The Private Clinic Limited – Birmingham is operated by The Private Clinic of Harley Street Limited. Facilities include three operating theatres, one treatment room, two consultation rooms, one nurse room and a recovery area.

The service provides cosmetic surgery for adults aged 18 and older. The main service provided by this clinic was hair transplant, endovenous laser ablation (EVLA) (removal of varicose veins) with sclerotherapy, EVLA and vaser liposuction.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 29 September 2016.

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.

We do not currently have a legal duty to rate cosmetic surgery, or the regulated activities they provide but we highlight good practice and issues that service providers need to improve.

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

We found the following issues that the service provider needs to improve:

• Record keeping, including the use of recognised early warning scores systems to assess deteriorating patients’ needed to improve. Clinical staff were not signing in the specific sections of patient records relevant to their position, for example nurse or doctor.

• Staff should document multidisciplinary team briefs before surgery and complete the to demonstrate this had been done and would enable the provider to do ongoing audit.

• Medicine management needed to improve to ensure it meets legal guidelines, for example two signatures were not always present in the controlled drugs book.

• Clinical staff needed to input into medicines audits to ensure errors were analysed and staff learnt lessons from mistakes.

However, we also found: the following areas of good practice:

• Staff were very dedicated and passionate to provide a responsive service to their patients. Patients felt well cared for and were given ample time to make decisions and not put under any pressure to have surgery.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve.

Heidi Smoult

Deputy Chief Inspector of Hospitals