27 April 2022
Doctors of the World Clinic provides medical care, information and practical support to excluded people such as destitute migrants, sex workers and people with no fixed address. The clinic is based in a migrant support hub building called ‘The People’s Place’ and which brings together different charitable organisations supporting vulnerable people. Doctors of the World Clinic has a dedicated reception and three clinical rooms as well as four interview spaces for non-clinical social support. The clinic facility offers step free access and is located approximately 10 minutes from Pudding Mill Lane and Stratford underground/DLR train stations.
The service provides a telephone advice line for patients (non-clinical advice); 10:00am–12:00pm Monday to Thursday. There is a recorded message outside of these times, signposting to Accident & Emergency if someone is unwell.
Patients can text and/or email the clinic throughout working hours (9:00am-5:00pm) Monday-Friday. Texts and emails are regularly monitored throughout the day. There is an auto-response on the clinic’s email, advising patients to attend Accident & Emergency or call 999 in a medical emergency; or attend an urgent care centre/call 111 if a patient feels they need to see a doctor urgently.
Remote GP clinical consultations are conducted flexibly on a shift basis according to availability of volunteers, Monday to Friday. Appointment sessions run from 10:00-1:00pm (3 slots of 1 hour) and 1-4:00pm (3 slots of 1 hour).
How we inspected this service
Before our inspection, we gathered and reviewed information from a number of sources including patient feedback submitted via our website and information submitted by the provider.
During our inspection, we spoke with staff, reviewed clinical records and reviewed 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.
27 April 2022
This service is rated as
overall (last inspection February 2018, unrated under a previous provider).
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? – Outstanding
We carried out an announced comprehensive inspection at Doctors of the World Clinic on 24 February 2022 as part of our inspection programme.
Doctors of the World operates a clinic in Stratford, East London; providing medical care, information and practical support to excluded people such as destitute migrants, sex workers and people with no fixed address. A range of advocacy programmes are also provided across London.
The Senior Programme Lead 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:
- Leaders had an inspiring shared purpose. They strove to deliver and motivate staff to succeed. The leadership, governance and culture were used to drive and improve the delivery of high-quality person-centred care.
- People had comprehensive assessments of their needs, which included consideration of clinical needs, mental health, physical health and wellbeing.
- Learning was based on a thorough analysis and investigation of things that went wrong. All staff were encouraged to participate in learning and to improve safety as much as possible.
- Safeguarding vulnerable adults, children and young people was given priority.
- Clinical audits were carried out and all relevant staff were involved. There was participation in relevant local audits and other monitoring activities such as pathway and service reviews.
- There was a strong, visible, person-centred culture. Staff were highly motivated and inspired to offer care that was kind and promoted people’s dignity.
- There was a proactive approach to understanding the needs of different groups of vulnerable people and to delivering care in a way that met these needs and tackled health inequality. People could access appointments and services in a way and at a time that suits them.
- We saw evidence of high levels of staff satisfaction. Staff were proud of the organisation as a place to work and spoke highly of the culture.
- Innovative approaches were used to gather feedback from people who used services and the public, including people in different equality groups.
- Monitoring and reviewing activity generally enabled staff to understand risks and gave a clear, accurate and current picture of safety. However, records showed the provider’s landlord had initially failed to provide assurance that appropriate action had been taken to monitor fire risks and risks associated with a bacterium called Legionella (which can proliferate in building water systems). This assurance was provided shortly after our inspection.
- Although the service had not received any formal complaints in the previous 12 months, we noted information about how to make a complaint was only on display at the clinic and not on the service’s website.
- Leaders drove continuous improvement and staff were accountable for delivering change. There was a clear proactive approach to seeking out and embedding new ways of providing care and treatment.
The areas where the provider should make improvements are:
- Take action to make its complaints procedures more accessible.
- Continue to log periodic risk assessments for Legionella and fire safety.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care