Archived: London Centre for Aesthetic Surgery

Updated 11 January 2023

The London Centre for Aesthetic Surgery is operated by ‘London Centre for Aesthetic Surgery’ and is a small independent clinic, which has been registered since April 2002. The clinic provides cosmetic surgery services for private patients over the age of 18 years. Cosmetic procedures were carried out under local anaesthetic or conscious sedation with an anaesthetist present.

Care was delivered by the provider, a doctor supported by anaesthetists who operated under practising privileges. Practising privileges are a well-established system of checks and agreements, whereby doctors can practise in hospitals without being directly employed by them. The service employed one nurse on a zero hours contract and used agency nursing staff as required.

Patients are admitted for planned day case surgical procedures. The service does not provide overnight accommodation. Facilities include one treatment room, two recovery rooms and two consultation rooms.

The registered manager is the owner of the service. The service is registered to provide the following regulated activities;

• Diagnostic and screening procedures
• Surgical procedures
• Treatment of disease, disorder or injury

The clinic also offers cosmetic procedures such as dermal fillers, fat harvest and fat injections. We did not inspect these services as they are outside of the scope of CQC registration.

Following our comprehensive inspection in November 2022, the service was rated inadequate and we suspended the registration of the provider for 8 weeks.

I am placing the service into special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate overall or for any key question or core service, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.

Updated 11 January 2023

We rated the service as inadequate because:

• Managers did not make sure staff were competent. The service did not have processes to monitor the professional registration of the bank nurse working in the service. They did not have assurance of checks in place for agency nurses used to support the delivery of services as they did not keep records of agency usage. They did not have processes in place to provide assurance that staff had up to date training in key skills, understood how to protect patients from abuse, and managed safety well.
• The service did not control infection risk well. Processes for checking medicines and emergency equipment were not regularly carried out. A significant amount of medicines stored in the treatment room had expired and medicines requiring refrigeration were stored at room temperature. The controlled drugs accountable officer had not received training for this role. Controlled drug entries in the register were not always recorded in line with required standards of the controlled drug regulations.
• Risks to patients were apparent in relation to poor maintenance and availability of clinical equipment, the presence of expired single use clinical equipment and environmental risks that had not been sufficiently assessed or mitigated. There was limited evidence the service managed safety incidents well and learned lessons from them due to limited reporting of events and learning opportunities.
• Consent processes did not include evidence of a cooling off period when patients were making decisions about cosmetic surgery. There was little evidence of recognised national guidance informing clinical protocols within the service. The provider had no processes to collect performance measures and supply these to the Private Healthcare Information Network (PHIN).
• Leaders did not have the necessary knowledge, skills or abilities to run the service. Leaders did not operate effective governance processes throughout the service. Staff did not use systems to manage performance effectively. They did not identify, review or manage risks and issues effectively.

However:

• People could access the service when they needed it and did not have to wait too long for treatment. The service planned and took account of patients’ individual needs. Staff were focused on the needs of patients receiving care.
• The service engaged well with patients and made it easy for them to give feedback.

Updated 11 January 2023

We rated the service as inadequate. See the summary above for details.