Background to this inspection
Updated
24 April 2020
Hornsey Park Surgery is located in a converted residential property. The practice is provided by a single handed GP and is located off the main road which is accessible by local bus and train services. Consultations take place on the ground floor.
It provides care to approximately 4,400 patients. The practice area population has a deprivation score of 3 out of 10 (1 being the most deprived). The practice cares for a diverse population with approximately 41% of its patients being from black and ethnic minority backgrounds.
The practice holds a GMS (General Medical Services) contract with NHS England. This a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract.
It is registered with the Care Quality Commission to provide the regulated activities: Diagnostic and screening procedures; Family planning; Maternity and midwifery services; and Treatment of disease, disorder or injury.
The clinical team consists of one female GP partners, three male and two female regular locums, two female practice nurses, a practice manager and an administrative and reception team.
The practice’s opening hours are 8am to 6:30pm on weekdays, with extended hours appointments operating between 10am to 2pm on Saturdays.
Standard appointments are 10-15 minutes long, with double appointments available to patients who request them, or for those who have been identified with complex needs. Telephone consultations and home visits are available. Appointments can be booked online by patients who have previously registered to use the facility.
When the practice is closed, patients are redirected to a contracted out-of-hours service. The local Clinical Commissioning Group has commissioned an extended hours HUB service, which operates at two locations between 6.30pm and 8pm on weeknights and from 8am to 8pm at weekends. The practice is one of the host locations for the HUB service. Patients may book appointments with the service by contacting the practice.
Updated
24 April 2020
We previously carried out an announced comprehensive inspection at Hornsey Park Surgery, on 31 May and 3 June 2019, and rated the practice as inadequate for safe and well-led; requires improvement for effective and caring; and good for responsive. This gave the practice an overall rating of inadequate and we placed the practice into special measures.
At the inspection, on 31 May and 3 June 2019, we rated safe and well-led as inadequate because:
- The practice had not provided care and treatment in a way that kept patients safe and protected them from avoidable harm;
- There was a lack of systems and processes established and operated effectively to ensure compliance with requirements to demonstrate good governance.
We rated effective and caring as requires improvement because:
- There was an absence of clinical oversight and governance and we were not assured patients’ treatment or ongoing needs were being regularly reviewed and updated. For example, clinical meetings were infrequent and although locum GPs discussed patients, we noted this was on an informal basis and did not involve the practice’s advanced nurse practitioner.
- The provider had limited evidence of actions taken to improve below average patient satisfaction on how staff treated patients with care and concern.
As a result of our findings, at the 31 May and 3 June 2019, we served warning notices under Section 29 of the Health and Social Care Act 2008, as the provider was failing to comply with the relevant requirements of Regulation 12, Safe care and treatment and Regulation 17 Good Governance of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We carried out a warning notice follow up inspection, on 26 September 2019, to assess whether the concerns identified in the warning notices had been addressed by the provider. At that inspection we found that the provider had appropriately addressed all the concerns identified in the warning notices.
At this inspection, on 26 February 2020, we carried out an announced comprehensive inspection and found all the issues identified previously had been addressed to an appropriate standard.
We rated the practice as good in safe, caring, responsive and well-led, and requires improvement in effective. This gave the practice an overall rating of good.
We rated the practice as good for providing safe, caring, responsive and well-led services because:
- 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.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
- The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
We rated the practice as requires improvement for providing effective services because:
- The uptake of childhood immunisations was lower than the World Health Organisation’s target of 95%.
- The uptake of cervical screening was lower than the national target of 80%.
For the responsive domain, we rated all the population groups as good.
For the effective domain, we rated older people; people with long-term conditions; people whose circumstances may make them vulnerable; and people experiencing poor mental health as good. We rated families, children and young people as requires improvement because performance in the uptake of childhood immunisations were below the World Health Organisation targets. We rated working age people as requires improvement because performance in the uptake of cervical screening was below the national target.
Whilst we found no breaches of regulations, the provider should:
- Continue with action plan to improve clinical outcomes for chronic obstructive pulmonary disease and atrial fibrillation.
- Continue to improve the uptake of childhood immunisations and cervical screening.
As a result of the above findings the provider has been taken out of special measures.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care