Exeter Travel Clinic Also known as The Exeter Travel Clinic

Updated 6 August 2019

Exeter Travel Clinic is a private fee-paying travel health clinic located at 22 Southernhay West, Exeter city centre. The building is listed and has some restrictions for those with mobility issues. However, alternative arrangements were in place to meet the needs of patients, whether at schools, patients’ home or organisation.

The clinic is open on Monday, Tuesday and Wednesday between 9am and 17.30pm, on Thursday 9am until 9pm and Fridays and Saturdays between 8.30 and 5pm. The clinic provides the regulated activities of: Treatment of disease, disorder or injury and diagnostics and screening.

Further information about the service can be found at www.travelhealthconsultancy.co.uk

The clinic was set up in 2008 as Exeter Travel Health consultancy. The clinic provides pre-travel health assessments, travel health advice, anti-malarial medications, travel vaccinations and non-travel vaccinations to individuals, universities, companies and charities. The clinic is also a registered yellow fever vaccination centre.

The provider/director of the company is a registered nurse who has post-graduate diplomas in travel medicine and tropical nursing.

The provider employs a team of six registered nurses with travel medicine experience (just over one whole time equivalent). These nurses also work elsewhere within the NHS. The team of nurses are supported by four part time reception staff and an accountant/receptionist.

How we inspected this service

Our inspection team was led by a CQC lead inspector. The team included a member of the CQC medicines optimisation team.

The methods that were used at this inspection included speaking with the provider, interviewing staff, observations and review of documents and comment cards.

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 6 August 2019

This service is rated as Outstanding overall. (Previous inspection November 2017- No rating given)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Outstanding

Are services caring? – Good

Are services responsive? – Outstanding

Are services well-led? – Outstanding

We carried out an announced comprehensive inspection at The Exeter Travel Clinic as part of our inspection programme to ask the service provider the following key questions; Are services safe, effective, caring, responsive and well-led?

Exeter Travel Clinic is a fee-paying private travel health clinic located in Exeter city centre. The clinic provides travel health advice and training to individuals, universities, companies and charities. People of all ages intending to travel abroad can seek advice regarding health risks and receive both information and necessary vaccinations and medicines.

The director of the travel clinic 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 obtained feedback through 22 comment cards. These were all positive and contained comments relating to the efficient and excellent service and knowledgeable, friendly and professional staff. There were no negative comments or suggestions. Patient comments included feedback that they had their procedures fully explained beforehand and felt involved in decision making.

Our key findings were:

• Staff had the relevant skills, knowledge and experience to deliver the care and treatment offered by the service.
• Medicines and emergency equipment were safely managed.
• The service was offered on a private, fee paying basis only.
• The practice had facilities and was well equipped to treat patients and meet their needs.
• Assessments of a patient’s treatment plan were thorough and followed national guidance.
• Patients received full and detailed explanations and costs of any treatment options.
• The service had systems in place to identify, investigate and learn from incidents relating to the safety of patients and staff members.
• There was an established leadership structure and staff felt supported by management.
• There were effective governance processes in place.
• There were processes in place to safeguard patients from abuse.
• There was an infection prevention and control policy; and procedures were in place to reduce the risk and spread of infection.
• There were clear systems in place to receive, manage and learn from complaints.
• The service encouraged and valued feedback from patients and staff.
• Feedback from patients, stakeholder and healthcare professionals was consistently positive.
• The provider shared knowledge with the wider community through journals, education, developing education programmes, and editing and writing books.

The areas where the provider should make improvements are:

• Continue to implement the revised system to review the dates of the Patient Group Directions.

We saw the following outstanding practice:

The provider demonstrated commitment to system-wide collaboration, communication and education by sharing skills and knowledge with the wider community. There was a strong record of sharing work and knowledge locally, nationally and internationally. For example, being a course director, providing education sessions for local GPs, practice nurses, occupational health staff and private companies and organisations. For example, providing a range of travel medicine study day teaching sessions to regional NHS practice nurses and being a resource and information centre, for local NHS Practice Nurses.

There were clear educational pathways for staff which were usually funded by the organisation. Staff were encouraged, supported and given opportunities to develop. Often this training was over and above what was expected.

There was evidence of ongoing academic study and review with national and international stakeholders and educational establishments. Learning was used to make service improvements. The provider was a noted academic and had participated in editing and publishing articles in national and international journals.

There was a proactive and embedded culture of promptly responding to changes in evidence-based guidance, feedback and being alert and actioning wider learning from national serious incidents. This often included implementing practice significantly earlier than official publication.

For example, the provider reacted promptly to a coroner’s report following fatal adverse reactions to yellow fever vaccines within the UK. This included communicating with pharmaceutical manufacturers highlighting the risks identified through the coroner’s report and updating clinic polices before the UK NICE guidelines were updated.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care