St Andrews Medical Centre

Updated 16 February 2024

St Andrews Medical Centre is located at Greenhill Park Surgery, Greenhill Park, London, NW10 9AR

The provider also runs a sister practice (which is registered as a separate location with CQC) at:

Neasden Medical Centre

21 Tanfield Avenue

London

NW2 7SA

Tel: 084 4477 8747

Patients registered with either practice may attend either site with Greenhill Park Surgery formally operating as a branch site for Neasden Medical Centre as well as the registered location for St Andrews Medical Centre. Some aspects of the service (for example, governance arrangements, website, clinical meetings and in-house clinical pharmacy) are integrated across both patient lists.

The practice provides NHS services through a General Medical Services (GMS) contract to around 1600 patients living in the Harlesden and surrounding area in North West London. The practice is part of the North West London Integrated Care Service and is part of the K&W South Primary Care Network.

The practice is run by a partnership of 2 GPs. The partnership employs 5 sessional GPs, two practice nurses and two clinical pharmacists across both sites. The administration team is led by a practice manager and includes several administrators and reception staff. Two receptionists are trained to carry out phlebotomy duties and one is a trained healthcare assistant.

The same GP partner (female), a practice nurse and 2 reception staff are normally based at Greenhill Park to promote continuity. Patients can consult with a male GP at the Neasden Medical Centre site if they prefer. St Andrews Medical Centre also has access to associated staff resources through its membership of the K&W South primary care network.

The practice population falls within in the fourth most deprived decile in England (the lower the decile the greater the level of income deprivation). There is a higher-than-average proportion of males and patients aged over 35 in the practice population compared to the English average and a markedly smaller proportion of young children. The population is ethnically diverse with just under a half of people identifying as white; around a fifth identifying as black and another fifth as Asian.

The practice reception is open Monday to Friday between 8.00am and 6.30pm. Patients may book appointments by telephone, through an online ‘e-consultation’ form or in person. Weekend and evening primary care appointments are also available at other sites in Brent.

When the practice is closed, patients are directed to contact the local out of hours service via NHS 111. This information can be accessed on the practice website.

The practice is registered with CQC to carry out the following regulated activities: diagnostic and screening procedures; treatment of disease, disorder or injury and surgical procedures.

Updated 16 February 2024

We carried out an announced comprehensive inspection at St Andrews Medical Centre from 21-23 June 2023. Overall, the practice is rated as good.

Safe - Good

Effective - Good

Caring - Good

Responsive – Requires improvement

Well-led - Good

We have not previously inspected the practice since it became a partnership. Prior to that the service was provided by one of the current partners as an individual provider and was inspected on 7 December 2020 when it was rated requires improvement overall. It was rated requires improvement for providing safe, effective, caring, responsive and well-led services. We carried out a follow-up visit on 21 October 2022 to check that the practice had addressed breaches of regulations. We did not rate the practice at that time.

During the inspection process, the practice highlighted efforts it was making to improve access to the service in response to increased patient demand after the COVID-19 pandemic. These had only recently been implemented so there was not yet verified evidence to show the impact, for example, in the national GP patient survey results.

Why we carried out this inspection

The practice partnership was newly registered in April 2023. This inspection was the first inspection following the change in registration. At this inspection, we covered all key questions:

• Are services safe?
• Are services effective?
• Are services caring?
• Are services responsive?
• Are services well-led?

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:

• 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 short 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 provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs. However, the practice was underperforming on the cervical cancer screening target.
• Staff were able to provide examples of how they treated patients with kindness and respect. The practice had improved its scores in relation to patient experience.
• Patients could access care and treatment in a timely way, prioritising patients with more urgent needs. However, patient feedback about access was variable. The practice had adjusted its appointment system in response to patient feedback.
• The way the practice was led promoted the delivery of high-quality, person-centre care.

Whilst we found no breach of regulations, the provider should:

• Continue to monitor patient experience of access and make adjustments as required.
• Follow-up patients with asthma in line with guidelines if they have received 2 or more courses of rescue steroids in the previous 12 months.
• Take action to improve its performance in relation to cervical screening and childhood immunisation targets.
• Make arrangements to inform staff about a freedom to speak up guardian.
• Take action to expand the patient participation group.

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