Background to this inspection
Updated
11 May 2018
Dr Philip Mackney, also known as The Elgin Clinic, operates from purpose-built premises at 40 Elgin Avenue, Westminster, London W9 3QT. The practice is on a single-level and has access to six consulting rooms.
The practice provides NHS primary care services to approximately 4,500 patients and operates under a General Medical Services (GMS) contract (a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract). The practice is part of NHS West London Clinical Commissioning Group (CCG).
The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures, treatment of disease, disorder or injury and maternity and midwifery services.
The practice staff comprises of a principal GP, a male and female salaried GP (totalling 24 sessions per week), a practice nurse (eight sessions per week) and full-time healthcare assistant. The clinical team are supported by a practice manager and a team of six administration and reception staff.
The practice is open between 8.15am and 5pm on Monday, Tuesday, Wednesday and Friday and from 8.15am to 1.15pm on Thursday. The practice offers on-line services, which include appointment booking and repeat prescriptions which can be accessed through the practice website . Appointments are available with a doctor in the morning from 8.40am to 11.30am and in the afternoon from 2.30pm to 4pm except Thursday when the practice is closed. Telephone consultations are also available for those not able to attend the practice. The practice does not currently provide any extended hours appointments; however, patients have access to two GP hub services offering appointments from 6pm to 9pm Monday to Friday and from 8am to 8pm on Saturday and Sunday. These appointments are bookable through the practice and we saw this was advertised in the waiting room and on the practice website.
The practice population is in the second most deprived decile in England. People living in more deprived areas tend to have greater need for health services. Data shows that 48% of patients at the practice area were from Black and Minority Ethnic (BME) groups. The highest proportion of the practice population was in the 15 to 44 year old age category.
Updated
11 May 2018
We carried out an announced comprehensive inspection at Dr Philip Mackney (The Elgin Clinic) on 20 June 2017. The overall rating for the practice was Requires Improvement. The full comprehensive report on the 20 June 2017 inspection can be found by selecting the ‘all reports’ link for Dr Philip Mackney on our website at www.cqc.org.uk.
This inspection, on 5 April 2018, was an announced comprehensive inspection to confirm that the practice had carried out their plan to meet the requirements that we identified in our previous inspection on 20 June 2017. This report covers our findings in relation to those requirements and any improvements made since our last inspection. The practice is now rated as Good overall.
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
At this inspection we found:
- The practice had addressed the findings of our previous inspection in respect of significant events, patient safety alerts, repeat prescribing, prescription management and premises and health and safety risk assessments.
- There were systems in place to safeguard children and vulnerable adults from abuse and staff we spoke with knew how to identify and report safeguarding concerns.
- There was an open and transparent approach to safety and a system in place for reporting and recording significant events. The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
- The practice had systems in place to ensure care and treatment was delivered according to evidence-based guidelines.
- Some patient outcomes, for example, those with long-term conditions were below local and national targets. However, we saw that improvements had been made and the practice had plans in place to further address these shortfalls.
- Results from the national GP patient survey showed patients rated the practice comparable with others for aspects of caring. Patients told us they were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
- Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients were able to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
- The practice had good facilities and was well equipped to treat patients and meet their needs.
- There was a clear leadership structure and staff felt supported by management.
- The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.
The areas where the provider should make improvements are:
- Review the arrangements for raising concerns around controlled drugs with the NHS England Area Team CD Accountable Officer.
- Review the understanding of reception staff of ‘red flag’ sepsis symptoms that might be reported by patients and how to respond.
- Continue to monitor patient outcomes in relation to patients with long-term conditions, mental health and the childhood immunisation programme.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice