VHK Women's Health Clinic

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The 2 doctors who owned the service had put in place a proactive and positive culture of safety based on openness and honesty. Concerns about safety were fully investigated. The 2 doctors who owned the service ensured lessons were learnt to identify and embed good practices. They managed prescriptions safely and in a way which met people's needs. They made sure clinic areas were clean and well maintained and wore personal protective equipment where required. The 2 doctors who owned the service received appropriate training in areas such as safeguarding adults and treatment of menopause.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Patients experienced care based on the latest updates and learning which followed national updates and safety incidents. The 2 doctors who owned the service had specialist expertise in how to treat symptoms of menopause and additional factors which could affect this.

The 2 doctors who owned the service demonstrated a strong culture of learning. They carried out regular case reviews and gave examples of learning from these. They attended course and were members of subject matter groups to aid and improve learning.

The service had a significant events policy in place. The 2 doctors who owned the service followed this policy and discussed events and incidents during quarterly governance meetings. From the sample of significant events we reviewed, we found staff reviewed them in line with their policy and lessons were learnt to improve the quality of care. We saw evidence the service was signed up to receive safety events and medicine safety alerts and discussed these within quarterly governance meetings.

The service shared information about patients' treatment appropriately with relevant healthcare professional such as their GP. This meant the patient experienced a joined up approach of the management of their health.

The 2 doctors who owned the service had processes in place to ensure pathways and transitions for people back to their GP or to other services were clear and easy to follow. People’s records showed the referrals were made promptly and followed up to ensure there was a delay in someone receiving treatment.

Partners worked alongside the service to make improvements to the systems. For example, they suggested feedback to the service to help them improve their follow up GP letters.

The service had a referral policy and appropriate processes in place for referral to other services including back to the patients registered GP. If an urgent referral was required, the service rang the named GP with the patients consent and provided the information to ensure continuity of care was delivered. We saw these were completed in a timely manner and patients were followed up 2 weeks later to ensure they received their appointment.

The 2 doctors who owned the service understood their responsibility to safeguard patients from harm. They used the pathways provided by the local authority safeguarding team and understood how to use this to keep patients safe. They were trained in safeguarding to an appropriate level and had received training about how to recognise domestic abuse. The 2 doctors who owned the practice were trained to recognise safeguarding and incidents of domestic abuse. Most patients were seen on their own to allow them to speak freely about any concerns they had. At the time of our assessment the service had not had to make any safeguarding referrals; however, were away of the local partners they would need to contact if they did need to for example the local authority, the police or to Multi Agency Risk Assessment Conferences (Marac) following a domestic abuse assessment.

During our assessment we found the service had systems and processes in place to ensure patients were safeguarded from harm. They had a safeguarding lead and the 2 GPs who owned the service had received safeguarding training to a level appropriate to their roles within the service.

Patients told us the service fully informed them of all the treatment options available to them including the potential benefits and side-effects.

The 2 doctors who owned the service understood the risks of the treatments they offered. They ensured all patients completed a pre appointment questionnaire and discussed this during the appointment so that every aspect of risk could be explored. This included risk related to obesity, high blood pressure and the psychological impact on patients of menopausal symptoms. The 2 doctors who owned the service ensured patients had the option to leave the appointment and think about the treatment options before deciding whether to continue.

Staff followed internal policies and operating procedures which were based on best practice guidance when assessing and treating patients. Assessments were detailed and covered all aspects of risk to ensure patients received the appropriate treatment and support.

The 2 doctors who owned the service knew how to raise an alarm in an emergency to alert patients and other staff. The clinic room was equipped with an emergency alarm button for staff to use. They did not lone work and used the facilities provided by the landlord to ensure people were safe when using the building.

The 2 doctors who owned the service rented a room in a modern building which was used by 2 medical centres. The communal areas such as reception were large and open, and patients were greeted by a receptionist who showed them where to wait to be called for an appointment. Facilities and equipment in the premises were well-maintained and were suitable for the intended purpose.

The service worked from a clinical room that was managed by an external company. The 2 doctors who owned the service worked alongside them to ensure the safety and upkeep of the premises. The service had one piece of equipment that required calibration and we saw evidence this had been completed annually. Fire exits were clearly marked and clutter free. The 2 doctors who owned the service had full access to the emergency kit which was provided and maintained by the 2 GP practices who also used the building.

Patients told us they thought the staff were knowledgeable around women’s health. They told us their understanding of their own health improved following their appointment at the service.

The 2 doctors who owned the service had the skills, experience and training they needed to do their roles. They were committed to completing relevant training, so they were continually improving practice in line with national guidance. The 2 doctors who owned the service each had an external clinical supervisor they met with regularly. This meant they could provide a safe level of care to patients.

The 2 doctors who owned the service were both were appropriately qualified and experienced. They were both practising NHS GP’s, were members of the General Medical Council (GMC) and were up to date with revalidation which means they had been approved to continue to practice as doctors. The 2 doctors who owned the service were both members of the British Menopause Society (BMS) and participated in regular educational meetings. They held various extended role qualifications to support them within their role. For example, one member of staff had undertaken an advance certificate in menopause care. We reviewed the training records and found the 2 doctors who owned the service had received and were up to date with appraisals, mandatory training and training required for their role.

Patients had no concerns about the cleanliness of the clinical area. The 2 doctors who owned the service used personal protective equipment (PPE) such as aprons and gloves when required. Hand washing facilities were available.

The 2 doctors who owned the service had received training in infection, prevention and control (IPC). They used single use equipment which was disposed of in line with national guidance.

The premises were visibly clean and suitable personal protective equipment was available. We found systems in place for cleaning of the clinical room and management of clinical waste. Handwashing facilities including liquid soap, hand gel and paper towels were available in the clinic room.

The 2 doctors who owned the service had an effective system in place to manage IPC which included a policy and both staff had completed IPC training. We saw evidence of regular monthly IPC audits being completed by an external cleaning company organised by the landlord. The service had arrangements in place to manage healthcare waste and staff were aware of the action to take in event of sharps or contamination injury. The clinic room was cleaned daily, and equipment was cleaned between patients using appropriate wipes.

Patients were happy with the way their prescription was provided and dispensed. They knew they could contact staff if there were any issues, and these would be resolved promptly.

The 2 doctors who owned the service were able to explain the process for using prescriptions. These were sent electronically to a private pharmacy where the prescription would be held for up to 4 weeks. The doctors worked together to ensure all patients were chaperoned when having an intimate examination or procedure. For example, having an intrauterine device (IUD) such as hormonal coil fitted as part of their hormonal replacement therapy (HRT). The doctors regularly reviewed patients' medicines. This meant patients received the health checks required so treatment could be continued.

The 2 doctors who owned the service used electronic prescriptions. Medicines such as IUDs were stored safely and checked in line with national guidance. The 2 doctors who owned the service ensured medicines were appropriately prescribed and monitored. They completed regular audits of prescribing and found all prescriptions were issued appropriately and monitored in line with guidance.

The service prescribed medicines on a private electronic prescription. This was held and managed safely and securely. They did not administer or dispense medicines to patients. The service prescribed some medicines that were off label. These medicines were not recommended by the National Institute for Health and Care Excellence (NICE) for menopause treatment but were recommended in other pieces of national guidance such as British Menopause Society. The 2 doctors who owned the service followed these guidelines and patients were given a full explanation of their purpose, potential risks, benefits and gave their consent. When off label medicines were prescribed, such as testosterone used in hormone replacement therapy, we found appropriate systems were in place to check bloods prior to prescribing and then testosterone levels were checked at three months.