We carried out an announced comprehensive inspection on 19 November 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Samedaydoctor Manchester Clinic (owned by SDD Medical Ltd) is a franchise of Samedaydoctor Holdings LLP based in London. The clinic is owned by the clinical lead and the business partner. The practice provides private primary medical services to the whole population.

The clinical lead is the 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 received feedback through 16 Care Quality Commission comment cards completed prior to the inspection. Each comment about the service was positive about the quality of the service. Respondents indicated that they were always treated with dignity and respect; respondents trusted the opinion of the clinicians and felt involved in planning their care and treatment. Respondents felt the staff were helpful and approachable and the facilities were clean and pleasant to use.

Our key findings were:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events, incidents and accidents.
• Information about services and how to complain was easily available to patients.
• Services were provided from modern, well equipped and well-maintained premises in line with patient needs.
• There were systems in place to check all equipment had been serviced regularly.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff maintained the necessary skills and competence to support the needs of patients.
• Staff were up to date with current guidelines and were supported by an accessible and visible leadership team within the Samedaydoctor group.
• Risks to patients were well managed for example, there were effective systems in place to reduce the risk and spread of infection.
• The provider was aware of, and complied with, the requirements of the Duty of Candour.
• There was a clear leadership structure and staff felt supported by management. The clinic proactively sought feedback from patients, which it acted on.
• The provider was proactive in monitoring the quality of the service and made changes in response to the findings.
• The provider had effective systems in place to communicate with statutory agencies.
• The registered manager has ensured corporate policies are aligned to local polices and are relevant to the Manchester clinic.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

We carried out an announced comprehensive inspection on 18 February 2016 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations

Background

The samedaydoctor Manchester clinic operates a private GP and medical service to patients of all ages in Manchester city centre. The Samedaydoctor group has a number of clinics and its headquarters in London. The Samedaydoctor management team, including the Chief Medical Officer, provides clinical and business leadership and is responsible for all aspects of governance for all the clinics including the Manchester clinic. There are between 500 and 1000 patients currently registered with the Manchester clinic. The clinic manager told us a significant number of appointments were one-off consultations including patients from foreign countries who require medical assistance whilst visiting the UK from abroad and are often privately funded by travel or medical insurance companies. The clinic also specialises in travel vaccinations and sexual health services. Same day appointments and pre-booked appointments are available. The service is open Monday to Friday from 8.00am to 6pm and from 10.00am to1.00pm on Saturdays. There is no out-of-hours provision or agreement with external providers.

The clinic has a doctor’s consultation room, a clinic room, a waiting and reception area and an administration office. The clinic is based on the first floor of shared premises and is accessible by stairs or a lift.

A GP is on duty at the clinic each day and is supported by an administrator and the clinic manager. The medical team consists of six GPs, each of whom has a contract with Samedaydoctor as an independent contractor to work one day per week in the clinic. All the GPs also undertake NHS work with other providers. An advanced nurse practitioner provides additional support as required.

We reviewed 20 Care Quality Commission (CQC) comment cards that had been left for patients to complete, prior to our visit, about the services provided. All comments were very positive about the help they received and the manner in which they were treated. Patients attending the clinic on the day of the inspection did not request to speak with the inspector.

The clinic manager is the 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.

Our key findings were:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events, incidents and accidents.
• Patients reported they were treated with dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was easily available to patients
• Services were provided from modern, well equipped and well maintained premises in line with patient needs.
• There were systems in place to check all equipment had been serviced regularly.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff maintained the necessary skills and competence to support the needs of patients.
• Staff were up to date with current guidelines and were supported by an accessible and visible leadership team within the Samedaydoctor group.
• Risks to patients were well managed for example, there were effective systems in place to reduce the risk and spread of infection.
• The provider was aware of, and complied with, the requirements of the Duty of Candour.
• There was a clear leadership structure and staff felt supported by management. The clinic proactively sought feedback from patients, which it acted on.

We undertook a follow up inspection to Samedaydoctor on the 20 September 2013 to see what action the registered provider had taken to become compliant. We did not speak to people who used the service during this inspection.

We found that since our last inspection the registered provider had reviewed their recruitment processes and this now ensured that an effective recruitment process was being operated at the service.

We found that an audit of staff personnel files had been completed and all required documentation was in place. We found staff personnel files were well organised and information was easy to locate.

We found that the registered provider was now ensuring that people who used the service had their health and welfare needs met by staff who were fit and appropriately qualified to undertake their work.

Patients we spoke with said they had found it very easy to get an appointment at Samedaydoctor in Manchester.

One patient said of the treatment and care they had received; “I would recommend it and I would come back again”.

We found that patients consent was always sought prior to any treatment being given.

Patients told us they were happy with the care and treatment they received and that staff had explained everything to them. One patient told us; “I knew what was happening, the nurse explained everything to me.”

The service prescribed medication to patients and we found that patients were protected against the risks associated with medicines because the provider had good systems in place to manage medicines.

We found that there were enough staff on duty to meet the needs of patients but the registered provider did not operate a robust recruitment process.

We found that the registered provider had effective systems in place to monitor service delivery and outcomes for people who used the service.

Patients told us that they had found out about the service on the internet and by ‘word of mouth.’

One patient told us they had used the service before and had returned because of a previous positive experience. They told us the service was, “Easy to use, it’s a good service,” and “It’s instant. You are seen quickly and you get instant results.”

Patients told us they found the doctor really helpful and they felt listened to.

Patients told us that when they contacted the service to make an appointment they found reception staff helpful and described them as being, “Very efficient and we were offered a number of options and appointments.”

Patients said they were given good information.

They told us, “The GP was very nice,” and “The GP was very helpful, took time to explain things to us.”

And

“They are good 10/10.”

“We will use them again.”

“My overall experience was a good one and I would definitely use them again.”

Patients told us they liked the premises and that they provided a welcoming and clean environment.