22 November 2017
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection the Primrose Hill Surgery on 22 November 2017. This was in response to information of we had received regarding the professional relationship between the two partner GPs and the possible impact it was having on staff and the service.
The practice is now rated as requires improvement overall.
The key questions are rated as:
Are services safe? – Requires improvement
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Requires improvement
As part of our inspection process, we also look at the quality of care for specific population groups. We have rated the practice as requires improvement for the key questions of safe and well-led and overall. The concerns which led to these ratings apply to everyone using the service. Accordingly, the population groups are rated as:
Older People – Requires improvement
People with long-term conditions – Requires improvement
Families, children and young people – Requires improvement
Working age people (including those retired and students – Requires improvement
People whose circumstances may make them vulnerable – Requires improvement
People experiencing poor mental health (including people with dementia) - Requires improvement
At this inspection we found:
- The practice had been working with NHS England and the Camden CCG to resolve issues between the partners. One partner was to retire and the other would be taking over as sole practitioner. Staff told us that morale was improving.
- There were issues relating to fire safety at the premises, together with monitoring equipment, that need to be addressed to ensure safety risks are minimised.
- The practice had not been having regular clinical and staff meetings and the recording of the meetings had lapsed.
- The practice learned from incidents and took action to improve its processes.
- Published data showed the practice performance was comparable with local and national averages.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided. Care and treatment was delivered according to evidence-based guidelines.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found it easy to use the appointment system and told us they could access care when they needed it.
- Data from the GP patient survey showed that patient satisfaction was generally above local and national averages. Where a need for improvement had been noted, the practice had drawn up action plans.
The areas where the practice must make improvements as they are in breach of regulations are:
- Ensure care and treatment is provided in a safe way to patients.
- Ensure there are effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
The areas where the practice should make improvements are:
- Ensure that all staff have protected learning time and have sufficient opportunity for breaks.
- Ensure that accessible information regarding the service is available to patients with learning disabilities.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice