Dr Buyanovsky Ltd Also known as Dr Buyanovsky

Updated 12 April 2023

Dr Buyanovsky Ltd registered with the Care Quality Commission (CQC) as an organisation in May 2022 for the regulated activities of Treatment of Disease, Disorder or Injury, and Diagnostic & Screening Procedures in May 2022. The service is located near Baker Street tube station in London at office 9,121 Gloucester Place, London W1U 6JY. The service is open Monday to Friday 10am to 5pm and outside these hours if required in accordance with patients’ needs.

The provider has a sole and lead male doctor that is registered the General Medical Council (GMC) Specialist Register for General (internal) medicine. The lead doctor is not working within the NHS but may work at any grade in the NHS, including at consultant level in accordance with his registration.

The service provides private in person and home visiting services for adults and children over 5 years of age and over 90% are adults. Services include general medical check-ups, blood tests, electrocardiograms (ECGs), management of long-term conditions including hypertension (high blood pressure) and diabetes, and sexual health screening with referrals to secondary and specialist care where needed. The lead service does not offer surgical procedures, female pelvic examinations, cervical screening, obstetric care or vaccinations.

The service receives patients by word-of-mouth recommendation only and the lead doctor sees patients in person wherever possible. The provider’s website is under construction but shows the lead doctor’s mobile phone number where patients can access him directly. The lead doctor does not see walk in patients or more than a maximum of seven patients per day (except in an emergency), to allow time for management the service. The provider does not employ any staff but a full-time female practice manager with a clinical background was due commence employment on 14 March 2023, this was slightly delayed due to personal circumstances.

The lead doctor is the CQC registered manager and nominated individual for the provider. 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.

How we inspected this service

Before visiting, we reviewed a range of information we hold about the service and asked them to send us some pre-inspection information which we reviewed.

During our inspection we:

• Gathered information through interviews with the lead doctor on site and remotely.
• Completed clinical records reviews and discussed findings with the provider.
• Reviewed patient records to identify issues and clarify actions taken by the provider.
• Requested evidence from the provider.
• Undertook site visits.

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 12 April 2023

This service is rated as Requires improvement overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Inadequate

We carried out an announced comprehensive inspection at Dr Buyanovsky Ltd as part of our inspection programme and to provide a rating for the service. The service provides online and in-person General Practice (GP) consultations for adults and children including travel immunisations.

Our key findings were:

• The practice did not always provide care in a way that kept patients safe and protected them from avoidable harm. We found no evidence of unsafe patient care or patient harm but identified concerns including management of safety alerts and a lack of medicines and equipment for the event of a medical emergency.
• Risks to patients were not always assessed, monitored or managed effectively. This included clinical record keeping, prescriptions management, and chaperoning.
• Records we inspected indicated patients received effective care and treatment that met their needs, but records were incomplete including to ensure appropriate referrals and follow up. There were no arrangements in place to ensure or improve clinical governance or the quality of clinical care.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs.
• The provider did not have appropriate insight or capacity to lead, manage and promote the delivery of sustainable high-quality care. The provider recognised a need to improve and immediately began to increase its capacity including with additional staffing and external resource.

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

• Ensure that care and treatment is provided in a safe way.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services