During our visit we spoke with four people who use the service and eight staff of various disciplines, including healthcare assistants, a physiotherapist and consultant.

The majority of feedback from people who use the service was positive. Those we spoke with during our visit were very pleased with the service and commented that the staff were friendly and treated them with respect. Some people had attended the centre on a number of occasions, and each time were made to feel welcome. People said they were given sufficient information prior to their appointment about how to get to the centre and what to expect during their appointment. Some people said they would like more timely information, as they received information by post, after they had attended their appointment.

There were a number of systems in place to monitor the cleanliness and hygiene of the service to ensure that any risks of infection were controlled and minimised.

There were robust systems in place to ensure that appropriate recruitment checks were carried out prior to staff working at the service.

Relevant steps were taken to record any complaints received and the provider responded to these to the satisfaction of people who use the service.

Patients told us they attended the clinic for outpatient treatments and appointments. They told us they could see a general practitioner by appointment and there was a walk in service where they could see a medical practitioner for a ‘one off’’ consultation. People said they were fully informed about all aspects of their treatment and care.

Patients told us they completed an initial registration form on their first visit to the clinic and during their consultation the doctor carried out a comprehensive assessment of their health needs.

Patients told us they were very happy with treatment and care provided. The results of the patient satisfaction survey supported this. Patients described staff as 'great', 'marvellous' and “very good”. They told us reception staff were friendly and helpful.

Patients told us they had experienced treatment in other private and NHS facilities and stated that the clinic had provided by far the best experience they’d had.

BMI Syon Clinic is operated by BMI. Facilities include consulting rooms, a physiotherapy suite and diagnostic and imaging facilities.

The hospital provides outpatients and diagnostic imaging services.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 10th and 11th January 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.

We rated this hospital as good overall.

• Incidents were reported and investigated through a clinic wide electronic system. Lessons learnt were shared effectively with all staff electronically and through team meetings. Themes were identified and there was no blame culture.

• The clinic was a safe, clean environment and risk was minimised by regular cleaning and infection control monitoring.

• The clinic had recently introduced a facility for storing records which meant that records were available for all patient appointments. Provider data suggested only 28% of appointments had all available records previously.

• Sufficient staffing levels were maintained to keep patients safe.

• There were clear business continuity protocols in place and staff knew what to do in case of emergency.

• The clinic followed national and BMI guidelines and procedures which were kept updated.

• We saw evidence that staff gained consent from patients and followed procedures correctly.

• Patients gave good feedback about the care provided; they reported that staff were helpful and supportive.

• Patients said that they were well informed about their care

• We observed friendly interactions between patients and staff

• Patients were able to access the service and make appointments quickly at flexible times. There was efficient flow through the clinic and a wide range of specialties available.

• Staff described adjustments they made to meet the needs of patients they cared for.

• There were same-day clinics so that patients could have their appointment and imaging done in one visit.

• Learning from complaints was shared and managers improved the service in response to them.

• There was positive leadership and managers understood the challenges facing the clinic and devised strategies to overcome them and improve the service.

• The clinic had a clear vision and staff understood their roles in achieving the overall strategy.

• There was a positive and supportive working culture at the clinic, staff spoke highly of their managers and felt able to raise problems and concerns if they needed to.

However:

• There had been an Ionising Radiation (Medical Exposure) Regulation (IR[ME]R) reportable incident in imaging in the 12 months prior to inspection where a patient had undergone an unnecessary second scan due to poor record keeping and clinical communication.

• There was limited auditing of the clinical performance of the clinic so managers were reliant on patient complaints to identify clinical concerns

• There was not a clear power failure protocol in the imaging department

• There was limited staff and public engagement to obtain wider involvement in improving the service.

Amanda Stanford

Deputy Chief Inspector of Hospitals