The Hair Dr, Leeds Private Hospital

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We assessed 5 quality statements for this key question. We looked for evidence that people had the best possible outcomes because their needs were assessed. We checked that people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

This is the first inspection for this service. This key question has been rated Good.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People told us they had a thorough pre-operative assessment which addressed their concerns. They were confident their individual needs had been appropriately assessed and were fully understood.

Staff told us assessments considered the persons’ health, care, wellbeing, and communication needs, to enable them to receive care or treatment which had the best possible outcomes. The service assessed people’s psychological wellbeing, during the initial consultation, managed expectations with people prior to procedure and had an exclusion criterion for people who presented with perceived flaws in their appearance.

The service monitored hair growth through before and after procedure photographs taken with people’s consent, which was in line with CPSA guidelines.

The service did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

The service had clinical policies in place to support the staff in delivering evidence-based care which were up to date, but some did not identify a date for review. Following this assessment, up to date policies were provided.

The service had implemented a programme of audits to monitor guidelines, which included health and safety, medical records, fire checklist and WHO checklist audit. However, the clinical lead said they needed to focus more on these audits to identify themes and trends, but we also noted that following requests for completed audits these were not all provided and therefore, we did not receive assurance that the policies were effective.

Leaders provided us with details as to how they used audit to measure clinical outcomes and compared them to national standards, but they did not provide us copies of the audits.

People said the service had made sure that everything was just right for them.

The service ensured evidence based best practice utilising guidelines from the Royal College of Surgeons, British Association of Plastic, Reconstructive and Aesthetic Surgeons, International Society of Hair Restoration Surgery, and the General Medical Council.

The service worked well across teams and services to support people. Staff made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People told us they felt involved in the planning of their care. They had received information explaining their procedure and what to expect throughout appointments with the service. They spoke positively about the professionalism of the team.

Clinical and non-clinical staff told us the team worked well together to provide care and treatment for people.

We observed staff and teams working together well whilst watching a procedure, and in the day to day running of the service.

Care and treatment was co-ordinated effectively among relevant staff. Hair transplants were completed by a GMC registered doctor who was assisted by a trained technician.

We did not look at Supporting people to live healthier lives during this assessment. There is no previous rating for the Effective key question so we cannot yet publish a score for this area.

The service routinely monitored people's care and treatment to continuously improve it. Staff ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

People we spoke to were able to express their wishes for the overall outcome they wished to achieve, and the surgeon would discuss this with them to ensure people's expectations could be managed. People informed us that hair lines were marked onto the skin with the surgeon's input and recommendations.

Leaders told us photographs of the procedure site was taken on the day of the surgery to capture the before and after look, in line with CPSA guidelines to monitor outcome of hair transplant procedure and hair growth.

Leaders told us they collected people's satisfaction from a numerous sources, including internet platforms. We asked for copies, but did not receive individual responses.

We reviewed consent forms which showed clear consent for photographs to be taken, and that people were aware of which outcomes were realistic, and which were not.

Aftercare instructions were carefully explained. The service contacted people the day after surgery to check how they were, and face-to-face appointment were arranged for 1 week after surgery. The surgeon saw them again at 3 and 6 months after surgery and captured the progress of the surgery via photographs.

Leaders told us the policies needed reviewing to ensure they were all up to date and appropriate for the service.

Leaders told us they reported infection control and people's outcomes nationally; however, we could find no evidence of this.

The practice undertook performance outcomes measuring themselves against other service providers and discussed these at the quarterly Medical Advisory Committee.

The service did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

People told us they received information about care and treatment in a way they understood and had appropriate support and time to make decisions. People told us consent was signed two to three weeks before the surgery and they were advised they could change their mind at any time.

Staff gained consent from people for their care and treatment in line with legislation and guidance. Consent forms were completed and signed in the 6 care records we reviewed.

Staff had received training in Mental Capacity Act as part of their safeguarding adults training and could describe their roles and responsibilities under the Mental Health Act.

Staff told us people were given information regarding the procedure and the hair transplant surgeon was available to respond to questions prior to signing consent and afterwards. Written consent was sought for photography, if the person declined, their pictures would not be used on the service's public platforms for advertising.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment. The service followed the Royal College of Surgeons Professional standards for Cosmetic surgery Guidance which included the "14 day cooling off" period.

When we reviewed 6 sets of patient notes we saw in 5 instances that the only reference to a cooling off period was regarding the credit agreement. We received one blank consent for surgery which detailed a cooling off period, but this was not the same form as the one used in the six sets of notes we reviewed. We also noted that a cooling off period was not mentioned in any of the patient's information leaflets.

Staff undertaking consent were able to tell us how capacity to consent was managed by the service and how it is relevant. The said capacity assessments formed part of all pre-op assessments. However, we did not see evidence of this within the 6 sets on notes we reviewed.