Archived: East Quay Medical Centre

Updated 16 January 2020

East Quay Health Ltd provides a minor surgery service, available to all GP practices in Somerset, and which enables their patients to receive a small range of surgical treatments, under local anaesthetic, without the need to attend hospital.

The service is only accessible to patients following either a private or NHS referral from their own GP with procedures then being funded either privately or by the NHS. Costs are dependent upon the procedure required.

Typical minor surgery procedures include vasectomy (male sterilisation), sigmoidoscopy and pile banding (treatment for haemorrhoids), excision/biopsy of skin and subcutaneous tissue, and surgical treatment of ingrowing toenail.

The service runs very much upon demand but typically there are two to three sessions per week, on variable days, and one to two Saturdays per month.

Two surgeons who have substantive posts at NHS hospitals share their expertise with another surgeon, who is now also a GP, but who continues to provide surgical support to the service. They are supported by two experienced theatre nurses, an administrator and a registered manager who is also the practice manager for the host GP practice - East Quay Medical Centre.

East Quay Health Limited is a private company with its directorship and governance formed by the 11 partners of the host organisation, East Quay Medical Centre.

We carried out this inspection on 6 December 2019 and before visiting, we looked at a range of information that we hold about the service and information submitted by the service in response to our provider information request.

During our visit we interviewed clinical and non-clinical staff and reviewed documents. We did not speak to patients on the day of inspection as no procedures were being carried out.

We obtained positive feedback about the service from six CQC comment cards which had been completed by patients who had recently used the service. Comments referred to the care and attention that patients had received; being kept informed of the procedure being undertaken and professionalism of all staff.

We also used information from East Quay Health Limited’s own post-operative patient satisfaction survey forms. This is part of the service’s follow up process and we saw from the 62 survey forms received, that patient satisfaction was high

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 16 January 2020

This service is rated as Good overall.

The key questions are rated as:

• Are services safe? – Good
• Are services effective? – Good
• Are services caring? – Good
• Are services responsive? – Good
• Are services well-led? – Good

East Quay Health Ltd was established in 1992 and is registered with the Care Quality Commission (CQC) as a provider of a minor surgery service, available to all GP practices in Somerset. As a provider, its regulated activities are carried out at a specific location. In this instance the carrying out of those regulated activities takes place within East Quay Medical Centre where it has its own suite of rooms, including a theatre, consultation room, recovery room, sluice room and a small waiting area. All rooms are situated on the ground floor and are all fully accessible to patients who may have mobility issues.

For the purposes of this report, reference to Easy Quay Medical Centre refers to the provision of the minor surgery service provided by East Quay Health Ltd at East Quay Medical Centre and is not the provision of NHS services provided by East Quay Health Ltd at the same location. Those are separately regulated activities.

A previous inspection was carried out of East Quay Medical Centre on 28 November 2017 when we inspected the provision of minor surgery services. At that time, we did not rate the service but found the provider had met the requirements for providing safe, effective, caring, responsive and well led care and that there were no breaches of regulations.

We carried out this comprehensive inspection at East Quay Medical Centre on 6 December 2019 as part of our inspection programme.

The Practice Manager is the registered manager. A registered manager is a person who is registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’ who have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The service is registered with the CQC to provide acute services and surgical procedures.

Our key findings were:

• The service had systems in place to monitor the quality and safety of the service and had a clear vision and strategy to deliver high quality care for patients.
• There was a clear governance framework in place, underpinned by policies and procedures which were understood and followed by staff.
• Leaders understood and managed the priorities and issues the service faced. They were visible and approachable in the service for patients and staff.
• There were clearly defined systems, processes and practices to minimise risks to patient safety and there was an open culture to reporting and acting on concerns. Staff were involved with the learning from incidents and if things went wrong, staff apologised and gave patients honest information and suitable support.
• Information about services was available and easy to understand.
• Staff had the skills and knowledge to deliver effective care and treatment.
• There was an effective system in place for obtaining patients’ consent.
• The service had systems and processes in place to ensure that patients were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
• The service had good facilities and was well equipped to treat patients and meet their needs.
• The service was responsive to peoples’ needs, offering weekend appointments on an as needed basis.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care