The Gynae Centre

Updated 16 February 2022

The Gynae Centre is a small independent service in central London, offering gynaecological consultations and minor day surgery for women, as well as early medical (up to nine weeks and six days gestation) and surgical termination of pregnancy services (TOPs), within 14 weeks and six days of pregnancy. The centre provided TOPs services for women over the age of 16.

The location was rated inadequate and placed in special measures following a comprehensive inspection of the service in August 2021. We used our enforcement powers to serve two Warning Notices to the provider under section 29 of the Health and Social Care Act 2008. These was served for failing to comply with Regulations 12: Safe Care and Treatment, and Regulation 17: Good Governance.

We carried out a focussed, follow up inspection of the Safe and Well led domains of surgery and TOPs, to check compliance with concerns identified in the warning notices issued in September 2021. In order to re-rate the Safe and Well-led domains, we inspected and reported on all the key lines of enquires, in the respective core services.

Updated 16 February 2022

We carried out a focussed follow up inspection of the Safe and Well led domains of Surgery and Termination of pregnancy, to check compliance with concerns identified in the warning notices issued in September 2021. At this inspection we found:

• The provider had complied with the warning notices issued in September 2021. The provider had made improvements to comply with the provisions of Regulation 12: Safe Care and Treatment, and Regulation 17: Good Governance.
• The service now used systems and processes to safely prescribe, administer, record and store medicines. Medicines were now labelled safely in accordance with the provisions of the Human Medicines Regulations 2012.
• Staff now completed and updated risk assessments for each patient and removed or minimised risks. The service had implemented the use of a nationally recognised tool (National Early Warning System 2 (NEWS2)) to identify deteriorating patients and escalate them appropriately. In addition, women undergoing surgical terminations of pregnancy were now risk assessed for venous thromboembolism (VTE).
• Leaders now operated effective governance processes throughout the service. They had implemented an audit programme to monitor the effectiveness of care and treatment. The provider had implemented comprehensive policies and these included, infection prevention and control, medicines management, never events, safeguarding and risk management.

However:

• Some of the provider’s policies did not have a start or review date.

Updated 16 February 2022

We inspected the safe and well-led domains to investigate if the provider had complied with provisions of the warning notices issued in September 2021.

Our rating of safe and well-led improved.

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect women from abuse, and managed safety well. The service-controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff were positive about the leadership of the service and felt supported by the medical director. Staff felt respected and valued. They were focused on the needs of women receiving care. Staff were clear about their roles and accountabilities. The service had systems in place for effective the governance, management of risks and performance. Staff engaged well with women, to plan and manage services and all staff were committed to improving services continually.

However:

• Some of the provider’s policies did not have a start or review date.
• Although the service had developed a template for monitoring surgical site infections, this was not yet embedded in practice.

Updated 16 February 2022

We inspected the safe and well-led domain to investigate if the provider had complied with provisions of the warning notice issued in September 2021.

Our rating of safe and well-led improved.

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service-controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff were positive about the leadership of the service and felt supported by the medical director. Staff felt respected and valued. They were focused on the needs of women receiving care. Staff were clear about their roles and accountabilities. The service had systems in place for effective the governance, management of risks and performance. Staff engaged well with women, to plan and manage services and all staff were committed to improving services continually.

However:

• Some of the provider’s policies did not have a start or review date.