Archived: The Dentist Gallery

Updated 28 January 2020

The Dentist Gallery is an independent clinic in central London. The provider rents a room within a dental practice from which services are provided. The service is distinct from the dental practice.

The Dentist Gallery provides a range of bespoke healthcare service to adults and specialises in individualised hormone testing and therapy for the treatment of hormonal imbalances and thyroid related issues, which accounts for a small proportion of their clinical activity. Patients are treated with unlicensed compounded medicines. The provider offers aesthetic procedures, which accounted for the majority of their workload, but those services are out of the scope of registration with the Care Quality Commission.

Services are provided by a single doctor who carries out his own administrative and secretarial services. The service is located at 20 Rochester Row, London, SW1P 1BT. We visited this location as part of this inspection.

The service is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, and treatment of disease, disorder and injury.

Pre-inspection information was gathered and reviewed before the inspection. We spoke with the doctor and the personal assistant. We looked at records related to patient assessments and the provision of care and treatment. We also reviewed documentation related to the management

of the service. We reviewed patient feedback received by 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 28 January 2020

We carried out an announced comprehensive inspection at The Dentist Gallery as part of our inspection programme and to follow up on breaches of the Health and Social Care Act 2008 found at the previous inspection on 4 December 2019.

At the inspection of 4 December 2018, we found the regulations were not being met in relation to risk management (regulation 12), governance, assurance and auditing processes (regulation 17) and staffing (regulation 18). Requirement notices were served setting out the improvements the provider must make. We also said the provider should review the need for translation and interpreting services, access arrangements for patients with hearing difficulties and should review the information provided on their website. At this inspection on 16 December 2019 we found improvements had been made. Whilst we did not find any breaches of the regulations, we have set out areas the provider should review.

The Dentist Gallery offers individualised services relating to hormone testing and therapy, which accounts for a small proportion of their clinical activity. Patients were treated with unlicensed compounded medicines for the treatment of hormone imbalance and thyroid related issues. (Compounded medicines are made based on a practitioner’s prescription in which individual ingredients are mixed together in the exact strength and dosage form required to meet a patient's individual needs). They also offered minor surgery procedures and weight loss consultations.

We received two completed comment cards from patients which were both positive about their experiences of using the service. We were unable to speak to any patients who use the service as there were no appointments on the day of the inspection.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of regulated activities and services and these are set out in

Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Dr D Sister Limited provides a range of aesthetic procedures, which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.

The doctor 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’. Registered persons have 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 :

• Systems and processes were in place to keep patients safe. Improvements had been made to address shortcomings identified at the previous inspection. However, medical notes could still be further improved.
• There was some evidence of independent quality improvement activity. However, this was mitigated by the small size of the service and the nature of the treatment offered.
• The provider assessed needs and delivered care in line with guidance and standards.
• Patient care was coordinated and shared appropriately. Consent was consistently recorded.
• Treatment was provided in a caring manner.
• The service provided was responsive and met people’s needs.
• The provider had the experience, capacity and capability to run the service.

The areas where the provider should make improvements are:

• Continue to review and improve the detail provided in patient’s medical notes.
• Review and improve quality improvement activity to include independently instigated activity.
• Continue to review and improve policies covering the day to day operation of the service.
• Review wording on the service’s website to make it clear to patients that the efficacy and safety of unregulated compounded bioidentical hormones are unknown and that it is aspects of the service that are regulated, not the treatment.

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