Adrian Lower & Associates Ltd

Updated 20 September 2022

Background to Adrian Lower and Associates Ltd

Adrian Lower and Associates Ltd. provides consultations, examinations and treatments in obstetrics and gynaecology from a clinic located at 9 Upper Wimpole Street, London, W1G 6LJ.

The service offers private patients advice on a wide range of gynaecological and obstetric services. These include minor surgical procedures (such as Hysteroscopies) carried out under local anaesthetic, diagnostic ultrasound and contraceptive services (including insertion of Intrauterine Devices). The service also provides antenatal consultations and associated scans; and in addition is considered a leading authority on Asherman’s Syndrome - a condition concerning the lining of the uterus and which can affect fertility.

Adrian Lower and Associates Ltd is open Monday – Friday 8:30am - 5:30pm. The clinical team comprises Mr Adrian Lower (consultant gynaecologist) and two associate consultant gynaecologists (one female, one male). The clinical team are supported by a female medical secretary and a female administrator who undertake chaperone duties (having received training for this role).

Adrian Lower and Associates Ltd is registered with the Care Quality Commission to carry out the regulated activities of Treatment of disease, disorder or injury; Maternity and midwifery services; Family planning and Surgical Procedures and Diagnostic and screening procedures.

How we inspected this service

Before our inspection, we gathered and reviewed information from a number of sources including information submitted by the provider.

During our inspection, we spoke with staff, reviewed clinical records 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 20 September 2022

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

Adrian Lower and Associates Ltd. provides gynaecological consultations, examinations and treatments to private patients and is located at 9 Upper Wimpole Street, London, W1G 6LJ.

The service has a 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 carried out an announced comprehensive inspection at Adrian Lower and Associates Ltd on 25 July 2022 as part of our inspection programme.

Our key findings were:

• Leadership arrangements promoted the delivery of high-quality person-centred care and we also saw evidence of how this was supported by new, evidence-based techniques and technologies.
• The provider assessed needs and delivered care in line with current evidence-based guidance and we also saw evidence of safe and innovative use of pioneering approaches to gynaecological treatments.
• There were clearly defined and embedded systems and processes to keep patients safe and safeguarded from abuse.
• The service was tailored to meet patients’ needs and delivered in a way to ensure flexibility, choice and continuity of care.
• Although emergency oxygen, defibrillator and a range of emergency medicines were available on site, we noted the absence of three emergency medicines reasonably expected to be held by a gynaecological service. When this was highlighted, immediate steps were taken to stock these medicines.
• There were effective processes in place to identify and address risks; and practice management arrangements supported the delivery of high-quality person-centred care.

The areas where the provider should make improvements are:

• Take action to review emergency medicines protocols and ensure that medicines held are appropriate to the service.
• Take action to introduce a written protocol to confirm that, in cases of suspected cancer, patients who are advised to request an urgent referral via their NHS GP have done so.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

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