British Association for Performing Arts Medicine

Updated 30 May 2019

Our inspection team was led by a CQC lead inspector. The team included a CQC GP specialist adviser.

BAPAM is an independent healthcare service which has been registered with the CQC since June 2018. The services are provided from 4th Floor, 7-9 Bream's Buildings London EC4A 1DT.

The premise is accessible by a lift.

The service is registered by the Care Quality Commission to provide the regulated activities Treatment of disease, disorder or injury.

The service has good transport links with regular buses and local tube stations.

The service employs five locum GP’s who work pro-bono or for a minimal fee. The service employs a director, senior manager, clinic manager and administrative staff.

The service provides pre-bookable GP appointments for adults and children over thirteen who are professional performing artists or those who are studying performing arts. The service does not provide a walk-in clinic. The service has a telephone triage system which is managed by members of the administration team. The service books patients for an appointment if their symptoms are musculoskeletal, vocal, hearing or psychosocial related. Patients with concerns outside of these four clinical areas are re-directed to other services. BAPAM does not provide an urgent response service. Administration staff follow a triage pathway to ensure people with urgent concerns are directed to contact the emergency services or to attend their local hospital. There is always a GP on site or available on the telephone to assist the administration staff with the triaging process.

During consultations, the GP carries out an initial assessment based on the patient’s reported concerns and symptoms. Following a clinical pathway, the patient will then be referred to a specialist service or clinician for formal screening, diagnosis and treatment.

The service is available from Tuesday to Friday between 9.30am-5pm. Telephone assessments are available on request whilst face to face GP appointments are 30-60 minutes long.

We gathered and reviewed pre-inspection information before inspecting the service. On the day of the inspection we spoke with the service director, the service manager, a GP and members of the administration team. We also reviewed a wide range of documentary evidence including policies, written protocols and guidelines, recruitment, induction and training records, significant event analyses and patient feedback.

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 30 May 2019

We carried out an announced comprehensive inspection on 19 March 2019 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations

We carried out an announced comprehensive inspection at British Association for Performing Arts Medicine (BAPAM) on 19 March 2019. This inspection was carried out under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

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. In addition to GP services, BAPAM provides physiotherapy, osteopathy and psychiatry services which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.

BAPAM is a registered charity and private healthcare provider. The service is available to all British performing artists free of charge. The service provides an initial health assessment and then refers patients on to other services for screening, diagnosis and treatment.

Fifty-four people provided feedback about the service via CQC comment cards and two people provided feedback via the CQC website, all of which were positive about the service.

Our Key findings were:

• Systems and processes were in place to keep people safe.
• The service had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the service learned from them and improved their processes.
• Staff were aware of current evidence-based guidance and they had the skills, knowledge and experience to carry out their roles.
• 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 provider was aware of their responsibility to respect people’s diversity and human rights.
• Patients were able to access the service within an appropriate timescale for their needs.
• There was a complaints procedure in place and information on how to complain was readily available.
• The service had systems in place to collect and analyse feedback from patients.
• There was a clear leadership structure and staff felt supported by management.
• Governance arrangements were in place. There were clear responsibilities, roles and systems of accountability to support good governance and management.

The areas where the provider should make improvements are:

• Continue to review improvement activity to ensure 2-cycle clinical audits are carried out as planned.
• Continue to review future arrangements for stocking adrenaline.
• Continue to review arrangements in place to support patients with sensory impairments, including hearing impairments.

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