Lymphoedema Specialist Services are a small independent company who employ three full time members of staff and provide services predominantly, on the behalf of the NHS, across three Clinical Commissioning Groups in East Sussex.

Lymphoedema is a condition that causes swelling in the body’s tissues and can be categorised as either primary, secondary or chronic in type. The services treats patients with primary or secondary type lymphoedema.

Services we do not rate

We regulate independent community health services but do not currently have legal powers to apply the duty to rate all of them. Our methodology for small and medium community healthcare providers is based on not rating as there are no service specific frameworks to support consistent ratings decisions. However, we do take regulatory action as necessary, highlight good practice and issues that service providers need to improve.

We previously visited this service in March 2017 as part of our national programme to inspect all independent healthcare providers. We do not currently have a duty to rate independent community specialist services, however we did find one breach of regulation relating to the governance of the service.

We told the service it must:

• Ensure incidents and near misses were recorded, investigated and learned from.

• Ensure that staff are aware of their responsibilities in ensuring effective incident management processes.

We also told the service it should:

• Ensure that the translation policy followed best practice.

Following the inspection, we told the service that it must give us a plan of action showing how it would bring services into line with the regulations. The service provided a report on the actions it planned to take and updated us on progress, as the issues were resolved.

The purpose of our inspection on 5 December 2017 was to see if the service had made the necessary changes outlined in the action plan provided. During this follow up inspection we focused on the action plan and the areas of concern highlighted in the previous report. We did not inspect any other part of the core service, and focused on incident and risk reporting in line with the breach of regulation.

During this inspection we were assured that the service had met all the required improvements, recommendations and were no longer in breach of the regulations.

The service had significantly improved and had taken action to comply fully with regulations and we found:

• Incidents were being formally documented, and staff had access to flow charts detailing the process to follow if they needed to report an incident.

• A process and policy for booking formal translation was now in place.

We will continue to monitor the performance of this service and inspect it again, as part of our ongoing programme.

Amanda Stanford

Deputy Chief Inspector

Currently the organisation provides treatment for some NHS patients under a contract from the local clinical commissioning groups (CCG’s). Other people were able to access the service privately or through a case by case approach from the commissioners.

People who used the service told us how grateful they were to receive treatment from the Lymphoedema service. One person said, “I can’t believe I have managed to find someone who provides this service.” Another person said, “It’s made such a difference to my life.”

We saw that people were asked for their consent prior to receiving any treatment. We observed treatment and saw that this reflected relevant research and guidance.

The provider worked co-operatively with other providers and organisations. There was a complaints procedure in place at the organisation.

Staff were supported by the provider continuously to maintain and improve high standards of care by creating an environment where clinical excellence could do well.