Archived: Nuffield Health London City Medical Centre

Updated 1 June 2018

Nuffield Health Fitness and Wellbeing Centre is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening; and treatment of disease, disorder and injury. The location is part of Nuffield Health, a not for profit healthcare provider.

The service provides health assessments that include a variety of screening processes, including: 360 Health Assessment (a comprehensive health review for both male and female patients); and Lifestyle health Assessments. The purpose of the health assessments is to provide patients with a comprehensive review of their health, it covers key health concerns such as weight, diabetes, heart health, cancer risk and emotional wellbeing. Following the assessment and screening process patients have a consultation with a doctor to discuss the findings of the screening procedures and to consider and plan for any required treatment. Patients receive a comprehensive report detailing the findings of the assessment. The report includes advice and guidance on how the patient can improve their health together with information to support healthier lifestyles. Any patients requiring further investigations or any additional support are referred to other services, for instance, their own GP. The centre also provides GP services for private paying patients.

The service address is:

London Medical Centre, 25 Hosier Lane, London, EC1A 9PH

It is open Monday to Friday from 8.00am to 6.00pm.

The clinical staff team at the service consists of two part-time clinical lead doctors, (regional clinical lead and London clinical lead), together with a further nine doctors who work at the location part-time. This team includes female and male GPs. In addition, there is a regional clinical lead physiologist, a physiology team leader, and two senior physiologists who manage a team of seven other physiologists. A physiologist is a graduate in exercise, nutrition and health sciences. Physiologists are full professional members of the Royal Society for Public Health (RSPH), and are trained to carry out health assessments, give advice and motivate patients to make lifestyle changes affecting areas such as exercise, nutrition, sleep and stress management. The clinical team is completed by three physiotherapists, a Cognitive Behavioural Therapist, and two occupational therapists. The non-clinical team is led by a general manager, together with two administrative staff and a medical laboratory assistant. Physiologists, physiotherapists, cognitive behavioural therapists and occupational therapists are not included as clinicians in CQC’s Scope of Registration. This report only covers the regulated activities carried out by doctors.

We carried out an announced comprehensive inspection at Nuffield Health Fitness and Wellbeing Centre London City Medical Centre on 11 April 2018. Our inspection team was led by a CQC Lead Inspector who was accompanied by a GP Specialist Advisor, together with a Practice Manager and Practice Nurse Specialist Advisors. Before visiting, we reviewed a range of information we hold about the service and asked other organisations to share what they knew. We also reviewed the last inspection report published on 6 September 2013, any notifications received, and the information provided from the pre-inspection information request sent to the service prior to this inspection.

During our visit we:

• Spoke with a range of staff including the site manager, GPs, physiologists, a member of the non-clinical staff.
• Looked at the systems in place for the running of the service.
• Looked at rooms and equipment used in the delivery of the service.
• Viewed a sample of key policies and procedures.
• Explored how clinical decisions are made.
• Spoke with four patients and reviewed 18 CQC comment cards which included feedback from patients about their experience of the service.

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 1 June 2018

We carried out an announced comprehensive inspection on 11 April 2018 to ask the service the following key questions: are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Nuffield Health Fitness and Wellbeing Centre provides health assessments that include a range of screening processes. Following the assessment and screening process patients undergo a consultation with a doctor to discuss the findings of the results and any recommended lifestyle changes or treatment planning.

The service is registered with the Care Quality Commission (CQC) under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. For example, physiotherapy and occupational health assessments do not fall within the regulated activities for which the location is registered with CQC.

We received eighteen completed CQC comment cards. All the completed cards indicated that patients were treated with kindness and respect. Staff were described as friendly, caring and professional. Some patients commented on how using the service had helped them with their individual care needs. In addition, comment cards described the environment as pleasant, clean and tidy. We spoke with four patients during the inspection. All four patients were happy with the care and service they received.

Our key findings were:

• The service had clear systems to keep people safe and safeguarded from abuse. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
• Doctors assessed patients’ needs and delivered care in line with relevant and current evidence based guidance and standards.
• The service was offered on a private fee paying basis for adults only.
• Patients were treated with dignity and respect and they were involved in decisions about their care and treatment. Treatment was delivered in line with best practice guidance and appropriate medical records were maintained.
• Patients were provided with information about their health and with advice and guidance to support them to live healthier lives.
• Systems were in place to protect personal information about patients.
• Information about services and how to complain was available and easy to understand.
• An induction programme was in place for all staff and staff received induction training prior to treating patients.
• Staff were well supported with training and professional development opportunities. They were trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Systems were in place to deal with medical emergencies and staff were trained in basic life support.
• The practice had a clear vision to provide a safe and high quality service. And there was a clear leadership and staff structure. Staff understood their roles and responsibilities.
• There were clinical governance systems and processes in place to ensure the quality of service provision. Staff had access to all standard operating procedures and policies.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice