Archived: DMC Healthcare Limited

Updated 11 February 2021

DMC Healthcare Limited is an independent provider of a range of NHS services, including primary care GP practices and walk in centres, radiology reporting, endoscopy services and community dermatology services.

This review focused only on the community dermatology services.

At the time of our review the service was managed from DMC Healthcare’s corporate head office in London (35-37 Sylvan Grove, London SE15 1PD) and we only visited this location. Services were delivered from local healthcare sites including GP practices and community hospitals and a teledermatology service. Teledermatology involves sending digital photographs of the skin condition with the clinical history through the standard referral process. This can allow patients to receive a rapid opinion on diagnosis and management as an alternative to a face to face appointment.

The medical director is the registered manager and at the time of our review they were also the registered manager for seven other services for different providers. 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.

DMC Healthcare Limited holds contracts to provide consultant led community-based dermatology care and advice for tier one to three services, which does not include referral for suspected cancer. At the time of our inspection DMC Healthcare Limited had a total caseload of approximately 9,300 patients on their waiting lists. These contracts are to provide this service to NHS patients registered within the following CCGs.

• NHS Barking and Dagenham Clinical Commissioning Group
• NHS Redbridge Clinical Commissioning Group
• NHS Havering Clinical Commissioning Group
• NHS Southport and Formby Clinical Commissioning Group
• NHS South Sefton Clinical Commissioning Group
• NHS Lincolnshire East Lincolnshire Clinical Commissioning Group (now part of Lincolnshire Clinical Commissioning Group)
• NHS Leeds Clinical Commissioning Group
• NHS Wakefield Clinical Commissioning Group
• NHS Redditch and Bromsgrove (now part of Herefordshire and Worcester Clinical Commissioning Group)
• NHS Wyre Forest Clinical Commissioning Group (now part of Herefordshire and Worcester Clinical Commissioning Group)
• NHS South Worcester Clinical Commissioning Group (now part of Herefordshire and Worcester Clinical Commissioning Group)
• NHS East Riding of Yorkshire Clinical Commissioning Group
• NHS Brent Clinical Commissioning Group
• NHS Harrow Clinical Commissioning Group
• NHS Bexley Clinical Commissioning Group (now part of South East London Clinical Commissioning Group)

DMC Healthcare Limited is registered to provide the following regulated activities:

• Treatment of disease, disorder or injury
• Surgical procedures
• Diagnostic and screening procedures
• Family planning services

How we reviewed this service

We gathered information from the provider regarding their clinical audits and clinical governance and reviewed this prior to our review.

During the review we interviewed staff, which included the head office pharmacist, regional clinical lead, national clinical lead and the medical director. The interviews were carried out through video conferences or telephone calls. We also reviewed documents sent to us electronically by the provider.

Updated 11 February 2021

We carried out this announced focused review between 10 and 18 December 2020. The purpose of this review was to assess the providers compliance against the warning notice issued following our inspection of the service carried out between 30 July to 14 September 2020. The full report on this previous inspection can be found by selecting the ‘all reports’ link for DMC Healthcare Limited on our website at www.cqc.org.uk.

Due to the issues associated with the COVID-19 pandemic we undertook remote interviews and review of evidence that the provider submitted to us electronically.

At this review we found the service had made significant improvements with regard to the monitoring of certain patient groups prescribed a particular medicine to treat severe acne and was compliant with the warning notice issued we had issued following our last inspection.

Our key findings were:

• The new clinical governance structure which had just been implemented at the time of our last inspection was still in place, including the national and regional clinical lead roles, which were all part time roles. However, we found that the roles and responsibilities of the regional and national leads were not clearly defined or understood by all staff.
• The service had reviewed and updated their standard operating procedures (SOPs) with regard to prescribing and patient monitoring requirements for this particular medicine. The service was in the process of reviewing and introducing new systems and processes.
• We found that leaders had shared information about changes to policies and procedures with staff but there was no clear process for assurance that all staff including clinicians had read and understood the revised protocols.
• Leaders in the service were assuring themselves that the systems for prescribing and monitoring patients prescribed this medicine were operating correctly through audits.
• Review of this particular medicine was a standing agenda item on the two weekly clinical governance meeting agenda.

We are mindful of the impact of COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care