Archived: Samedaydoctor London City Clinic

Updated 30 June 2021

Samedaydoctor City Limited (the provider) is registered with the Care Quality Commission to carry out the regulated activities Diagnostic and screening procedures and Treatment of disease, disorder or injury.

The service is provided under franchise arrangements at the registered location Samedaydoctor London City Clinic, Pinnacle House, 23-26 St Dunstan’s Hill, London EC3R 8HN. The clinic is located on the ground floor of an office block, fully accessible to people with reduced mobility. There are two other associated clinic locations in London, one in the West End and the other at Canary Wharf, operated by Sameday Doctor Holdings LLP, and another in Manchester, operated by SDD Medical Ltd.

The provider offers a range of private GP services, including face to face, video and telephone consultations, email exchange, and testing. It offers referrals for x-rays and scans and to specialists for secondary care. It also provides services relating to sexual health and vaccinations, including childhood immunisations. Details of the services provided, together with prices, are available on the provider’s website – www.samedaydoctor.org

The clinic is open between 9.00 am and 5.00 pm on weekdays and from 10.00 am to 2.00 pm on Saturdays. Walk-in patients are seen, but currently they are strongly encouraged to book an appointment to help with social distancing measures. Walk-in patients are usually seen by the duty doctor within 15 minutes of arrival. Outside the times mentioned, patients can be seen by appointment at the sister clinic in the West End. Appointments, including for the same day, can be booked online, by email, telephone or by walking in during opening hours.

The childhood immunisation service is available four days a week between 10.00 am and 4.00 pm and one Saturday a month from 10.00 am to 2.00 pm.

The clinic team is comprised of two GPs, one of whom was the registered manager; a sexual health consultant; a baby vaccine consultant, who works from home; a baby vaccine nurse; the director of business and four administrative staff. Some members of the team also work at the other London clinics.

How we inspected this service

We reviewed documentary evidence sent to us by the provider, such as policies and records, conducted a remote online interview on 21 May 2021 with the registered manager for the service, which included reviewing several patients’ healthcare records. We undertook a site visit on 26 May 2021.

Updated 30 June 2021

Previous overall rating, 15 May 2019: Good.

Previous rating for the key question Safe: Requires Improvement.

This service is again rated as Good overall.

The key questions are rated as: -

Are services safe? – Good

The ratings carried forward from our previous inspection are: -

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We previously carried out a comprehensive inspection of Samedaydoctor London City Clinic on 15 May 2019, under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was conducted to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008. We rated the service Good overall and in respect of the key questions Effective, Caring, Responsive and Well-led. We rated the service as Requires Improvement in relation to the key question Safe. There were procedures in place for monitoring and managing risks. However: -

• There was a lack of a systemic approach for ensuring patient safety alerts had been actioned.
• The provider could not demonstrate care was provided in a way that kept patients safe and protected them from avoidable harm. For example: the adult and children safeguarding policies needed to be updated to reflect some of the new categories of abuse, the provider needed to evidence that staff had a Disclosure and Barring Service (DBS) check at an appropriate level to their role, and Patient Group Directions (PGDs) needed to be current and up to date.
• There were clear responsibilities, roles and systems for accountability to support good governance and management, but some of the arrangements, such as consultation reviews, were on an informal basis, so it was difficult for the provider to evidence any action taken or feedback given.

We served requirement notices in relation to Regulations 17 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and made some recommendations for improvement. The provider had produced a plan of actions to address these.

We carried out this focussed inspection to review the action taken by the service provider to meet the requirements of the regulations and to re-assess the rating for the key question Safe. We found the provider had taken appropriate action to address the issues noted at our inspection in May 2019 and have revised the rating for the key question Safe to Good.

The provider offers a range of private GP services, including face to face, video and telephone consultations, email exchange consultations, and testing. It offers referrals for x-rays and scans and to specialists for secondary care. It also provides services relating to sexual health and vaccinations, including provision of childhood immunisations.

The clinical lead for the service is 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’ with legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

Our key findings were:

• The provider had introduced an effective procedure for monitoring and actioning patient safety alerts.
• Safeguarding policies had been revised. Evidence of appropriate DBS checks was maintained, and suitable risk assessments carried out.
• Patient Group Directions (PGDs) relating to administering vaccines and medications were no longer used in the service. Where appropriate, Patient Specific Directions (PSDs) were used in accordance with relevant guidance.
• There was an effective system for conducting consultation and notes reviews and for feedback from the review to be given to members of the clinical team.

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