Enderley Road Medical Centre

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last inspection in 2018, we rated this key question as Good. At this assessment, the rating remains the same.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.
Staff and the PPG had contributed to the development of the practice vision and strategy, which was kept under review. The practice was aware of projected increases in the local population and was planning for future demand. For example, an additional consulting room had been created to increase appointment capacity and improve access for disabled patients.
Leaders had invested in staff learning and development, demonstrated through annual appraisals, monthly education meetings with external speakers, peer learning via buddy groups with multidisciplinary staff, staff training, upskilling of staff and other regular meetings designed to foster learning and knowledge sharing.
The practice developed bespoke templates, including for diabetes management, CKD, and paediatric safety netting, to support staff in delivering best-practice care.
The leadership team collaborated with the primary care network (PCN) to plan and deliver services that met the needs of the practice and local population. The practice manager, as PCN Digital and Transformation Lead, also shared expertise and knowledge across the network.

The practice had received positive feedback from network partners, highlighting their professionalism and commitment to delivering high-quality care for both their patients and the wider local network. This was particularly evident in feedback on the dermatology clinic and the practice’s performance in diabetic care.
 

The service had a longstanding and stable GP partnership structure. A clear leadership structure was in place, with each area led by a GP partner. Key functions, including safeguarding, had designated leads and deputies to ensure effective oversight and continuity.
There were inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.
Leaders actively invested in staff development, arranging educational meetings with external speakers, providing ongoing in-house training for reception staff, and offering opportunities for upskilling.

Staff told us leaders in the practice was approachable and responded to any concerns raised. Staff also told us leaders modelled the values of the practice. We saw the leadership team worked with other practices in the primary care network and were engaged in the development of primary care services within the local area.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them.
Policies and procedures to promote diversity and equality were in place. Staff had undertaken training in equality, diversity, inclusion and human rights. Adjustments had been made to ensure all staff were valued. In response to staff feedback about feeling isolated, the practice introduced cross-team “buddy groups” to improve communication and collaboration. Each group included a GP partner and a mix of clinical and non-clinical staff and was responsible for organising shared activities. Partners also held quarterly meetings with teams, providing ongoing opportunities for engagement and feedback.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. The practice had risk management arrangements and business continuity plans in place. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.
Leaders and managers supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. Managers met with staff regularly to complete appraisals and performance reviews. The provider had established governance processes that were appropriate for their service. Staff could access all required policies and procedures. Managers held regular practice meetings with staff, during which they discussed clinical concerns and emerging risks. Managers clearly recorded any actions arising from these meetings and ensured they shared these with staff. Staff took patient confidentiality and information security seriously.

The service understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.
Staff had made adjustments to improve coordination with community healthcare services, including regular meetings focused on patients at higher risk of hospital admission. Feedback from one service praised the practice’s GPs and staff for their responsive and efficient care.
The practice was 1 of 3 local practices within the primary care network offering a weekly minor surgery and dermatology clinic. The clinic, led by a GP partner with an Extended Role in Dermatology, accepted referrals from other GPs in Harrow. The practice had provided this clinic for 8 years, offering a service that would otherwise not have been available to patients in Harrow. Feedback from partner organisations and patients had been consistently positive.
The practice was a teaching practice for GP trainees and medical students and had been commended for its inclusive approach, supportive learning culture, and commitment to professional development. The provider stated that 3 GP registrars had been retained as salaried GPs, reflecting this supportive environment.
The practice had a proactive Patient Participation Group (PPG) that met face-to-face every 6–8 weeks, including an annual general meeting. Meetings were structured and minutes were approved by the PPG chair. Representatives from the PPG spoke positively about their interactions with the practice, the quality of care provided, and the responsiveness of staff in making service improvements in response to patient feedback.
 

The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The service utilised population data to drive targeted, high-quality care. They introduced a specialist pharmacist-led COPD review service for 130 patients, overseen by GPs, aligned with GOLD guidelines (a comprehensive framework for COPD management). Patients received education, self-management support, and medicines optimisation authorised by GPs, with 85% reporting improved ability to manage their condition. The pilot also upskilled the pharmacy and nursing team. Learning from the baseline results was being embedded into routine practice and shared across the PCN to support scalable, sustainable COPD care.

The practice also identified a high local need for integrated cardio-renal-metabolic (CRM) care, due to a high prevalence of diabetes and cardiovascular disease. They piloted an integrated CRM pathway for patients with poorly controlled diabetes and co-morbidities. The pathway provided continuity-led, GP-delivered care supported by HCA assessments, medicines optimisation, lifestyle referrals and structured follow-up. To date, 314 patients had completed follow-up, with clear improvements in outcomes: blood pressure control increased from 52% to 71%, non-HDL cholesterol from 36% to 55%, and HbA1c control from 41% to 62%. Patient feedback was positive, with 82% finding the clinics helpful and improved motivation reported. The pilot also developed workforce capability, training newly qualified GPs and pharmacists in integrated metabolic care. This integrated approach demonstrated measurable improvement in outcomes and a sustainable model of care which was shared across the PCN.

The work between the Patient Participation Group (PPG) and the practice demonstrated continuous learning, improvement, and innovation. The proactive PPG worked in close partnership with the practice to co-design and enhance services, resulting in clear improvements to patient experience. This was evidenced through effective outreach to patients, delivery of a community health fair, and the establishment of a friendship café to support wellbeing and reduce isolation.