We carried out an announced comprehensive inspection at the 157 Medical Practice (the practice) on 3 March 2020 as part of our inspection programme. It was the first inspection of the newly-registered service. The previous service provider, which had not been registered by the CQC, had been identified by service commissioners as being in difficulty. The practice has been operated by Federated4Health, the Pan Haringey GP Federation, since July 2019.
We have rated the practice as Good overall and in respect of the key questions Safe, Caring and Responsive. We have rated it as Requires improvement for providing Effective services. We saw unverified data indicating a significant improvement in all aspects of clinical care. This needs to be sustained and improved further, particularly in relation to outcomes for people with long term conditions and people experiencing poor mental health, where performance remains below past local and national averages. We have rated the practice as Outstanding in respect of the key question Well-led, in recognition of the considerable amount of work put in by leaders and staff to bring about improvement to the service, clinical performance and patients’ outcomes.
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 found that:
- The provider had made significant improvements to the service, following considerable work by leaders and staff. Patient feedback was particularly positive regarding increased access and caring aspects.
- We were shown unverified data which indicated improvement in all areas of clinical performance, resulting in improved patient outcomes. However, the data showed that some aspects of care, for example in relation to people with long term conditions and people experiencing poor mental health, remained below past averages, and cervical screening and childhood immunisation rates were below targets
- People are protected from avoidable harm and abuse.
- People’s care and treatment is planned and delivered in line with current evidence-based guideline, standards, best practice and legislation.
- People are supported, treated with dignity and respect and are involved as partners in their care.
- People’s needs are met through the way services are organised and delivered.
- The leadership, governance and culture are used to drive and improve the delivery of high-quality, person-centred care.
The areas where the practice should make improvements are
- Continue with efforts to improve the outcomes for people with long term conditions and those experiencing poor mental health.
- Continue with efforts to increase the uptake of cervical screening tests and childhood immunisations.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care