Brunswick Place Medical Centre - Care Quality Commission

Background to this inspection

Updated 3 August 2017

The Brunswick Medical Centre operates from 39 Brunswick Centre, London WC1N 1AF. The premises are leased by NHS England from a private landlord, located a short distance from Russell Square underground station, and also have good bus services nearby. The service has been provided by the Hurley Clinic Partnership (“Hurley”) since April 2013. Hurley operates a number of other services across London, Essex and Kent.

The practice provides NHS services through an Alternative Provider Medical Services (APMS) contract to approximately 6,700 patients. The practice is part of the NHS Camden Clinical Commissioning Group (CCG) which is made up of 35 general practices. The provider is registered with the Care Quality Commission to carry out the following regulated activities - Diagnostic and screening procedures; Maternity and midwifery services; Family planning; Treatment of disease, disorder or injury. The patient profile has a lower than average population of children, younger teenage and older patients, aged over-40; with a higher than average student and working age population, aged between 20 and 39 years. The deprivation score for the practice population is in the fourth “more deprived decile”, indicating a higher than average deprivation level among the patient group. Data indicated that over the past year or so the patient list had increased by almost a thousand.

There are 26 and a half GPs’ clinical sessions per week; each full session includes 18 patient appointments slots. The practice’s clinical team is made up of a female clinical lead GP, working seven clinical sessions a week, and a female salaried GP, working one and a half clinical sessions. Hurley’s Medical Director, a female GP, works two clinical sessions per week at the practice. A long term regular male locum GP works four clinical sessions. The 12 other GP clinical sessions each week are covered by regular locums from the provider’s bank of staff. The clinical team is completed by a full time female practice nurse, working eight clinical sessions; and a part time female healthcare assistant, who works two clinical sessions.

The administrative team comprises a practice manager and assistant practice manager, who both work at another practice half a week, but one is on site all the time. There is a reception supervisor and four receptionist / administrators. Hurley provides additional management and administrative support when needed.

The practice operates between the following times –

Monday 8 am to 8 pm

Tuesday 8 am to 8 pm

Wednesday 8 am to 8 pm

Thursday 8 am to 6.30 pm

Friday 8 am to 6.30 pm

Saturday 9 am to 12 noon

Routine appointments are available throughout the day and are 10 minutes long, although patients can book double appointments if they wish to discuss more than one issue. Routine appointments can be booked up to four weeks in advance. The practice also offers a number of same day urgent appointments. Requests for same day appointments are triaged by the duty GP. Appointments to review patients’ long term conditions are 20 minutes long.

Emergency home visits are available for patients who for health reasons are not able to attend the practice. Patients may also request telephone consultations to discuss non-urgent healthcare issues and the provider offers online consultations via a link on the practice website. If they have previously registered for the system, patients can book or cancel appointments and request repeat prescriptions online.

Further evening appointments, at two other practices in south Camden, can be booked by Brunswick’s reception staff at a patient’s request. In addition, a number of Saturday appointments are available under a local scheme operating at three other locations across the borough. The practice has opted out of providing an out-of-hours service. Patients calling the practice when it is closed are connected with the local out-of-hours service provider. There is information given about the out-of-hours provider and the NHS 111 service on the practice website, together with details of a walk-in clinic, which any patient can attend.

Overall inspection

Good

Updated 3 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of the Brunswick Medical Centre on 22 November 2016. The overall rating for the practice was requires improvement.

Under the key question of the practice providing Safe services, there had been insufficient evidence that staff recognised and acted upon significant adverse events, with appropriate investigation, reflection and learning. The practice had adopted the use of Patient Group Directions (PGDs) to allow nurses to administer medicines in line with legislation, but the PGDs had not been completed correctly and were therefor invalid. We served a requirement notice relating to the practice’s failure to comply with Regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also noted concerns highlighted by the GP Patient Survey, regarding continuity of care and patients’ satisfaction with GP consultations, under the key question, Caring.

The full comprehensive report on the November 2016 inspection can be found by selecting the ‘reports’ link for the Brunswick Medical Centre on our website at http://www.cqc.org.uk/location/1-1249244528. After the inspection, the practice sent us a plan of the action it intended to take to improve the quality of care and meet the legal requirements under the key question, Safe.

This inspection was an announced focussed inspection carried out on 13 July 2017 looking at the issues previously identified and to check and confirm that the practice had carried out its plan to meet the legal requirements. We found that the practice had taken appropriate action to meet the requirements of the regulations relating to providing a safe service.

In addition, under the key question of Caring, we looked at continuity of care and patients’ satisfaction with GP appointments. We saw evidence from the most recent GP Patient survey, the practice’s Friends and Family Test results and the provider’s own patient survey data, which showed a general sustained improvement since our inspection in November 2016.

Accordingly, we have revised the practice’s ratings in respect of providing a safe and caring service, which has led to a revision in the overall rating to Good.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice