Dr Carl Chang - Care Quality Commission

Background to this inspection

Updated 12 July 2017

Bush Hill Park Medical Centre is located in a residential area of Enfield, North London. The practice is located in privately owned premises on a small residential road. Patients can access the practice by car, with parking available outside the practice or by public transport, with a bus stop located approximately five minutes’ walk from the practice.

There are approximately 2200 patients registered at the practice. Statistics shows moderate deprivation levels among the registered population. Information published by Public Health England rates the level of deprivation within the practice population group as six on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. The registered population is higher than the national average for those aged between 20-69.

Care and treatment is delivered by two part-time GP partners (one male and one female). Five administrative and reception staff work at the practice and are managed by one of the partner GP’s. The practice does not employ a practice nurse or a healthcare assistant.

The practice is open at the following times:-

• 8:00 - 8:00 (Mondays, Wednesdays)

• 8:00 - 7:30 (Tuesdays, Fridays)

• 8:00 - 1:30 (Thursdays)

Clinical sessions are run during the following times:-

• 9:00 - 11:15 (Monday - Friday)

• 4:00 - 7:00 (Mondays, Wednesday)

• 4:00 - 6:00 (Tuesdays, Fridays)

Extended hours consultations are held every Monday and Wednesday between the times of 6:00pm -7:00pm.

Patients can book appointments in person, via the phone and online. Outside of normal working hours, patients are advised to contact the local out of hours service provider on telephone number 111.

The practice has a General Medical Services (GMS) contract and conducts the following regulated activities:-

Diagnostic and screening procedures
Treatment of disease, disorder or injury
Maternity and midwifery services
Family planning

Enfield Clinical Commissioning Group is the local commissioning team for this practice.

Overall inspection

Good

Updated 12 July 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Carl Chang (also known as Bush Hill Park Medical Centre) on 30 March 2016. The overall rating for the practice was Requires Improvement. The full comprehensive report on the March 2016 inspection can be found by selecting the ‘all reports’ link for Dr Carl Chang on our website at www.cqc.org.uk.

At our previous inspection in March 2016, we rated the practice as Requires Improvement for providing safe, effective and well-led services. At this time included amongst the issues we identified, was the practice could not provide sufficient evidence to confirm that clinical staff had specific training to administer vaccines and to conduct cervical screening. In addition, the practice did not have defibrillator and did not have the required mask for a child or the oxygen held at the practice.

This inspection was an announced focused inspection carried out on 24 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 30 March 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection. At this inspection, we found that the practice had made improvements to provide safe, effective and well-led services. As a result of these findings, the practice is now rated as Good for providing safe, effective and well-led services.

The change in the ratings for safe, effective and well-led, means that the practice is now rated as Good overall.

Our key findings were as follows:

All practice staff had undertaken basic life support training within the last 12 months.
The practice had access to a defibrillator. Oxygen held on site had both adult and child masks.
Practice policies and procedures had been recently reviewed and updated where required. This included systems for managing incidents and significant events as part of the requirements under the Duty of Candour and a revised business continuity plan.
The practice had a system in place to ensure that all emergency medicines held were in date.
Clinical staff had undertaken training to ensure competence in administering vaccines and conducting cervical screening.
The practice conducted regular fire drills. All staff members had been trained in what to do in the event of a fire.
All staff had an appraisal within the last 12 months and there was an induction programme for new staff.
The practice had devised a business strategy with proposed plans for the practice over the next five years.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice