1 July 2019
Veincentre Limited is registered as a limited company with the Care Quality Commission (CQC) and is the service provider. Clinics are provided at sites based in Manchester, Bristol, London, Stoke-on-Trent, Nottingham, Southampton and Oxfordshire. The services are provided to adults privately and are not commissioned by the NHS. During this inspection we visited the location in Stoke-on-Trent which is situated at:
- Lyme Vale Court, Lyme Drive Park, Stoke-on-Trent, Staffordshire, ST4 6NW.
Veincentre Stoke provides a private consultation and treatment service to adults with varicose veins. The service is owned and managed by the founder, medical director and registered manager, who is a consultant interventional radiologist. It provides consultations, ultrasound scanning and minimally invasive treatment procedures to manage symptoms and treat complications of venous insufficiency and improve the appearance of varicose veins.
A range of treatments are provided based on the assessed needs of patients. These treatments include foam sclerotherapy where injections of a solution are made directly into the vein, avulsions where small incisions are made in the skin and the vein removed and endovenous laser ablation (EVLA) a laser treatment carried out under local anaesthetic. The clinic comprises of two operating theatres, a recovery area and a reception area. All vascular services are located on the ground floor and the head administrative office is based on the first floor.
Opening hours are between 9am till 5.30pm Monday to Wednesday and 9am till 6pm Thursday and Friday. Clinics are provided on Tuesday and Wednesday 9.30am – 6pm and alternate Fridays 9.30am – 6pm, subject to consultant availability. Patients can choose to access the provider’s other clinics if convenient to them. Appointments can be booked over the telephone or by email. Patients are usually seen within three weeks of their initial enquiry however, additional clinics can be provided if demand exceeds this. Patients with urgent symptoms are prioritised. The service has an out of hour’s emergency telephone line that provides direct contact to a consultant.
The staff team at Veincentre Stoke consists of:
- A male consultant vascular surgeon
- Two male consultant interventional radiologists
- A business manager and assistant business manager
- A board of directors
- A female nurse practitioner and female staff nurse.
- A health care assistant
- Reception and administrative staff.
Practising privileges are given to two consultant ophthalmic plastic surgeons within the premises who undertake eyelid surgery under local anaesthetic.
We carried out an announced comprehensive inspection on 29 May 2019.
Before our inspection we reviewed a range of information we held about the service and asked the service to send us a range of information. This included the complaints they had received in the last 12 months, their latest statement of purpose, the details of their staff members, their qualifications and proof of registration with their professional bodies. As part of the inspection we spoke with a range of staff including the medical director/ registered manager, business director, a consultant interventional radiologist, a nurse practitioner, a health care assistant and administrative staff. We gained feedback from 29 patients, carried out observations and a review of documents.
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.
1 July 2019
We carried out an announced comprehensive inspection at Veincentre Stoke on 29 May 2019 as part of our inspection programme.
Veincentre Stoke is based in Stoke-on-Trent, Staffordshire and provides specialist non-surgical diagnosis and treatment for adults suffering from venous insufficiency, a condition that occurs when the venous walls or valves in the leg veins are not working effectively.
Dr David West 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.
Twenty-nine patients provided feedback about the service through our Care Quality Commission (CQC) comment cards. Six patients contacted the CQC directly to share their experience of the service. Feedback obtained clearly demonstrated positive outcomes for patients. Patients told us staff were excellent, caring, helpful, professional and friendly. They told us they were involved in decisions about their care and the service was good value for the money they had paid. They considered the clinic provided an excellent service with the care and treatment exceeding their expectations. Patients also told us they were given all the information they needed to make an informed decision about their treatment options in advance of their treatment in addition to receiving detailed aftercare support and advice.
Our key findings were
- There was a transparent approach to safety with effective systems in place for reporting and recording adverse incidents.
- There were effective procedures in place for monitoring and managing risks to patient and staff safety. For example, there were arrangements in place to safeguard vulnerable people from abuse, and to ensure the premises were safe for patients, staff and members of the public.
- There were systems in place for checking emergency equipment however, they were not always effective. This was rectified immediately after our inspection.
- There were systems in place for the appropriate and safe handling of medicines however, records were not always completed in line with national guidance following the administration of medicines. This was rectified immediately after our inspection.
- Patients received detailed and clear information about their proposed treatment which enabled them to make an informed decision. This included costs, risks and benefits of treatment.
- Clinicians assessed patients according to appropriate guidance, legislation and standards and delivered care and treatment in line with current evidence-based guidance.
- Staff were supported through supervision, training, coaching and mentoring appropriate to their role.
- Patient feedback was that staff were excellent, caring, helpful, professional and friendly.
- Patients were offered appointments at a time convenient to them and with the same clinician to ensure their continuity of care and treatment.
- Information about services and how to complain was available and easy to understand.
- The provider was aware of, and complied with, the requirements of the Duty of Candour.
- There was evidence of continuous improvement and innovation.
We saw the following outstanding practice:
- Veincentre Stoke delivered a super specialist service to treat varicose veins. (A super specialist is a sub-specialist who has self-limited their practice to one aspect of a sub-specialty). This single disorder management enabled more efficient working and delivery of care and treatment. Data showed to us by the service demonstrated outcomes for patients undergoing treatment for varicose veins were above national thresholds. For example, lower complication rates and higher patient reported outcome measures.
The areas where the provider should make improvements are:
- Follow and act on their own processes for checking that emergency equipment is in date.
- Monitor staff compliance with completion of records made following the administration of medicines.
- Review their processes for assessing that staff are physically and mentally suitable to carry out their role.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care