The Care Quality Commission
  • Doctor
  • Independent doctor

Medical Express Clinic

Overall: Good read more about inspection ratings

117A Harley Street, London, W1G 6AT (020) 7499 1991

Provided and run by:
Medical Express (London) Limited

All Inspections

30 March 2022

During a routine inspection

This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced desk-based focus review of Medical Express Clinic on 29 April 2021. This inspection was not rated but we identified a breach in regulation relating to Regulation 12 of the Health and Social Care Act (Regulated Activities) 2014. The full report for the April 2021 inspection can be found by selecting the ‘all reports’ link for Medical conducted as part of our inspection programme of independent health providers.

This inspection was a full comprehensive inspection carried out on 30 March 2022 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach of regulation identified during the April 2021 desk review of the service.

Our key findings were:

  • The service had systems in place which kept patients safe. These included checks on patients attending the service and risk assessments conducted to ensure staff and patients were safe whilst attending the centre.
  • Staff at the service had the skills and knowledge to provide effective care, but there was evidence that not all patient needs had been assessed.
  • The service obtained consent to care and treatment in line with legislation and guidance, but this was not documented.
  • Feedback on the service revealed high levels of patient satisfaction.
  • Provision of services at the clinic considered patient demand and included timely access appointments which included face-to-face, telephone and video consultations.
  • There was a focus on innovative, learning and improvement.

The areas where the service must make improvements:-

  • Ensure that care and treatment is provided in a safe way.

The areas where the service should make improvements: -

  • Ensure that up to date information is held on staff files (including performers checks).

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

29 April 2021

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Medical Express Clinic on 4 October 2018. The service was not rated but we found that it was not providing safe care in accordance with the relevant regulations. The full comprehensive report on the 4 October 2018 inspection can be found by selecting the ‘all reports’ link for Medical Express Clinic on our website at www.cqc.org.uk

This inspection was a desk-based review carried out on 29 April 2021 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in Regulations that we identified in our previous inspection on 4 October 2018. This report covers our findings in relation to those requirements and additional improvements made since our last inspection.

CQC inspected the service on 4 October 2018 and asked the provider to make improvements regarding providing safe care and treatment. We checked these areas as part of this focused inspection and found some of this had been resolved; however, there were areas where the provider did not provide safe care and treatment.

Medical Express Clinic provides an independent doctors consultation service from a single clinic in the Harley Street area of West London. Patients can book appointments or attend on a walk-in basis. The service provides onward referral to diagnostic and specialist services as appropriate. The service treats both children and adults. It typically treats between 200 and 500 patients per month.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some general exemptions from Regulation by CQC which relate to types of service and these are set out in Schedule 2 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At Medical Express Clinic, some services are provided to patients under arrangements made by their employer. These types of arrangements are exempt by law from CQC regulation and we did not include these within the scope of our inspection.

One of the GPs at the service 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 is registered to provide the regulated activities of diagnostic and screening services; treatment for disease, disorder or injury and surgical procedures.

We did not receive any patient feedback as part of this inspection.

Our key findings were:

  • The clinic now had a system in place to check parental authority.
  • The clinic had improved security arrangements in relation to the single entrance shared with other providers.
  • The system to communicate patients test results was now fully encrypted to ensure confidentiality.
  • The clinic now had a digital translator which could detect spoken languages and effectively translate them into a variety of different languages.
  • The clinic created feedback questionnaires at the clinic and invited patients to submit reviews on Trustpilot and Google, or via email when their services were complete.
  • There was now written evidence provided on the arrangements of substance misuse prescribing in the clinic. However, further action was required to make this clear on the service website.
  • We saw some evidence of clinical audit. However this was limited in scope and related to the prescribing of controlled drugs.
  • Relevant patient safety alerts had not been identified or acted on by the service.
  • The service was offering yellow fever vaccinations without being registered with the appropriate body.

The areas where the provider must make improvements as they are in breach of regulations are:

  • Ensure care and treatment is provided in a safe way to patients.

(Please see the specific details on action required at the end of this report).

In addition the provider should:

  • Review its quality improvement activity, in particular the scope to increase its use of clinical audit to drive improvement.
  • Take action to ensure substance misuse arrangements at the service are recorded clearly on the service website.

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

4 October 2018

During a routine inspection

We carried out an announced comprehensive inspection on 4 October 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Medical Express Clinic provides an independent doctors consultation service from a single clinic in the Harley Street area of West London. Patients can book appointments or attend on a walk-in basis. The service provides onward referral to diagnostic and specialist services as appropriate. The service treats both children and adults. It typically treats between 200 and 500 patients per month.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some general exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At Medical Express Clinic, some services are provided to patients under arrangements made by their employer. These types of arrangements are exempt by law from CQC regulation and we did not include these within the scope of our inspection.

One of the GPs at the clinic 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.

We received 31 completed comment cards completed by patients in the days leading up to the inspection. These were wholly positive and described the service as accessible, the quality of care as excellent, and the staff as kind, patient and professional.

The service is registered to provide the regulated activities of: diagnostic and screening services; treatment for disease, disorder or injury and, surgical procedures.

Our key findings were:

  • There was a vision to provide a competitive, personalised service with a strong focus on preventive care. However quality improvement activity was more limited.
  • The clinicians were aware of current evidence-based guidance and had the skills and knowledge to deliver effective care and treatment.
  • Patients were able to access the service in a timely way. Staff were caring.
  • The provider had some systems in place to protect people from avoidable harm and abuse. It had not appropriately assessed all risks however.
  • The provider had systems in place to record, monitor, analyse and share learning from significant events. Systems to act and learn from safety alerts were under-developed.
  • The service had arrangements in place to respond to medical emergencies.

We identified regulations that were not being met and the provider must:

  • Ensure care and treatment is provided in a safe way to patients.

You can see full details of the regulation not being met at the end of this report.

There were areas where the provider could make improvements and should :

  • Review its quality improvement activity, in particular the scope to increase its use of clinical audit to drive improvement.
  • Review the systems in place for supporting patients whose first language is not English.
  • Review the systems in place to obtain useful feedback from patients.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

During a check to make sure that the improvements required had been made

At our previous inspection in June 2013 we found the provider had not updated infection prevention and control policies to reflect current guidance, had not undertaken infection control audits and clinical waste was not stored securely. The provider was required to take action.

The provider has demonstrated that infection control policies have been updated. An audit of infection prevention and control showed that clinical waste was safely stored and there were arrangements in place to monitor the standard of cleaning.

3 June 2013

During a routine inspection

People told us they were happy with the service and staff. They described staff as "very nice" and "friendly". They told us staff asked their permission before undertaking an examination. They told us they had also signed a consent form. People said they were provided with information about treatment and tests they needed to have done.

People said the clinic was clean but also told us they thought it would be more clinical "like a hospital". We found the provider had not updated infection prevention and control policies and procedures in accordance with the latest guidance. Staff did follow general precautions to prevent the spread of infection.

The provider had safe and effective recruitment processes in place to ensure staff were fit and able to undertake their role. We saw records were stored securely and people's medical records were readily available and were fit for purpose.

22 September 2011

During a routine inspection

We were unable to speak with people who use the service about this outcome on this occasion. However, information leaflets and patients' guides are available and given to people to enable them make informed decisions about their care and treatment. Individual records are kept for each patient which show that patients experience safe and appropriate care.