CQC Raise Concerns Over the Safety of Independent Clinics and Doctors

A new report from the CQC analysing inspections of independent doctor services in England has raise concerns over safety.

The wide-ranging report looked at the quality of care being provided by:

  • private GP services
  • travel clinics
  • slimming clinics
  • circumcision clinics
  • allergy clinics
  • clinicians registered with the General Medical Council who provide consultations and/or treatments.

While some good practice was identified, analysis found that just under half of independent consulting doctor services and slimming clinics were not providing safe care, in accordance with the relevant regulations, on their first inspection.

Key Concerns

  • The safety and efficacy of prescribing.
  • Record keeping.
  • Clinicians not communicating their activity with the patient’s GP.
  • Limited functionality and interconnectivity of IT systems with NHS primary care services.
  • Almost a quarter of slimming clinics were not meeting the regulations for effective care, with some found to be treating people with medicines not recommended by the National Institute for Health and Care Excellence (NICE) or the Royal College of Physicians.
  • Inspectors found examples of appetite suppressants being prescribed to patients with a BMI lower than that recommended, or to patients with high blood pressure.
  • Concerns were also found around safeguarding in other types of providers, such as circumcision clinics. While these services had systems to obtain consent from both adults with parental responsibility in place, they had not always obtained written consent from both parents before a procedure, or only asked for consent from both parents when the provider suspected a possible dispute.

Encouragingly, re-inspections of slimming clinics showed evidence of improvement over the course of the inspection programme, with evidence that providers had addressed concerns and applied learning both from inspections of their own services and those of other providers.

Ursula Gallagher, Deputy Chief Inspector of General Practice and lead for Independent Providers said:

“In looking at this diverse group of services, we have found and highlighted some truly responsive care. We were also pleased to see that on re-inspection, providers showed improvement in a number of areas where we had found very real concerns such as safe prescribing.

“However, this was not always the case and too often we saw poor prescribing practice and providers with a limited awareness of their responsibilities – not just to their patients but to the wider healthcare system. I hope this report will help providers and others to identify what they need to do and where they might focus their efforts.

“Everyone providing these types of services has a legal responsibility to offer safe, high-quality care that not only meets the needs of the people using it, but also meets the legal requirements that exist to protect patients. Where this isn’t the case and we see risks to patient safety, we will not, and have not, hesitated to stop providers from operating.”

From the 1st April 2019 the CQC will start to introduce ratings for independent consulting doctors and clinics to align with their approach to regulating other services. This clear, at a glance indication of quality is designed to empower people to make informed choices about their care.

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