- GP practice
Archived: The Town Surgery
Important:
The provider of this service changed. See new profile
All Inspections
3 November 2016
During a routine inspection
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at The Town Surgery on 3 November 2016. Overall the practice is rated as good.
Our key findings across all the areas we inspected were as follows:
- There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
- Risks to patients were assessed and well managed.
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Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
- Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
- Patients said they were treated with compassion, dignity and respect.
- Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
- Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
- There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
- The provider was aware of and complied with the requirements of the duty of candour.
- Practice management and governance arrangements facilitated the delivery of high-quality person-centred care.
The areas where the provider should make improvement are:
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Review the current arrangements for the storage of prescription pads in the reception office.
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Review the care outcomes for patients with a learning disability.
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Continue to monitor national GP patient survey results which showed that patient satisfaction on how nurses treated patients with care and concern was below national and local averages.
- Introduce a formal protocol to accommodate gender specific GP consultation requests.
We previously inspected this location in 2014. The inspection was part of a pilot scheme, testing our new methodology for inspecting general practices and consequently, the practice was not rated.
3 June 2014
During a routine inspection
The Town Surgery is a single handed practice that provides primary medical services to over 3450 patients living in Enfield. NHS Enfield CCG is a membership organisation of 54 local GP practices and is responsible for commissioning health services for a population of around 310,000 people. 38.8% of the population belong to non-white minorities which is more than three times higher than the England average (12.3%). Enfield has a relatively high rate of long term unemployment and a high proportion of obese children.
Rates of smoking during pregnancy are significantly better than the England average, as are the number starting breast feeding.
The practice has three male GPs and one nurse. The practice offers a range of services including, phlebotomy, antenatal care, cervical screening and the well person clinic.
On the day of our inspection, 3 June 2014, we spoke to staff, patients and their relatives. Prior to our inspection we spoke to other professionals involved in delivering integrated care such as midwives and Health Visitors. We also collected patient views through comments cards that were left at the practice two weeks prior to the inspection.
As part of the inspection we looked at all the regulated activities provided by the service which were diagnostic and screening, surgical procedures and treatment, disease, disorder or injury. At the time of our visit the practice was no longer performing minor surgeries due to absence of a separate treatment room.
The Town Surgery provided a safe and effective service for all population groups. There were appropriate procedures in place to deal with emergencies, and to clean and service equipment and premises. Staff were aware of infection control procedures and had received appropriate training.
There were effective systems in place to ensure that staff followed best practice including guidance from the National Institute of Health and Care Excellence (NICE) and the Royal College of GP (RCOGP). There was a training and appraisal schedule for both clinical and non clinical staff.
Patients were treated with dignity and respect. We observed staff speaking to patients in a polite and professional manner over the telephone and in person. Staff told us that they chaperoned patients when requested as all three doctors that worked at the practice were male. There were arrangements in place to support people who had suffered a bereavement.
The practice was responsive to the needs of the population it served. Patients told us that they came to the practice as they could see the same doctor all the time and they felt that the doctors understood their needs and gave them enough time during consultations.
The practice had a democratic leadership approach and due to its small size. Staff said it felt more like a “family”. Both clinical and non clinical staff felt that the doctors were supportive and that they were given opportunities to attend training sessions. Staff said they were able to raise concerns about their work without fear.