Archived: Primrose Hill Surgery

Updated 10 January 2018

The Primrose Hill Surgery operates from 97-99 Regents Park Road, London NW1 8UR. The building is leased and was originally commercial premises. It is close to Chalk Farm underground station, with good transport links.

The practice provides NHS services through a General Medical Services (GMS) contract to approximately 6,300 patients. It is part of the NHS Camden Clinical Commissioning Group (CCG) which is made up of 35 general practices. The practice is registered with the CQC to carry out the following regulated activities - diagnostic and screening procedures, treatment of disease, disorder or injury, and maternity and midwifery services. The patient profile for the practice has a lower than average teenage and younger adult population, with a higher number of working age patients. The locality has a lower than average deprivation level.

The practice has a clinical team of two female GP partners, who each work seven clinical sessions per week and three salaried GPs (two female and one male), who work four or five clinical sessions. The two female salaried GPs are on maternity leave and their work is being covered by long-term locums. It has recently been confirmed as a training practice and a registrar (a GP in training) will be starting at the practice early in 2018. There is a part-time practice nurse, who works five clinical sessions across Tuesday, Thursday and Friday and a locum nurse also works one session on Friday. An administrative nurse works eight hours a week on non-clinical matters. The practice manager’s post is currently vacant; there are four administrators (three part-time) and four medical receptionists (three of whom also work part-time).

The practice reception operates between 9.00 am to 6.00 pm, Monday to Friday. The practice closes for lunch between 12.30 pm and 2.00 pm. Morning appointments are available between 9.00 am and 12.30 pm on Monday, Tuesday and Wednesday; and between 8.30 am and 12.30 pm on Thursday and Friday. Afternoon appointments run from 2.00 pm until 8.00 pm on Monday and from 2.00 pm until 6.00 pm on Tuesday, Wednesday and Friday. There are no clinical appointments on Thursday afternoon and the practice is closed at weekends. Routine appointments – of 10 minutes for GPs and 15 minutes for nurses - can be booked up to one month in advance. Patients can book appointments online if they have previously registered to do so. Same-day urgent appointments are available. The GPs also conduct telephone consultations with patients and make home visits.

In addition to the extended hours operated by the practice on Monday evening, the CCG had commissioned an extended hours service operating between 6.30 pm and 8.00 pm on weeknights and from 8.00 am to 8.00 pm at weekends at four “Hub” locations across the borough. Patients may book appointments with the service by contacting the practice.

The practice has opted out of providing an out-of-hours service. Patients calling the practice when it is closed are connected with the local out-of-hours service provider. There is information given about the out-of-hours provider and the NHS 111 advice service on the practice website - www.primrosehillsurgery.co.uk

We previously inspected the practice in April 2016, when we rated it good in respect of the five key questions and overall. We carried out this inspection in response to receiving information regarding the professional relationship between the two partner GPs and its possible impact on staff and the service.

Updated 10 January 2018

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection the Primrose Hill Surgery on 22 November 2017. This was in response to information of we had received regarding the professional relationship between the two partner GPs and the possible impact it was having on staff and the service.

The practice is now rated as requires improvement overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Requires improvement

As part of our inspection process, we also look at the quality of care for specific population groups. We have rated the practice as requires improvement for the key questions of safe and well-led and overall. The concerns which led to these ratings apply to everyone using the service. Accordingly, the population groups are rated as:

Older People – Requires improvement

People with long-term conditions – Requires improvement

Families, children and young people – Requires improvement

Working age people (including those retired and students – Requires improvement

People whose circumstances may make them vulnerable – Requires improvement

People experiencing poor mental health (including people with dementia) - Requires improvement

At this inspection we found:

• The practice had been working with NHS England and the Camden CCG to resolve issues between the partners. One partner was to retire and the other would be taking over as sole practitioner. Staff told us that morale was improving.
• There were issues relating to fire safety at the premises, together with monitoring equipment, that need to be addressed to ensure safety risks are minimised.
• The practice had not been having regular clinical and staff meetings and the recording of the meetings had lapsed.
• The practice learned from incidents and took action to improve its processes.
• Published data showed the practice performance was comparable with local and national averages.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. Care and treatment was delivered according to evidence-based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found it easy to use the appointment system and told us they could access care when they needed it.
• Data from the GP patient survey showed that patient satisfaction was generally above local and national averages. Where a need for improvement had been noted, the practice had drawn up action plans.

The areas where the practice must make improvements as they are in breach of regulations are:

• Ensure care and treatment is provided in a safe way to patients.
• Ensure there are effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the practice should make improvements are:

• Ensure that all staff have protected learning time and have sufficient opportunity for breaks.
• Ensure that accessible information regarding the service is available to patients with learning disabilities.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 10 January 2018

Updated 10 January 2018

Updated 10 January 2018

Updated 10 January 2018

Updated 10 January 2018

Updated 10 January 2018