Archived: Medelit Back Office

Updated 20 March 2020

Medelit Back Office is an independent provider of medical services. The service provides home and office visiting services in general practice and nurse led services. It also provides a range of other services such as physiotherapists, speech therapists, psychologists which fall outside of the CQC scope of registration. The service operates across London and Liverpool but the office for the service is based at 74 Victoria Drive, London, SW19 6HL.

The switchboard for the service is open from 8:30am until 5:30pm seven days per week, although home visits may be undertaken outside of these hours, by prior arrangement. The service does not provide continued care for long term conditions and does not prescribe high risk medicines which would require regular review.

The Clinical Director manages the service and triages all calls requesting a home visit. The service also employs (on a contract basis) two general practitioners, a nurse and a range of other clinicians who provide services not regulated by CQC.

During the inspection we used a number of methods to support our judgement of the services provided. For example, we interviewed staff, and reviewed documents relating to the service.

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 20 March 2020

We carried out an announced comprehensive inspection at Medelit Back Office as part of our inspection programme and to follow up on breaches of regulations. The location was not rated following the previous inspection in line with CQC policy at the time of that inspection.

At the previous inspection of 10 January 2019, we found breaches of Regulation 12 of the Health and Social Care Act 2008, specifically in relation to emergency medicines and equipment, infection control and the receipt and management of medicines and equipment alerts. We asked the provider to make improvements. We checked these areas as part of this comprehensive inspection and found these issues had been resolved.

Medelit Back Office is an independent provider of medical services, specifically general practice and nursing services at people’s homes, hotels or workplaces. This 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 as some of its activities fall outside the scope of registration. The service is provided as a visiting service across London and Liverpool, but the office from which the service is operated is 74 Victoria Drive, London, SW19 6HL.

The Clinical Director is also 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. The premises is an office only, no clinical services are provided from the base address. The service is registered with the Care Quality Commission (CQC) to provide the regulated activity of treatment of disease, disorder or injury.

Due to the nature of the service we did not receive any completed comment cards from patients and were not able to speak with any patients who had used the service as part of this inspection.

Our key findings were :

• The service had systems to manage risk so that safety incidents were less likely to happen. The service had not needed to report safeguarding concerns or investigate significant events, but systems were in place should they need to.
• Doctors undertaking home visits did not take emergency medicines or equipment with them, however we found appropriate risk assessments had been carried out and policies were in place to direct clinicians in case of an emergency to ensure people received timely, emergency care and treatment.
• The service did not provide infection control or clinical equipment to doctors utilising the service however appropriate risk assessments had been carried out and policies had been put in place to ensure clinicians were aware of the requirement to provide and carry specific personal protective equipment prior to accepting a call and to check it at regular intervals throughout the year.
• Care and treatment were delivered according to evidence based guidelines. There was limited evidence of clinical audit, however what had been carried out was appropriate given the nature of the service and the number of patients that had been seen.
• Staff had been trained in areas relevant to their role.
• Information about services was available and easy to understand. The complaints system was clear and was clearly advertised.
• Patients were able to access care when they needed it.
• The service had governance procedures in place supported by policies and protocols, and staff were aware of how to access and utilise them.

Although we found no breaches of the regulations, the areas where the provider should make improvements are:

• Review and consider the inclusion of a pulse oximeter in the list of mandatory items clinicians were to carry in their bag.
• Review and further consider opportunities to carry out quality monitoring activity, including clinical audits.

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