Archived: Bath

Updated 29 July 2019

Nomad Travel Clinic in Bath is located at 2-3 Abbey Gate Street Bath BA1 1NP. It is situated within a Cotswold Outdoor Store but is independent of the store. The service is registered to provide the following regulated activities; Treatment of disease, disorder or injury, Diagnostic and screening procedures and Transport services, triage and medical advice provided remotely. The private travel clinic is a location for the provider TMB Trading Limited who have owned Nomad Travel since June 2016. TMB Trading Limited provide nine travel clinics across England and Wales.

The clinic offers travel health consultations, travel and non-travel vaccines, blood tests for antibody screening and travel medicines such as anti-malarial medicines to children and adults. The service works with Public Health England to deliver post-exposure Rabies vaccination and holds a licence to administer yellow fever vaccines.

The clinic employs nurses and a pharmacist to deliver the clinical care and an administrative staff member. It sees approximately 170 patients per month. Virtual support for the travel nurses is provided by the medical team who are based at the head office in London. The Bath clinic is open on Tuesday, Thursday, Friday and Saturdays from 9.30am until 6pm. In addition, Nomad provide a telephone consultation service with specialist travel nurses and have a central customer service team to manage appointment bookings. We did not inspect the advice service as part of this inspection.

The clinical operations manager for the provider, is the CQC nominated individual. A nominated individual is a person who is registered with the CQC to supervise the management of the regulated activities and for ensuring the quality of the services provided.

We carried out this inspection as part of our comprehensive inspection programme of indpendent health providers.

How we inspected this service

During the visit we:

• Spoke with staff, including the CQC nominated individual and registered manager, both of whom also work as nurses in the travel clinic, and the store host for the service.
• Reviewed a sample of patient care and treatment records.
• Reviewed comment cards in which patients shared their views and experiences of the service.

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 29 July 2019

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 of Bath on 28 May 2019 as part of our inspection programme.

We had previously carried out an announced comprehensive inspection of the service in 18 December 2018 and found that it was compliant with the relevant regulations.

The service is a private travel clinic located in the city of Bath. There was a registered manager in post. 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:

• The service had systems to assess, monitor and manage risks to patient safety, and reliable systems for appropriate and safe handling of medicines.
• The service learned from, and made changes as a result of, incidents and complaints.
• The service assessed need and delivered care in line with current legislation, standards and evidence-based guidance, and reviewed the effectiveness and appropriateness of the care provided.
• Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• The service treated patients with kindness, respect and dignity, and patient feedback was positive about the service.
• Each patient received individualised travel health information including additional health risks related to their destinations and a written immunisation plan specific to them.
• The service organised and delivered services to meet patients’ needs. The service also carried out off site visits, for example to schools and offices, and had policies and processes in place to support these visits.
• There was a clear leadership structure in place and staff felt supported by management.
• The service proactively sought feedback from patients and staff, which it acted upon.
• The service had effective oversight of the clinical care provided to patients.

The area where the provider should make improvements are;

• Establish a risk assessment that clearly details required actions in the event of a cardiac arrest.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care