Archived: Queens Clinic

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We found that the service was not providing effective care because: The provider did not have adequate discussions with patients about their care and treatment options so patients were not able to make informed choices or properly consent to treatment as a result. The provider did not follow national policies and guidelines for treatments or best-practice guidelines. There were no systems and processes to monitor outcomes and provide assurance that treatments were safe and effective.

This service scored 25 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service was not able to demonstrate that all management options were being discussed with patients to best demonstrate that their needs were being met. We asked the provider why discussions regarding risk, consent, and treatment options were not sufficiently detailed in the clinical records to show that NICE guidelines were being followed. They reported they did not feel that recording this level of detail was required, which was not in line with General Medical Council (GMC) best practice guidelines.

There were no systems or processes in place to support people's needs being properly assessed prior to receiving treatment. We found people were not presented with all available treatment options and therefore were not able to make informed decisions about their care.

The provider told us they did not carry out procedures which were not in line with the National Institute for Health and Care Excellence (NICE) guidelines. They said procedures were only carried out if they were supported by NICE guidelines or the RCOG. This was contradictory to the provider website which advertised various procedures, for example vaginal laser treatment, which were not supported by evidence, NICE or the RCOG. The provider told us they had suspended this particular procedure and would review evidence every 3 months until it was deemed to be effective and safe. This was not reflective of the website information which was a concern because it was not clear that patients were given accurate and safe information about their care, or appropriately advised on the best evidence-based course of treatment.

People did not always receive care, treatment, and support that was evidence-based and in line with good practice standards. There were no systems in place to ensure that staff were up to date with national legislation, evidence-based practice and required standards. People were not always told about current practice that was relevant to their care.

The provider reported that where patients consented for information to be shared, this would be forwarded to the patient’s GP. However, the service was not able to evidence how and where this was recorded on the electronic clinical database or in paper records. Initially, the provider said this was done via email but then said this was done by phone. However, there was no evidence to show any safe and effective referrals or handovers took place between Queen’s Clinic and external clinicians including NHS GPs.

CQC asked the provider if they had a protocol for sharing information with patients’ GPs. The provider stated there was a policy in place. However, there was no formalised process and no evidence of a policy in place.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

The provider said they carried out audits, but there was no evidence of this. The provider said safety audits were done externally as well as self-auditing however, no external auditor had been appointed and no internal audits had been carried out. We asked specifically if any surgical outcome audits had taken place, the provider said there had but there was no evidence of this.

The service did not have planned audits for specific conditions or outcomes. The clinical database could not be searched in relation to a safety alert, or to assist in outcome-based audits. No audits had taken place since the previous practice manager left in December 2023. Documentation audits seen during the inspection were carried out in June 2023. Audit data from June 2023 was poor quality and did not provide any meaningful overview of risk or potential improvement to quality of care. We asked for evidence of any plans to improve audit results, but the provider was unable to provide this.

The provider had no knowledge of principles of informed consent, and laws around proper consent for patients. Full details of discussions with patients including risks, benefits and treatment options were not included in clinical records. We asked the provider specifically why this was, and they said if risks were rare, patients would not be told. This was not in line with GMC best practice guidelines and resulted in patients being denied the right to informed consent about their treatment.

There were systems or processes in place to aid consent but they were not sufficiently developed to underpin informed consent. The provider had made minor updates to the consent forms since the previous inspection but did not sufficiently detail discussions of all risks and benefits of procedures in order to provide patients with the opportunity to make an informed choice about their care.