The Treetops

Updated 2 July 2021

The Octagon, Hesslewood Country Office Park, Ferriby Road, Hessle HU13 0LH is the venue used by the Provider, Clinical Collective Ltd to deliver a tele-dermatology service and a pain management clinic. At the start of the Covid-19 pandemic the Provider introduced a ‘mylink’ solution which allows GP’s to send a secure link to their patient at home (SMS/Email) if the patient can not be seen by the GP due to lock down or isolation etc. This allows patients to make their own referral, including images and any questions they may have. Patients are referred to the service by GPs either via a tele-medicine platform, the electronic referral system or through self-referral on the tele-medicine platform. All referrals are screened by the specialist clinical team to determine whether they are appropriate for the clinical service. Referrals can be made 24 hours a day onto the system.

The pain management clinic is delivered from a primary care building located at Harworth Primary Care Centre, Scrooby Rd, Harworth, Doncaster DN11 8JN. Staff working in the pain clinic were self-employed and were contracted by the Provider to deliver the pain clinics. These clinics are held periodically to meet the number of referrals received. Referrals can be made by GPs or patients can self-refer.

We visited the The Octagon location during the inspection.

The Provider is registered with the Care Quality Commission to carry out the regulated activities of treatment of disease, disorder or injury, diagnostic and screening procedures and surgical procedures.

How we inspected this service

Before visiting we reviewed a range of information we hold about the service and information which was provided by the service.

During the inspection:

• we spoke with staff.
• reviewed key documents which support the governance and delivery of the service.
• made observations about the area the service was managed from.
• reviewed a sample of treatment records.
• looked at information the service used to deliver care and treatment plans.

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 2 July 2021

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 The Octagon on 14 May 2021 as part of our inspection programme.

The service provides a Consultant led tele-dermatology service and a Consultant led pain management clinic in a community setting with care pathways to secondary care available when needed.

The Information Assurance 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 feedback through two comment cards from patients that had attended the pain clinic. Both patients were very positive about the care and treatment they had received. At the time of the inspection there were no patients attending the dermatology service due to COVID -19 therefore we did not speak to them about the service.

Our key findings were:

• The service provided care in a way that kept patients safe and protected them from avoidable harm.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording incidents.
• Risk assessments had been completed to assure the provider of the safety of the premises.
• Patients received effective care and treatment that met their needs.
• Staff were appropriately trained to carry out their roles.
• Staff maintained the necessary skills and competence to support the needs of patients.
• Patients received effective care and treatment that met their needs.
• Staff treated patients with compassion, respect and kindness and involved them in decisions about their care.
• There was a clear strategy and vision for the service. The leadership and governance arrangements promoted good quality care.

We saw the following outstanding practice:

The Provider had supplied all the GP Practices in the area they covered with a technology stand which included a webcam and dermatoscope/microscope. Prior to Covid-19 the Provider’s support team went onsite to carry out training and since then they had used video calls very effectively to continue the training. One of the Consultants had provided a video clip of himself using the equipment to practices, to support any new staff in using the equipment. This enabled the GPs to send photographs of the patient’s skin condition to the Provider, promoting appropriate assessment, treatment and onward referral if necessary.

The areas where the provider should make improvements are:

• Continue to review and develop the clinical record system.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care