Northern Circumcision Clinic - Leeds

Updated 24 July 2019

Updated 24 July 2019

We carried out an announced comprehensive inspection at the Northern Circumcision Clinic – Leeds as part of our inspection programme.

The service provides circumcision to those under 18 years of age for both therapeutic and non-therapeutic reasons, and carries out post procedural reviews of patients who have undergone circumcision at the clinic.

One of the directors of the service 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 people. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service made use of patient feedback as a measure to improve services. They produced their own surveys and results were analysed and discussed on a regular basis. Results from their last survey in November 2018 showed that 100% of eight respondents had positive comments to make regarding the services they had received.

In addition, we received 13 Care Quality Commission comment cards. These were all very positive regarding the care delivered by the service, many mentioning the caring and professional manner of staff. We also spoke with parents whose children had accessed the service, these parents were complimentary about the level of care and service they and their child had received.

Our key findings were:

• The service was offered on a private, fee paying basis only and was accessible to people who chose to use it.
• Circumcision procedures were safely managed and there were effective levels of patient support and aftercare.
• The service had systems in place to identify, investigate and learn from incidents relating to the safety of patients and staff members.
• There were systems, processes and practices in place to safeguard patients from abuse, and we saw how these had been used in the past to raise concerns with safeguarding bodies.
• The service always communicated with the GP service with which patients were registered with via letters sent post-procedure.
• The service had developed materials for parents/service users which explained the procedure and outlined clearly the recovery process.
• Patient outcomes were evaluated, analysed and reviewed as part of quality improvement processes. Clinical audits we saw demonstrated the effectiveness of the service
• Whilst the service had low levels of complaints, we saw evidence that when these were received they had been investigated thoroughly and mechanisms were in place to make subsequent improvements to the service.
• The health and safety risk assessments had been undertaken for the service. Staff were also aware of the health and safety procedures in place within the hosting GP practice.
• There was a clear leadership structure, with governance frameworks which supported the delivery of quality care.
• Staff personnel files were kept. However, it was noted that these did not contain copies of signed contracts or details of staff immunity status.
• The service encouraged and valued feedback from parents and older patients. Comments and feedback for the service showed high satisfaction rates.
• Communication between staff was effective and we saw that meetings and post sessional debriefings were being held.

The area where the provider should make improvement is:

• Improve staff immunity status checks to give assurance that necessary checks have been carried out in relation to measles, mumps and rubella, and varicella.

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