Background to this inspection
Updated
30 August 2018
Watling Medical Centre comprises a main location based in Burnt Oak, London Borough of Barnet and a branch location approximately four kilometres away in Stanmore, London Borough of Harrow. The combined patient list of 15,100 patients is split across the two sites. We visited both locations during our inspection.
Twenty one percent of patients are aged under 18 (equalling the national practice average) and 13% are 65 or older (compared to the national practice average of 17%). Fifty nine percent of patients have a long-standing health condition. The services provided by the practice include child health care, ante and post natal care, immunisations, sexual health and contraception advice and management of long term conditions.
The practice holds a General Medical Services contract with NHS England. The staff team comprises six partner GPs (one female, six male providing 34 sessions per week across the two sites), seven female salaried GPs providing 19 sessions across the two sites), one female nurse practitioner, two female practice nurses (providing 12 sessions per week across two sites), a female health care assistant, a practice manager and administrative/reception staff.
The practice’s opening hours are:
• Monday- Friday 8:30am-6:30pm (phone lines are closed 12:30pm-2pm except for medical emergencies).
The practice offers extended hours opening at the following times:
• Monday: 6:30pm – 7:30pm
• Saturday: Burnt Oak and/or Stanmore 9:30am-12:30pm (by appointment only)
Appointments are available at the following times:
• Monday: 8:30am-12:30pm and 1:30pm-7:30pm
• Tuesday–Friday: 8:30am-12:30pm and 1:30pm-6:30pm
Outside of these times, cover is provided by an out of hours provider.
The practice is registered to provide the following regulated activities which we inspected:
Diagnostic and screening procedures; Maternity and midwifery services; and Treatment of disease, disorder or injury; and Surgical procedures; and Family Planning.
This inspection was to confirm that the provider had carried out their plan to meet the legal requirements in relation to breaches in regulations that we identified in our previous inspection on 28 July 2016.
Updated
30 August 2018
This practice is rated as Good overall. (Previous rating 25/10/2016 – Good)
The key questions at this inspection are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
We carried out an announced comprehensive inspection at Watling Medical Centre on 21 June 2018. This inspection was to confirm that the provider had carried out their plan to meet the legal requirements in relation to breaches in regulations that we identified in our previous inspection on 28 July 2016. At that time the service was rated as requires improvement for safe services, rated as good for providing effective, caring, responsive well led services; and rated overall as good. This report covers our findings in relation to those requirements and also in relation to additional improvements made since our last inspection.
At this inspection we found:
- The practice had taken action to address the Legionella risks identified at our last inspection (Legionella is a term for particular bacteria which can contaminate water systems in buildings).
- Protocols for monitoring patients on high risk medicines had not recently been reviewed.
- 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 routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
- The provider had good facilities and was well equipped to treat patients and meet their needs. For example, automated doors had recently been introduced at its branch location.
- Clinical leadership, management and governance of the service assured the delivery of high-quality and person-centred care.
We saw one area of outstanding practice:
In March 2016, the practice introduced a health champion programme designed to motivate, empower and support patients to make healthier lifestyle choices and signpost them to relevant services/organisations. Feedback from clinicians has been positive; with many feeling that the health champions provide a valuable service within the practice which has reduced the number of patients seeking their advice on social issues. Since our last inspection in July 2016 the programme has:
• trained five volunteers
• enlisted one health champion to volunteer at the practice; signposting individuals to relevant services and supporting patients writing letters (for example to housing services).
• undertaken 127 patient contacts; signposting patients to services such as housing advice, financial support, employment advice, carers support and smoking cessation.
The areas where the provider should make improvements are:
- Ensure policies are reviewed and updated as required.
- Take action to improve how carers are identified.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice
Please refer to the detailed report and the evidence tables for further information.