eXroid (HQ)

Updated 5 October 2022

The Registered Provider is eXroid Technology Limited

Innovation House

Ramsgate Road

Sandwich

CT13 9ND

The eXroid team of clinicians is backed and supported by a management team based at the headquarters who have experience in hospital and healthcare management, both in the NHS and private healthcare.

eXroid is a private company providing consultations and treatments for patients with internal Haemorrhoid Disease (HD). eXroid is an electrotherapy treatment for haemorrhoids, which is offered from CQC registered clinics (which are part of the provider’s registration) across the UK and is an alternative to banding for people with smaller haemorrhoids.

The company operates a four-tier management responsibility structure. This structure may be adapted as the company grows :

Chairman and Medical Director

Founder and Commercial Executive Director

Managing Director

Finance and Commercial Director

Non-Executive Director

Operations Manager

Regularity Affairs Quality Assurance Manager

Marketing Manager

Sales and Patient Services Manager

International Business Development Manager

Chief Clinical Operations Officer

Digital Communications Officer

Patient Services Officer

Services are provided from the following satellite clinics:

• Quinn Clinics Bristol Clinic and Head Office, 4 Redland Court Road, Bristol, BS6 7EE - Mon-Fri: 10am-6 pm or 12-8pm.
• 26 Castle Street, Canterbury, Kent. CT1 2PX - Mon-Sat: 8:30-5:00
• Spire London East Hospital, Roding Lane South, Redbridge, Essex. IG4 5PZ - 9.00am – 5.00pm Mon – Sat.
• Stratum Dermatology Clinic, 5, Ormond Terrace, Regent St, Cheltenham GL50 1HR - Mon-Fri: 8:30am-5.00pm
• 10 Harley Street London W1G 9PF - Mon-Fri: 8:30am-9:00pm, Sat-Sun: 8:30am-5:30pm.
• Raynes Park Health Centre, 1 Lambton Road, Wimbledon, SW20 0LW - Mon-Fri: 8:30am-8.00pm, Sat: 9:00am-1:00pm.
• Pall Mall Medical, 61-67 King Street, Manchester. M2 4PD - Mon-Fri: 8:00am -7.30pm, Sat:10:00am-2:00pm.
• Oaklands Hospital, 19 Lancaster Road, Salford, Greater Manchester, M6 8AQ
• Stratum Dermatology Clinic, Cantay House, 38-39 Park End St, Oxford OX1 1JD - Mon-Fri: 8:30am-5.00pm
• Ipswich Road, Woodbridge, Suffolk. IP12 4FD - Mon-Fri: Tues: 8:00am-8:00pm and Mons, Weds, Thurs, Friday 8:00am-6:30pm
• The Crescent Clinic, 9 The Crescent, Taunton, TA1 4EA
• Midland Health, Highfield Clinic, 23a Highfield Road, Edgbaston, Birmingham, B15 3DP - Mon-Fri: 8:00am-7.00pm, Sat: 8:00am - 1:00pm
• 1 Park Avenue, Solihull, West Midlands, B91 3EJ - 8.00am – 5.00pm Mon–Fri, 8.30am – 3.00pm Sat.
• Little Aston Hall Drive, Little Aston, Sutton Coldfield, B74 3UP - 8.00am – 5.00pm Mon–Fri, 8.30am – 3.00pm Sat.
• Spire Dewsbury Clinic, Dewsbury, West Yorkshire. WF13 4AN - Mon-Fri: 9am-6:00pm
• Spire Elland Hospital, Elland, West Yorkshire. HX5 9EB - Mon-Fri: 8:00am -7.30pm, Sat:10:00am -2:00pm.
• Spire Methley Park Hospital, Methley Lane, Methley, Leeds, LS26 9HG - 9.00am – 5.00pm Mon – Sat.
• Healthshare Clinic Winchester, Chilcomb Park, Chilcomb Lane, Winchester. SO21 IHU - Mon-Fri: 8:00am - 6.00pm.

There are three satellite clinics that are outside of CQC regulation:

• the areas Cyncoed Consulting Rooms, Cyncoed Medical Centre, Dartington Drive, Cardiff. CF23 8SQ - Mon-Thurs: 8:30am-5:30pm and Friday 8:30am-12pm.
• GP Matters, 24 Buckingham Terrace, Glasgow G12 8ED - Mon-Thur: 9:00am -6:00pm, Fri: 9:00-1:00pm/
• Remedy Clinic, 29 Westland Square, Pearse Street, Dublin 2, D02 W135 - Mon-Fri: 7.00am – 9.00pm Weekends: 8.00am - 6.00pm

The Cardiff satellite clinic is regulated by Healthcare Inspectorate Wales (HIW) who undertook a remote quality check of Cyncoed Consulting Rooms as part of its programme of assurance work and registered the premises in January 2021.

The Glasgow clinic is regulated by Health Improvement Scotland. It is currently administered through the Health and Social Care Directorates of the Scottish Government.

The Dublin clinic is regulated by HIQA (Health Information and Quality Authority) who promote safety and quality in healthcare services in Ireland. To do this, they inspect hospitals and other healthcare providers and talk to patients, staff and managers to determine if healthcare providers are meeting national standards.

Therefore, all of these clinics fall outside of the CQC scope of registration.

Treatment and care is delivered by one of the provider’s GMC registered consultant grade specialist doctors, the majority of which are colorectal surgeons or general surgeons with a specialist interest in colorectal treatment, who are supported by chaperones and an administration/ service provider management team. The doctors had practising privilege which was the 'licence' agreed between individual medical professionals and a private healthcare provider. In effect, they set out the clinician's offer, such as the range of surgery they are competent to perform. The nurses/chaperones were also not employed directly by eXroid, some were agency contracted and some were provided directly by the clinic sites. Those provided by the clinics directly were stipulated in the clinic contract.

Services were provided to patients aged 18 years or over. The patient profile was from an informed, largely adult population; however, there was potential for attracting individuals with learning difficulties, or psychological or psychiatric conditions.

Patients with haemorrhoids can call for advice and guidance or book an appointment online. There is a tailored assessment framework in use with a pre examination consultation, including medical history and symptom recording. A proctological (a rectal) examination with a GMC Specialist Consultant is undertaken.

The service provides a post examination consultation, including specialist advice on treatment options and suitability for the electrotherapy treatment. There are informed consent procedures. Treatment of up to three haemorrhoids can be provided. The service utilises eCAT (a clockface) diagnostic tool for patients to take away for tracking changes in their condition. Aftercare services include a four-week post-treatment patient follow-up call and access to patient services experts.

All patients were given an emergency contact number as part of their aftercare support.

All clinics had disabled access apart from Canterbury Skin and Laser Clinic which is situated on three floors: the ground floor and two upper floors. Waiting areas and facilities were provided by the satellite clinics.

How we inspected this service:

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Speaking with staff in person and on the telephone.
• Requesting evidence from the provider.
• A short site visit to the service.

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 we looked at during the inspection.

Updated 5 October 2022

This service is rated as Outstanding overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Outstanding

Are services caring? – Outstanding

Are services responsive? – Good

Are services well-led? – Outstanding

We carried out an announced comprehensive inspection at eXroid (HQ) as part of our inspection programme. This was the provider’s first inspection of the service since it registered with the Care Quality Commission (CQC) in February 2020.

eXroid (HQ) provides electrotherapy for the treatment of haemorrhoids (piles) by colorectal specialist consultants in the UK, in clinics across the country.

The service is registered with CQC to provide the following regulated activities: Treatment of disease, disorder or injury.

The Chairman and Medical Director 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.

Our key findings were:

• Policies and procedures were comprehensive, up to date and relevant to the service.
• All staff had the appropriate level of training for safeguarding adults relevant to their role and staff training in other required subjects was up to date.
• Consent was recorded appropriately for each contact with the patient.
• Patient feedback was positive about their care experience.
• The service was supportive of patients’ needs and patients were able to access the service in a timely manner.
• There was clear leadership and leaders had the capacity and skills to deliver high-quality, sustainable care.
• The provider had effective processes for planning of the future leadership and workforce of the service.
• Governance arrangements were implemented effectively.
• The provider had a culture which drove high quality sustainable care. There were high levels of satisfaction across all staff.
• There were clear responsibilities, roles and systems of accountability to support good governance and management.
• There were consistently high levels of constructive engagement with staff and people who use services.
• There were systems and processes for learning, continuous improvement and innovation.

We saw the following outstanding practice:

• The provider had developed an accredited device which used electrotherapy technology to shrink internal haemorrhoids. They had undertaken over 4000 haemorrhoid treatments in the UK and were gaining valuable insight and understanding in the progression and changes in this disease. They undertook analysis of these treatments regularly, to understand the occurrence and prevalence.They aimed to publish findings so that both sufferers and medical professionals could access more data in this area, in order to improve services and advice currently available.

• The provider had developed a patient assessment tool to monitor treatment progress, which was the subject of a poster presentation at The European Society of Coloproctology. The provider had developed this into a leaflet which patients were able to share with their GP or other specialist to update them on treatment progress and as an education tool.

Dr Sean O*Kelly
Interim Chief Inspector of Primary Medical Services and Integrated Care