of consistently positive feedback from patients using the GP service.
• The service actively sought and acted on feedback from patients using the GP service to improve the service.
• The service used information about care and treatment to make improvements and the GPs were actively involved in leading quality improvement activity.
• The service was accessible. Patients were able to consult with a GP within an appropriate timescale for their needs.
• Staff we spoke with understood the vision, values and strategy and their role in achieving them.
• The GP service was underpinned by clear systems of governance and processes for managing risk, issues and performance.

The areas where the provider should make improvements are:

• Introduce a consistent system to check that adults accompanying children to see a GP always have parental authority.
• Take steps to consistently record and audit ‘safety netting’ advice given to patients and any ‘red flag’ symptoms in the patient notes in line with General Medical Council guidelines.
• Take steps to ensure that staff, including non-clinical staff, who have GP patient-facing roles, are aware of the risks of sepsis and relevant protocols.
• Formalise a policy on the range of prescribed medicines where the patient’s NHS GP should be kept informed for safety reasons and the appropriate response if patients refuse consent to share this information with them.
• As the GP service develops, increase clinical improvement activity and obtain more focused patient feedback on the quality of clinical care.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services

Updated 28 February 2023

Portland Place Outpatient Centre has a diagnostic suite located on the ground floor that provides a range of services such as general X-ray imaging, interventional and diagnostic ultrasound, computerised tomography (CT) and magnetic resonance imaging (MRI). The service operates from Monday to Friday from 8am to 8pm and Saturdays from 8am to 2pm. The service treats patients who are 18 years old and above.

Updated 28 February 2023

The outpatient department consists of 17 consulting rooms located over two floors. The service offers both in-person and remote consultations. Specialties include Heart and Vascular, Cardiology, Digestive Diseases, Colorectal Gastroenterology, Hepatobiliary, General Medicine, Gynaecology, Urology, Orthopaedics and Rheumatology. In the 12 months prior to our inspection the service held 34,676 outpatient appointments. The service operates from Monday to Friday from 8am to 8pm and Saturdays from 8am to 2pm. The service treats patients who are 18 years old and above.