We were unable to speak with people using the service as no appointments had been made during the inspection so Dr Afzal was free to discuss the service with us. At present confidential questionnaires were being given to children and young people so they could give their opinions about the service to an independent organisation. This feedback would be used to reflect on the service and was benchmarked against feedback about other UK psychiatrists.

People received sufficient information prior to an appointment and were seen in private. Their views were taken into account in the planning of care and treatment. Confidentiality and privacy was maintained. The risks associated with people’s mental health were reviewed at each appointment and there were systems for follow up or admission to hospital if needed.

Dr Afzal received annual appraisal and undertook training so her practice was up to date and reflected current guidance and research. Training included safeguarding of children and medical emergencies. She had peer support and supervision. There were systems to refer safeguarding concerns appropriately.