Trailfinders Travel Clinic

Updated 10 May 2022

Trailfinders Travel Clinic provides private travel health services including travel immunisations in the Royal Borough of Kensington and Chelsea in London. Services are provided to both adults and children. The address of the registered provider is Trailfinders Limited, 42-50 Earl Court Road, London, W8 6FT. Trailfinders Limited is registered with the Care Quality Commission to provide the regulated activity: Treatment of disease, disorder or injury at one location, 194 Kensington High Street W8 7RG.

Trailfinders Travel Clinic aims to provide a comprehensive travel vaccination and health advice service. Regulated services offered at Trailfinders Travel Clinic include travel health consultations and treatment. Treatments may include the dispensing of medicines and immunisations in relation to travel health. Trailfinders Travel Clinic has been operating for 36 years.

The service premises are leased, located within a Trailfinders Limited travel agency and accessed via stairs at lower ground floor level. The premises used by patients visiting the clinic consist of a patient waiting area, one consultation room and one patient toilet. The clinic also has use of a meeting room on the ground floor for patients with restricted mobility and access to a toilet with disabled facilities. Prior to our inspection the service had opened and closed in accordance with lockdown and travel restrictions during the Covid-19 pandemic and reopened fully in October 2021. The service is open for travel health consultations and treatment appointments Monday to Saturday from 9am to 5pm and appointments are approximately 30 minutes in duration. Appointments are pre-bookable, which the service is keeping under review considering patient's need for walk-in appointments and changing requirements and guidance relating to Covid-19.

The clinical lead doctor was in the process of applying to be 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 operations director for the provider is the CQC nominated individual. A nominated individual is a person who is registered with the CQC to supervise the management of the regulated activities and for ensuring the quality of the services provided.

The clinical staff team are one-part time clinical lead doctor, five part-time doctors, one full-time lead nurse prescriber, and five part-time nurses. The clinical team are supported by seven reception staff members and the operations director. The service is operated by one doctor or one nurse prescriber each day, with support from two reception staff.

The service average treatment of patients per annum had been significantly impacted by the Covid-19 pandemic and its wider effects on the travel industry. At the time of our inspection, the service estimated it had treated approximately 1,050 patients from the beginning of the year 2022.

How we inspected this service

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider.
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A site visit.

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 10 May 2022

This service is rated as Good overall. (Previous inspection 8 January 2019 – The service was not rated but was complaint with the relevant regulations).

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? – Outstanding

We carried out this inspection as part of our comprehensive inspection programme of independent health providers. The service is a private travel clinic located on Kensington High Street, London.

Our key findings were:

• The clinical staff leadership team were outstanding; staff had worked diligently and consistently since at least 2012 to drive positive, leading edge, and at scale improvements in the travel health sector.
• The service assessed patient need and delivered care in line with current legislation, and reviewed the effectiveness and appropriateness of the care provided.
• Clinical and non-clinical staff had been trained to provide them with the skills and knowledge to deliver effective travel health services.
• The service had systems to assess, monitor and manage risks to patient safety and there were reliable systems for appropriate and safe handling of medicines.
• The service organised and delivered services to meet patients’ needs and made changes as a result of incidents and patient feedback.
• The service treated patients with kindness, respect and dignity, and patient feedback was positive about the service.
• There was a clear leadership structure in place and staff felt supported by management.
• The service had effective oversight of the clinical care provided to patients.
• The service had a governance framework in place which supported the delivery of quality care. The service operated effective processes for identifying and managing issues and risks and improving performance.
• Without exception, staff described a working culture where they were supported to deliver excellence for patients using its services. Staff across all roles provided us with examples of their feedback to management that was utilised to continuously improve service delivery.

We saw the following examples of outstanding practice:

• Clinical staff worked passionately on their own resource and initiative and were also supported by the provider to facilitate improvements in travel health locally, nationally and at a global level. Examples include, authoring and reviewing best practice guidelines for the Royal College of Nursing (RCN), reporting to the UK government on protecting the health of travellers, undertaking research on the Ebola Virus in collaboration with global partners; and educating across a wide range of audiences and settings in the private and public sector such as the NHS, Universities, at National and International Conferences, and for an organisation set up to protect global workforces from health and security threats.

The areas where the provider should make improvements are:

• Review and evaluate recent improvements to assure that an adult accompanying a child has parental authority.
• Undertake a risk assessment to determine an appropriate duration between clinical staff enhanced DBS checks.

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