DrDucu London

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

The service provided information people could understand, and people were involved in decisions about their care. They knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access. People were involved in planning their care and understood options around choosing to withdraw or not receive treatment.
 

The service monitored and worked to improve access. The environment was adjusted to meet the needs of people with conditions that could create a barrier to access.
 

The service worked to reduce health and care inequalities through service planning, quality monitoring, staff training and feedback. Patients were involved in decision‑making about their care and the options available to them and planning their care.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

The service made sure people were at the centre of their care and treatment choices and staff decided, in partnership with people, how to respond to any relevant changes in their needs. Staff told us they discussed all the treatment options available to patients and recommended the least invasive treatment. For example, if a problem could be treated with medicine, they recommended this over surgical intervention. We saw evidence that if a patient’s condition had been caused through lifestyle, such as alopecia, staff gave the patient information to help them live a healthier lifestyle and prevent a recurrence of the condition.
 

The patients we spoke with told us they were given information about alternative treatment options. For example, patients with aesthetic/cosmetic conditions that did not pose a risk to their health were made aware that one alternative to surgery was to do nothing. The clinic manager told us they provided individual guidance and aftercare support for people with pre‑existing health conditions such as diabetes or asthma through referrals to the GP’s with
their consent.
 

Refreshments including tea, coffee, water and individually wrapped chocolate were available for patients to help themselves free of charge. As patients attending the clinic were normally leaving within three hours, more substantial food was not available.
 

Staff told us people’s procedures and follow‑up appointments were booked at times that were best for the person. We observed staff communicating with people in a person‑centred way.

The service understood the diverse health and care needs of its patients and provided choice and continuity. Care was planned and delivered in ways that met people’s needs. The clinic treated a diverse range of patients from different backgrounds and cultures. 

The service had added a general practitioner provision to its services. The GP services was delivered by a qualified GP for private patients. Managers ensured patients who did not attend appointments were contacted to make alternative arrangements.
 

People were offered follow‑up reviews either in person or remotely, which supported those living outside London. Patients saw the same surgeon throughout their pathway, from initial consultation and assessment to post‑operative aftercare. The service scheduled routine  post‑operative reviews, and clinic managers accessed patient records electronically and carried out follow‑up calls. Any concerns were escalated to the surgeon.
 

People received clear aftercare instructions and contact details when discharged. They could contact the service for advice or if complications arose, and clinic managers coordinated any required follow‑up with surgeons. One person who returned for additional treatment told us they were satisfied with the care received on both occasions.
 

Staff had received up‑to‑date training on supporting patients with learning disabilities and autism. They described reasonable adjustments they made, such as extending appointment times and ensuring the clinic was free of other patients to provide a calm environment and allow extra time for understanding and questions.
 

Aftercare instructions included how to contact the service out of hours and advised people to attend their local accident and emergency department in an emergency. Staff gave examples of clinicians providing advice out of hours. When people attended another healthcare provider, the service supplied contact details for the hair transplant surgeon, a summary of the procedure and aftercare instructions.
 

People told us their procedures were well coordinated. They said staff planned and delivered care that met their individual needs and reported no issues or delays with appointments or consultations. The service provided dedicated parking spaces at the rear of the premises, and the waiting area was spacious and suitable for patients.

The service had a defined discharge process set out in its discharge standard operating procedure. We saw completed discharge summaries in the records we reviewed. Staff shared discharge information with relevant parties once consent was obtained. Where direct GP communication was clinically indicated, they issued a formal clinic‑to‑GP letter. Otherwise, staff strongly encouraged patients to share their discharge summary with their GP.

The service had a patient information leaflet at the clinic, which contained detailed information about the surgical procedures and other key information. This information was not available in languages other than English. However, we were told the service used translation services for patient whose first language was not English. However, we did not see any evidence of contact with the translation services.

The service provided us with different patient information leaflets from other service providers for various cosmetic surgical procedures which were out of CQC scope of registration. The use of information leaflets produced by other service providers created inconsistency in the guidance given to patients. This reduced assurance that information was accurate, service‑specific and aligned with the clinic’s own governance arrangements. Relying on external leaflets also limited the provider’s ability to ensure that patient information reflected current legislation, best‑practice guidance and the clinic’s own procedures. This issue indicated gaps in oversight and information management that could impact the delivery of a safe, consistent and well‑led service. Information about the clinic, including the various cosmetic, aesthetic and other conditions the service treated, was available on the service’s website. The clinic’s website stated that all treatments available were minimally invasive, performed under
local anaesthetic or no anaesthetic at all. This helped patients make informed decisions about their care and treatment. There was a member of staff responsible for keeping all information on the website updated.

There was an enquiry form on the clinic’s website to enable people to book a consultation. Patients were given information advising them how to prepare for their planned treatment at the clinic. This contained information about the medical and cosmetic reasons for treatment and signposted patients to videos online of the various treatments carried out, patient experiences and videos detailing the stages of recovery after surgery. The information was written in clear language that patients could easily understand.

The service made it easy for people to share feedback and ideas or raise concerns about their care, treatment and support. Clinical staff involved people in decisions about their care and treatment. A member of staff told us, “If people wanted to make a complaint, I helped them write it, and I took the complaint to the manager.” Staff told us they always tried to address complaints or concerns immediately and provide reassurance to patients.
 

The provider had a complaint’s policy. The policy outlined the process patients needed to follow to make a complaint. The policy included details of the Independent Healthcare Sector Complaints Adjudication Service (ISCAS), a third‑party organisation where patients could escalate their complaints if they remained dissatisfied with the service’s response. This was in line with best practice for the escalation of complaints in independent healthcare. The service had not received any formal complaints in the six months before our assessment. Patients were
given details of how to make a complaint if the problem could not be resolved.
 

Managers shared patients feedback, comments and compliments with staff during meetings and these were used to improve the service. The service undertook a patient satisfaction survey, and all respondents said they were treated in a clean and safe environment. The survey also showed that all respondents were satisfied with the treatment they received and had been given enough information about their treatment and aftercare.

The service made sure people could access the care, support and treatment they needed when they needed it. The clinic was open from 10am to 6pm Monday to Friday, and on Saturday from 11am to 6pm. All patients attending the clinic had self‑referred and were paying their own fees.
 

Patients did not have to wait long for consultations or treatment appointments. Staff told us patients typically did not wait more than a couple of days to be seen at the clinic. Patients normally booked their appointments and consultations by telephone and online. Managers worked to keep cancellations to a minimum. When patients had their appointments or operations cancelled at the last minute, managers made sure they were rearranged as soon
as possible. The manager told us only one person cancelled their procedure since they moved into this new location.
 

The service considered the needs of patients, including those from protected characteristics such as wheelchair users, by ensuring the clinic was easily accessible with step‑free access. If patients had any individual needs, they notified the clinic in advance, so the clinic was aware and delays were mitigated.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Managers told us they had not received requests for surgical treatment from people whose first language was not English. They said that if this occurred, they arranged a consultation using a translator, translator. However, we did not see any evidence of contact with the translation services. The provider did not have any resources to help people with sight
or hearing difficulties access treatment.

The design and layout of the premises meant treatment could always be accessed by wheelchair users. There was an elevator (lift) available for wheelchair users to access all floors at the clinic. The service kept disabled patient access and outcomes to identify potential health inequalities, and this information was used to inform service planning for the delivery of sustainable care.
 

The provider had an equality, diversity and inclusion policy that supported staff to identify and address discrimination and inequality that could disadvantage diverse groups of people in accessing care. Staff considered each patient’s physical, mental, emotional and social needs under the Equality Act. All staff completed cultural awareness training, equality and diversity training and autism awareness training as part of their mandatory training.
 

Staff demonstrated to us that they were aware of discrimination and inequality. Staff provided examples of adjustments they made for people to ensure equity in experiences, for example adjusting appointment times for people who were unwell or who lived outside London. Clinical staff gave examples of how they provided a positive patient experience and protected people’s rights by promoting equality and removing barriers, based on their own knowledge and experience rather than through an established process.

People were supported to plan for important life changes, so they had enough time to make informed decisions about their future. Most people we spoke with felt they were able to make informed choices about their care and plan their future care at a time that suited them. People were given time to reflect on the information they had been given about the surgical procedures offered at the clinic. In line with national guidance from the Royal College of Surgeons, people had to wait for 14 days from the point of consultation before they could consent to cosmetic surgical procedures. This allowed them time to think about the advantages and disadvantages of surgery before deciding whether they wanted to proceed.
 

When staff asked patients to consent to invasive treatment procedures, they provided them with information about all the risks involved in having the treatment and what not having the treatment was likely to mean. Patients were supported to make informed choices about their care and plan their future care, with the support and involvement of their family or carer if they wished. Staff discussed healthy lifestyles for going home and recovery from the patient’s operation. They reinforced key information and gave written advice based on current best
practice. Discharge summaries were given to the patient’s and follow‑up appointments were
made before discharge.