Regency Clinic – City of London is operated by Regency International Clinic Ltd. Facilities include one operating theatre, a two-bedded recovery ward, X-ray, outpatient and diagnostic facilities.

The service provides gynaecology surgery, outpatient and diagnostic imaging, care and treatment. The service also provides private GP consultations. All procedures that required anaesthesia were carried out using local anaesthetic; the service did not provide general anaesthetic. We inspected surgery and outpatients at this inspection.

In 2017 average monthly activity levels were:

Surgical procedures: three to four

Diagnostic and screening procedures: four to six

Treatment of disease, disorder or injury: six to eight

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 28 February 2018.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

The main service provided by this clinic was surgery and outpatients services were also provided.

Services we rate

We rated this service as good overall because:

• The service managed staffing effectively and services always had enough staff with the appropriate skills, experience and training to keep patients safe and to meet their care needs.
• The senior team maintained checks of registration with the General Medical Council and the Nursing and Midwifery Council of professionals who provided services under practising privileges. Radiographers were registered with the Health and Care Professions Council and the senior team monitored this each time a locum radiographer worked in the clinic.
• The service was compliant with the standards set by the British Association of Day Surgery (BADS) and the Association of Anaesthetists of Great Britain and Ireland (AAGBI) in relation to medical records, clinical equipment, monitoring patient risk and the provision of a follow-up emergency advice service.
• There had been no instances of unplanned or emergency patient transfers to other facilities or hospitals and no unplanned readmissions or unplanned returns to the operating theatre since the clinic came into operation.
• All permanent staff had undergone an appraisal in the previous 12 months, in line with the provider’s policy.
• Clinical staff completed accredited training from nationally recognised bodies.
• All of the patient feedback we received reflected a good standard of kind, compassionate and understanding care. Staff training reflected national standards of care delivery established in National Institute for Health and Care Excellence (NICE) quality statement 15 in relation to dignity and kindness.
• Staff provided clinical services tailored to patient demand, such as a well women clinic.
• There was no waiting list for the service.
• There had been no complaints in the previous four years and staff demonstrated a proactive approach to acting on other feedback.
• The leadership structure and working culture were well established and the senior team valued feedback from staff and patients.

However:

• After the inspection, we reviewed policies which were inconsistent regarding the pregnancy rule which was a concern as the service were performing procedures on women who were trying to get pregnant. The service did not have oversight of these inconsistencies. 
• Safety monitoring systems were in place but were not always fully effective as we found emergency equipment that needed to be replaced and expired medicines stored in the clinical room.
• The service did not audit or benchmark patient outcomes against national standards or similar services.

Following this inspection, we issued a requirement notice for the breach of Regulation 12 and told the provider that it should make some improvements to help the service improve. Details are at the end of the report.

Amanda Stanford

Deputy Chief Inspector of Hospitals (Interim)