Archived: The Private Clinic Limited - Bristol

Our summary of our key findings from our inspection are as follows;

• Consent forms for some procedures were not clearly labelled and contained information about all possible treatments which was not always edited to reflect which treatment a patient was undergoing.
• Safety cannulas were not being used, and a sharps injury had been reported as an adverse incident.
• The service did not routinely carry out venous thromboembolism (VTE) risk assessments for all patients undergoing surgical procedures.
• Resuscitation equipment was not stored in a  trolley with tamper evident tags.
• Medical gases were stored in a store room but did not have any warning signs on doors to the room.
• Patient records were not always complete or legible and surgeon’s summary letters were not included in patient notes.
• Risks associated with procedures were not always recorded, or were illegible.
• Staff were not up to date with some training and records were not up to date.
• Psychological assessments were not recorded in patient notes.
• There were no prescription audits which checked the quality of the prescriptions filled out.
• The clinic monitored some clinical outcomes from surgical procedures including ultrasound assessments of treatment effectiveness for  varicose vein treatments.
• There was no audit of consent forms.
• One treatment room was visible from the road, meaning consultations could be viewed from outside.
• Clinical staff were unaware of translation or interpretation services.
• Most staff were aware of the values for the clinic, however some staff were unaware of the vision for the clinic.
• Risk registers were held centrally and were accessible to all clinics, however, some staff were unsure how to access them.
• The clinic was not using coding for its surgical procedures.
• One doctor working under practising privileges at all clinic locations was not on the Voluntary General Medical Council specialist register, which was a condition of the Provider's granting of practising privileges.

However;

• Staff had a clear understanding of local safeguarding procedures which were clearly displayed.
• Safety data was collected centrally by the provider to look for trends and was shared with clinic managers through a structured governance framework.
• All staff had received a minimum of basic life support training.
• There was a detailed infection prevention control audit which showed good compliance.
• Agency nurses and anaesthetic staff had thorough inductions, and provided evidence of their clinical practice to the clinic.
• The clinic followed National Institute for Clinical Excellence (NICE) guidance for varicose veins treatment.
• The clinic had received good patient feedback and had started collecting Friends and Family Test data.
• The clinic benchmarked patient satisfaction data against other clinics within the business.
• Staff had undertaken specialist training to help enhance the aftercare given to patients.
• There was a thorough process for granting practicing privileges for doctors working at the Private Clinic Bristol, and the clinic held evidence of competencies on site.
• Staff were compassionate in their approach to patient’s needs.
• Patients could have multiple follow-up appointments and all patients were given a 24 hour emergency phone number.
• Staff treated anxious patients with kindness and compassion.
• Alternative treatment options were discussed with patients.
• Patients waited four to six weeks for their procedures.
• Operating lists had been adjusted to minimise delays following patient feedback.
• The clinic took account of patients’ individual needs including dietary requirements.
• The clinic was a member of the Independent Healthcare Sector Complaints Adjudication Service (ISCAS) and the Centre for Effective Dispute Resolution (CEDR).
• Leaders were very visible and approachable.
• The registered manager had a virtual forum for help and advice from their peers in other clinics.
• Doctor’s levels of indemnity insurance and skills were monitored both in clinic and centrally using a database.
• There was evidence of improvements made as a result of infection, prevention control audits.
• The clinic followed General Medical Council guidance on the marketing of cosmetic procedures.