9 November 2022
The MC Clinic Ltd provides medical treatment for patients focused around the use of cannabis-based products for medicinal use (CBPMs) by experienced medical staff. The service is located at 10 Harley Street, London, W1G 9PF. The building entrance lobby is accessed via steps from the pavement. Wheelchair access is via a ramp at the front of the building. The service has access to two consultation rooms and a waiting area for patients. However, at the time our inspection most consultations were taking place online due to Covid–19.
The opening hours are 9am to 6pm with patients’ appointments between 9.30am and 5pm. Patients can also book appointments for evenings and weekends. The medical team comprises of nine consultants who specialise in Psychiatry, Pain and Neurology. There is also a managing director, operations manager, clinic nurse advisor and nine patient services coordinators.
The service treats a range of conditions including pain, psychiatric conditions, neurological conditions, gastroenterological, cancer and palliative care.
How we inspected this service
We spoke with the managing director, clinical director, registered manager, one of the consultants, administration manager and administrative staff. We looked at records related to patient assessments and the provision of care and treatment. We also reviewed documentation related to the management of the service. We reviewed patient feedback.
To get to the heart of patients’ experiences of care and treatment, we asked the following three questions:
- Is it safe?
- Is it effective?
- Is it caring?
- Is it responsive?
- Is it well-led?
These questions therefore formed the framework for the areas we looked at during the inspection.
9 November 2022
This service is rated as
overall. (Previous inspection March 2022 – Requires improvement)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Good
We carried out this announced focused inspection of The Medical Cannabis Clinic under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions and to follow up on breaches of regulation we identified in a compliance review in March 2022 and to follow up on information of concern that we had received. At the last inspection carried out in March 2022 we found they were not operating effective systems and processes to ensure good governance in accordance with the fundamental standards of care, in particular:
- Individual care records did not always indicate what the patient was being treated for.
- There were no details of discussion in Multi Disciplinary Team (MDT) meetings to demonstrate robustness of decision making.
- The provider did not have effective processes in place to assess the competencies of all staff they employed in order to plan appropriate training and development.
- We were not assured that the systems for reporting and following up on incidents were operating effectively.
- The policies relating to medicines and prescribing of cannabis based medicinal products did not cover important operational aspects of the service and were not always followed.
At this inspection on 28 & 29 September and 7 October 2022 we carried out a full comprehensive inspection and found significant improvements had been made.
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations
The Medical Cannabis Clinic provides medical treatment for patients focused around the use of Cannabis Based Products for Medicinal Use (CBPMs) by experienced medical staff working within the government guidelines.
The operations manager was 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.
We did not speak directly with patients during the inspection.
Our key findings were:
- Significant improvements had been to the service which included recruitment of appropriately skilled staff and implementation of key systems and processes to ensure effective monitoring of care and treatment.
- The provider had systems in place to protect people from avoidable harm and abuse.
- The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
- There was a clear vision to provide a safe, personalised, high quality service.
- All staff we spoke to felt valued by the leaders and said there was a high level of staff support and engagement.
- The systems for reporting and following up on incidents were operating effectively.
- The policies relating to medicines and prescribing of cannabis based medicinal products covered important operational aspects of the service and were followed by all clinicians.
- Patients could access care and treatment from the service within an appropriate timescale for their needs.
- The service had a business development strategy that effectively monitored the service provided to assure safety and patient satisfaction.
The areas where the provider should make improvements are:
- Review all active patient records to ensure they contain a copy of relevant identification.
- Implement a process to record and identify clinical outcomes for patients.
- Continue to review information available for patients in relation to medicine delays.
Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA
Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services