360 Health- London Bridge

Updated 30 December 2019

360 Health - London Bridge provides travel health services including vaccinations, medicines and advice on travel related issues to both adults and children travelling for business or leisure. It also provides services to corporate clients. Alongside it’s travel vaccines service, phlebotomy, visa medicals and wellness screens are also available. The service is a designated yellow fever vaccination centre. Services are provided on a fee-paying basis only. No NHS services are provided.

The service is operated by 360 Health, also known as London Vaccination Clinic. They own seven sites across London which are satellite sites, London Bridge being the main site.

The service is in a busy central Location, adjacent to a main London transport terminal. It is housed within a serviced office building which is shared with other businesses. The provider rents the space from a landlord. The treatment room is located on the ground floor with office space and bathroom facilities on the basement floor. The reception is manned by a receptionist employed by the building management from 9am to 6pm after which the service provides reception cover. The premises are not ideally suited to those with mobility difficulties due to the layout of the premises and lack of a lift. Patients with mobility concerns could be seen at one of the provider’s other sites which we were told were fully accessible.

Services are available between 9 am to 8 pm Monday to Friday and between 9 am and 5 pm on Saturdays. We were advised that opening hours were subject to seasonal changes. Information about opening times would be displayed on the service’s website.

The location is operated by the CQC registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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 clinical team consists of two nurses in addition to the co-founder and medical director who were a nurse and a doctor respectively. Both nurses were relatively new to the service but were well experienced in travel medicine. The service also used long-standing bank nursing staff when required. For busier periods. The administrative team is led by a director of operations and there is one senior administrator. Those staff who are required to register with a professional body were registered with a licence to practice.

The service is registered with the CQC to provide the regulated activity of treatment of disease, disorder or injury.

How we inspected this service

Before visiting, we reviewed a range of information we hold about the service and asked other organisations to share what they knew. During our visit we:

• Spoke with a range of clinical and non-clinical staff including the co-founder, medical director, lead nurse and the operations manager.

• Reviewed an anonymised sample of the personal care or treatment records of patients.

• Reviewed service policies, procedures and other relevant documentation.

• Inspected the premises and equipment used by the service.

• Reviewed CQC comment cards completed by service users and spoke with a patient.

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 30 December 2019

We carried out an announced comprehensive inspection at 360 Health-London Bridge on 11 November 2019. The service was previously inspected on 25 May 2018. In accordance with CQC policy at the time, this service was not rated following that inspection. We found whilst most of the standards were being met, the systems to manage risks at the service were not always effective and there was limited evidence of quality improvement. These issues impacted negatively on the overall standard of governance at the service. A Requirement Notice was made in relation to breaches of regulation 17 of the Health and Social Care Act 2008 (Regulate Activities) Regulations 2014. We also said the provider should formally document risk assessments and leadership roles within the practice policies. We checked these areas as part of this comprehensive inspection and found they had all been resolved.

360 Health-London Bridge is a travel clinic which provides a range of travel vaccinations, medical assessments and health screening offered on an appointment and a same-day, walk-in basis. The service is operated by 360 Health, also known as London Vaccination Clinic. They own seven sites across London which are satellite sites, London Bridge being the main site for the purposes of oversight, management and governance. We did not visit the other sites which operate at differing times of the day and year, depending on patient demand, some consisting of a single room.

The leadership team at the clinic includes the co-founder and chief executive officer who is a nurse prescriber and the medical director 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. There is also an operations director who manages the day to day running of the service.

Clinical services are provided by two nurses, one being the lead nurse, who are overseen by the co-founder and medical director.

Feedback we received through 21 comment cards completed by people who used the service were positive and a patient we spoke with. One commented about some difficulty finding the clinic but was positive about their experience of using the service.

Our key findings were :

• There was a system in place for acting on significant events.
• Risks associated with the premises and the delivery of care and treatment were well managed.
• There were arrangements in place to protect children and vulnerable adults from abuse.
• Care and treatment was provided in accordance with current guidelines.
• Patient feedback indicated that staff were compassionate, the care provided of a high standard and that it was easy to access appointments.
• The service had a system to receive and respond to complaints.
• There was a clear vision and strategy and staff spoke of an open and supportive culture. There was effective governance to ensure risks were addressed and patients were kept safe.

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