b2 Chalfont Clinic

Updated 18 July 2023

b2 Chalfont Clinic is a registered location for the provider, b2: Chalfont Clinic Ltd and registered with the Care Quality Commission (CQC) in November 2021. The service provides a small range of treatments for people (children and adults) that come under scope of regulation of CQC. These treatments are given via pre-bookable appointments. Patients attend an initial consultation, where a treatment plan is discussed and agreed, and then they are booked in for treatment at a later date. Only specific treatments are regulated by CQC, they include surgical options for the removal of skin lesions, lumps and bumps. For example, skin tags, warts, seborrheic keratosis, dermatofibroma, cysts and lipomas.

Surgical techniques and methods include a combination of:

• Cryotherapy (treatment that involves the use of freezing or near-freezing temperatures)
• Curettage (treatment in which tissue is scraped and removed)
• Cautery (treatment used to burn and remove lesions)
• Excision (treatment that involves the removal of tissue using a scalpel or other cutting tool)

As part of the dermatology clinic, there are additional non-surgical treatments available for a range of skin conditions, including acne and rosacea.

Treatments are provided from:

• b2 Chalfont Clinic, 64 Deanway, Chalfont St. Giles, Buckinghamshire HP8 4JT

The clinic website is: www.b2chalfontclinic.uk

The clinic is located in a renovated design studio and comprises of 6 treatment rooms, a medical suite, a staff area and 2 reception areas. The dermatology service is provided in the medical suite located on the first floor. The clinic is open every weekday, whilst the dermatology clinic is open on Fridays only with core opening hours of 9am to 5pm. This service is not required to offer an out of hours service. However, patients who need medical assistance out of operating hours can access out of hours support via the service and this is detailed in patient literature supplied by the service.

Regulated activities (treatments regulated by CQC) are provided by a single clinician who is a Dermatologist (referred to in the report as the clinician) who joined the clinic in December 2022. There are 2 Directors and a practice manager who are supported by a small front of house team who undertake the day-to-day management and running of the service.

How we inspected this service

We carried out this inspection on 30 June 2023. Before visiting the location, we looked at a range of information that we hold about the service. During our inspection, we visited the clinic, and we interviewed staff, reviewed documents and clinical records, and made observations relating to the service and the location it was delivered from. We were shown examples of patient feedback which the provider had collected prior to the inspection. We did not speak to patients on the day of the site visit.

To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 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 18 July 2023

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 b2 Chalfont Clinic in Chalfont St. Giles, Buckinghamshire on 30 June 2023. The service was registered with the Care Quality Commission (CQC) in November 2021. We carried out this first rated inspection as part of our regulatory functions. The inspection was undertaken to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of regulated activities and services, and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

b2 Chalfont Clinic provides a wide range of independent health services, including chiropractic and osteopathy, which are not within CQC scope of registration. We did not inspect, or report on, those services that are outside the scope of registration.

The clinic is registered with CQC to provide the following regulated activities:

• Treatment of disease, disorder or injury
• Surgical procedures

Therefore, we only inspected the provision of treatments relating to the surgical removal of skin lesions, lumps and bumps and non-surgical treatments for a range of skin conditions which started in December 2022.

The clinic was originally founded in 2012 by 2 chiropractors, the clinic has expanded and registered with CQC in 2021 following the introduction of services within scope of CQC regulation. Both the original founders are now Directors, they continue to practice and 1 is also the CQC registered manager. A registered manager is a person who is registered with the CQC 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.

Our key findings were:

• There were systems to assess, monitor and manage risks to patient safety.

• The clinic assessed needs and delivered care in line with relevant and current evidence-based guidance and standards. Monthly clinical governance meetings reviewed care, treatment, and outcomes; however, the provider was unable to provide any evidence which demonstrated quality improvement.

• Feedback from patients about the service was positive. The medical suite which housed the dermatology clinic was located away in a separate area from the main clinic and had a separate private waiting area to promote privacy and dignity.

• The clinic was responsive to the needs of their patients. Staff prioritised patients’ convenience and ensured appointments ran on time.

• The governance and quality assurance processes were effective and drove improvement in the service provision. However, some improvements were needed to formalise and document this activity. A review was also required in relation to registration with the Information Commissioners Office.

Whilst we found no breaches of regulations, the provider should:

• Formalise activity to strengthen quality improvement, including the introduction of clinical audit cycles to audit regulated activity within the dermatology clinic.

• Review their registration with the Information Commissioners Office.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Healthcare