The London Transgender Clinic

Updated 30 December 2021

The London Transgender Clinic provides a consultation service to transgender and non-binary individuals, offering guidance and support related to primary care; reproductive options, voice and communication therapy and mental health services (assessment, counselling, psychotherapy). They also offer hormonal treatment and make arrangements for surgery at another independent hospital. Some of these services are arranged with individual professionals working external to the provider location under partnership arrangements. There is on-site provision for minor surgical procedures under local anaesthetic.

The service is registered to provide the following regulated activities:

- Treatment of Disease, Disorder and Injury

- Surgical Procedures

- Diagnostic and Screening Procedures

On-site aesthetic procedures including hair removal are available but do not come under the regulated activities and were not part of this inspection.

The registered manager is Mr Christopher Inglefield. Mr Inglefield is a consultant surgeon who has practising privileges at the hospital where surgery is undertaken.

This service had a focused inspection carried out on 28 September 2021 in response to concerns raised with the Care Quality Commission (CQC). Following that inspection we told the provider they must take action to address concerns related to staff mandatory training and the management of incidents. As a result, we served a warning notice under section 31 of the Health and Social Care Act 2008.

We undertook this follow up site visit on 9 December 2021 to check if the provider had addressed the concerns within the expected time frame.

The inspection methodology for outpatients was used for the areas of focus.

Updated 30 December 2021

We inspected specific parts of this service and rated it as Inadequate for well-led. We served the provider with a warning notice and told them they must make improvements because we found:

• The service had not set up a clear protocol for staff to follow regarding mandatory safety training. Staff were not clear what subject’s they were expected to complete relevant to their role. The frequency of required training and at what level was not formally stated. There was no oversight of staff training or monitoring of their completion of training.
• The service did not have a formalised system to report, manage and investigate safety incidents. There was a lack of a documented system for staff to follow for reporting adverse incidents and near misses. The investigative process for incidents was not clearly stated. Because of this, there was a risk that lessons learned from incidents were not being shared. Safety information was not being collected and used it to improve the service.
• The service did not have a well set out governance arrangement or programme of audit to help staff make improvements when and if needed.

However:

• Services were planned and took account of patients’ individual needs. People could access the service when they needed to and did not have to wait too long for treatment or follow up care.
• Staff assessed risks to patients, made sure these were acted on and kept good care records to show the pathway of treatment and care, including details related to informed consent. Staff managed the prescribing of medicines well and made arrangements to ensure patients had access to required medicines.

Updated 30 December 2021