Harrow Health Care Centre

Updated 3 December 2018

Harrow Health Care Centre is an independent clinic and offers private GP consultations, travel health consultations, travel and non-travel vaccines and travel medicines such as anti-malarial medicines to children and adults. The clinic is also a registered yellow fever vaccination centre.

They offer gastric band adjustments (post-bariatric surgery patient aftercare) and acupuncture treatments (a form of alternative medicine in which thin needles are inserted into the body). They also offer urine drug and alcohol tests service.

Dr Winifred Jane Woyka has specialised in offering a range of occupational health services but these services are out of the scope of this inspection.

The team consists of five GPs, four travel clinic nurses and a business manager supported by a team of administrative staff.

Services are provided from: Harrow Health Care Centre, Clementine Churchill Hospital, Sudbury Hill, Harrow, Middlesex, HA13RX.

On 7 November 2018, our inspection team was led by a CQC lead inspector. The team included a GP specialist adviser and a practice nurse specialist adviser.

Online services can be accessed from the practice website: www.harrowhealthcare.co.uk.

The clinic is open between 8am to 8pm Monday to Thursday, 8am to 6pm Friday and 9am to 12pm Saturday.

The service is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, family planning and treatment of disease, disorder or injury. This service is registered with CQC under the Health and Social Care Act 2008 in respect of the services it provides.

Pre-inspection information was gathered and reviewed before the inspection. We spoke with the principal GP, a doctor, two travel clinic nurses, a business manager and administrative staff. We collected written feedback from five members of staff. We looked at records related to patient assessments and the provision of care and treatment. We also reviewed documentation related to the management of the service. We reviewed patient feedback received by the service.

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 3 December 2018

We carried out an announced comprehensive inspection on 7 November 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.

Harrow Health Care Centre is a private clinic providing GP consultations, 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 license to administer yellow fever vaccines.

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 Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Harrow Health Care Centre offers a range of occupational health services but these services were out of the scope of this inspection.

The principal GP 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 53 patient Care Quality Commission comment cards and spoke with two patients. All of the feedback we received was 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:

• The provider offered private GP consultations to adults and children. They offered gastric band adjustments (post-bariatric surgery patient aftercare) and acupuncture treatments (a form of alternative medicine in which thin needles are inserted into the body). They offered urine drug and alcohol tests service.
• The provider offered vaccination and travel clinic services to adults and children.
• Each travel clinic patient received an individualised travel health brief which was tailored to their specific needs and travel plans. The health brief outlined a risk assessment; 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.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• There were arrangements in place to protect children and vulnerable adults from abuse.
• The provider ensured that care and treatment was delivered according to evidence based guidelines and up to date travel health information.
• There was evidence of quality improvement activity including the clinical audit.
• Consultations were comprehensive and undertaken in a professional manner.
• Consent procedures were in place and these were in line with legal requirements.
• Systems were in place to protect personal information about patients.
• Appointments were available on a pre-bookable basis.
• Staff had the relevant skills, knowledge and experience to deliver the care and treatment offered by the service.
• There was an infection prevention and control policy and procedures were in place to reduce the risk and spread of infection.
• Vaccines, medicines and emergency equipment were safely managed. There were clear auditable trails relating to stock control.
• 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 service proactively sought feedback from staff and patients, which it acted on.
• There was a clear vision and strategy and staff spoke of an open and supportive culture.

The areas where the provider should make improvements are:

• Review systems to verify a patient’s identity on registering with the service.
• Consider ways to monitor antimicrobial prescribing.
• Consider how to improve access to patients with hearing difficulties.
• Ensure a response to complaints includes information of the complainant’s right to escalate the complaint if dissatisfied with the response.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice