London Gynaecology at Austin Friars

Updated 16 July 2021

The London Gynaecology at Austin Friars (the location) is operated by London Gynaecology Limited (the provider) at 15 Austin Friars, London EC2N 2HE. The provider is registered with the Care Quality Commission to carry out the following regulated activites: Diagnostic and screening procedures and Treatment of disease, disorder and injury, Maternity and Midwifery, Surgical Procedures and Family planning services.

The London Gynaecology at Austin Friars provides services to people aged 18 years and older. At the time of inspection, the clinic saw an average of 200 people per month. The service is located on the ground floor of a five floor shared building but operates as an independent entity and do not share any facilities. The premises consists of a large reception and waiting area, two diagnostic rooms, an ultrasound room, a sluice room (a closed room designed for the disposal of waste products), staff room, nursing station, and two water closets.

The service was run by two directors (one of which was the registered manager, the other was the safeguarding lead). The staff team comprised a female chief operating officer and a female practice manager, a female clinic manager, a female finance manager, a female business and marketing manager (freedom to speak up guardian), a female public relations officer who worked on a contractual basis. The administrative team consisted of four and an administrative support team of three. The clinical team comprised a female nursing team of three (the lead nurse was also a freedom to speak up guardian) and four consultant gynaecologists (male and female) who were awarded practising privileges by the provider, and a female nutritional therapist who works on a contractual basis. They had additional consultants available to utilise as needed to provide clinics and services to patients based on demand for the service.

Before inspecting, we reviewed a range of information we hold about the service, any notifications received, and the information given by the provider at our request prior to the inspection.

During the inspection we:

• Spoke with a range of staff including the directors, the chief operating officer, clinic manager, practice manager, a consultant gynaecologist, a nurse and an administrator.
• Looked at the systems in place for the running of the service.
• Explored how clinical decisions were made.
• Looked at rooms and equipment used in the delivery of the service and made observations of the environment and infection control measures.
• Viewed a sample of key policies and procedures.
• Reviewed feedback from patients about their 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 16 July 2021

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 at London Gynaecology at Austin Friars as part of our inspection programme. The provider, London Gynaecology Limited registered with the CQC in April 2020 and began operating The London Gynaecology at Austin Friars in February 2021. This was the services first CQC inspection.

One of the service’s directors 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.

We received 70 patient feedback forms. All the feedback indicated that patients were treated with kindness and respect. Staff were described as friendly, caring and professional. In addition, comment cards described the environment as pleasant, clean and tidy.

Our key findings were:

• The provider had clear systems to keep people safe and safeguarded from abuse. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
• Staff assessed patients’ needs and delivered care in line with relevant and current evidence based guidance and standards.
• Patients were treated with dignity and respect and they were involved in decisions about their care and treatment and appropriate medical records were maintained.
• Systems were in place to protect patients’ personal information.
• Information about services and how to complain was available and easy to understand.
• An induction programme was in place for all staff and evidence of certificate of specialist training was maintained for consultants.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• The provider had a clear vision to provide a safe and high-quality service and there was a clear leadership and staff structure. Staff understood their roles and responsibilities.
• We saw that there was a system for managing significant events and that learning and improvement was encouraged.
• Staff and patients had access to all standard operating procedures and policies.
• The provider had taken steps to implement quality improvement activity but there were areas for improvement identified. Namely, the provider had not sufficiently monitored the activity carried out by the consultants to ensure they were following clinical guidance.
• The provider did not have effective safeguards in place to ensure only persons 18 years old or above accessed services.

The areas where the provider should make improvements are:

• Develop a comprehensive program of quality improvement including clinical audit to drive improvement in care and treatment outcomes.
• Update the service’s prescribing policy to include medication which should not be prescribed.
• Include third stage process for independent resolution of complaints to the service’s patient information leaflet.
• Include safety alerts as a standing item to the clinical meeting agenda.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care