We carried out an announced comprehensive inspection on 21 January 2019 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 service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Dr John Keet provides an independent doctors consultation service from premises in the Marylebone area of West London. Patients are typically referred by another medical professional and book appointments in advance. The service provides onward referral to specialist services and liaison with patients’ own GPs and other clinicians as appropriate. The service treats adults only. It typically treats around 5 patients per month.

We received 18 comment cards completed by patients in the days leading up to the inspection. These were wholly positive and described the clinician as thorough and attentive and the environment as clean and safe.

The service is registered to provide the regulated activities of: diagnostic and screening services and treatment for disease, disorder or injury.

Our key findings were:

• There was a vision to provide a high quality, personalised service with a strong focus on well coordinated care.
• The doctor was aware of current evidence-based guidance and had the skills and knowledge to deliver effective care and treatment.
• Patients were able to access the service in a timely way and described the service as caring.

• The provider had systems in place to protect people from avoidable harm and abuse.

• The provider had systems in place to record, monitor, analyse and share learning from significant events and safety alerts.

• The service had arrangements in place to respond to medical emergencies.

There were areas where the provider could make improvements and should:

• Review and implement appropriate quality improvement activity for example, carrying out documented audits of activity such as prescribing and record keeping.
• Review the way that notes are stored to ensure these can be safely transported within the premises.
• Review the process for updating policies so the date of the last or next review is clear.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice