Knoll Medical Practice

Updated 26 July 2022

Knoll Medical Practice operates from Orpington Health & Wellbeing Centre 19 Homefield Rise Orpington BR6 0RT. The Practice is open Monday to Friday 8am to 6.30pm.

The provider is registered with the Care Quality Commission (CQC) to provide the regulated activities of treatment of disease, disorder or injury, maternity and midwifery services, family planning services, surgical procedures and diagnostic and screening procedures.

The practice is situated within the Bromley Clinical Commissioning Group (CCG) and delivers General Medical Services (GMS) to a patient population of about 13,000. This is part of a contract held with NHS England.

The practice is part of the wider network of GP practices Orpington Primary Care Network (PCN) which comprises of 10 practices covering an approximate patient population of 60,000.

The practice had increased its patient population significantly over the last four years from eight thousand to 13 thousand and relocated in September 2019 to a newly built multipurpose health and wellbeing centre sharing its location with other services such as phlebotomy, dermatology and sexual health.

Information published by Public Health England shows that deprivation within the practice population group is in the ninth decile (9 of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 87% White, 6% Asian, 4% Black, 2% Mixed, and 1% Other.

Local enhanced services provided by the practice included Sexual Health, NHS Health Checks

Influenza Vaccinations, Minor Surgery, Diabetes, Covid Vaccinations, Safeguarding, ADHD, DMARDS, Gender Dysphoria, Gonadorelin, Learning Disability Health Checks and Weight referral management.

The practice has two male and two female GP partners. They employ six salaried GPs four female and two males. Knoll Medical Practice became an accredited training practice in 2020. At the time of our inspection there was one ST3 in training at the practice. There is also a nursing team which comprises of three female practice nurses and one female healthcare assistant. There are two male paramedics and one female physicians associate. The practice has a practice manager, operations manager and a finance manager, in addition seven administrators, ten reception staff and two secretaries.

Extended access is provided locally by Bromley GP Alliance for late evening and weekend appointments. Out of hours services are provided by 111.

Updated 26 July 2022

We carried out an announced inspection at Knoll Medical Practice between 20 and 22 June 2022. Overall, the practice is rated as Good.

Set out the ratings for each key question

Safe – Requires improvement.

Effective - Good.

Caring - Good

Responsive - Good

Well-led - Good.

Following our previous inspection on 14 April 2016, 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 Knoll Medical Practice on our website at www.cqc.org.uk

This inspection was a comprehensive inspection part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach which involved a site visit: We looked at the Safe, Effective and Well-led key questions.

How we carried out the inspection/review

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider.
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A short site visit.

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 have rated this practice as Good overall

We found that:

• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

We found breach of regulations. The provider must:

• Ensure care and treatment is provided in a safe way to patients

Please see the specific details on action required at the end of this report.

The areas where the provider should make improvements are:

• Continue to take action to improve cervical screening uptake.
• Continue to obtain and record staff immunisation status.
• Continue to plan and develop medicines management for patients.
• Undertake a patient survey.
• Improve communication with staff.
• Inform all staff about the Freedom to speak up Guardian.

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