Queens Clinic

Updated 12 March 2024

Queens Clinic is a private gynaecological service located on the second floor at 75-76 Wimpole Street, Marylebone, London, W1G 9RT. The building entrance lobby is accessed via steps from the pavement. Wheelchair access is via a ramp at the front of the building (patients are advised of this and a member of staff is available to assist patients). The service is easily accessible by public transport and is a short walk from Bond Street. There are two consultation rooms, one minor operations room, one reception room and a waiting area for patients.

The service is staffed by a lead clinician, who is the sole owner of the business, and registered manager. At the time of the inspection, the service also employed a health care assistant (HCA), and a single administrative members of staff.

The opening hours are 9am to 9pm, Monday to Friday and between 9am to 6pm on Saturdays. Patients have access to the lead clinician by phone for out of hours emergencies.

The service provides private consultations to adults. A variety of services are offered including gynaecological diagnostic and minor surgery procedures.

How we inspected this 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 12 March 2024

This service is rated as inadequate overall. The service had previously been inspected on 13 February 2020, 9 February 2021, 2 September 2021, 30 November 2021, 2 September 2022 and 30 September 2022, and in each case, there were breaches of CQC regulations.

Following the inspection on 30 September 2022, the service was rated as inadequate overall, and in the effective and well led key questions. The safe key question was rated as requires improvement, and the responsive and caring key questions were rated as good. The service was found to be in breach of regulations 17 and 18 of Health and Social Care Act (HSCA) (RA) 2014 and warning notices were put in place. The specific issues found at the inspection of 30 September 2022 were:

• During surgical procedures undertaken under local anaesthetic, the surgeon was the only regulated health professional present, which had not been risk assessed.
• Some clinical records were either incomplete or unclear.
• The service had not undertaken any two cycle or outcome-based audits.
• Consent procedures at the service were not adequate.
• A lack of explicit detail in clinical records meant that it was not possible to ascertain what procedures had been carried out.
• Staff at the service had not been appraised.
• The service had not developed leadership and governance procedures to address breaches of CQC regulations identified in previous inspections.
• There was a lack of clear clinical governance procedures at the service to show that the service was providing safe and effective care.

We carried out an announced comprehensive inspection of Queens Clinic on 16 and 24 January 2024, to review the breaches of regulation. We found that the breaches of regulation from the previous inspection had not been addressed, and other issues of concern were found. Following this inspection, the service is rated as inadequate overall and the key questions are rated as:

Are services safe? – Inadequate

Are services effective? – Inadequate

Are services caring? – Not rated

Are services responsive? – Good

Are services well-led? – Inadequate

Our key findings from this inspection were:

• The service had some systems to manage risk. However, the service was not following safeguarding best practice and its own safeguarding policy. In addition, the service had limited quality improvement mechanisms in place, so it was unclear how the service was determining if the care was of sufficient standard, and that incidents were not being missed.
• The service undertook procedures under local anaesthetic, but in the event of an adverse reaction to local anaesthetic, the lead clinician was the only person available to manage this. The lack of a second clinician had not been adequately risk assessed.
• The service had not reviewed the effectiveness and appropriateness of the care it provided.
• A review of clinical records and consent forms found we were not consistently able to ascertain what procedures had been undertaken, or what consent process had been followed, including the explanation of risks and provision of information. In some instances, attendances at the clinic were not accompanied by a consultation note. There were also examples where it was unclear what protocols and guidance the provider had followed in providing treatment.
• Staff treated people with compassion, kindness, dignity and respect.
• Patients were able to access care and treatment from the service. An adequate complaints system was in place.
• Governance systems, particularly those that ensured safe and effective care, were ineffective and unclear.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure systems and processes are established and operated effectively to ensure compliance with the requirements of safe care and treatment.
• Ensure systems and processes are established and operated effectively to ensure compliance with the requirements of good governance.
• Ensure systems and processes are established and operated effectively to ensure compliance with the requirements of good staffing.

This service was placed in special measures in September 2022. Insufficient improvements have been made such that there remains a rating of inadequate overall and for the safe, effective and well led key questions. Therefore we are taking action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration if they do not improve.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services