The Harley Street Breast Clinic is a private breast screening and diagnostic service based in central London. The service offers a single speciality which accepts patients on a referral or walk-in basis. The service is owned and operated by UniLabs Ltd, and was registered with the CQC in October 2010. The Harley Street Breast Clinic provides a one stop clinic where patients have a consultation and diagnostic tests, with results provided to the patient usually on the same day. Diagnostic tests provided by the service include ultrasound, mammogram, and biopsy. The service also has a walk-in or referral breast screening service for women over the age of 40. Staff at the service included breast surgeons, mammographers, radiographers, registered nurses, and healthcare assistants. 

Services we rate

We rated it as good overall.

• The service environment was clean and well maintained.
• There were comprehensive infection prevention and control processes.
• The service had enough staff, with the right mix of qualification and skills, to keep patients safe and provide the right care and treatment.
• Staff completed and updated risk assessments for each patient. Patient records were clear, up-to-date and easily available to all staff providing care.
• The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately, and any incidents were investigated thoroughly. 
• The service provided care and treatment based on national guidance and evidence of its effectiveness.
• Managers monitored the effectiveness of care and treatment and used the findings to improve them.
• The service made sure staff were competent for their roles.
• Doctors, nurses and other healthcare professionals supported each other to provide good care.
• Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness.
• During this inspection we saw all staff treating patients with dignity, kindness, compassion, courtesy and respect.
• Staff provided reassurance and support for patients throughout their appointment.
• The service had a strong person-centred culture. Staff were motivated and inspired to offer care that was kind and reflected the individual needs of each patient.
• Patents we spoke with were happy with reporting times. Diagnostic reports were usually available on the same day
• Patients were offered a choice of appointment times. Patients we spoke with told us they were given appointment times that suited them.
• The service had an agreement with a translation phone service to provide access to an interpreter if needed.
• The provider’s website provided useful information about the service, staff, procedures that were provided, and the referral process. 
• The service had a clear management structure.
• Staff told us the registered manager and clinical director were approachable and supportive, and that they could reach them when needed.
• Staff were positive and happy in their role and stated the service was a good place to work. Staff told us they felt supported, respected and valued by the management.
• There was a robust corporate and local governance framework in place which oversaw service delivery and quality of care.

However:

• Referral forms did not provide guidance on referral criteria or space for information about complex needs.
• The service incident and complaints policy did not include information on duty of candour.
• The service did not collect or analyse information relating to waiting times, missed appointments, or cancellations.
• The service did not have a specific vision or strategy document.

The provider had a consent policy which outlined the ways consent could be given and what constituted valid consent. The policy also detailed what staff should do if somebody refused consent.

Staff told us that before they carried out any procedure they explained it to the person receiving the treatment. They took the person's medical history, informed them about what to expect from the procedure and how they would receive the results. We saw "client feedback" forms and one person said staff "were very friendly and helpful explaining all that they were about to do."

Equipment was maintained appropriately. The mammography unit was tested for radiation level safety every 6 months by an external radiographer who would carry out tests to ensure that the radiation levels were within safe limits. Weekly quality assurance testing was carried on the mammography unit and the ultrasound scanner to ensure they were working efficiently.

People were made aware of the complaints system. This was provided in a format that met their needs. Details of how to make a complaint were available in the waiting area of the service. We saw a copy of the complaints form and it was in an accessible format.

We did not speak with patients on this occasion. However, most respondents to the patient survey stated that they were provided with adequate information and the clinic facilities were clean and tidy.