Archived: Shropshire Skin Clinic

Updated 24 March 2020

Shropshire Skin Clinic is based at The Lodge, Farley Road, Much Wenlock, Shropshire TF13 6NB. The clinic is registered with CQC for diagnostic and screening procedures; treatment of disease, disorder or injury; surgical procedures and is an Independent Healthcare Company.

Shropshire Skin Clinic provides a small range of medical aesthetic treatments. These are performed by a consultant dermatologist and their team who specialise in aesthetic treatments and skin disease. The clinic provides services to NHS and private paying patients. A wider range of treatments are available at the provider's other registered location situated approximately 17 miles away in Shrewsbury, Shropshire and was not inspected as part of this inspection.

The service is led by a director partnership who own the business and the Much Wenlock and Shrewsbury premises, from which they provide services.

In addition to the Director and Consultant Dermatologist, Dr Stephen Murdoch, one speciality doctor, two GPs with a special interest, one clinical assistant, one nurse, one health care assistant and a receptionist work at the Shropshire Skin Clinic. The provider employs other clinicians on an arranged sessional basis supported by a team of 21 administrative staff and a business manager based at their main site in Shrewsbury, Shropshire.

The clinic opened in 2004 and offers a dermatology service to adults and children over 12 years of age. The clinic functions as an independent provider to the NHS for 87% of its work. The service is commissioned by three Clinical Commissioning Groups (CCG’s) which are either in or on the border of Shropshire, Powys, and Telford and Wrekin. They also take out of area referrals in line with NHS Tariff. On average, the clinic sees 800 NHS and 800 private episodes per year. Some patients were seen more than once. Only 1% of children aged 12 and over were currently treated at this clinic

The clinic’s current core opening times are between 9am and 5pm Monday to Wednesday, although this is flexible and dependent on consultant availability. Patients are also able to access care and treatment provided at the provider’s main site in Shrewsbury, which is open Monday to Thursday between 9am and 8pm and Friday between 9am and 5pm. Services at the clinic are offered on a booked appointment only basis and can be made by using the provider’s central telephone number.

Further details about the clinic can be found on their website: www.stmichaelsclinic.co.uk

How we inspected this service

We reviewed information about the service in advance of our inspection visit. This included:

• Information we held about the service.
• Material we requested and received directly from the service ahead of the inspection. This included information about the complaints they had received in the last 12 months and the details of their staff members, their qualifications and training.
• Information reviewed on the day of the inspection including some policies, a sample of staff recruitment files, patient records, audits and records held at the practice.
• Information available on the service’s website.
• Patient feedback in surveys, CQC comment cards and telephone discussions.

We inspected Shropshire Skin Clinic on 20 January 2020 as part of our inspection programme. During the inspection we spoke with the Director, Practice Manager Director and Business Manager. There were no clinics held on the day of the inspection. Therefore following the inspection we spoke with two patients and a close relative that had accompanied their family member at the clinic for diagnosis and treatment.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 24 March 2020

We carried out an announced comprehensive inspection at Shropshire Skin Clinic as part of our inspection programme and to provide the service with a rating. 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.

Shropshire Skin Clinic is based in Much Wenlock, Shropshire and provides a dermatology service to NHS patients within Telford and Wrekin, Shropshire and Powys. The Clinic provides services from The Lodge, Farley Road, Much Wenlock, Shropshire TF13 6NB and also has another registered location known as St Michaels Clinic in Shrewsbury, Shropshire.

The service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of regulated activities and services and these are set out in and of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Shropshire Skin Clinic provides a limited range of non-surgical cosmetic interventions, for example botulinum toxin injections which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.

As a provider of Independent Healthcare, the service is able to offer a private dermatological service to patients within those areas offered to the NHS and beyond those geographical boundaries.

The service is managed from the provider’s main site at St Michael’s Skin Clinic, in Shrewsbury, Shropshire. The directors of the company are Dr Stephen Murdoch and Mrs Alison Murdoch.

Dr Stephen Murdoch 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.

In preparation for the inspection, the service had been sent comment cards and a collection box from CQC and had encouraged patients to fill these in prior to the inspection. We received a total of 14 completed comment cards which, included patients who had received diagnosis or treatment. Following the inspection and with the consent of patients, we also telephoned and spoke with two patients and a close relative that had accompanied their family member at the clinic for diagnosis and treatment. Feedback from comment cards and telephone discussions were very complimentary about the service and the care and treatment received. Patients spoke highly of the service and described staff as professional, attentive, friendly, caring, thoughtful and efficient.

Our key findings were :

• The service had clearly defined processes and systems in place to keep people safe and safeguarded from abuse.
• There was an open and transparent approach to safety and a system in place for recording, reporting and learning from significant events, incidents and complaints.
• There were effective arrangements in place for monitoring and managing risk.
• Staff had received essential training in safe working practices.
• The provider had effective recruitment procedures in place to ensure staff were suitable for their role.
• Patients received effective care that met their needs, kept them safe and protected them from avoidable harm.
• The premises were clean, well maintained and well equipped to treat patients and meet their needs.
• Patients were provided with detailed information about any proposed treatment and costs where applicable, which enabled them to make an informed decision.
• Patients were offered convenient, timely and flexible appointments.
• Patients told us staff involved them in their care and treatment and treated them with compassion, kindness, dignity and respect.
• Written arrangements were in place between the service and the local hospital for transferring the care of patients with a cancer diagnosis.
• The service reviewed the effectiveness and appropriateness of the care provided.
• There were clear responsibilities, roles and systems for accountability to support good governance and management that assured the delivery of high-quality care and treatment.

The areas where the provider should make improvements are:

• Consider developing a lone working policy and risk assessment.
• Ensure safety checks carried out on the defibrillator also include checks on expiry dates of defibrillator pads.
• Improve the monitoring of vaccine fridge temperature checks.
• Develop a structured programme of structured quality improvement activity.

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