Hammersmith Private Hospital

Updated 4 May 2021

Hammersmith Private Hospital is operated by Curis Healthcare Limited. The service opened in 2014. In January 2017, the clinic began functioning as a cosmetic surgery provider, providing operations such as breast augmentation, hair transplant and liposuction. It is a private clinic in London. The clinic accepts self-referrals from patients living in London and internationally. The service does not provide services to NHS-funded patients or patients under the age of 18.

At the time of this inspection, there was no registered manager, but an application had been submitted to the CQC for the person who had been recruited into this position. The director of governance and compliance was the nominated individual.

The clinic provides cosmetic surgery and is registered to provide the following regulated activities:

• Surgical Procedures

Activity (August 2020 to 12 March 2021):

• The clinic carried out 865 surgical cosmetic procedures (of which 826 were day cases and 39 were overnight stays) and 19 hair transplant procedures.
• There were 1018 outpatient appointments, which were a mix of pre-operative face-to-face appointments and post-operative surgeon reviews or wound care appointments.
• The most common surgical procedures carried out were various types of breast augmentation (612) and breast lift (150). Other procedures carried out included revision surgery (56), breast reduction (11), rhinoplasty (7), abdominoplasty (7), abdominoplasty & liposuction (6), multiple procedures of types already listed (5), implant removal (4), surgical reshaping of the outer ear (2), liposuction (1) and arm lift (1).

There were five surgeons, five anaesthetists, and one resident medical officer (RMO) working under practising privileges at the clinic. The service employed five registered nurses, four health care assistants, two operating department practitioners, two patient care coordinators, three receptionists and two housekeeping staff, as well as having its own bank nursing staff. The accountable officer for controlled drugs (CDs) was the nominated individual.

The service was inspected five times before, in February and March 2018, 12 June 2019, 30 October 2019, 2 July 2020 and 6 August 2020. The July 2020 inspection took place using our focused inspection methodology, looking specifically at infection prevention control and the management of risk relating to transmission of COVID-19. Following this inspection, we issued an urgent notice of decision to impose conditions on their registration as a service provider in respect of the regulated activity of surgical procedures. A focused follow-up inspection took place on 6 August 2020 to assess whether these conditions could be lifted, and it was determined the provider had made improvements in all required areas. However, as this inspection was focused and only looked at the ‘safe’ domain, the location remained rated ‘requires improvement’ overall.

Updated 4 May 2021

Our rating of this location improved. 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 and acted on them. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• 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 their procedures and supported them to make decisions about their care. Key services were available six days a week.
• 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 patients, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it.
• 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. The service engaged well with patients to manage services and all staff were committed to improving services continually.

However:

• Not all care records were complete. Out of 10 records, three did not have a signed COVID-19 consent form, one National Early Warning Score (NEWS-2) chart had not been scored, and there were missing signatures and incomplete checklists across the rest. The clinic conducted a monthly documentation audit and we saw evidence any omissions were addressed by staff and actions had been taken where documentation fell below the expected standard.
• In another record, the ‘sign-in’ stage of the World Health Organisation (WHO) surgical safety checklist for patients was incomplete. In the quarterly WHO checklist audit, there were some omissions noted such as missed ‘sign-in’ in the October 2020 audit, and three missed ‘sign-out’ stages in the January 2021 audit. The nominated individual had addressed this with staff and now joined the team brief via video link at the start of each day to ensure improved compliance.
• Not all staff were aware what the term ‘duty of candour’ meant.
• There was a low response rate to formal patient feedback questionnaires given out by the clinic, although we saw more patients did leave feedback online.
• Not all plastic surgeons were on the GMC's specialist register in the relevant area of practice, in line with the Royal College of Surgeons (RCS) recommendations. All medical staff not on the specialist register were encouraged to review this within their appraisal process.
• Not all staff had been given formal training in chaperoning patients at the time of inspection. This was addressed immediately following inspection.
• The service had an equality and diversity policy, but this contained some typographical errors and did not seem to be tailored to the clinic.

Updated 4 May 2021