Breakspear Medical Group

Updated 13 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Services are provided from:

Breakspear Medical Group

Hertfordshire House

Wood Lane

Paradise Industrial Estate

Hemel Hempstead

Hertfordshire

HP2 4FD

The service is open Monday to Saturday from 9am to 5pm and is closed for bank holidays.

The inspection was led by a CQC inspector and a specialist advisor who:

• Carried out an announced inspection on 11 May 2018.
• Spoke with ten members of staff in a range of clinical and non-clinical roles.
• Reviewed a sample of patient records.
• Looked at the comments made by patients on 41 CQC comment cards.
• Reviewed audits, internal reports and patient satisfaction surveys.

We informed local stakeholders that we were inspecting the service; however, we did not receive any information from them.

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.

Two full time doctors and three-part time doctors lead clinical treatment. This team represents a range of specialties, including in psychiatry, infectious diseases and autonomic neurophysiology. Ten registered nurses, each with training and experience in a clinical specialty, provide care and treatment.

At the time of our inspection the service had 2000 registered patients and provided care on a private basis with some extra-contractual care provided on behalf of the NHS. The service was equipped for children although this was rare and in the previous 12 months the service had provided care or treatment to five children. In the previous year 44% of new patients were seen based on personal recommendation, 40% were seen as a follow-up visit and 8% were referred by an NHS or private consultant.

The service provides environmental medicine treatment for patients experiencing allergies, sensitivities and intolerances in addition to myalgic encephalomyelitis, chronic fatigue syndrome, malnutrition or obesity, smoking cessation and alcohol and drug harm reduction. The service also provides care and investigative treatment for patients living with Lyme disease.

There are four consulting rooms, two main wards with trollies and seats and three individual side rooms. There is a dedicated children’s treatment room and a children’s play area adjacent to space used for immunisations. There is a kitchen on site staffed by dedicated chefs and patients have access to two waiting areas and a dining room. An accredited laboratory is on site and the team maintains agreements with accredited laboratories worldwide that provide timely screening of biological samples. 

Updated 13 August 2018

We carried out an announced comprehensive inspection on 11 May 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of the provision of advice or treatment by, or under the supervision of, a medical practitioner, including the prescribing of medicines for the purposes of allergy treatment and immunisations.

The service manager 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.

41 people provided feedback about the service using CQC comment cards ahead of our inspection. All comments were positive and 39 people noted specific, detailed information about their experiences. Some patients noted they had used the service for over nine years and said their treatment had demonstrably improved their quality of life. Some cards were written by the parents of children, who said they felt all the staff had treated their child appropriately with respect. All 41 comment cards referred to the kindness of staff or the dignity with which they were treated.

Our key findings were:

• Care and treatment was delivered by a well-trained team that maintained up to date knowledge of the latest national and international guidance.
• The ethos of the service was demonstrably patient-centred with effective clinical governance processes in place.
• Treatment was evidence-based and a dedicated researcher worked with clinicians to ensure patients had access to outcomes from the latest research to guide safe and effective treatment.
• Staff placed considerable value on engagement with patients and feedback was consistently positive, with a significant track record of care that had positively impacted patient’s lives.
• Staff demonstrated passion, motivation and a drive for innovation in meeting individual needs
• The clinical team used the outcomes of international research and internal resources to meet the needs of patients who had exhausted treatment options elsewhere.

There were areas where the provider could make improvements and should:

• Review infection control audit processes to ensure areas of substandard performance are promptly addressed.
• Review fire risk assessments in the building and review day-to-day environment management processes to ensure good fire safety standards.
• Only supply unlicensed medicines against valid special clinical needs of an individual patient where there is no suitable licensed medicine available.