Wandsworth GP Federation Community Interest Company

Updated 27 March 2017

Battersea Healthcare Community Interest Company is a GP - owned community interest company and social enterprise set up to provide quality healthcare for the people of Wandsworth. The services provided are a Musculoskeletal Interface Clinical Assessment Service (MICAS) and dermatology outpatient services. These were provided through a network of partner organisations that make those services available across Wandsworth

The services they provide are commissioned by Wandsworth Clinical Commissioning Group, and so are available to all patients registered with GP practices in Wandsworth.

The Musculoskeletal Interface Community Assessment Service (MICAS) provides registered patients in Wandsworth with assessment and treatment of bone and joint conditions and the dermatology service caters for a range of dermatological conditions.

MICAS engage a mix of clinical skills including GPs with Specialist Interest (GPSI) in musculoskeletal problems (A GPSI supplements their role as a generalist by providing an additional service while still working in the community). They also engaged Sports & Exercise Medicine Consultants, and Extended Scope Physiotherapists (ESP). The ESP’s are specialist physiotherapists or who work in an extended role alongside a Medical Consultant). The Dermatology Service engaged the services of GPSIs, and Dermatology Consultants from acute hospitals. Approximately 2,800 new patients and 1,000 follow-up patients were seen in 2015 by MICAS, whereas the dermatology outpatients’ services saw 1,300 new patients and 750 follow-up patients. Children and young people over the age of three accounted for about 8% of the dermatology services provided.

All referrals are received and managed by a central hub located in Battersea. The hub is open from Monday to Friday 8.30am until 5pm and book patients into the appropriate service following clinical triage. The provider offers services from four locations in Wandsworth offering patients a choice of location and times to suit their lifestyle. We inspected the main head office as well as two GP practices where dermatology services were provided.

Jeremy Fenwick 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.

As part of our inspection, we asked for CQC comment cards to be completed by patients prior to our inspection. We received 21 comment cards which were positive about the standard of care received. We spoke with six people on the day of inspection and telephoned 16 people who also provided positive feedback about the service.

Updated 27 March 2017

Updated 27 March 2017

There are no ratings for this inspection as we do not currently rate small community based independent health services.

• There were systems for identifying, investigating and learning from incidents relating to the safety of patients and staff members.

• The service had clearly defined and embedded systems, processes and practices in place to safeguard patients from abuse.

• The staffing levels were appropriate for the provision of services offered with a good staff skill mix across the service.

• Risk management processes were in place to manage and prevent harm.

• Patient outcomes were reviewed as part of audits or quality improvement.

• Staff had the relevant skills, knowledge and experience to deliver the care and treatment offered by the clinic.

• The clinic shared relevant information with other services appropriately and in a timely way.

• Staff understood the relevant consent and decision-making requirements of legislation and guidance, including the Mental Capacity Act 2005.

• Staff treated patients with dignity and respect.

• Patients were involved in decisions about their care and treatment.

• The service offered flexible appointments to meet the needs of their patients.

• There was a system in place which ensured a clear response to complaints with learning disseminated to staff about the event.

• The clinic had a governance framework that supported the delivery of quality care.

• There was a clear leadership structure; however there was no robust scheme of delegation within the service.

• The service encouraged and valued feedback from patients, the public and staff.

However;

• There was no dedicated clinician input to medicines management. Medicines used at the clinic were being managed by a person who was not a clinician. However after the inspection, we were told by the provider, that Medical Director and Clinical Lead had input into medicines management.

• The provider did not have appropriate medicine storage facilities. Medicines were stored in a plastic storage container.

• The consulting rooms where patients are examined, but which do not have a height adjustable examination table.

• Patients were not given copy of the consent form.

• There was no information available in the clinics informing patients on how to make complaints. The complaint process was not available to patients.