This service is rated as
Good
overall.
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 an unannounced comprehensive inspection of the Portland Place Outpatient Centre, Cleveland Clinic London as part of our inspection programme. The Portland Place Outpatient Centre provides outpatient services; diagnostic services including radiology; and a GP service. The Portland Place Outpatient Centre has not previously been inspected.
This report focuses on our findings in relation to the GP service at Portland Place Outpatient Centre. The GP service is a primary care medical service, open to patients of any age.
Our key findings were:
- The service had clear systems in place to safeguard patients identified as being at risk of abuse or neglect. However, systems for checking parental authority were not consistently in place and were not formalised.
- Patients’ immediate and ongoing needs were fully assessed.
- The GPs were able to readily refer patients for further diagnostic testing and specialist consultation as required on the same site or through the provider’s nearby hospital service.
- Care records were generally written and managed in a way that kept patients safe. However, the GPs did not always clearly record the ‘safety netting’ advice provided to patients or clarify the presence or absence of ‘red flag’ symptoms (that is, symptoms that might indicate a more serious illness). Safety-netting refers to the advice given to a patient about the actions to take if their condition fails to improve or deteriorates after the consultation.
- Patients were treated with compassion, kindness, dignity and respect.
- We saw evidence of consistently positive feedback from patients using the GP service.
- The service actively sought and acted on feedback from patients using the GP service to improve the service.
- The service used information about care and treatment to make improvements and the GPs were actively involved in leading quality improvement activity.
- The service was accessible. Patients were able to consult with a GP within an appropriate timescale for their needs.
- Staff we spoke with understood the vision, values and strategy and their role in achieving them.
- The GP service was underpinned by clear systems of governance and processes for managing risk, issues and performance.
The areas where the provider should make improvements are:
- Introduce a consistent system to check that adults accompanying children to see a GP always have parental authority.
- Take steps to consistently record and audit ‘safety netting’ advice given to patients and any ‘red flag’ symptoms in the patient notes in line with General Medical Council guidelines.
- Take steps to ensure that staff, including non-clinical staff, who have GP patient-facing roles, are aware of the risks of sepsis and relevant protocols.
- Formalise a policy on the range of prescribed medicines where the patient’s NHS GP should be kept informed for safety reasons and the appropriate response if patients refuse consent to share this information with them.
- As the GP service develops, increase clinical improvement activity and obtain more focused patient feedback on the quality of clinical care.
Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA
Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services