The Everglade Medical Practice

Updated 17 February 2023

The Everglade Medical practice is located within the Grahame Park Health Centre, situated in Barnet, North London. It is part of North Central London Integrated Care System in the Barnet local area. The practice holds a General Medical Services contract (an agreement between NHS England and general practices for delivering primary medical services).

The practice is registered with the Care Quality Commission to carry on the regulated activities of Maternity and midwifery services, Treatment of disease, disorder or injury, Family planning, Surgical procedures and Diagnostic and screening procedures.

The practice had a patient list of approximately 11,000.

The clinical team is comprised of four GP partners (one male and three females) and three salaried GPs (two female and one male).

The clinical team also includes two female nurses and a female health care assistant. The also has staff shared by their local primary care network, this includes clinical pharmacists, social prescribers, physiotherapists and a phlebotomist.

The practice is open from 8am to 6:30pm on Monday to Friday. Routine appointments with GPs and nurses are 10-15 minutes long. Patients may book appointments with the extended hours service, provided at Hub locations across four local practices. Additional extended hours service appointments could be booked weekdays between 6.30pm – 8pm and Saturdays 9am to 5pm.

Updated 17 February 2023

We carried out an unannounced comprehensive inspection at The Everglade Medical Practice on 1 November 2022. We continued the inspection with a revisit of the practice on 24 November 2022. Overall, the practice is rated as requires improvement.

Safe - requires improvement

Effective - requires improvement

Caring - good

Responsive - requires improvement

Well-led - requires improvement

At our previous inspection on 17 May 2017 the practice was rated good overall and for all key questions. The full reports for previous inspections can be found by selecting the ‘all reports’ link for The Everglade Medical Practice on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection to follow up concerns reported to us.

How we carried out the inspection

This inspection was carried out by:

• Conducting staff interviews
• Completing clinical searches on the practice’s patient records system
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A site visit over two days.

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We rated the practice as requires improvement for providing safe services because we had concerns relating to: infection prevention control; administration of Rotavirus vaccine; out of date and/or missing emergency medicines and equipment.

We rated the practice as requires improvement for providing effective services because the uptake for cervical screening was well below the national target of 80%, and the uptake of childhood immunisations were also well below the world health organisation target of 95%. We also found there was no documented evidence confirming nurse prescribing was being regularly monitored.

We rated the practice as good for providing caring services because staff dealt with patients with kindness and respect and involved them in decisions about their care.

We rated the practice as requires improvement for providing responsive services because the GP patient survey data and patients we interviewed showed dissatisfaction with telephone access and the types of appointments offered.

We rated the practice requires improvement for well-led because we were not assured there was appropriate governance, systems and processes in place to ensure appropriate infection prevention control measures were in place; systems were in place to ensure medicines and equipment remained in-date; there were up-to-date policies; documented supervision of the nurse prescriber; and the safe administration of the rotavirus vaccine.

The provider took immediate action to address the concerns identified above and introduced systems and processes to prevent recurrence. However, as these changes are new, they need to be monitored and become embedded in practice before we can be satisfied the concerns have been fully mitigated. Please see the evidence tables for more details.

We found two breaches of regulations. The provider must:

• Ensure that care and treatment is provided in a safe way (Please see the specific details on action required at the end of this report).
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. (Please see the specific details on action required at the end of this report).

In addition, the provider should:

• Take action to improve the uptake of cervical screening and childhood immunisations.
• Take action to improve patient experience evidenced by GP patient survey results data, particularly in regard to access.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services