Fortius Clinic

Updated 28 November 2019

Fortius Clinic is operated by Fortius London Limited and provides private outpatient consultations, diagnostic scans and interventional radiology services from purpose-built premises at Fortius Clinic, 17 Fitzhardinge Street, London, W1H 6EQ. The service specialises in orthopaedic care and sports injuries with specialists covering knee, foot & ankle, spine, shoulder, elbow, hand & wrist, hip & groin, podiatry and pain conditions. Those staff who are required to register with a professional body were registered with a licence to practice.

Clinic services are available to insured and referred fee paying patients.

Fortius London Limited provides similar services at two other separately registered locations in London as well as surgical procedures at a fourth, separately registered location. None of these locations were inspected during this inspection.

The service has a board of ten directors of which six are clinicians and four are non-clinicians.

The premises at 17 Fitzhardinge Street, consist of a ground floor patient reception and waiting area and one consultation room. On the first floor there is a patient waiting area and two consultation rooms; on the second floor there is a patient waiting area and two consultation rooms; on the third floor there is a patient waiting area, one consultation room, and one treatment room; on the fourth floor there are admin offices, a meeting room, a radiology reporting room and a staff area. The lower ground floor houses an MRI scanner and X-ray facilities.

Access to all floors is by steps or a lift.

The service operates from Monday to Friday between 8am and 8pm, and on Saturday mornings between 8.30am and 12.30pm. The service does not offer out of hours services.

We carried out this inspection on 3 October 2019 and before visiting, we looked at a range of information that we hold about the service and information submitted by the service in response to our provider information request.

During our visit we interviewed clinical and non-clinical staff, observed practice and reviewed documents.

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 28 November 2019

This service is rated as Outstanding overall.

The key questions are rated as:

• Are services safe? – Outstanding
• Are services effective? – Good
• Are services caring? – Good
• Are services responsive? – Good
• Are services well-led? – Outstanding

We carried out this comprehensive inspection at Fortius Clinic on 3 October 2019 as part of our inspection programme.

The Chief Operating Officer 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’ who have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The service is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures and treatment of disease, disorder or injury.

Our key findings were:

• The service had comprehensive systems in place to monitor the quality and safety of the service and had a clear vision and strategy to deliver high quality care for patients. There was a clear governance framework in place, underpinned by policies and procedures which were understood and followed by staff.
• Leaders understood and managed the priorities and issues the service faced. They were visible and approachable in the service for patients and staff. They supported staff to develop their skills and take on more senior roles.
• There were clearly defined systems, processes and practices to minimise risks to patient safety and there was a genuinely open culture to reporting and acting on concerns. All staff were involved with the learning from incidents and this learning was also shared with the wider service. When things went wrong, staff apologised and gave patients honest information and suitable support.
• There was a quality improvement programme in place to monitor and improve outcomes for patients, and staff we spoke with were committed to providing high quality care. There was a regular programme of clinical audits and the findings were discussed in team meetings and shared with appropriate staff.
• People were cared for by staff who had the necessary skills and competencies. All staff were up to date with mandatory training.
• Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. An open culture where patients, their families and staff could raise concerns without fear was evident.
• Leaders and staff actively and openly engaged with patients, staff, equality groups, the public and local organisations to plan and manage services. They collaborated with partner organisations to help improve services for patients.
• All staff were committed to continually learning and improving services. They had a good understanding of quality improvement methods and the skills to use them. Leaders encouraged innovation and participation in research.
• Staff kept detailed records of patients’ care and treatment. Records were clear, up to date and easily available to all staff providing care.
• Systems and processes were in place to ensure that patients were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
• The service had good facilities and was well equipped to treat patients and meet their needs. The design, maintenance and use of facilities, premises and equipment kept people safe.
• The service was responsive to peoples’ needs, offering weekend appointments on an as needed basis and the ability to book appointments via a dedicated app which was available to download.

We saw the following outstanding practice:

• Staff described a positive culture and there was a genuinely open and transparent approach to raising concerns and responding to risks. Staff were complimentary about the leadership and felt well supported to develop within their roles.
• The service had implemented a bespoke software solution to ensure that established pathways were followed, and outcomes collected.
• Staff worked especially hard to make the patient experience as pleasant as possible by responding to the holistic needs of their patients. Staff went above and beyond for their patients.
• Audit processes were embedded within the clinic and the provider’s other services and we saw how this drove quality improvement and patient safety.
• There was a continual drive to further improvement with flexibility to redesign service delivery to meet new challenges.
• We saw innovation and a commitment to engage with others to highlight and share best practice.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care