Archived: Nippon Club North Clinic

Updated 2 September 2019

Nippon Club North Clinic is located within the Hospital of St John and St Elizabeth in the St John’s Wood area of west London. The clinic provides a primary care service for Japanese patients. The service offers primary care consultations including cervical screening, childhood immunisations and travel health (including the yellow fever vaccination). It also offers some in-house diagnostic testing, for example, endoscopy.

The clinic’s patient population largely comprises working age adults and their families who have moved to London from Japan. All current staff members speak Japanese and are fluent in English.

The clinic is open Monday to Friday from 9am to 7pm; Saturday from 9am to 5pm and Sunday from 9.30am to 12.30pm. The clinic operates with more restricted consultation hours in early August over the holiday period but the telephone line remains open as usual. Appointments are available with a doctor or a nurse.

The staff team includes three doctors seconded on a fixed term basis as part of a rolling secondment programme with a Japanese university hospital; three permanent nurses and permanent administrative and reception staff. At the time of the inspection Nippon Club's secretary general was the acting manager for the service.

The clinic is located within a modern, purpose-built hospital facility. The consultation rooms and shared waiting area are accessible by lift or stairs and the clinic is signposted within the hospital.

We carried out this inspection on 28 June 2019. The inspection team comprised one CQC inspector and a GP specialist advisor. The team was accompanied by an interpreter.

Before visiting, we reviewed a range of information we hold about the service and asked the

provider to send us some information about the service which we also reviewed.

During our visit we:

• Spoke with the staff who were present, including the service manager, two doctors on duty, one nurse and one receptionist.
• Reviewed documentary evidence relating to the service and inspected the facilities, equipment and security arrangements.
• Reviewed several patient records with the doctor. We needed to do this to understand how the service assessed and documented patients’ needs, consent and any treatment required.
• We spoke with patients attending the clinic on the day of the inspection and reviewed comment cards completed by patients attending the clinic in advance of the inspection. In total, ten patients provided feedback.

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 formed the framework for the areas we looked at during the inspection.

Updated 2 September 2019

This service is rated as Good overall . (Previous inspection July 2018 was not rated)

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 announced comprehensive inspection at Nippon Club North Clinic on 28 June 2019 as part of our inspection programme. The inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 so that an overall rating could be given. At this inspection we also followed up a breach of regulation 17 Good governance which was identified at our previous inspection on 12 July 2018.

Nippon Club North Clinic is located within the Hospital of St John and St Elizabeth in St John’s Wood in West London. The clinic provides a primary care service for Japanese patients. The doctors are restricted by the terms of their licence to practice in the UK and must only provide care to Japanese nationals.

The secretary general of Nippon Club Limited is the acting manager for the service. The service does not currently have a registered manager for the location but this is in process. (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.)

We received comment cards completed by patients in the days leading up to the inspection and interviewed patients on the day of the inspection. In total, ten patients contributed their views which were positive about the service and described the service as kind and caring. Several patients commented that they found it very helpful to be able to access a Japanese-speaking service.

Nippon Club North Clinic is registered to provide the regulated activities of diagnostic and screening services; and, treatment of disease, disorder or injury.

Our key findings were:

• Systems were in place to protect people from avoidable harm and abuse.
• When mistakes occurred, lessons were learned and action was taken to minimise the potential for recurrence. Staff understood their responsibilities under the duty of candour.
• Staff were aware of current evidence-based guidance.

• Staff were qualified and had the skills, experience and knowledge to deliver effective care and treatment.
• Patient feedback indicated that patients were very positive about the service.
• The service was accessible to patients including outside normal working and school hours.
• Information about services and how to complain was available.
• There was clear leadership, staff felt supported and the staff team worked well together.

• There was a vision to provide a high quality, culturally appropriate service for Japanese patients living in London.
• The service had systems in place to monitor and improve the quality of service provision.
• There was scope to increase the scope and impact of clinical quality improvement activity.

The areas where the provider should make improvements are:

• Review and assess the training needs of administrative staff, particularly those with face to face contact with patients, in relation to sepsis and other ‘red flag’ symptoms.
• Review the scope to improve evidence-based prescribing of antibiotics.
• Review the quality improvement programme with a view to increasing the scope and impact of clinical audit and other improvement work.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care