Francis Road Medical Centre

Updated 1 February 2024

Francis Road Medical Centre is situated at 94 Francis Road, Waltham Forest, London, E10 6PP. The practice operates from a converted residential property. The practice has access to 4 consulting rooms, all situated on the ground floor. Office and administration areas are situated on the first floor accessed via stairs.

The practice provides NHS primary care services to approximately 7,160 patients living in the Leyton area of London through 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 Waltham Forest Integrated Care Board (ICB) and registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures; treatment of disease; disorder or injury; maternity and midwifery services; surgical procedures and family planning.

Information published by Public Health England shows that deprivation within the practice population group is in the fifth lowest decile (5 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 45% White, 28% Asian, 17% Black, 5% Mixed, and 5% Other. The age distribution of the practice population closely mirrors the local and national averages.

The practice provides a range of services including childhood immunisations, chronic disease management, cervical screening and travel advice and immunisations, sexual health screening and NHS health checks.

The practice staff comprises of a lead GP who provided five clinical sessions and three male & female salaried GPs who provided a combination of 24 clinical sessions.

The GPs are supported by a practice nurse, one pharmacist and one pharmacy technician and one healthcare assistant. Administration staff include a part-time practice manager, 1 assistant manager and 5 administration and reception staff. The practice is a training practice for undergraduate and postgraduate medical students.

The practice is open from 8am to 6.30pm Monday to Friday and closed at weekends and bank holidays. The practice telephone lines are active from 8am to 6.30pm and from 9am to 12.30pm on Thursday, after which calls are diverted to the Federation. When the surgery is closed, out-of-hours services are accessed through the local GP hub which offers evening and weekend GP and nurse appointments. Urgent care is accessed via NHS 111. The practice offers a range of appointment types including book on the day, telephone and e-consultations and advance appointments.

The practice is part of a wider network of GP practices, Forest Integrated Health Primary Care Network (PCN) that provides services for up to 55,000 patients within the network.

Updated 1 February 2024

We carried out an announced comprehensive follow-up inspection at Francis Road Medical Centre on 13 June 2023. Overall, the practice is rated as inadequate.

Safe - inadequate

Effective - requires improvement

Caring - requires improvement

Responsive - inadequate

Well-led - inadequate

Following our previous inspection on 21 September 2022, the practice was rated inadequate overall and for all key questions except requires improvement for providing caring services.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Francis Road Medical Centre on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection to follow up on breaches of regulation found at the previous inspection and information of concern received.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• A short site visit.
• Conducting staff interviews using video conferencing and face to face.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.

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.
• Staff feedback

We found that:

• The systems, practices and processes to keep people safe and safeguarded from abuse continued to be inadequate.
• Appropriate standards of cleanliness and hygiene were not met.
• The systems to assess, monitor and manage risks to patient safety continued to be inadequate.
• Staff did not always have the information they needed to deliver safe care and treatment.
• We continued to find the system in place to ensure learning took place and improvements were made continued to be inadequate and placed people at risk.
• The practice was unable to demonstrate that all staff had the skills, knowledge and experience to carry out their roles.
• Staff did not always treat patients with kindness, respect and compassion. Feedback from patients was mixed about the way staff treated people.
• Services did not always meet patients’ needs.
• People were not always able to access care and treatment in a timely way.
• Leaders could not demonstrate that they had the capacity and skills to deliver high quality sustainable care.
• The practice culture did not support high quality sustainable care.
• There were inadequate governance arrangements.
• There was little to no management of patient complaints and we had no assurance patient complaints were managed effectively.
• The practice had improved in relation to ensuring patients needs were assessed and care and treatment was delivered in line with current legislation.

We found breaches of regulations. The provider must:

• Ensure that care and treatment is provided in a safe way.

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

I am placing this service in special measures. Services placed in special measures will be inspected again within 6 months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within 6 months if they do not improve.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care