London IVF and Genetics

Updated 18 March 2022

London IVF and Genetics Centre is a private clinic in London. It provides consultations and ultrasound scans prior to fertility treatments, as well as post-fertility treatment follow-up appointments. Patients seen at the clinic go on to be seen at another facility that provides fertility treatments to assist a person/s in becoming pregnant, which falls under the scope of regulation by the Human Fertilisation and Embryology Authority (HFEA). The service primarily serves private patients over the age of 18 from London, but also accepts patient referrals from outside this area, including international patients. The clinic consists of one consultation and scanning room, leased by the hour. There was a shared patient reception and access to a toilet.

We have never inspected this service before. It was registered in 2015 and the registered manager has been in post since opening. The registered manager was the sole clinician working at the service, with support from a team of medical secretaries to manage bookings and patient contact.

The main service provided by this hospital was outpatient services. Where our findings on outpatient service – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the outpatient service.

Updated 18 March 2022

This is the first time we rated this service. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. The registered manager had training in key skills. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well.
• Staff provided good care and treatment and gave patients enough to drink. The registered manager monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients and supported them to make decisions about their care. Key services were available six days a week.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients.
• The service planned care to meet the needs of patients, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• The registered manager ran services well using reliable information systems. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients to plan and manage services and all staff were committed to improving services continually.

However:

• At the time of our inspection, the clinic’s safeguarding policy was not comprehensive and did not reference female genital mutilation (FGM), although the lead doctor did have knowledge in this area. Following inspection, the provider submitted evidence they had adapted the safeguarding policy to include information on FGM.
• The team of medical secretaries had not received any safeguarding training at the time of our inspection. Following our inspection, the provider told us they had arranged for these secretaries to have level one safeguarding adults training.
• The chairs in the leased clinic room were not wipe clean, presenting an infection prevention control risk.
• At the time of inspection, the doctor did not have access to the cleaning records of the external cleaner to demonstrate all areas were cleaned regularly. Following our inspection, the provider met with the building management and put into place an assurance process regarding cleaning of the leased clinic room.
• There was no assurance process in place to ensure the defibrillator was in working order. Following our inspection, the provider met with the building management and put into place an assurance process regarding defibrillator checks.
• Within the leased room there were disposable items used by other services who used the same space that were out of date. There was no checklist in place to indicate which items were specifically for this service. Following our inspection, the provider introduced such a checklist.
• The sharps bin was stored on the floor and the temporary closure was not in use. Following our inspection, the sharps bin was moved to a secure location.
• The clinic did not have a formally documented admission policy that set out a safe and agreed criteria for the types of patients that were able to be treated. Following inspection, the provider submitted evidence they had drafted an admission policy.
• The response rate of formal patient feedback questionnaires was low. However, the completed feedback form and thank you cards and emails from the previous 12 months were consistently positive about the clinic.
• A chaperone was offered for all intimate examinations and the lead doctor told us they would ask an agency nurse to come in should the patient wish. However, this was not formally documented anywhere.
• The service did not have a formally documented vision or strategy.
• There was no formal risk assessment document to minimise risks associated with lone working. There was an informal arrangement with the clinic next door in case of any issues whilst seeing patients, but this was not documented. Following our inspection, the provider drafted a formal risk assessment regarding lone working at the clinic.
• The ultrasound machine was the property of the building that the leased clinic room was in. On the day of inspection, the doctor did not have access to evidence that the manufacturer maintained and serviced it annually. Following inspection, the lead doctor met with the building management and put into place an assurance process regarding the maintenance of the ultrasound machine.
• There was no formal drafted policy regarding frequent scanning.
• There was no audit or peer review of ultrasound images and reports to check their quality.
• Scans were stored on the ultrasound machine but there was no system to store these images separately or to delete or archive these.

Updated 18 March 2022

This is the first time we rated this service. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. The registered manager had training in key skills. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well.
• Staff provided good care and treatment and gave patients enough to drink. The registered manager monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients and supported them to make decisions about their care. Key services were available six days a week.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients.
• The service planned care to meet the needs of patients, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• The registered manager ran services well using reliable information systems. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients to plan and manage services and all staff were committed to improving services continually.

However:

• The ultrasound machine was the property of the building that the leased clinic room was in. On the day of inspection, the doctor did not have access to evidence the manufacturer maintained and serviced it annually. Following inspection, the lead doctor met with the building management and put into place an assurance process regarding the maintenance of the ultrasound machine.
• There was no formal drafted policy regarding frequent scanning.
• There was no audit or peer review of ultrasound images and reports to check their quality.
• Scans were stored on the ultrasound machine but there was no system to store these images separately or to delete or archive these.

Diagnostic imaging is a small proportion of service activity. The main service was outpatient services. Where arrangements were the same, we have reported findings in the outpatient section.

Updated 18 March 2022

This is the first time we rated this service. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well.
• Staff provided good care and treatment and gave patients enough to drink. The registered manager monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients and supported them to make decisions about their care. Key services were available six days a week.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients.
• The service planned care to meet the needs of patients, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• The registered manager ran services well using reliable information systems. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients to plan and manage services and all staff were committed to improving services continually.

However:

• At the time of our inspection, the clinic’s safeguarding policy was not comprehensive and did not reference female genital mutilation (FGM), although the lead doctor did have knowledge in this area. Following inspection, the provider submitted evidence they had adapted the safeguarding policy to include information on FGM.
• The team of medical secretaries had not received any safeguarding training at the time of our inspection. Following our inspection, the provider arranged for these secretaries to have level one safeguarding adults training.
• The chairs in the leased clinic room were not wipe clean, presenting an infection prevention control risk.
• At the time of inspection, the doctor did not have access to the cleaning records of the external cleaner to demonstrate all areas were cleaned regularly. Following our inspection, the provider met with the building management and put into place an assurance process regarding cleaning of the leased clinic room.
• There was no assurance process in place to ensure the defibrillator was in working order. Following our inspection, the provider met with the building management and put into place an assurance process regarding defibrillator checks.
• Within the leased room there were disposable items used by other services who used the same space that were out of date. There was no checklist in place to indicate which items were specifically for this service. Following our inspection, the provider introduced such a checklist.
• The sharps bin was stored on the floor and the temporary closure was not in use. Following our inspection, the sharps bin was moved to a secure location.
• The clinic did not have a formally documented admission policy that set out a safe and agreed criteria for the types of patients that were able to be treated. Following inspection, the provider submitted evidence they had drafted an admission policy.
• The response rate of formal patient feedback questionnaires was low. However, the completed feedback form and thank you cards and emails from the previous 12 months were consistently positive about the clinic.
• A chaperone was offered for all intimate examinations and the lead doctor told us they would ask an agency nurse to come in should the patient wish. However, this was not formally documented anywhere.
• The service did not have a formally documented vision or strategy.
• There was no formal risk assessment document to minimise risks associated with lone working. There was an informal arrangement with the clinic next door in case of any issues whilst seeing patients, but this was not documented. Following our inspection, the provider drafted a formal risk assessment regarding lone working at the clinic.