Archived: Lancashire Clinic

Updated 30 June 2021

Dr Ajay Nigam FRCS ED, FRCS Eng, FRCS (ORL) is the registered provider. He is a consultant Ear Nose and Throat (ENT) surgeon who is on the General Medical Council (GMC) specialist register. Dr Nigam delivers regulated activities from two registered locations based in Lytham and Garstang.

Lancashire Clinic is a private clinic providing a range of diagnosis and treatment for all ear, nose and throat related disorders. The clinic offers outpatient services for adults and children.

The service is based at 15 Church Road, Lytham, Lytham St Annes, Lancashire, FY8 5LH. The clinic team consists of one doctor, a health care assistant and two reception / administration staff who work between two locations.

The clinic is open Monday to Friday 9am to 4pm and Saturdays from 9am to 5pm.

Website: www.lancashireclinic.co.uk

The service is registered with CQC to undertake the following regulated activities:

• Treatment of Disease, Disorder or Injury
• Diagnostic and Screening Services.
• Surgical Procedures.

How we inspected this service

We carried out this comprehensive inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Throughout the COVID -19 pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently. This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Requesting a provider information return and additional evidence from the provider prior to the site visit.
• Conducting staff interviews remotely using telephone calls.
• A shorter site visit to enable us to undertake a tour of the premises, interview the provider, review clinical records and other documents relating to the service.
• Further communications for clarification.

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.

Updated 30 June 2021

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 announced comprehensive at Lancashire Clinic as part of our inspection programme.

Lancashire Clinic is a private clinic providing a range of diagnosis and treatment for ear, nose and throat related disorders. The clinic offers outpatient services for adults and children.

Comment cards were not distributed to the provider prior to the inspection in order to minimise the risks associated with the COVID- 19 pandemic. No patients attended the clinic on the day of our inspection.

Our key findings were:

• Systems and processes were in place to keep people safe including the maintenance of the premises, clinical equipment and the management of infection control, medication and clinical waste.
• The provider had made several changes to the premises and the management of patient appointments to control the risks associated with transmission of the Covid-19 virus. This included the installation of perspex screens in-between consulting rooms and a microphone system to enable face to face consultations and audiology testing to take place safely during the pandemic.The service had good facilities and was well equipped to treat patients and meet their needs.
• Systems, processes and records had been established to seek consent and to offer coordinated and person-centred care.
• The provider was aware of current evidence-based guidance and they had the skills, knowledge and experience to carry out this role.
• Patients were encouraged to provide feedback and systems were in place to act on and learn from any complaints.
• Patients were able to access care and treatment from the clinic within an appropriate timescale for their needs.
• There was a clear leadership structure and staff felt supported by management
• Staff had access to ongoing training, supervision and appraisal.
• There were clear responsibilities, roles and systems of accountability to support good governance and management.

The areas where the provider should make improvements are:

• Continue to undertake clinical audits and with the routine peer review of clinical records.
• Continue to review and update policies and procedures.
• Include the contact details of the mediation and alternative dispute resolution service in the complaint’s procedure, so patients understand how they can escalate any concerns.
• Record individual medicines and expiry dates when undertaking weekly medicine checks.
• Routinely seek feedback from patients on the quality of clinical care they receive.
• Formalise and document the risk assessment completed for the absence of an oxygen cylinder and defibrillator at the clinic.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care