HCA Healthcare UK Chiswick Outpatients

Updated 12 April 2022

Chiswick Medical Centre is managed by Chiswick Outpatients Centre LLP. Chiswick Outpatient Centre is an outpatient satellite centre which forms part of the management umbrella of The Lister Hospital. The Lister Hospital is one of the independent services under HCA Healthcare UK.

The main service provided by this hospital was outpatients services. Other core services provided included diagnostic imaging, surgery, services for children and young people and maternity.

Overall, 9929 patients attended the centre between January 2021 and December 2021. Of these, 534 were children and young people. There were 1936 patient attendances for diagnostic imaging services, 48 of whom were children.

Staff carried out 227 minor surgery procedures between January and October 2021. Minor procedures undertaken included excision of lesions, biopsies, and incision and drainage.

The centre operates a paediatric clinic once a week. Paediatric trained nurses were provided by another location.

Maternity clinics operated on an adhoc basis. There were 18 patient attendances between January and December 2021. A pre-arranged midwife from another location, attended the centre to support consultant-led maternity clinics. The last maternity clinic held was in October 2021 and there were none held during our inspection.

Facilities at the centre include an outpatient unit, imaging unit and a paediatric unit. The centre offers a range of specialities including breast care, cardiology, dermatology, endocrinology, gastroenterology, general medicine, general surgery, gynaecology, neurology, neurophysiology, neurosurgery, orthopaedics, paediatrics, pain management, plastic surgery, primary care, urology and respiratory care. The centre offers imaging services including ultrasound imaging, mammography, computed tomography scan and magnetic resonance imaging.

We carried out a comprehensive inspection of outpatient, surgery and children and young peoples’ services on 11 January 2022. We held additional staff interviews on 17 and 18 January 2022. We returned to the inspect diagnostic imaging services on 2 February 2022.

Updated 12 April 2022

We had not previously rated this location. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers ensured staff were competent. Staff worked well together for the benefit of patients, supported them to make decisions about their care, and had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait for treatment.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. All staff were committed to improving services continually.

However:

• The paediatric service did not participate in clinical audits to monitor outcomes for children and young people.
• Although staff working in the paediatric unit received the provider's standardised formal induction, the local unit did not have a formal induction checklist.
• The service did not provide paediatric specific information to families ahead of their first visit.

Updated 12 April 2022

We had not previously rated this service. We rated it as good because:

• Staff understood how to protect children, young people and their families from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
• Staff treated children, young people and their families with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.
• The design, maintenance and use of facilities, premises and equipment kept people safe. The service was designed to meet the needs of children and young people.
• The service controlled infection risk well. Staff used equipment and control measures to protect children, young people, their families, themselves and others from infection. They kept equipment and the premises visibly clean.
• The service managed patient safety incidents well. Staff recognised and reported incidents. Managers investigated incidents and shared lessons learned with the whole team.
• Leaders operated effective governance processes, throughout the service and with partner organisations.
• The service had enough nursing staff with the right qualifications, skills, training and experience to keep children, young people and their families safe from avoidable harm and to provide the right care and treatment.
• The service was inclusive and took account of children, young people and their families' individual needs and preferences.
• Leaders had the skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for patients and staff.
• People could access the service when they needed it and received the right care promptly.
• Staff completed and updated risk assessments for each child and young person and removed or minimised risks.

However:

• The paediatric service was not specifically involved in national clinical audits in relation to outcomes for young people or children.
• Leaders and teams used systems to manage performance, however this was not informed by paediatric specific audits or performance monitoring.
• While nursing staff were part of the service, consultants working in the paediatric unit did not appear to have ownership or a collective identity as part of the service.

Updated 12 April 2022

We had not previously rated this service. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. All staff were committed to improving services continually.

Updated 12 April 2022

We had not previously rated this service. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities.

Updated 12 April 2022

We had not previously rated Surgery at this location. We rated it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed patient safety incidents well.
• Staff provided good care and treatment and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait for treatment.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients to plan and manage services and all staff were committed to improving services continually.