Colney Medical Centre

Updated 27 November 2018

The Colney Medical Centre (the location) is operated by The Gynaecology Partnership Ltd (the provider) at Kings Road, London Colney, St Albans. The provider is registered with the Care Quality Commission to carry out various regulated activities at this location and eight satellite locations across Hertfordshire Valley and Barnet. The regulated activities relating to this location are Diagnostic and screening procedures and Treatment of disease, disorder and injury, Surgical Procedures and Family planning services.

The Colney Medical Centre provides a Specialist Community Clinic for gynaecology services to people aged 16 years and over from across the Hertfordshire Valley and Barnet localities. At the time of our inspection, the Clinic provided services to a population of over one million patients, receiving an average of 7,200 referrals from Hertfordshire Valley and 3,300 referrals from Barnet each year. The gynaecology services provided are commissioned by the Hertfordshire Valley Clinical Commissioning Group and the Barnet Clinical Commissioning Group.

The Colney Medical Centre shares a three storey converted premises with a GP practice (occupying the ground floor) but operates as an independent entity (occupying the first floor). Both services share staff facilities such as the staff room and second floor meeting area. There is a car park to the rear of the premises and additional roadside parking available free of charge. The administrative hub is open from 9am to 6pm Monday to Friday.

At the time of our inspection the Colney Medical Centre was led by a team of three Directors; a female GP with Special Interest in Gynaecology (GPSI), a male GP and a male GP Consultant Gynaecologist. They utilise additional consultants and GPSIs as needed to provide clinics and services to patients based on demand for the service. They are supported by nurses, a sonographer, a service manager and a team of administrative staff.

The Gynaecology Partnership Ltd operates as a hub and spoke model with the location at Colney acting as the administrative hub alongside the provision of clinical services. Services are provided from eight additional satellite locations, four in Hertfordshire Valley and four in Barnet. These locations were:

1. Bridgewater House Health Centre, 7 Printers Avenue, Watford WD18 7QR
2. Coleridge House Medical Centre, 2 Coleridge Crescent, Woodhall Farm, Hemel Hempstead, Herts HP2 7PQ
3. Hemel Hempstead Hospital, Hillfield Road, Hemel Hempstead, HP2 4AD
4. The Grove Medical Centre, Borehamwood Shopping Park, Borehamwood, WD6 4PR
5. Oak Lodge Medical Centre, 234 Burnet Oak Broadway, Edgware, Middlesex HA80AP
6. Wentworth Medical Practice, 38 Wentworth Avenue, Finchley, London N3 1YL
7. Longrove Surgery, 70 Union Street, Barnet, Herts EN5 4HT
8. BMI The Garden Hospital, 46/50 Sunny Gardens Road, Hendon, London NW4 1RP

We inspected the Colney Medical Centre on 11 October 2018. The inspection team included a lead inspector, a GP Specialist Adviser, a practice nurse specialist adviser and a practice manager specialist adviser. 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 our inspection we:

• Spoke with a range of staff including the Chief Executive and Finance Officer, GPSI Governance Lead, Consultant Governance Lead, the interim service manager, the previous service manager and a nurse. (The previous service manager had left the clinic the week prior to our inspection but attended on the day of inspection.)
• Looked at the systems in place for the running of the service.
• Explored how clinical decisions were made.
• Looked at rooms and equipment used in the delivery of the service and made observations of the environment and infection control measures.
• Viewed a sample of key policies and procedures.
• Reviewed CQC comment cards which included feedback from patients about their experiences of the service.
• Visited the satellite location at Coleridge House Medical Centre.

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 27 November 2018

We carried out an announced comprehensive inspection on 11 October 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Colney Medical Centre (the location) is described as a Specialist Community Clinic and provides a range of specialist gynaecology services to patients aged over 16 years. The Clinic is commissioned by the Hertfordshire Valley Clinical Commissioning Group and Barnet Clinical Commissioning Group to provide care and services to patients under an NHS funded agreement.

Services include a range of testing, screening and treatment processes undertaken by a GP with a Special Interest (GPSI) in Gynaecology or a Consultant Gynaecologist as appropriate. Patients are referred to the Clinic by their GPs for gynaecological assessments and/or treatments. All referrals are triaged by a Consultant or GPSI upon receipt. Following review of referral, the service either provides further advice to the referring GP with regard to patient care, refers the patient onto secondary care for assessment or treatment within an acute hospital setting or arranges for the patient to be seen within the Specialist Community Clinic by a GPSI in gynaecology or a Consultant Gynaecologist as needed.

The Chief Executive and Finance Officer 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.

We received 30 completed CQC comment cards. All the completed cards indicated that patients were treated with kindness and respect. Staff were described as friendly, caring and professional. In addition, comment cards described the environment as pleasant, clean and tidy.

Our key findings were:

• The provider had clear systems to keep people safe and safeguarded from abuse. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
• Staff assessed patients’ needs and delivered care in line with relevant and current evidence based guidance and standards.
• Patients were treated with dignity and respect and they were involved in decisions about their care and treatment. Treatment was delivered in line with best practice guidance and appropriate medical records were maintained.
• Patients were provided with information about their health and with advice and guidance to support them to live healthier lives.
• The service actively sought feedback from patients and displayed the results and actions taken in response to feedback received.
• Systems were in place to protect patients’ personal information.
• Information about services and how to complain was available and easy to understand.
• An induction programme was in place for all staff and all staff received role specific training.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• The provider had a clear vision to provide a safe and high-quality service and there was a clear leadership and staff structure. Staff understood their roles and responsibilities.
• There were clinical governance systems and processes in place to ensure the quality of service provision. We saw that there was a system for managing significant events and that learning and improvement was encouraged.
• Staff had access to all standard operating procedures and policies which were regularly reviewed and updated.

The areas where the provider should make improvements are:

• Review emergency medicines to ensure that stocks of medicines held are appropriate for the needs of the service.
• Review and improve the process for undertaking and recording checks of emergency equipment.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice