Archived: Elms Medical Practice

Elms Medical Practice is operated by STAHMIS Ltd. The service is consultant-led and provides diagnostic imaging services (ultrasound scans) to NHS patients who attend GP practices within St. Albans, Harpenden, and the surrounding areas. The aim of the service is to see patients within their local community to prevent them from waiting for an NHS hospital appointment.

We inspected this service using our comprehensive inspection methodology. We carried out an announced inspection on 8 October 2018.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

The main service provided by Elms Medical Practice is diagnostic ultrasound scans.

Services we rate

We have not previously inspected this service. At this inspection in October 2018, we rated the service as good overall.

We found the following areas of good practice:

• Staff were caring, kind and engaged well with patients.

• Services were planned in a way that met the needs of patients and the local community. Patients were offered a choice of appointments in three locations within their local community.

• Staff recognised incidents and knew how to report them. All incidents were investigated and lessons learned were shared across the team.

• Managers promoted a positive culture that supported and valued staff. Staff confirmed they felt respected and valued.

• The service had arrangements in place to manage risks to patients. Patient referrals were screened against set criteria, which had been shared with local GPs.

• Staff understood their responsibilities regarding consent, and consent was undertaken in line with national guidance and the service’s consent policy.

However, we found areas of practice that the service needed to improve:

• There was no evidence that peer review audits of the ultrasound images and reports were undertaken, as recommended by the British Medical Ultrasound Society (BMUS).

• Personnel files for the consultant radiologists were incomplete, which meant we could not be assured that the radiologists were suitable and competent for their role. This was addressed by the service following our inspection.

• There was no formal arrangement in place to ensure STAHMIS Ltd was informed of any performance problems or other concerns relating to a consultant’s practice. Following our inspection, the service improved their management of practising privileges.

• The service did not have a robust governance framework. Clinical governance and director meetings were not held consistently and the service did not review and share audit results.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with one requirement notice. Details are at the end of the report.

Amanda Stanford

Deputy Chief Inspector of Hospitals (Central)