Tajmeel clinic ltd

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

At our last assessment we rated this key question good. At this assessment the rating has remained good.

Good: This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Description: We maximise the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

Quality Statement Score:

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing

The surgeon completed risk assessments for each patient when they attended for a pre-procedure consultation. This included risks around allergies, previous medical history and a more in-depth assessment of patients’ psychological wellbeing.

The surgeon was clear about who they could provide safe treatment for, how to meet patients’ expectations, and they showed us a list of absolute or relative conditions that would exclude patients from receiving treatment at the clinic.

Patients who had uncontrolled diabetes were not candidates for follicular unit transplant (FUE) hair transplants due to the risk of infection. Likewise, patients who were smokers were also not advised to have FUE hair transplants, unless they could cease smoking for at least 2 weeks before the procedure, due to the increased risk of infection. Other hair restoration services, such as medicines or platelet rich plasma (PRP) therapy could be considered for those patients who were not candidates for FUE hair transplant surgery. PRP therapy increases the blood supply to the hair follicles and helps to decrease hair loss.

Patients were given aftercare instructions and were supplied with the medicines and products required to reduce the incidence of post-operative complications. The aftercare plan detailed what steps the patients should take and at what time, for the 7 days following the surgery. These included measures such as what time to take pain relief and steroids to prevent swelling. Patients were advised to sleep sitting upright for a period following the surgery.

Description: We plan and deliver people’s care and treatment with them, including what is important and matters to them and in line with legislation and current evidence-based good practice and standards.

Quality Statement Score:

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The surgeon followed up-to-date policies to plan and deliver high quality care according to best practice and national guidance. They followed guidance on hair transplant surgery standards from the following organisations:

• Cosmetic Practice Standards Authority (CPSA)
• The Royal College of Surgeons (RCS) professional standards for cosmetic surgery
• The British Association of Hair Restoration Surgery (BAHRS)
• National Institute for Health and Care Excellence (NICE)

The BAHRS provided guidance on clinical standards and professional standards for hair transplant surgeons. The CPSA provided guidance on hair transplant surgery standards, including the risks to patients, the requirements for the clinical environment and education and training requirements.

The provider had policies relevant to the service such as infection control and decontamination policy and procedure, needle stick policy and a premises safety policy. The policies were dated and included dates for review to ensure they were in line with current national guidance. This was an improvement as a result of the last inspection.

The provider had established processes to ensure medical safety alerts would be received. This ensured they would be told if there were any issue with the medicines they purchased.

Description: We work effectively across teams and services to support people, making sure they only need to tell their story once.

Quality Statement Score:

We scored the service as 3. The evidence showed a good standard. The service worked well as a team to support people. They made sure people only needed to tell their story once.

Staff meetings were held, and documented, where the surgeon and the hair technicians met to discuss issues relating to the service. In addition, the surgeon participated in peer review and clinical outcome review meetings with another hair transplant surgeon external to the service.

This demonstrated a positive approach to team working both within the service and with external colleagues and services.

Description: We support people to manage their health and wellbeing.

Quality Statement Score:

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing.

The surgeon verbally promoted a healthier lifestyle, such as diet advice and smoking cessation both before and following surgery and advice on alcohol consumption but did not have written information to support this.

Patients wishing to proceed with hair transplants were required to stop smoking for at least 2 weeks before the procedure. This is because smoking can cause an increased risk of infection. The surgeon encouraged patients to stop smoking following the procedure when required.

Description: We routinely monitor people’s care and treatment to continuously improve it and to ensure that outcomes are positive and consistent, and that they meet both clinical expectations and the expectations of people themselves.

Quality Statement Score:

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Summarise your findings here using the topics below:

The service collected information about the number of treatments provided and surgical site infections. Information was captured using online feedback using an application (internet search engine review linked to the service’s website). Outcomes for patients reported in this way were positive and consistent.

The service did not report any adverse incidents, including surgical site infections, in the 12 months before our inspection. This information was based on patient feedback only. However, given the small and distinct patient group the service was confident the data was accurate.

There were no relevant national clinical audits for hair restoration services. However, the service used their own results to improve future patient outcomes. We saw evidence relating to how ethnicity can affect FUE hair transplant surgery and how the surgeon now examined graft quality more regularly for these cases. There was a case-based discussion around hair line design. This considered a more conservative hair line when in doubt and to be cautious about placing the hair line on or below the frontalis muscle.

Outcomes for patients were positive, consistent and met expectations. Patients were reviewed following their hair restoration procedures at regular intervals to assess outcomes. Photographs were taken at review appointments, and patients were encouraged to send in their own photographs to demonstrate their progress.

Description: We tell people about their rights around consent and respect these when we deliver person-centred care and treatment.

Quality Statement Score:

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

The surgeon received and kept up to date with training in the Mental Capacity Act. They understood how and when to assess whether a patient had the capacity to make decisions about their care. We were told patients who lacked capacity to make informed decisions about their care would not be treated in the clinic.

Staff gained consent from patients for their care and treatment in line with legislation and guidance. They followed guidance from the Royal College of Surgeons Professional Standards for cosmetic surgery, which states that the surgeon carrying out the procedure is responsible for discussing and gaining consent with patients; this responsibility should never be delegated.

The service used a 2-stage consent process, in line with legislation and guidance. Initial consent was given at the consultation stage and the 2nd consent was obtained on the day of the procedure. The consent form held information about the procedure and specific detail such as the amount of grafts, fees, expectations, complications and about how the procedure was performed. Once patients had all the information required to make an informed decision, they had time to reflect on their decision and were given a minimum cooling off period of 14 days. This reflected national guidance for such procedures.