• Doctor
  • GP practice

St Andrews Medical Practice

Overall: Good read more about inspection ratings

50 Oakleigh Road North, Whetstone, London, N20 9EX (020) 8445 0475

Provided and run by:
St Andrews Medical Practice

All Inspections

4 October 2023

During a routine inspection

We carried out an announced comprehensive at St Andrews Medical Practice on 27 September and 4 October 2023. Overall, the practice is rated as good.

Safe - Good

Effective - Good

Caring - Good

Responsive - Requires improvement

Well-led - Good

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

Why we carried out this inspection

We carried out this inspection as part of our programme of inspecting locations that had been inspected as part our first phase of inspections using our current methodology.

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:

  • Conducting staff interviews using video conferencing.
  • 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.
  • A 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 found that:

  • The practice had established systems and processes that kept patients safe and protected them from avoidable harm.
  • Patients received care and treatment that met their needs, however clinical searches we conducted showed that not all long-term conditions reviews were being carried out according to national guidelines.
  • The practice used clinical and quality improvement audits to improve patient outcomes.
  • Staff had the skills and knowledge to carry out their role effectively, however training records we viewed did not accurately reflect this.
  • There were systems in place to manage and mitigate risk relating to the practice, but these not always utilised.
  • There was compassionate and effective leadership at the practice.
  • Governance systems relating to policies were not always reviewed regularly.
  • The most recent National Patient Survey revealed that patients at the practice did not always access care and treatment in a timely way.
  • The practice had an active patient participation group (PPG).
  • There was evidence of continuous improvement and innovation at the practice.

We found two breaches of regulations. The provider must:

  • Establish effective system and processes to ensure good governance in accordance with the fundamental standards of care.
  • Act in an open and transparent way with relevant persons in relation to care and treatment provided to service users.

Whilst we found no additional breaches. The provider should

  • Review practice management governance systems.
  • Regularly review practice risk register to ensure full oversight and management of current and potential future risk.
  • Employ systems to ensure clinical monitoring of patients is conducted according to national guidelines.

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

23 June 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St. Andrew’s Medical Practice on 23 June 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • The practice had strong clinical leadership, managerial leadership and governance arrangements. For example, a

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

  • The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, one of the partner GPs developed a cross borough, multi-professional learning group which was often hosted at the practice. The group was comprised of local GPs, secondary care consultants, pharmacists, social workers, nurses and health care support workers.

  • Feedback from patients about their care was consistently positive. For example, all of the practice’s national patient survey respondents (113 patients) scored the nursing team at 90% or more regarding all aspects of care and treatment. For example, 100% fedback that they had confidence in the last nurse they saw and 92% fed back that they felt involved in decisions about their care and treatment. The nursing team spoke positively about how educating and involving patients in their care and treatment decisions had positively impacted on patient outcomes in areas such as weight management and blood pressure management.

  • The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example, the practice routinely undertook outreach with local community groups which had enabled it to host several drop-in and referral based services covering dementia support, social services and carer support.

  • The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. For example, the practice had acted on a Patient Participation Group (PPG) group suggestion for a mobile telephone contact number for priority patients/carers to contact the practice/named GP in an emergency.

  • The practice had good facilities and was well equipped to treat patients and meet their needs.

  • The practice actively reviewed complaints and how they were managed; and also made improvements as a result.

  • The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision was regularly reviewed and discussed with staff.

We saw several areas of outstanding practice including:

  • The practice provided a mobile telephone number to enable priority patients to contact the practice/named GP in an emergency. This was seen as particularly important for non-verbal patients as it allowed messages to be texted to the practice. the enhanced by promptlysotherefore

  • One of the partner GPs developed a cross borough multi-professional collaborative learning group hosted at the practice. The group was comprised of local GPs, hospital consultants, pharmacists, social workers, nurses and health care support workers. Clinicians from St Andrew’s Medical practice spoke positively about how the learning group broadened clinical knowledge and positively impacted on care and treatment in areas such as heart disease management.

However there were areas of practice where the provider should make improvements:

  • Consider documenting its five year strategy so as to further promote its community outreach approach amongst local people and third sector stakeholders.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice