The Frater Clinic

Updated 28 July 2021

The Frater Clinic is based at 94 Harley Street, London, W1G 7HX. The clinic rents three rooms on the ground floor. Several other healthcare services are based in the building, and there is a shared reception, waiting room and toilets. The area is well served by public transport.

The clinic provides private general practice (GP) care and travel medicine services (including vaccinations) to adults and children. The majority of the clinic’s patients are non-UK residents or residents that travel frequently. Where patients are assessed as needing assessment and treatment by a consultant specialist, the GP refers to either a consultant specialist with practising privileges, who sees the patient at the clinic, or an independent specialist. Patients pay the clinic for both GP and specialist care received at the clinic, and the consultant specialists then invoice the clinic for their payment. GP care at the clinic includes travel medicine, treatment of short and long-term conditions, immunisations and antenatal care.

During the Coronavirus pandemic, patients are triaged and offered a telephone or video consultation. If a face to face consultation is deemed to be necessary, arrangements are in place. Patients of all ages are seen. GP services are by appointment, with appointments lasting typically 30-60 minutes and can be longer when necessary.

Prior to COVID, Minor surgery was performed at the clinic by a doctor who specialise in dermatology. The staff team comprises the medical director, who works as a GP and a practice manager. The clinic granted practising privileges to four consultants. The consultants attend the clinic when there is a patient who requires an appointment. The consultant’s individual specialties are in cardiology, endocrinology, breast surgery and geriatric and general medicine. The majority of care provided by the clinic is episodic. Consulting hours are 9.30am-5.30pm, Monday to Friday, for booked appointments only. When the clinic is closed, patients are directed to other services. The clinic’s website address is: www.thefraterclinic.com. We visited The Frater Clinic on 7 July 2021. The team was led by a CQC inspector, accompanied by a GP specialist advisor. Before the inspection, we reviewed notifications received about the service, and a standard information questionnaire completed by the service. During the inspection, we interviewed staff, made observations and reviewed documents.

Updated 28 July 2021

This service is rated as Good overall. (Previous inspection April 2019 – Requires improvement)

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 focused inspection at The Frater Clinic, to follow up on previous breaches of regulations. During this inspection we inspected safe, effective and well led.

CQC inspected the service in April 2019. We rated the service as requires improvement overall due to concerns with, limited quality improvement activity in relation to the clinical outcomes for patients. At the time of inspection there was no evidence of a process in place to follow-up on patients that were referred for secondary care. The minutes of meetings attended by the consultants granted practising privileges could not be used as a record that could be referred back to and used for follow-up purposes because they did not capture the detail of the meeting or agreed outcomes.

We checked these areas as part of this focused inspection and found the concerns had been resolved.

The Frater Clinic is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the private medical services it provides. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The Frater Clinic provides corporate health screening and pre-employment screening programmes to some employers. These types of arrangements are exempt by law from CQC regulation. Therefore, we did not inspect these. The service is registered with the CQC for the regulated activity of treatment of disorder, disease and injury.

The provider 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.

Our key findings were:

• The service made improvements to their policies and protocols since the last inspection.
• The audits we reviewed demonstrated quality improvement for patients.
• Processes for patients to access a chaperone within the clinic had been reviewed.
• The practice was now using an electronic recording system to support quality improvement.
• Governance arrangements had improved to ensure oversight of risk.
• Risks to patients were assessed and well managed.

The areas where the provider should make improvements are:

• Continue to embed the programme of planned quality improvement activity and consider ways to broaden its scope.
• Review clinical staff safeguarding training levels.
• Consider reviewing/updating regulated activates to include Diagnostic and screening procedures, and Maternity and midwifery services.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care improvement)