This service is rated as Good overall. The service was previously inspected in March 2018.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at BMI The Cavell Hospital as part of our ratings inspection programme for Independent Health Providers.

Enfield Community Gynaecology offers consultant led gynaecological consultations from facilities located at the BMI Cavell Hospital, Enfield. The service is commissioned by the local Clinical Commissioning Group and patients access the service via their GP.

The Service 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.

Fifteen people provided feedback about the service.

Our key findings were:

• The service had systems to manage risk so that safety incidents were less likely to happen.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. Clinical staff ensured that care and treatment was delivered according to evidence-based guidelines.
• Clinical staff were qualified and had the skills, experience and knowledge to deliver effective care and treatment.
• The practice was actively engaged in activities to monitor and improve quality and outcomes.
• Facilities and premises were appropriate for the service being delivered.
• All 15 of the CQC comment cards we received were positive, with key themes being that reception staff were kind, clinical staff were knowledgeable, communicative and compassionate; and that the overall environment was clean.
• There was a proactive approach to understanding the needs of the local community and towards delivering care in a way that met these needs.
• The culture of the service encouraged candour, openness and honesty.
• People could access appointments and services in a way and at a time that suited them.
• We saw examples of inclusive and effective leadership.
• Governance arrangements facilitated the delivery of safe and high quality clinical care.

We saw the following outstanding practice:

• The service employed clinical staff who worked across several CCG areas and was conscious this provided an opportunity to identify and share good practice and learning. The service was able to show examples of when it had used this capacity to benefit patients, including developing guided clinical assement forms to support GPs making fertility referrals in a way which helped minimise avoidable disappointment and distress to patients who did not meet certain criteria, a process which allowed its clinicians to refer patients directly to hysteroscopy from the triaging stage without being required to attend assessment consultations which were not clinically necessary and sharing learning between CCGs relating to a conservative approach to the management of asymptomatic polyps. In each case, the service or it’s clinical director developed the improvement in one CCG area and shared this in other CCG areas.

Dr Rosie Benneyworth BM BS BMedSci MRCGP 

​Chief Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection on 1 March 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.

Enfield Community Gynaecology offers consultant led gynaecological consultations, examinations and minor surgical procedures under local anaesthetic from facilities located at the BMI Cavell Hospital, Enfield. The service is commissioned by the local Clinical Commissioning Group and patients access the service via their GP.

The service provides a clinic every Wednesday from The Cavell Hospital between 9am-5pm and occasional clinics on Mondays. A monthly Saturday clinic based at Green Lanes Surgery, Winchmore Hill is also provided. The Green Lanes Surgery location was not visited as part of this inspection.

The service sees 200-500 patients per month across the two sites and has a staffing team consisting of seven gynaecologist specialists, two doctors, one nurse, two health care assistants and two administrative staff. Patients access the service via GP referral and we were advised that the service treated approximately 75% of all gynaecological referrals in the local CCG area.

Our key findings were:

• The service had systems to manage risk so that safety incidents were less likely to happen.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. Clinical staff ensured that care and treatment was delivered according to evidence-based guidelines.
• Clinical staff were qualified and had the skills, experience and knowledge to deliver effective care and treatment.
• The practice was actively engaged in activities to monitor and improve quality and outcomes.
• Facilities and premises were appropriate for the service being delivered.

• All 30 of the CQC comment cards we received were positive, with key themes being that reception staff were kind, that the lead consultant was knowledgeable and communicative; and that the overall environment was clean.

• There was a proactive approach to understanding the needs of the local community and towards delivering care in a way that met these needs.
• The culture of the service encouraged candour, openness and honesty.
• People could access appointments and services in a way and at a time that suited them.
• We saw examples of inclusive and effective leadership.
• Governance arrangements facilitated the delivery of safe and high quality clinical care.