Dr Timothy Evans Also known as Dr Timothy Hugh David Evans

Updated 6 December 2017

Dr Timothy Evans, also known as The Royal Mews Surgery, is a unique practice situated within the grounds of Buckingham Palace providing GP services to the residents and employees (including temporary summer employees) of the Royal Household and their families. The single location practice covers Buckingham Palace, St James’s Palace, Clarence House and Kensington Palace.

The practice provides NHS primary care services to a closed register of 288 patients and operates under a General Medical Services (GMS) contract (a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract). The practice is part of NHS Central London Clinical Commissioning Group (CCG).

The practice is registered as an individual with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures, treatment of disease, disorder or injury, maternity and midwifery services and family planning.

The practice staff comprises of a principal GP (five sessions per week), a full-time practice nurse and part-time practice manager. The practice is open between 8am and 5pm Monday to Friday. Pre-bookable appointments are available with the doctor on Monday from 2.30pm to 4.30pm, Tuesday 9am to 11am, Wednesday 11.30am to 12.45pm, Thursday 2.30pm to 4.30pm and Friday 9am to 11am. Patients could access the duty doctor after 5pm, during weekends and public holidays. We saw that emergency and out-of-hours information was provided for patients in the waiting room and the practice brochure which included the NHS 111 service and the nearest NHS walk-in clinic.

The practice provided a range of services to its patients which included chronic disease management, cervical screening, travel vaccines, childhood immunisations, family planning advice, health checks, phlebotomy and health promotion which included smoking and alcohol cessation and weight management.

Updated 6 December 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Timothy Evans on 3 December 2014. The overall rating for the practice was good with requires improvement in providing well-led services. The full comprehensive report on the 3 December 2014 inspection can be found by selecting the ‘all reports’ link for Dr Timothy Evans on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection carried out on 19 October 2017 to confirm that the practice had carried out their plan to meet the requirements that we identified in our previous inspection on 3 December 2014. This report covers our findings in relation to those requirements and any improvements made since our last inspection.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Patient feedback was positive and showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available.
• Patients we spoke with said they found it easy to make an appointment.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership and staffing structure and all staff we spoke with were aware of their own roles and responsibilities.
• All staff we spoke with were aware of the requirements of the duty of candour. Staff told us the culture encouraged openness and honesty.

The areas where the provider should make improvement are:

• Consider Public Health England’s Protocol for ordering, storing and handling vaccines (March 2014) in relation to the use of a secondary thermometer.
• Consider how any person with a hearing impairment would access the service.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 6 December 2017

The practice is rated as good for the care of people with long-term conditions.

• The practice had identified 14% of its registered patients as having a long-term condition. For example, diabetes, asthma and hypertension. We saw evidence of the effective management of these patients which included a structured annual review to check their health and medicines needs were being met. The practice demonstrated a recall system for these patients.
• Patients were referred to local services, for example DESMOND (Diabetes Education and Self-Management for Ongoing and Diagnosed) training courses for people with type two diabetes.
• Annual influenza vaccines were offered for patients with chronic diseases.

Updated 6 December 2017

The practice is rated as good for the care of families, children and young people.

• The clinical team demonstrated a good understanding of the needs of children and families.
• The practice offered ante-natal care and baby and pre-school checks which included childhood immunisations.
• The practice liaised with the local health visitors and home visits were arranged for new mothers and families.
• Cervical screening and family planning advice was available.

Updated 6 December 2017

There were eight patients over the age of 70 registered with the practice. The numbers of patients in this population group of older people was therefore insufficient for the Care Quality Commission to pass comment and so we were unable to rate it. However, the practice staff demonstrated an awareness of the needs of patients over the age of 70 which included access to health checks, influenza vaccination and support services, for example, podiatry.

Updated 6 December 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• Patients within the category made up the majority of registered patients at the practice.
• Patients told us they had access to timely appointments, often on the same day, with both the doctor and the nurse.
• Patients had access to appropriate health assessments and checks including NHS checks for patients aged 40-74. There was appropriate follow-up on the outcome of health assessments and checks where abnormalities or risk factors were identified.

Updated 6 December 2017

This population group was not represented in the registered patients, so we could not rate it.

Updated 6 December 2017

This population group was not represented in the registered patients, so we could not rate it.