MICAS

Updated 5 September 2022

Battersea Healthcare Community Interest Company- Musculoskeletal Interface Clinical Assessment Service (MICAS) is located at Bolingbroke Medical Centre, Wakehurst Road, Battersea SW11 6BF.

The provider Battersea Healthcare Community Interest Company is located at Mayfield Surgery, 246 Roehampton Lane, London SW15 4AA.

The service website can be accessed through the following link: https://www.bhcic.co.uk/

The provider has moved location since the last inspection.

The provider offers a musculoskeletal assessment service for conditions including lower back pain, shoulder and elbow, hands, hips, knee, foot and ankle, persistent pain and rheumatological conditions to patients aged 16 and over.

They also provide patients with a point of access to arrange appointments or ask questions about referrals and clinicians can refer patients to other services such as physiotherapy, rheumatology, orthopaedics, pain clinics or to other services that best support the patient assessment, for example for further investigations such as MRI, ultrasound, x-rays and blood tests.

The services office hours are between 8:30am and 4:30pm Monday to Friday and closed on weekends. The service provides 12 clinics at Bolingbroke Medical Centre throughout Monday to Friday. There is no out of hours provision, service users are directed to contact their GP out of hours.

How we inspected this service

Before visiting, we reviewed a range of information we hold about the service and asked them to send us some pre-inspection information which we reviewed.

During our inspection we:

• Spoke with the head of clinical services and governanceremotely through video conferencing.

• Spoke with staff (head of contract delivery, service manager, medical director and administrative staff).

• Reviewed personnel files, practice policies and procedures and other records concerned with running the service.

• Reviewed a sample of records.

• Looked at information the service used to deliver care and treatment plans.

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 5 September 2022

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 inspection at Battersea Healthcare Community Interest Company (BHCIC) on 29 June 2022 as part of our inspection programme. BHCIC first registered with CQC in April 2013. Since that time they have moved location and changed their registered manager. This is the first inspection of this service since the registration changes.

Battersea Healthcare Community Interest Company provide a Musculoskeletal Interface Clinical Assessment Service (MICAS) who provide care to patients with complex musculoskeletal (MSK) conditions who require further investigations, have overlapping symptoms and/or are patients that have not responded to self-management and physiotherapy previously.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Battersea Healthcare Community Interest Company is registered in respect of the provision of treatment of diseases, disorder or injury; diagnostic and screening procedures. Therefore, we were only able to inspect the clinical consultations, examinations and treatments in musculoskeletal medicine.

The head of contract delivery and service manager are the registered managers. 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:

• There was an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and monitored.
• There was a system in place to receive safety alerts issued by government departments such as the Medicines and Healthcare products Regulatory Agency.
• Staff had the skills, knowledge, and experience to deliver effective care and treatment.
• Staff assessed patients’ needs and delivered care in line with current evidence-based guidance.
• To ensure and monitor the quality of the service, the service completed audits which showed the effectiveness of the service.
• Information about services and how to complain was available and easy to understand.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• The service held a range of policies and procedures which were in place to govern activity; staff were able to access these policies.
• We saw there was leadership within the service and the team worked together in a cohesive, supported, and open manner.
• The service proactively sought feedback from patients, which it acted on.

The areas where the provider should make improvements are:

• Provide sepsis and chaperone training for all members of staff.
• Consider stocking an anaphylaxis kit for medical emergencies and a spill kit.
• Review recommendations from risk assessments so actions can be put in place where necessary.
• Provide protected time for staff to complete training.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services