Dr Todd Mitchell, Consultant Psychiatrist

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This means we looked for evidence that leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this inspection, the rating has remained the same.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service was led by the consultant psychiatrist, who was also the registered manager and registered provider. They worked closely with Harley Therapy, which managed the operational aspects of the service, to ensure patients received a high-quality, responsive and efficient service.The consultant psychiatrist and administrative support staff shared a commitment to delivering safe, effective and person-centred care. Effective communication between the clinical and administrative functions supported the day-to-day delivery of the service.

The consultant psychiatrist had the skills, knowledge and experience to lead the service effectively.

The consultant psychiatrist maintained professional competence through annual appraisal, continuing professional development, peer review and revalidation. They demonstrated a caring and compassionate focus on patients’ needs and a commitment to keeping clinical practice up to date. Patients described the consultant psychiatrist as open and clear in their communication.

The service aimed to create a positive culture where people felt they could speak up and their voice would be heard.

There were positive working relationships between the consultant psychiatrist, the remote Harley Therapy administrative team, and the premises management team at 10 Harley Street Ltd.

Staff described effective communication and collaborative working arrangements, which supported an open and positive culture where people felt able to speak up, share feedback and raise concerns. Staff were confident that their views would be listened to and acted upon where appropriate.

The service valued equality, diversity and inclusion and sought to ensure people were treated fairly, with dignity and respect.

The consultant psychiatrist understood the importance of equitable care and of responding to protected characteristics and individual circumstances. Patients said they felt respected and valued as individuals.

The service had clear responsibilities, systems of accountability and governance arrangements that supported good-quality, sustainable care.

The service held regular monthly team meetings to discuss service delivery, governance matters and opportunities for improvement. The consultant psychiatrist had implemented a comprehensive range of policies and procedures to support the safe and effective delivery of care. These included policies relating to complaints, chaperones, infection prevention and control, controlled drugs, prescribing, safeguarding adults and children, data protection, governance, patient safety and consultancy arrangements. Policies and audits were reviewed annually to provide assurance that systems were operating as intended.

The consultant psychiatrist was aware of and had systems in place to meet the requirements of the duty of candour. They participated in an annual appraisal process through the Independent Doctors Federation, which included reflection on clinical practice, continuing professional development and personal development objectives. The consultant psychiatrist was supported to meet professional revalidation requirements and was allocated protected time for professional development activities, including appraisals, peer review and clinical audit. These arrangements supported professional accountability and provided assurance that the consultant psychiatrist maintained the knowledge and skills required for their role.

The consultant psychiatrist maintained a risk register to identify, monitor and mitigate risks within the service. Risks were regularly reviewed, and appropriate controls were implemented. For example, professional isolation had been identified as a potential risk and was mitigated through regular collegial contact with collaborating clinicians for case-based discussions six to eight times per year, active membership of professional networks, and regular consultative dialogues with the leadership team at Harley Therapy.

The service worked with GPs, NHS services and other specialists to support coordinated care and physical health monitoring.

Care records showed communication with specialist teams and other professionals. The service sought patients’ consent before sharing information with other healthcare providers and used this communication to support continuity and safe care.

The service focused on continuous learning and improvement.

The consultant psychiatrist engaged with a range of professional networks and external organisations to support ongoing service development and maintain awareness of developments in mental health care.

The consultant psychiatrist participated in regular discussions with professional colleagues to reflect on clinical practice, share learning and consider developments in assessment and treatment approaches. This supported opportunities to consider different perspectives, identify improvements where appropriate and maintain awareness of emerging practice within the wider mental health sector.

The consultant psychiatrist also collaborated and consulted with other local clinicians and maintained links with specialist services, enabling the service to learn from wider professional experience and support continuous improvement in the care provided to patients.