Chelsea Bridge Clinic

Updated 23 September 2019

Aspen Medical Services Ltd provides private medical services from purpose built premises at Chelsea Bridge Clinic, Ground Floor Riverfront, Howard Building, London, SW8 4NN. The clinic provides whole health and well-being solutions offering services including physiotherapy, osteopathy, rehabilitation, sports performance, hyperbaric oxygen therapy, dermatology, cosmetic services, weight loss services including nutritional therapy and personal training programmes, acupuncture, stress therapy, counselling, hypnotherapy, stress therapy, coaching, laser aesthetics, micropigmentation, and phlebotomy/blood collection.

The premises consist of a ground floor, level access patient reception and waiting area, second patient waiting room, fitness studio, consultation rooms, treatment room and hyperbaric oxygen therapy room. There are also storage and maintenance areas and staff offices on the ground floor. A mezzanine level provides space for a third patient waiting area, shower room and treatment rooms for the wellbeing services offered.

Clinic services are available to any fee paying patient and is primarily focussed on services for adults.

The service has one clinic director and two clinic managers. The clinic staff include physiotherapists, rehabilitation specialists, personal trainers, osteopaths, pilates instructors, acupuncturists, coaches, men’s and women's health specialists, a nutritional therapist, a consultant dermatologist, medical aestheticians, masseusses, a consultant orthopaedic surgeon, phlebotomists, two GPs, two healthcare assistants, a nurse and receptionists, marketing staff and administrative assistants. Those staff who are required to register with a professional body were registered with a licence to practice. Relevant staff were also registered for providing specialist services. The clinic outsourced its human resources, accounting, information technology, telephony and legal services, with the clinic manager responsible for monitoring contracts.

The service operates Monday to Saturday and on Sunday by request. Clinic hours run from 11am to 8pm on a Monday, 8.30am to 9pm Tuesday to Friday and 8.30am to 5.30pm on a Saturday. The clinic offered some out-of-hours services, including home visits, and was making arrangements with another service to provide GP consultations out-of-hours, with access to patients’ clinic records.

The clinic launched in 2008, offering physiotherapy, training and pilates and spa services. In 2016 the clinic registered with CQC when medical dermatology was added as a service. The most recent services to be added are GP care and consultations with an orthopaedic surgeon.

Since 2008 the clinic has provided services for 30,804 patients across all of its services, although most of these services are not within scope of CQC registration. The dermatology service is operated by a consultant dermatologist who sees patients who have been assessed as needing an assessment or who have been referred/booked directly.

The orthopaedic surgeon sees patients who have been referred by other doctors for specialist advice or assessed as needing an assessment by the physiotherapy team. The consultation is carried out as part of the Chelsea Bridge Clinic services. If the surgeon assesses the patient as needing physiotherapy, this treatment is carried out by the clinic. If the patient is assessed as needing surgery, this is either carried out by the surgeon at a hospital at which the surgeon has practicing privileges or the patient is referred elsewhere (including to NHS services). After surgery, the patient may be seen again by staff at the clinic for post-operative rehabilitation.

Full GP services have been offered as a pilot since April 2019.

How we inspected this service

Before visiting, we reviewed a range of information we hold about the service. During our visit we:

• Spoke with a range of staff.
• Reviewed comment cards where patients and members of the public shared their views and experiences of the service.
• Reviewed service policies, procedures and other relevant documentation.
• Inspected the premises and equipment in use.

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 23 September 2019

This service is rated as Good overall. (Previous inspection November 2017, the clinic was not rated and was meeting the requirements).

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 Chelsea Bridge Clinic as part of our inspection programme. We inspected all five key questions.

Aspen Medical Services Ltd provides private medical services from purpose built premises at Chelsea Bridge Clinic, Ground Floor Riverfront, Howard Building, London, SW8 4NN. The clinic provides services in dermatology, orthopaedics and general health (including general practice appointments).

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 regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Chelsea Bridge Clinic provides a range of non-medical and complimentary therapies (e.g. physiotherapy, acupuncture, coaching, personal training and hyperbaric oxygen therapy) and cosmetic interventions (including laser aesthetics) which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.

The clinic manager 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.

Fifteen people provided feedback about the service.

Our key findings were:

• There were systems to assess, monitor and manage risks to patient safety.
• Systems and processes kept patients safe from abuse. Staff whose records we checked had completed appropriate safeguarding training for their role, although it was not practice policy that clinical staff should have level three training in child safeguarding. There was a system to assure that an adult accompanying a child had parental authority, but this was informal rather than formally documented.
• There was equipment and medicines to deal with medical emergencies. These were adequate for the services fully implemented at the time of the inspection, but did not cover all of the most common risks for the services that the clinic provided.
• We saw evidence that clinicians assessed needs and delivered care and treatment in line with current legislation, standards and guidance (relevant to their service).
• There was quality improvement activity, although this was not consistent across the whole service. The clinic was developing measures of effectiveness for its newer medical services.
• Staff had the skills, knowledge and experience to carry out their roles, and worked together, and worked well with other organisations, to deliver effective care and treatment.
• Staff supported patients to manage their own health, and obtained consent in line with legislation and guidance.
• Staff treated patients with kindness, respect and compassion and helped patients to be involved in decisions about care and treatment.
• The service organised and delivered services to meet patients’ needs. It took account of patient needs and preferences.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs.
• The service had a clear vision and credible strategy to deliver high quality care and promote good outcomes for patients.
• There were clear responsibilities, roles and systems of accountability to support good governance and management.

We saw the following outstanding practice:

• The service had reviewed safety systems in other healthcare systems and other industries and had recently introduced a ‘good catch’ process. Good catches were defined as issues that could have caused injury, incident or a deterioration in the quality of care had they not been rectified.
• Good catches were noted on a form that included the issue identified, the risk level, the root and contributory cause and the action taken.
• The service was sharing the good catches with staff and using them to identify areas for staff/policy development. Short video reminders for staff were being created to reinforce key messages.

The areas where the provider should make improvements are:

• Review the training policy to check this is aligned with national guidance, e.g. on safeguarding. Consider formalising the system for verifying patient identity and adults accompanying children.
• Review the emergency medicines and equipment to check they are adequate for the services being developed.
• Review measures of effectiveness to develop comprehensive measures across all of the services offered. Consider how governance will remain effective when new specialities are added.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care