During an assessment under our new approach
Dr Todd Mitchell is the registered provider and manager of an independent consultant-led outpatient psychiatry service for adults aged 18 and over. The service provides assessment, diagnosis and treatment for a range of general psychiatric conditions. It is registered to provide treatment of disease, disorder or injury, and diagnostic and screening procedures.
The service offered remote consultations and face-to-face appointments at 10 Harley Street, London. It operated on Tuesdays, Wednesdays and Thursdays from 9am to 2pm. Clinical care was delivered by the consultant psychiatrist. Administrative support was provided through arrangements with Harley Therapy.
We rated the service good overall and good for safe, effective, caring, responsive and well-led. The service had clear processes to assess referrals and manage risk, and patients received personalised care in line with relevant guidance. Patients gave consistently positive feedback about access, communication, involvement and the way they were treated. Governance arrangements were proportionate to the size and nature of the service and included audit, peer review, appraisal and risk oversight.
The provider should strengthen arrangements for people who require language support. The service did not have a formal system for professional interpreting, and family members had sometimes supported communication during consultations.
During the inspection visit to the clinic, the inspection team:
• Carried out an environmental tour of the site, including the shared reception area and the consultant psychiatrist’s office.
• Spoke with 7 patients.
• Reviewed 2 online feedback forms completed by patients using the service.
• Spoke with the consultant psychiatrist.
• Spoke with the remote administrative assistant.
• Reviewed 6 patient care and treatment records.
• Checked how prescription stationery was stored and managed.
• Reviewed information and documents relating to the operation and management of the service.
• Reviewed policies and procedures relating to the running of the service.
Our rating of safe stayed the same. We rated it as good. The premises were clean, the consultant’s office was furnished, well-maintained and fit for purpose. The number of patients on the consultant psychiatrist’s caseload was well managed. The consultant did not keep a waiting list. Patients told us the service was flexible regarding appointments and appointments ran on time.
Our rating of effective stayed the same. We rated it as good. The consultant psychiatrist delivered a holistic, recovery-oriented service, offering pharmacological and psychological interventions where appropriate. The consultant psychiatrist completed comprehensive mental health assessments on admission and considered relevant physical health needs. They developed personalised care plans with patients, which were regularly reviewed. Treatment and care were delivered in line with national guidance and best practice to support patients’ recovery and wellbeing.
Our rating of caring stayed the same. We rated it as good. The consultant psychiatrist treated patients with compassion, kindness and respect. Patients’ privacy and dignity were maintained through confidential consultations, private treatment environments, and by involving patients in decisions about their care. Patients were actively involved in care planning and risk assessment, and their feedback was sought to improve the quality of care and treatment provided.
Our rating of responsive stayed the same. We rated it as good. The consultant psychiatrist carried out comprehensive clinical, psychosocial and mental health assessments to develop personalised care plans that reflected each patient’s individual needs, preferences, values and recovery goals. Care was tailored and reviewed to ensure it remained responsive to patients’ changing circumstances.
Our rating of well-led stayed the same. We rated it as good. The consultant psychiatrist had the skills, knowledge and experience to carry out their role effectively. Governance was monitored through regular audits, patient record reviews and risk oversight processes. Findings were used to address shortfalls, monitor quality and support continuous improvement.
People’s experience commentary
Feedback from patients was consistently positive. People described timely access to initial appointments, reliable appointment arrangements and flexibility to move between face-to-face and online consultations.
Patients said they were treated with kindness, dignity and respect. They felt listened to and had enough time to explain their concerns. They said the consultant psychiatrist explained diagnoses, treatment options, medicines and potential side effects clearly, and involved them in decisions about their care.
Patients knew how to seek support if their mental health deteriorated. They described prompt responses to queries, including questions about medicines. They also reported that the administrative support was helpful and responsive.