Archived: Dr Woolfson's Practice

Updated 18 July 2022

The service is provided by Dr Gerald Woolfson.

Dr Gerald Woolfson is registered to provide a service (Dr. Woolfson’s Practice) from the registered location address below:

3 The Mount

London

NW3 6SZ

The service website is: www.geraldwoolfson.co.uk

Dr. Woolfson’s Practice is registered to provide:

• Treatment of disease, disorder or injury

Dr. Woolfson’s Practice provides clinical psychiatric assessment, diagnosis and treatment for people who are experiencing a range of mental health problems. Dr. Woolfson provides second opinions for patients who require further assessments and diagnosis. The service offers different types of therapies such as psychotherapy and cognitive behavioural therapy.

The provider has two separate service lines: a clinical psychiatric assessment service and a medico-legal assessment service. The medico-legal service is not within CQC’s scope of registration; therefore, we did not inspect this part of the service.

Dr. Woolfson’s Practice was registered with the CQC in November 2021 and has not been inspected before. The service employed a consultant psychiatrist and a practice secretary. The consultant for this service was a sole practitioner. This meant they did not have a team of colleagues to provide support and oversight of their work. To mitigate the risks this could present, the consultant attended annual appraisals that included a review of their clinical practice.

Dr. Woolfson’s Practice was open three days per week and online consultations were planned in advance for those days. Opening days and times were not set.

How we inspected this service

During the inspection visit to the service, the inspection team:

• reviewed feedback from 18 separate patients
• spoke with the registered manager and the practice secretary
• reviewed five treatment records
• reviewed seven prescriptions and checked where prescription pads were stored and managed
• reviewed two staff employment records

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 18 July 2022

This service is rated as Inadequate overall.

The key questions are rated as:

Are services safe? – Inadequate

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Inadequate

We carried out a short notice announced comprehensive inspection at Dr. Woolfson’s Practice as part of our inspection programme. Dr. Woolfson’s Practice provides a consultant-led outpatient service that assesses, diagnoses and treats adults aged 18 and above who are experiencing a range of mental health problems. The service also provides medico-legal service which are not within the scope of registration, therefore we did not inspect or report on this.

The service is led by one consultant psychiatrist who is also 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 reviewed the provider’s feedback folder that included several patient comments ranging from 2020 to 2022. Comments and feedback were positive and described the doctor who led the service as being professional, kind and understanding.

Our key findings were:

• The provider had not ensured that medicines were prescribed and managed safely in accordance with the British National Formulary (BNF) and National Institute for Health and Care Excellence (NICE) guidance. For example, four patients had not received any physical health checks prior to the initiation of treatment, despite the doctor prescribing medicines that could cause physical health complications. The doctor had not always used the correct form when prescribing a Controlled Drug and did not have a robust system in place to send Controlled Drug prescriptions to patients.
• The service lacked an effective governance system to identify, monitor and address current and future risks including risks to patient safety. The doctor had not considered the associated risks of non-compliance with national prescribing guidelines and was not aware of the key organisations involved in ensuring medicines are prescribed and managed safely in the UK, such as the Controlled Drugs Accountable Officer (CDAO) and the Medicines & Healthcare products Regulatory Agency (MHRA). The lack of a system to review national guidance put patients at risk of preventable harm.
• The doctor who led the service had not been trained in vulnerable adults safeguarding training. At the time of our inspection, we raised this to the doctor to address immediately.
• The provider did not have a system in place to ensure that Disclosure and Barring Service (DBS) checks had been completed prior to employment commencing.

However,

• Staff treated patients with kindness, respect and compassion. The feedback from patients that used the service was positive. Patients were satisfied with the care and treatment received and felt the doctor listened to them.
• Patients could access care and treatment from the service within an appropriate timescale for their needs. The service was clear about what they could offer, and if they were unable to support a patient they would signpost to another service.

As a result of the concerns we identified we issued the provider with a Warning Notice under Section 29 of the Health and Social Care Act 2008. The provider had failed to comply with the relevant requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We require the provider to make the necessary improvements and be compliant with the regulation by 1 July 2022. You can see full details of the regulations not being met at the end of this report.

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

• The provider must ensure that medicines are prescribed and managed safely in accordance with the British National Formulary (BNF) and The National Institute for Health and Care Excellence (NICE) guidance.
• The provider must ensure that clinical staff receive the correct level of vulnerable adults safeguarding training.

The areas where the provider should make improvements are:

• The provider should ensure that Disclosure and Barring Service (DBS) checks are completed prior to employment commencing.

Jemima Burnage

Deputy Chief Inspector of Hospitals (Mental Health)