ELECTIVE SURGERY 2009/10
QUALITY ACCOUNT
Table of Contents 2
STATEMENT ON QUALITY – ELECTIVE DAY CASE SURGERY
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OUR GOALS
ABOUT OUR QUALITY ACCOUNT
BOARD APPROVAL
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PRIORITIES FOR IMPROVEMENT – PATIENT SAFETY
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RELATED GOALS
PLANNED ACTIONS FOR 2010/11
PERFORMANCE INDICATORS
CURRENT PERFORMANCE – PATIENT SAFETY INCIDENTS
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PRIORITIES FOR IMPROVEMENT - CLINICAL EFFECTIVENESS
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RELATED GOALS
PLANNED ACTIONS FOR 2010/11
PERFORMANCE INDICATORS
CURRENT PERFORMANCE – PATIENT RECORDS AUDIT
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PRIORITIES FOR IMPROVEMENT - PATIENT EXPERIENCE
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RELATED GOALS
PLANNED ACTIONS FOR 2010/11
PERFORMANCE INDICATORS
CURRENT PERFORMANCE – COMPLAINTS
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REVIEW OF SERVICES
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PARTICIPATION IN CLINICAL AUDITS – NATIONAL
PARTICIPATION IN CLINICAL AUDITS - LOCAL
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RESEARCH
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PARTICIPATION IN CLINICAL RESEARCH
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GOALS AGREED WITH COMMISSIONERS
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USE OF THE CQUIN PAYMENT FRAMEWORK
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WHAT OTHERS SAY ABOUT CLINICENTA
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STATEMENTS FROM THE CQC
FEEDBACK FROM SERVICE USERS – PATIENT SATISFACTION SURVEY 2009
FEEDBACK FROM REFERRERS
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FEEDBACK FROM COMMISSIONING PCTS, LINKS, OSCS
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DATA QUALITY
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NHS NUMBER AND GENERAL MEDICAL PRACTICE CODE VALIDITY
INFORMATION GOVERNANCE TOOLKIT ATTAINMENT LEVELS
CLINICAL CODING ERROR RATE
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REVIEW OF QUALITY PERFORMANCE 2009/10
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INTERNAL IMPROVEMENT PROGRAMME
CLINICAL GOVERNANCE
RISK MANAGEMENT
INFECTION PREVENTION AND CONTROL
CLINICAL AUDIT PROGRAMME
PHARMACY SERVICE IMPROVEMENTS
SUMMARY
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Statement on Quality – Elective Day Case Surgery
I am pleased to present on behalf of the Clinicenta Board, the Quality Account for our
Elective Surgery service for 2009/10.
Clinicenta has been offering free elective day case treatments to NHS patients in north
London since January 2009.
We offer a range of day case procedures covering: general surgery; ear, nose and
throat; orthopaedics; ophthalmology; gynaecology and urology. This range is set to
increase during 2010/11 to include inpatient orthopaedic services.
Services are currently provided at the Advanced Surgery Centre, Colindale. The planned
increase will see us widening our service provision to Highgate Hospital and Holly House,
Buckhurst Hill during 2010/11.
Our Goals
At Clinicenta, we are dedicated to providing every patient with the best possible care and
clinical excellence. Our goals are:
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To treat all of our patients with dignity and respect in a way we would like
ourselves or our families to be treated
To deliver healthcare to the highest of professional standards, using experienced
and qualified staff
To listen to patients, staff and partners, and respond to all raised concerns
To continuously strive to improve the services we provide by seeking and
delivering best practice
To achieve high levels of patient experience, developing open and trusted services
through feedback on our care via direct contact with service users, patient
satisfaction surveys or clinical audit
The provision of high quality services is at the heart of what we aim to achieve. In this
respect, our goals are deceptively simple, but we know that achieving them will require
continuous planning, time and effort.
About Our Quality Account
The Quality Account for Elective Surgery illustrates the progress we have made towards
our goals during our first year of operations, and our planned improvements for the
coming year.
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It has been developed after discussion from service users, referrers, service
commissioners and staff at every level of the organisation, including those who deliver
the service day-to-day.
Over the past year, we have done well in some areas as the results of our patient
satisfaction survey shows.
Lessons have also been learned and these very much influenced the service
improvements that we made in 2009/10 and our further service improvement priorities
for 2010/11.
As a result, we think we will see real quality improvement over the coming year.
Board Approval
This quality account has the full backing of the Clinicenta Board.
Our Directors are satisfied that it provides a fair and accurate account of our
performance in 2009/10 and our service improvement priorities for 2010/11.
By order of the Board
Simon Hopkinson
Chief Executive Officer, Clinicenta
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Priorities for Improvement – Patient Safety
Related Goals
To deliver healthcare to the highest of professional standards, using experienced and
qualified staff
Planned Actions for 2010/11
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To fully establish a revised, integrated clinical governance structure to ensure that
our staff and the service they provides continues to meet the required standards
for good quality clinical care
To further develop our infection prevention and control frameworks and
programme to ensure best outcomes for patients, and compliance with the
forthcoming regulatory Code of Practice for Infection Prevention & Control, to
include:
o Formal reporting processes against agreed infection prevention and control
programmes
o Monitoring of hospital infection prevention and control audit results and
action planning
o Development and monitoring of infection surveillance programmes at each
of our clinical sites
To implement a new clinical audit programme with a view to identifying future
service improvement priorities
To also review national audit data related to our case mix on a regular basis
To continue to improve our staff health and safety training, building on the
existing programme
Performance indicators
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Number of patient safety incidents
Number of infections
Performance against audit criteria
Current performance – patient safety incidents
In 2009/10, Clinicenta saw electives patients on 1,668 occasions. Of these, 1214 were
outpatient visits and 454 were day case admissions.
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During the year, patient safety concerns were reported and investigated on five
occasions. Three of these were designated as “near misses” which meant that while no
patient came to any harm, their care fell short of the standard that we aspire to. Two
were designated as incidents. Remedial actions were put into place for both the incidents
and near misses.
In percentage terms, all of the above amounted to 0.3% of the total number of patient
visits, or 1% of the total number of day cases.
Our aim is to improve on this in 2010/11.
Priorities for Improvement - Clinical Effectiveness
Related Goals
To continuously strive to improve the services we provide, by seeking and delivering best
practice.
Planned Actions for 2010/11
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To continue to improve our internal performance monitoring systems to support
the day-to-day management of service activity - to include further refinement of
the current patient tracking (PTL) arrangements for 18 weeks. Our new
Management Reporting Model is the initial stages of development (see Internal
Improvement Plan section below), and this will be the focus of further work in
2010/11 as we think it will play a significant role in high quality service delivery
To embed new operational service models, constructed during our 2009/10
Internal Improvement Programme, within each clinical site
To undertake monthly patient records audits, building on previous work to ensure
that patient records continue to meet acceptable standards of completeness and
quality
Performance Indicators
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Achievement against contracted performance requirements
Achievement against 18 weeks
Achievement against audit criteria
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Current performance – Patient Records Audit
Audit Purpose
A full audit of Elective Surgery Patient Records was commissioned by the Clinicenta
Director of Clinical Innovation and Governance in March 2010, to demonstrate the
completeness of patient clinical records.
Audit Scope
All patient records held at the Advanced Surgery Centre were audited. The audit covered
the following types of the patient record, checking for an acceptable standard of
completeness:
Outpatient Notes
Outpatient notes
Outpatient letters
Pre-operative assessment notes
Consent forms
Surgery Notes
Pre-admission notes
Theatre Notes
Recovery Notes
Anaesthetic Records
Discharge Summaries
Audit Criteria
Records were audited against the following standards defined by the Clinicenta Associate
Medical Director:
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Presence of outpatient notes or an outpatient letter for every patient whose
referral was accepted
Pre-Operative assessment notes completed where the patient was listed for
surgery
Consent forms completed where the patient was listed for surgery
Pre-admission notes where the patient was admitted for surgery
Theatre and recovery notes where the patient was admitted for surgery
Anaesthetic notes where the patient was admitted for surgery and where
applicable for patients who had Local Anaesthesia
Discharge summaries for patients who had completed surgery
Results
The results demonstrated that the generation and filing of discharge summaries for
patients going home after surgery was our biggest issue, and a rectification plan is now
in place to resolve this.
The results did not give rise to any particular concerns around the practice of individual
staff members.
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Priorities for Improvement - Patient Experience
Related Goals
To treat all our patients with dignity and respect in a way we would like ourselves or our
families to be treated.
To listen to patients, staff and partners, and respond to all raised concerns.
To achieve high levels of patient experience, developing open and trusted services
through feedback on our care via direct contact with service users, patient satisfaction
surveys or clinical audit.
Planned Actions for 2010/11
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To send out referrer satisfaction questionnaires in order to gain regular feedback
from referrers, with a particular emphasis on service quality
To meet regularly with: Primary Care Trusts; Local Involvement Networks; and,
Overview and Scrutiny Committees, as appropriate, to ensure there is two-way
dialogue as well as continued feedback on service performance
To review and improve patient fact sheets for surgical procedures (in response to
our 2009 patient satisfaction survey)
To complete clinical due diligence work to extend our services for patients in
north-central London (Highgate) and north-east London (Buckhurst Hill) in the
coming year.
Performance Indicators
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Number of complaints/ compliments
Patient satisfaction
Referrer satisfaction
Current performance – Complaints
In 2009/10, we received a total of 8 formal complaints: 4 were from referrers and 4
were from patients.
The 4 referrer complaints mainly related to administrative aspects of our service, and the
secretarial service at the Advanced Surgical Centre has been increased as a result.
The 4 patient complaints were all linked to problems experienced after discharge. This
represents a relatively small percentage of the 1668 patients that we saw during the
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year (0.2%), but this is not a cause for complacence, particularly as our service will be
expanding. We have since reviewed all of our processes related to discharge as part of
our Internal Improvement Plan.
Review of Services
During 2009/10 Clinicenta provided and/or subcontracted 1 NHS service for elective day
case surgery (this excludes our primary care and community-based health services
which are not required to produce a quality account until 2010/11).
Clinicenta has reviewed all of the data available to them on the quality of care of its
elective day case service.
The income generated by the NHS service reviewed in 2009/10 represents 10 per cent of
the total income generated from the provision of NHS services by Clinicenta for 2009/10.
The review of service incorporated a systematic review of service delivery as part of its
Internal Improvement Programme.
Participation in Clinical Audits – National
During 2009/10, 1 national clinical audit and no national confidential enquiries covered
NHS services that Clinicenta provides.
During that period Clinicenta participated in 100% of the national clinical audits and
national confidential enquiries which it was eligible to participate in.
The national clinical audits that Clinicenta participated in during 2009/10 are as follows:
National Elective Surgery PROMs
The national clinical audits that Clinicenta participated in, and for which data collection
was completed during 2009/10, are listed below alongside the number of cases
submitted to each audit or enquiry as a percentage of the number of registered cases
required by the terms of that audit or enquiry.
National Elective Surgery PROMs
Hernias – 19 forms submitted* (50%)
Varicose veins – 5 forms submitted* (45%)
Hip replacements – Not applicable
Knee replacements – Not applicable
*Source: PROMs Hospital Liaison Team
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The reports of no national clinical audits were reviewed by the provider in 2009/10 and
Clinicenta intends to take the following actions to improve the quality of healthcare
provided:
Review national audit data related to case mix, as part of our revised audit programme.
Participation in Clinical Audits - Local
The report of 1 local clinical audit was reviewed by the provider in 2009/10 and
Clinicenta intends to take the following actions to improve the quality of healthcare
provided:
Main Actions Arising from the Patient Records Audit
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A local policy has been developed, detailing individual responsibilities for patient
records standards, management and approvals
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A process for the day-to-day checking of patient records for completeness is to be
implemented, following staff training
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A plan is now in place for monthly quality audit of patient records – see also
section on Priorities for Improvement – Clinical Effectiveness
Research
Participation in Clinical Research
The number of patients receiving NHS services provided or sub¬contracted by Clinicenta
in 2009/10 that were recruited during that period to participate in research approved by
a research ethics committee was 0. This is because Clinicenta does not presently
undertake clinical research.
Goals Agreed with Commissioners
Use of the CQUIN payment framework
Clinicenta income in 2009/10 was not conditional on achieving quality improvement and
innovation goals through the Commissioning for Quality and Innovation payment
framework because the Clinicenta elective surgery service does not use any of the NHS
National Standard Contracts and is therefore not eligible to negotiate a CQUIN Scheme.
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What Others Say About Clinicenta
Statements from the CQC
Clinicenta is not required to register with the Care Quality Commission for its elective
surgery service at present.
Clinicenta is not subject to periodic reviews by the CQC for its elective surgery service.
Clinicenta has not participated in any special reviews or investigations by the CQC during
the reporting period.
Feedback from Service Users – Patient Satisfaction Survey 2009
Patient feedback from the patient satisfaction survey conducted on Clinicenta’s behalf by
the Picker Institute in December 2009 has been positive, and is summarised below:
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Picker
Score for
2009
National
Outpatient
Survey**
Patient
Response
Clinicenta
Score*
Patient offered a choice of appointment time
Yes
68%
34%
Admission date changed by hospital
Yes
27%
22%
If drove to appointment they found a place to
park
Yes
67%
59%
Doctor always gave answers the patient could
understand
Yes
84%
64%
Always had trust and confidence in doctor
Yes
94%
82%
Doctors did not talk in front of patients
Yes
92%
87%
Member of staff never said one thing and
another member said another
Yes
90%
87%
Patient involved in decisions about care and
treatment as much as they wanted to be
Yes
78%
69%
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Always given enough privacy
Yes
96%
89%
A member of staff completely explained the
risks and benefits of the operation or
procedure
Yes
74%
68%
A member of staff completely explained what
would be done in the operation or procedure
Yes
80%
78%
A member of staff completely explained how
the operation or procedure had gone
Yes
70%
70%
A member of staff completely explained the
purpose of medicines
Yes
78%
76%
A member of staff completely told them about
medication side effects to watch for when
going home
Yes
63%
39%
A member of staff completely told them about
any danger signals they should watch for after
they went home
Yes
47%
29%
Hospital staff told them who to contact if they
were worried about their condition or
treatment after they left hospital
Yes
96%
69%
Received copies of letters sent between hospital
doctors and their GP
Yes
54%
41%
Overall rating of care received as excellent
Yes
83%
40%
Recommendation definitely of hospital to
friends and family
Yes
98%
69%
* A total of 52 questionnaires were completed.
** Picker results are based on the average scores among the 74 NHS trusts who conducted the 2009 Outpatient survey
with the Picker Institute.
Respondents were also given the opportunity to add their comments to the survey
questionnaire to tell us firstly, if there was anything good about their care and secondly,
if there was anything that could be improved.
Respondents were very positive about all of our staff, including doctors, nurses,
managers and receptionists, referring to them as professional, friendly, happy,
supportive, caring, respectful, attentive, kind, helpful, informative and warm.
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Things mentioned as particularly good were:
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The hospital was very clean
The room had its own en-suite facility
Being pleased to meet the consultant on arrival and for him to be with them at the
theatre
Being made to feel welcome
Processing was quick
Excellent lunch provided
Being checked regularly
Being given as long to rest as needed
Issues mentioned by respondents to improve included:
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Being vague about dressings and when to change them
No fact sheet given about Hysteroscopy/ Mirena Coil until after procedure
Seeing surgeon too soon post-operatively when they were still tired and sleepy
Nurses not offering the personal touch the consultants offered
Computerised system needed speeding up
Too many questions to fill in
Long waiting time prior to theatre
Provision of car parking spaces for patients
No letter of confirmation prior to admission; had to chase up but nobody called
back leading to unnecessary stress on the day
These issues were fed into our improvement priorities for both 2009/10 and 2010/11.
Feedback from Referrers
We have had quite a lot of feedback, including some constructive criticism, from General
Practitioner referrers during our first year. Our response has been as follows:
Initially, some General Practitioners suggested our Choose and Book site did not lend
itself to easy referral, insofar as it wasn’t always clear what electives procedures were on
offer from Clinicenta. We have worked to improve this.
Similarly, some of the procedure codes listed in or General Practitioner information
booklet was not felt to be in a “GP-friendly” format. We actually enlisted one of the
referring General Practitioners to rework the booklet to make it more easy to use.
In addition, some General Practitioners wanted to be able to upload the Clinicenta
referral form onto their own medical information system (EMIS) in order to speed the
transfer of patient data onto the form. We now provide the form in both PDF and
Windows formats to enable them to do this if they wish.
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During 2009/10 we have built a good working relationship with the PCT referral hub in
Camden, which has helped us to streamline the referral process in many instances and
maintain good communication if queries arise. We are now working with the Barnet PCT
referral hub with a view to doing the same.
In 2010/11 we plan to instigate more formal referrer satisfaction audits – an audit brief
for this has been already been drafted, with a view to starting to audit General
Practitioner/referrer satisfaction during the coming year.
Feedback from commissioning PCTs, LINks, OSCs
Clinicenta’s Elective Surgery service was established in 2009, and during its first year of
operation formal feedback from service commissioners has mainly been channelled
through regular joint service review meetings with NHS London, who oversee the
electives contract.
Clinicenta will be working to improve feedback mechanisms with our commissioning
Primary Care Trusts (PCTs), Local Involvement Networks and Overview and Scrutiny
Committees (OSCs) in 2010/11.
Data Quality
NHS Number and General Medical Practice Code Validity
Clinicenta did not submit records during 2009/10 to the Secondary Uses Service for
inclusion in the Hospital Episode Statistics which are included in the latest published
data.
Information Governance Toolkit Attainment Levels
The Clinicenta score for 2009/10 for Information Quality and Records Management
assessed using the Information Governance Toolkit was:
Not assessed in 2009/10. This will be assessed in 2010/11
Clinical Coding Error Rate
Clinicenta was not subject to the Payment by Results clinical coding audit during the
reporting period by the Audit Commission.
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Review of Quality Performance 2009/10
Internal Improvement Programme
A major quality improvement venture in 2009/10 was the implementation of a
systematic Internal Improvement Programme. This enabled us to really “take stock” of
the Elective Surgery service at the end of its first year, and to focus on quality issues
that had arisen during the course of that year, particularly with regard to our internal
communications, documentation and general performance monitoring. This programme
is summarised below.
In January 2010 Clinicenta commenced a 3-month intensive review of all operational
processes within the Elective Surgery service, engaging staff at all levels of the
organisation in order to give an “end-to-end” process review. The aim was to directly
address short term quality issues, whilst building longer term service capability. The
DMAIC improvement framework was used for this, which can be summarised as follows:
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Define the goals of the improvement activity clearly
Measure the current process performance
Analyse the current process to find ways of eliminating the gap between current
performance and desired goal
Improve the current process
Control the new process
This framework, backed by brainstorming sessions, process mapping, challenge
definition and root cause analysis, was utilised by staff during a series of facilitated
workshops and working parties in order to develop, and follow through on, agreed
improvement action plans.
Staff entered into the process with great enthusiasm, and the following main actions
were completed:
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Publication of revised operating models for each the Advanced Surgery
Centre and Highgate Hospital
o These models define role responsibilities and provide practical step-by-step
processes for each part of the operational service - from referral through to
patient discharge
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The development of supporting Standard Operating Procedures (SOPs)
o These document each process step within the Operating Model, in detail, for
staff training purposes and for easy reference
o The SOPs include:
 Use of the Clinicenta Electronic Patient Record
 Patient Record Management
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Management of samples and images
Checks and communications for outpatient clinics
Cancellation of clinics/ surgery
Management of medical staff
Patient scheduling and transfer
Improved performance monitoring
The need for better performance information to guide and enhance day-to-day
management of services, and inform discussions with service commissioners was
strongly highlighted during the service review.
A list of required performance indicators was drawn up from a service perspective, and a
Performance Manager was then appointed by Clinicenta to oversee the development of a
Management Reporting Model comprising 3 levels of performance report, as follows:
Level 1- Management Information Packs: These give both operational managers and
clinical staff a monthly overview of how their service is performing, and where
improvements can be made.
Level 2 – Data and Trend Analyses: These provide a more detailed breakdown of
monthly service performance by referring Primary Care Trust, which to aid joint service
review with service commissioners over the coming year.
Level 3 – Senior Leadership Team Reports: These incorporate the most critical
aspects of the Level 1 and Level 2 reports to enable the Clinicenta Senior Leadership
Team to stay fully in touch with service performance and trends, and monitor service
improvement initiatives.
An added bonus was that the Internal Improvement Programme was incredibly useful as
a means of bringing a relatively new workforce together to pool their knowledge and
build stronger bonds.
It has also informed our improvement priorities for 2010/11, in terms of ongoing
performance monitoring and staff training to fully embed the revised processes into dayto-day clinical practice.
Clinical Governance
Clinical governance seeks to improve the quality of patient care through a culture of staff
learning and continuous service improvement. The main objectives are to:
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Use resources efficiently
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Develop staff in line with their professional and service needs
Promote organisational learning from events
Deliver clinically effective services
Provide a good patient experience
During 2009/10, Clinicenta reviewed its clinical governance processes and updated its
governance policies at both a corporate level and an individual service level.
The Elective Services Governance Committee now meets each month to review and
agree actions related to service development, staff training, risk management, infection
control and clinical service audit.
The diagram below demonstrates how this work flows through to the Clinicenta Board,
management and leadership teams and clinical services. Experiences gained at a service
level are, in turn, fed back through the committee structure to help inform decisions
about further service developments and initiatives.
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Risk Management
Over the past year we have revised and improved our internal risk management system
to ensure that key service risks are identified, documented, robustly managed and
monitored.
The Risk and Audit Committee plays a key role in this respect by, among other things,
providing risk and audit information for consideration by the Electives Services
Governance Committee. For example, each monthly governance meeting now
incorporates a detailed review of the Elective Surgery Risk Register, to which identified
service risks are regularly added and graded. Identified risks that are thought to be
significant are also escalated to the Corporate Risk Register for further review and action
planning.
Key achievements in Risk Management in 2009/10
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The Clinicenta Incident Reporting and Management Policy has been revised
(including the Serious Untoward Incidents Policy)
The Incident Report form has been revised and re-launched along with staff
training on how to use it
Staff training has also been undertaken for nursing and theatre staff for:
o Health and Safety
o Risk assessment
o Lone working
o Accident reporting – including needlestick injuries
o Complaints
o Confidentiality
Baseline Risk Assessments have been performed for:
o Equipment
o Waste
o Lone Working
o Aggressive Behaviour
o Needlestick Injury
o Slips/trips/falls
o Travelling
In addition, all MHRA, DH and NPSA safety alerts and best practice guidance
relevant to Elective Surgery activity has been circulated to staff and acted upon as
necessary.
Infection Prevention and Control
Clinicenta has been developing its Infection Prevention and Control programme and
frameworks during 2009/10 with the help of experts in the field, in order to ensure
compliance with the forthcoming Code of Practice for Infection Prevention & Control. This
work has also informed our improvement priorities for 2010/11, which include:
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Formal reporting processes against agreed infection prevention and control
programmes
Monitoring of hospital infection prevention and control audit results and action
planning
Development and monitoring of infection surveillance programmes at each of our
clinical sites
Clinical Audit Programme
During 2009/10 Clinicenta appointed an Audit Manager to help develop and oversee a
systematic audit programme for all of our clinical services, including Elective Surgery
during the coming year.
A Health and Safety audit has already been carried out at the Advanced Surgery Centre.
This took place on 7th June and the audit report will shortly be released.
Pharmacy Service Improvements
Clinicenta initiated pharmacy reviews at the Advanced Surgery Centre in December 2009
and April 2010. Reviews were based on Care Quality Commission inspector standards for
the storage and handling of medicines, prescribing and administration of medicines these standards form part of the due diligence process for all new Elective Surgery sites.
The Acute Surgery Centre’s pharmacy service provider, Edgware Community Hospital
(part of Barnet and Chase Farm NHS Trust), attended the first review and has since
worked with Clinicenta and the Advanced Surgery Centre on several practice
improvements, mainly around drugs storage. The Clinicenta Medicines Policy has also
been updated.
The focus for in 2010/11 will be to work with the new Elective Surgery sites to ensure
pharmacy service standards are fully met.
Summary
This Quality Account gives a fair and open assessment of what we have achieved in
2009/10 and main areas for quality improvement in 2010/11 for our Elective Surgery
service. As the service was only launched in January 2009, it has been a year of intense
learning on our part, which has been further underpinned by:
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Patient and referrer feedback
A wide-ranging assessment by staff of the service we are offering to patients
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Our own, internal review of our clinical governance, risk management, infection
prevention and control, pharmacy and clinical audit arrangements
This has not always been easy, but it has been worthwhile and has helped us to identify
and prioritise the service quality initiatives that are already being implemented and will
continue to be implemented and regularly reviewed over the coming year.
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Obtaining Further Copies of Our Quality Account
Our 2009/10 Quality Account for Elective Day Case Surgery can be downloaded from:
www.clinicenta.com
Hard copies are also available on request from:
Quality Account
Clinicenta Ltd
Hampden House
Monument Business Park
Warpsgrove lane
Chalgrove
Oxford
OX44 7RW
Clinicenta Ltd
Suite 27, Hampden House
Monument Business Park
Warpsgrove Lane
Chalgrove
Oxford
OX44 7RW
Tel: +44 (0) 1865 893293
Fax: +44 (0) 1865 893299
www.clinicenta.com
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