Archived: Greenhill Park Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Greenhill Park Medical Centre on 26 March 2015. The practice also provides services at another surgery at Neasden Health Centre. Patients registered with the practice may attend either surgery. On this occasion we inspected Greenhill Park Medical Centre which is the practice’s smaller, branch surgery and overall we rated the service at this location as requires improvement.

Specifically, Greenhill Park Medical Centre required improvement for providing safe and effective services and for being well-led. The practice also required improvement for its care of older people; people with long-term conditions; families, children and young people; people of working age; people whose circumstances may make them vulnerable; and, people experiencing poor mental health. The practice was rated as good for providing caring and responsive services.

Our key findings were as follows:

• The practice had effective systems in place to manage risks associated with staff recruitment, infection control, child protection and safeguarding and medical emergencies. Staff needed to be clearer on who was the lead for these areas in the practice however.
• The practice understood the needs of the population and had developed the service and skills of the staff team to meet patients’ needs. We found that care for long-term conditions such as diabetes was being managed effectively in the community and care was provided in partnership with other specialist and community services.
• Patient satisfaction scores for both this branch and the main practice were generally positive. Thirty-six patients completed Care Quality Commission (CQC) comment cards about the service before our inspection. All but three of these were wholly positive about the service and staff.
• Feedback was positive about access to appointments and the practice scored better than other practices in the local area for this aspect of care.
• Staff told us they were well supported and had access to the training they needed to develop in their role.

However, there were also areas of practice where the provider needs to make improvements.

Action the provider MUST take to improve:

Importantly, the provider must:

• Ensure that all prescription materials are stored securely and can be tracked.
• Ensure that patient group directions in use in the practice are correctly signed by the principal GP and practice nurse.

• Provide clinical staff, regular opportunities for effective clinical review, reflection and support.
• Ensure that staff are aware of the designated practice lead for child protection, safeguarding, health and safety, infection control and other key areas of practice.

Action the provider SHOULD take to improve:

The provider should:

• Develop an audit programme so that where appropriate audit cycles are completed and the results of clinical audit are shared across the clinical team.
• Expand its cytology service so that eligible patients routinely have the option of having cervical smears at the practice.
• Where appropriate, share relevant significant events with other health providers to help reduce the risk of reoccurrence.
• Develop a system to monitor the implementation of national safety alerts
• Do more to obtain patient feedback about the service, for example by setting up a patient participation group.
• Implement a reminder system to ensure that required updates, for example, in relation to staff members' mandatory training are not missed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice