Archived: Roodlane Medical Limited - Fleet Street, part of HCA Healthcare UK Primary Care Services

Updated 14 January 2020

Roodlane Medical – Fleet Street is an independent provider of private GP services. It is run by Roodlane Medical Limited, which is part of HCA Healthcare UK. HCA Healthcare UK provides services including hospitals, clinics, diagnostics centres and GPs at a range of locations in England. HCA Healthcare UK acquired Roodlane in 2011.

Roodlane Medical – Fleet Street is based at a multidisciplinary primary care site at 2-3 Salisbury Court in the financial district of the City of London. We visited this site as part of this inspection. Services offered at this site include GP appointments, health screening, occupational health, psychology services, physiotherapy, and vaccination services.

Information from the service provider indicates that the Fleet Street site provides approximately 7,500 GP appointments, 3,000 GP health screening appointments and 900 occupational health appointments during a 12-month period. This equates to approximately 4,300 individual patients per year.

Most patients have their services arranged through their employers. Additionally, individual patients have the facility to pay directly for their care and treatment. Services are available to any fee-paying patient, including adults and children. Most patients using the site are adults.

Clinical and occupational health services are provided by four doctors and one physiotherapist. Additional staff working at the site consists of two reception staff and one technician.

The service is open from 8am until 6pm on Mondays to Fridays. The service is not open at weekends, as the service has identified there is currently no patient need. Appointments are available within 24 hours and can be provided at shorter notice for urgent concerns. Patients can book appointments by telephone, or on-line (approximately 30% of patients use this facility). Home visits are not available.

The service is accessible to wheelchair users. Patient facilities are situated across three floors accessible by stairs. A lift is available if needed. A tube station is approximately 300 metres away.

The service website address is: https://www.hcahealthcare.co.uk/facilities/roodlane-medical

How we inspected this service

We reviewed information about the service in advance of our inspection visit. This included:

• Data and other information we held about the service.
• Material we requested and received directly from the service ahead of the inspection.
• Information available on the service’s website.
• Patient feedback and reviews accessible on various websites.

During the inspection visit we undertook a range of approaches. This included interviewing clinical and non-clinical staff, reviewing feedback from patients who had used the service, speaking with patients, reviewing documents, examining electronic systems, and assessing the building and equipment.

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 14 January 2020

We carried out an announced comprehensive inspection at Roodlane Medical – Fleet Street on 9 October 2019 as part of our current inspection programme. We previously inspected this service on 12 June 2018 using our previous methodology, where we did not apply ratings.

Roodlane Medical – Fleet Street is an independent provider of private GP services which are regulated by the CQC, and are provided on a fee-paying basis from its site in London.

The service also provides certain corporate healthcare services which are not regulated by CQC; 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 general 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. At Roodlane Medical – Fleet Street services are provided to patients under arrangements made by their employer. These types of arrangements are exempt by law from CQC regulation. Therefore, at this service, we were only able to inspect the services which are not arranged for patients by their employers.

The lead GP based at the site is the registered manager. 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.

We received 31 completed CQC comment cards, which were all positive about the service. Patients commented that the staff were professional and caring, the environment was clean and comfortable, and that clear, detailed information was provided.

Our key findings were:

• The service provided care in a way that kept patients safe and protected them from avoidable harm.
• There was an open and transparent approach to safety and a system in place for recording, reporting and learning from significant events and incidents. The service had clear systems to manage risk so that safety incidents were less likely to happen. When incidents happened, the service learned from them and reviewed their processes to implement improvements.
• There were clearly defined and embedded systems, processes and practices to keep people safe and safeguarded from abuse, and for identifying and mitigating risks of health and safety.
• Patients received effective care and treatment that met their needs.
• The service organised and delivered services to meet patients’ needs. Patients said that they could access care and treatment in a timely way.
• The service reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines and best practice.
• Patients told us that all staff treated them with kindness and respect and that they felt involved in discussions about their treatment options.
• Patient satisfaction with the service was consistently high.
• Clinical staff had the appropriate skills, knowledge and experience to deliver effective care and treatment.
• The service took complaints and concerns seriously and responded to them appropriately to improve the quality of care.

We saw examples of outstanding practice:

• The service had a comprehensive and proactive approach for those experiencing domestic abuse and violence. Services were prioritised at a service and organisational level. There was a national domestic abuse helpline available for patients and staff. The service used an innovative and creative system to provide support contact details for survivors of domestic abuse and violence, whereby these details could be retained discreetly.
• The service had developed and implemented advanced risk-based screening models which used new technology to support holistic and comprehensive care delivery.

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