The key questions are rated as:
Are services safe? – Requires improvement
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Requires improvement
We carried out an announced comprehensive inspection at Heathrow Medical Services as part of our inspection programme.
Heathrow Medical Services is a private service providing travel health advice, travel and non-travel vaccines and travel medicines such as anti-malarial medicines to children and adults. In addition, the clinic holds a licence to administer yellow fever vaccines. The provider offers a range of occupational health services and specialist medicals for aircrew, airport and oil and gas employees but these services were out of the scope of this inspection.
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 general exemptions from regulation by CQC which relate to particular types of service and these are set out in of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At Heathrow Medical Services, services are provided to patients under arrangements made by their employer. These types of arrangements are exempt by law from CQC regulation. Therefore, at Heathrow Medical Services, we were only able to inspect the services which are not arranged for patients by their employers.
The clinical director 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 seven patient Care Quality Commission comment cards. All of the comment cards we received were positive about the service. Patients said they were satisfied with the standard of care received and said the staff was approachable, committed and caring.
Our key findings were:
Risks to patients were assessed and well managed in some areas, with the exception of those relating to fridge temperature checks, recruitment checks and gaps in staff safeguarding training which were not always monitored appropriately. However, fridge temperatures were recorded within the recommended range since March 2019.
- There was a lack of good governance to ensure effective monitoring and assessment of the quality of the service.
- The service had failed to identify that a clinical member of staff was not using appropriate internal travel health risk assessment tool and policies were not always followed appropriately.
- There was an insufficient system in place for recording and acting on significant events as the service did not learn and make improvements in a timely manner when things went wrong.
- There was evidence of quality improvement activity.
- Care and treatment records were complete, legible and accurate, and securely kept.
- Consent procedures were in place and these were in line with legal requirement.
- Each patient received individualised travel advice, which was tailored to their specific needs and travel plans. The health advice included all travel vaccinations that were either required or recommended, and specific health information including additional health risks related to their destinations with advice on how to manage common illnesses.
- Systems were in place to protect personal information about patients.
- Patients were able to access care and treatment in a timely manner.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- The service had gathered feedback from the patients.
- Information about services and how to complain was available.
- The provider was aware of and complied with the requirements of the Duty of Candour.
- There was a clear leadership structure and staff felt supported by management.
The areas where the provider must make improvements as they are in breach of regulations are:
- Ensure care and treatment is provided in a safe way to patients.
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care