Thornhill Clinic - Luton Also known as Circumcision Centre

Updated 4 July 2022

Thornhill Clinic – Luton is an independent doctors treatment and consultation service in Luton. The service provides a private circumcision clinic and private GP services.

The address of the service is,

1-3 Thornhill Road

Luton

Bedfordshire

LU4 8EY

Information regarding the service can be found on the service’s website www.circumcisioncentre.co.uk

The service operates from, 9am to 5pm Monday to Friday and on the occasional Saturday according to demand.

The circumcision service covers all age ranges from infants (under 2 years old), younger boys (under 8), to older boys and adult men. The clinic also provides private GP services, medicals (pre-dominantly for taxi drivers) and some minor surgery such as mole removals and joint injections.

The service is run by three clinical and one non-clinical directors. The clinical team includes two consultant urologists and two GPs. They are supported by a health care assistant. There is a team of reception staff all led by the practice manager who is also the non-clinical director.

How we inspected this service

Before inspecting, we reviewed a range of information we hold about the service, any notifications received, and the information given by the provider at our request prior to the inspection.

During the inspection we spoke with staff including GPs and urologists, the practice manager and reception staff.

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 4 July 2022

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 Thornhill Clinic - Luton as part of our inspection programme.

Thornhill Clinic – Luton provides private circumcision services to infants, aged three days onwards, children and adults. The clinic also provides a private GP service, including medical health checks and occasional minor surgery such as mole removals and joint injections.

The Thornhill Clinic – Luton is registered with the Care Quality Commission (CQC) under the Health and Social Care Act 2008 to provide the following regulated activities:

• Surgical procedures
• Treatment of disease, disorder or injury

The practice manager 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.

Due to the COVID-19 pandemic, CQC comment cards were not able to be used. Prior to the inspection, patients and relatives were encouraged to complete ‘Share your experience’ forms through the CQC website. We received eight comments that were all positive about the service. Staff were described as friendly and excellent and people who provided feedback said they were made to feel comfortable when visiting the clinic.

Our key findings were:

• Systems were in place to keep people safe and manage risks. Infection prevention and control (IPC) measures had not been audited at the time of the inspection. However, immediately following the inspection the provider provided evidence of a completed IPC audit.
• Appropriate measures were taken to identify patients and their parents or guardians and to gain consent for procedures.
• Following circumcisions, all patients were issued with a prescription for antibiotic medicines with instructions not to collect the antibiotic medicines unless instructed by a doctor if an infection occurred. The records we reviewed showed the service did not always use the antibiotic recommended by the Medicines and Healthcare products Regulatory Agency (MHRA) to support good antimicrobial stewardship. The service opted for an alternative antibiotic to reduce the cost to the patient.
• There were processes in place to manage significant events and complaints and ensured that lessons were learnt and shared when things went wrong. We saw one incident of post-operative bleeding had been discussed at a clinical meeting. However, this was not documented as a significant event. Immediately following the inspection, the service provided an analysis of the event and reviewed their Accident, Incident and Adverse Event Policy and Procedure.
• Clinical audit and peer review was used to improve quality.
• Staff were appropriately trained to carry out their roles. Staff understood the requirements of legislation and guidance when considering consent and decision making.
• Feedback from patients was positive regarding the service and the care received.
• The facilities and premises were appropriate for the services delivered.
• The service was led by a team of directors who were knowledgeable about issues and priorities relating to the quality and future of services.
• There was a focus on continuous learning and improvement and the provider had developed a strong culture of innovation. The service researched circumcision techniques used by other services both in the UK and abroad to ensure they were performing the most appropriate and effective operations.

The areas where the provider should make improvements are:

• Continue to monitor IPC measures through the use of audit and complete the identified actions.
• Follow guidelines to support good antimicrobial stewardship.
• Document all significant events to ensure learning is explored and shared.

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