Sussex Medical Chambers

This service is rated as Good overall.

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? – Good

We carried out this announced comprehensive inspection of Sussex Medical Chambers on 2 and 3 November 2022, under Section 60 of the Health and Social Care Act 2008. 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. This was the provider’s first inspection of the service since it registered with the Care Quality Commission (CQC).

How we carried out the inspection:

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Speaking with staff in person, on the telephone and using video conferencing.
• Requesting documentary evidence from the provider.
• A site visit.

We carried out an announced site visit to the service on 2 and 3 November 2022. Prior to our visit we requested documentary evidence electronically from the provider. We spoke to staff on the telephone and using video conferencing prior to our site visit.

Sussex Medical Chambers is an independent provider of NHS commissioned outpatient services. This service is registered with CQC under the Health and Social Care Act 2008 in respect of the services it provides. These include community vasectomy and urology services, non-obstetric ultrasound, bone density (DEXA) scanning for the diagnosis of osteoporosis and a tier 3 weight management programme. (Tier 3 is a service for those with severe and complex obesity, including those who are considering bariatric surgery. It is structured to provide patients with a combination of intensive treatment and maintenance support.)

Sussex Medical Chambers is registered with the Care Quality Commission to provide the following regulated activities: Treatment of disease, disorder or injury; Diagnostic and screening procedures; Surgical procedures; Family planning; Services in slimming clinics.

The service employs two operations managers who are the registered managers. 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.

Our key findings were:

• There were safeguarding systems and processes to keep people safe. However, some staff had not completed training in the safeguarding of children and vulnerable adults at an appropriate level to support their role, in line with current guidance.
• There were processes in place for the induction of staff and monitoring of role-specific competencies.
• There were records to demonstrate that recruitment checks had been carried out in accordance with regulations.
• Arrangements for chaperoning and clinical assistant support for clinicians, were effectively managed.
• There were processes to assess the risk of, and prevent, detect and control the spread of infection.
• There were governance and monitoring processes to provide assurance to leaders that premises they were leasing were safe and suitable for use, including satellite locations.
• There were appropriate arrangements to manage medical emergencies and suitable emergency medicines and equipment in place at satellite locations. However, there was a lack of an emergency pull cord in the accessible toilet facilities within the DEXA scanning unit.
• There were clinical protocols in place across all services, to provide guidance to staff.
• There were clear and comprehensive DEXA scanning and reporting protocols, local rules and radiation risk assessments in place.
• Clinical record keeping was comprehensive and complete, and in line with best practice guidance.
• Risks associated with the transfer of some hard copy patient records from satellite locations had not been adequately assessed.
• There were effective processes in place for the management of incoming referrals and processes to support the tracking of patients to ensure their timely access to treatment.
• There was evidence of monitoring and auditing of patient treatment outcomes in line with agreed key performance indicators.
• There were effective governance, incident reporting and risk assessment processes in most areas. However, some staff were unclear about documentary incident reporting processes.
• There was effective and open communication and information sharing amongst the staff team. There were regular team meetings and staff felt motivated to contribute to driving improvement within the service.
• Staff were subject to regular review of their performance and felt well supported by managers.
• Service users were asked to provide feedback on the service they had received, and the service acted promptly to respond to and share feedback with the team. There were high levels of patient satisfaction across all services.
• Complaints were managed appropriately.

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.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Monitor staff immunisation status to ensure prompt identification of any incomplete records.
• Obtain evidence of certification of completed training for all clinical staff.
• Improve staff awareness of incident reporting templates.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services