This service is rated as Good overall.

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 The Silverthorn Centre as part of our inspection programme. The service had not been previously inspected.

The service is a specialist dermatology clinic which provides NHS funded treatment through referrals by local GP practices. The service is commissioned by Waltham Forest Clinical Commissioning Group.

We received 47 completed comment cards about the service. Comments were almost all positive; describing an efficient, professional and friendly service. One patient commented about confusion caused by lack of clear signs directing patients to where the service is located. Another patient reported to have experienced long waits between appointments and perceived lack of availability of urgent appointments, however this was not representative of the overall patient experience.

Our key findings were:

• The service had systems to assess, monitor and manage risks to patient safety, and reliable systems for appropriate and safe handling of medicines. The service learned from, and made changes as a result of, incidents and complaints.
• The service assessed need and delivered care in line with current legislation, standards and evidence based guidance, and reviewed the effectiveness and appropriateness of the care provided through clinical audits.
• The service treated patients with kindness, respect and compassion, and patient feedback was positive about the service experienced.
• The service organised and delivered services to meet patients’ needs.
• There was a clear leadership structure in place, and staff told us that they felt able to raise concerns and were confident that these would be addressed.
• The service had a governance framework in place, which supported the delivery of quality care, and processes for managing risks, issues and performance.

The areas where the provider should make improvements are:

• Review the stock of emergency medicines available and carry out a risk assessment of which drugs are or are not necessary to be held.

• Review consent processes in respect of minors to ensure consistent recording of their relationship to their accompanying adult.

• Review translation procedure of written information to ensure service used provides accurate translation, particularly in the case of medical terminology.

• Review protocol for laboratory requests to ensure it reflects the agreed updated procedure.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care