The Care Quality Commission
  • Hospital
  • Independent hospital

Hammersmith Private Hospital

Overall: Good read more about inspection ratings

Enhance Medical, The Triangle 5-17, Hammersmith Grove, London, W6 0LG (020) 8563 8111

Provided and run by:
Curis Healthcare Limited

Important: The provider of this service changed. See old profile

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Hammersmith Private Hospital on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Hammersmith Private Hospital, you can give feedback on this service.

12 March 2021

During a routine inspection

Our rating of this location improved. We rated it as good because:

  • The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients and acted on them. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
  • Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on their procedures and supported them to make decisions about their care. Key services were available six days a week.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
  • The service planned care to meet the needs of patients, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it.
  • Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients to manage services and all staff were committed to improving services continually.

However:

  • Not all care records were complete. Out of 10 records, three did not have a signed COVID-19 consent form, one National Early Warning Score (NEWS-2) chart had not been scored, and there were missing signatures and incomplete checklists across the rest. The clinic conducted a monthly documentation audit and we saw evidence any omissions were addressed by staff and actions had been taken where documentation fell below the expected standard.
  • In another record, the ‘sign-in’ stage of the World Health Organisation (WHO) surgical safety checklist for patients was incomplete. In the quarterly WHO checklist audit, there were some omissions noted such as missed ‘sign-in’ in the October 2020 audit, and three missed ‘sign-out’ stages in the January 2021 audit. The nominated individual had addressed this with staff and now joined the team brief via video link at the start of each day to ensure improved compliance.
  • Not all staff were aware what the term ‘duty of candour’ meant.
  • There was a low response rate to formal patient feedback questionnaires given out by the clinic, although we saw more patients did leave feedback online.
  • Not all plastic surgeons were on the GMC's specialist register in the relevant area of practice, in line with the Royal College of Surgeons (RCS) recommendations. All medical staff not on the specialist register were encouraged to review this within their appraisal process.
  • Not all staff had been given formal training in chaperoning patients at the time of inspection. This was addressed immediately following inspection.
  • The service had an equality and diversity policy, but this contained some typographical errors and did not seem to be tailored to the clinic.

6 August 2020

During an inspection looking at part of the service

Hammersmith Private Hospital is operated by Curis Healthcare Limited. Facilities include one main theatre, two clinic rooms used for hair transplant operations, consulting rooms, a two-bedded recovery area and a three-bedded ward with overnight stay facilities.

The service provides cosmetic surgery such as breast enlargement and hair transplants, as well as non-surgical interventions.

The service was inspected four times before, in February and March 2018, 12 June 2019, 30 October 2019 and 2 July 2020. Following the October 2019 inspection, two requirement notices relating to infection prevention control and governance remained outstanding. The July 2020 inspection took place following a number of concerns reported to us through the ‘give feedback on care’ section of our website. We inspected this service using our focused inspection methodology, looking specifically at infection prevention control and the management of risk relating to transmission of Covid-19. Following this inspection, we issued an urgent notice of decision to impose conditions on their registration as a service provider in respect of the regulated activity of surgical procedures at Hammersmith Private Hospital. This focused follow-up inspection took place on 6 August 2020 to assess whether these conditions could be lifted.

Services we rate

Our rating of this hospital/service stayed the same. We rated it as Requires improvement overall. We only inspected safe during this focused inspection. Our rating of safe improved. We rated it as good because:

  • The service provided mandatory training in Covid-19 and infection prevention control to all staff and made sure everyone completed it. 
  • The service controlled infection risk well. Staff used equipment and control measures to protect patients, themselves and others from infection. They kept equipment and the premises visibly clean.
  • The design, maintenance and use of facilities, premises and equipment kept people safe. Staff were trained to use them. Processes for the management of clinical waste had been reviewed.
  • Staff completed and updated risk assessments for each patient and removed or minimised risks. There were arrangements to enable staff to identify and quickly act upon patients at risk of deterioration.
  • Staff kept detailed records of patients’ care and treatment in relation to Covid-19 transmission risk. Records were stored securely.
  • The service used systems and processes to safely prescribe and store medicines.

Following this inspection, we told the provider that it should make an improvement, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Nigel Acheson

Deputy Chief Inspector of Hospitals (London and South)

2 July 2020

During an inspection looking at part of the service

Hammersmith Private Hospital is operated by Curis Healthcare Limited. Facilities include one main theatre, two clinic rooms used for hair transplant operations, consulting rooms, a two-bedded recovery area and a three-bedded ward with overnight stay facilities.

The service provides cosmetic surgery such as breast enlargement and hair transplants, as well as non-surgical interventions.

The service was inspected three times before, in February and March 2018 and on 12 June 2019, and again on 30 October 2019. Following the June 2019 inspection, we served a warning notice and identified breaches in Regulation 12 (Safe Care and Treatment) and Regulation 17 (good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The October 2019 inspection was undertaken using our focused inspection methodology to re-inspect the safe and well-led domains only to determine if improvements had been made. Following this inspection, although some improvements had been made, we issued the provider with two requirement notices relating to infection prevention control and governance.

Following a number of concerns reported to us through the ‘give feedback on care’ section of our website, we inspected this service using our focused inspection methodology. We carried out an unannounced inspection of the clinic on 2 July 2020, looking specifically at infection prevention control and the management of risk relating to transmission of Covid-19.

Services we rate

We only inspected safe during this focused inspection. Our rating of safe went down. We rated it as inadequate. Our rating of this hospital/service stayed the same. We rated it as Requires improvement overall because:

  • The service did not control infection risk well. There were inadequate control measures to protect patients, staff and others from infection. Staff did not keep equipment and the premises visibly clean.
  • The service did not provide mandatory training in Covid-19 to all staff and did not make sure everyone completed it. The design, maintenance and use of facilities, premises and equipment did not keep people safe. Staff did not manage clinical waste well.
  • Staff did not complete adequate Covid-19 risk assessments for each patient and did not remove or minimise risks.
  • Staff did not keep detailed records of patients’ care and treatment in relation to Covid-19 transmission risk. Records were not always stored securely.
  • The service did not use systems and processes to safely prescribe and store medicines.

Following this inspection, we issued an urgent notice of decision to impose conditions on their registration as a service provider in respect of the regulated activity of surgical procedures at Hammersmith Private Hospital. We told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with one requirement notice that affected Hammersmith Private Hospital. Details are at the end of the report.

Nigel Acheson

Deputy Chief Inspector of Hospitals (London and South)

30 October 2019

During an inspection looking at part of the service

Ziering London Clinic (One Health) is operated by Curis Healthcare Limited. Facilities include one main theatre, two clinic rooms used for hair transplant operations, consulting rooms, a two-bedded recovery area and a three-bedded ward with overnight stay facilities.

The service provides cosmetic surgery such as breast enlargement and hair transplants, as well as non-surgical interventions.

The service was inspected three times before, in February and March 2018 and on 12 June 2019. During the June 2019 inspection, we served a warning notice and identified breaches in Regulation 12(Safe Care and Treatment)and Regulation 17(good governance)of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.We inspected this service using our focused inspection methodology to re-inspect the safe and well-led domains only to determine if improvements had been made. We looked at processes around mandatory training, infection control, environment, culture and leadership. We carried out the unannounced focused inspection on 30 October 2019.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we rate

Our rating of this hospital stayed the same. We rated it as Requires Improvement overall. Our rating for safe and well led stayed the same as requires improvement. Our rating for effective, caring and responsive remain unchanged as these domains were not inspected this time.

At the last inspection in June 2019 we identified following actions the provider must take to meet the regulations:

  • The provider must have systems to monitor staff compliance with mandatory training.

  • The provider must ensure there are effective systems to control infection risk well.

  • The provider must ensure there are effective systems to safely record and store medicines, including controlled drugs and emergency medicines on resuscitation trolleys.

  • The provider must have effective systems for the maintenance of facilities, premises and equipment to keep people safe.

  • The provider must ensure they are auditing their compliance with Association of Anaesthetics of Great Britain and Ireland (AAGBI) and Association for Perioperative Practice (AfPP) guidance for nursing and theatre staffing.

  • The provider must ensure leaders have effective governance systems in place.

  • The provider must ensure practising privileges are reviewed according to their policy.

  • The provider must review the safeguarding policy to reflect the requirements of the Care Act 2014 (Chapter 14) statutory guidance.

  • The provider must ensure there are regular and effective staff meetings or forums to support staff.

  • The provider must ensure there is an open reporting culture in relation to incidents and shared learning from complaints and incidents.

  • The provider must ensure it is meeting requirements under Regulation 20 (Duty of Candour) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At the last inspection in June 2019 we identified following actions the provider should take to make improvements in relation to safe and well-led:

  • The provider should embed a culture of using the World Health Organisation (WHO) Surgical Safety Checklist in a meaningful way for all surgical procedures, including hair transplant procedures.

    The provider should have effective systems for disposal of medicines.

  • The provider should amend the admission policy to reflect what senior staff reported on the day of inspection regarding body mass index (BMI) limits for patients treated at the clinic.

At this inspection, we found following areas the provider still needs to improve:

  • Not all premises were visibly clean, and we found dust on high surfaces. The provider did not monitor the standards of cleaning carried out by the external company. However, the service had made improvements to control infection risk since our last inspection and had strengthened their own systems for the maintenance of facilities, premises and equipment within the theatre.

  • Although there was now a functioning medical advisory committee (MAC) and the provider had reviewed the practising privileges of all doctors, they still did not follow their own policy and reviewed these outside of the MAC.

  • Leaders had re-established governance processes which operated throughout the service. However, we were unable to comment on the effectiveness of this system as it was at an early stage of implementation. We were also concerned the registered manager may not have sufficient allocated time to focus on governance and operational duties.

However, we found provider had made improvements in the following areas:

  • The service provided mandatory training in key skills to all staff and made sure everyone completed it.

  • Staff understood how to recognise and report abuse. Since the last inspection, staff had received training on safeguarding adults and children level two. The provider had updated the safeguarding policy which reflected the requirements of the Care Act 2014 (Chapter 14) statutory guidance.

  • Managers regularly reviewed staffing levels and skill mix, and gave bank and agency staff a full induction. The provider had assessed compliance with Association for Perioperative Practice (AfPP) and Association of Anaesthetics of Great Britain and Ireland (AAGBI) guidance. All staff had in-date basic life support training (level two) and five staff had immediate life support training.

  • The service now used systems and processes to safely record and store medicines.

  • The service managed patient safety incidents well. Staff recognised incidents and near misses but did not always report them or grade them appropriately. Managers investigated incidents and there was now a system to share learning from incidents with staff. The service used monitoring results to improve safety. Staff collected safety information.

  • At the time of the last inspection, a safer surgical checklist based on the World Health Organisation (WHO) guidance was used for cosmetic procedures only and the service did not use the WHO checklist for hair transplant procedures. Since the last inspection, this had now been implemented for hair transplant procedures too.

  • The provider had amended the admission policy to reflect body mass index (BMI) limits for patients treated at the clinic.

  • Staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss and learn from the performance of the service. The centre had made improvements to the risk management system and engaged with staff regarding improving the service.

Following this inspection, we told the provider it must take action to comply with the regulations and it should make other improvements, even though a regulation had not been breached, to help the service improve. We issued the provider with two requirement notices which affecting the Ziering London Clinic. Details are at the end of the report.

Nigel Acheson

Deputy Chief Inspector of Hospitals (London and South)