Attenborough Surgery

Updated 19 June 2023

Attenborough Surgery operates from 4 sites in Watford.

The main site, Bushey Medical Centre, is located in a purpose built health centre in the Bushey area of Watford. The address is:

Bushey Medical Centre
London Road
Bushey

Watford
Hertfordshire
WD23 2NN

The practice also delivers services from 2 other purpose built health centres. Both are located in residential areas of Watford at:

Carpenders Park Surgery

Harrow Way

Watford

Hertfordshire

WD19 5EU

Holywell Surgery

83B Tolpits Lane

Watford

Hertfordshire

WD18 6NT

Attenborough Surgery also provides services from a converted residential property in Watford at:

The Tudor Surgery

139 Bushey Mill Lane

Watford

Hertfordshire

WD24 7PH

We visited all 4 sites as part of this inspection.

The provider is registered with CQC to deliver the following Regulated Activities: diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and the treatment of disease, disorder or injury.

The practice is situated within the Hertfordshire and West Essex Integrated Care Board (ICB) and delivers General Medical Services (GMS) to a patient population of about 31,400. This is part of a contract held with NHS England.

Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the eighth lowest decile (8 of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 83% White, 11% Asian, 3% Black, 2% Mixed and 1% Other.

The age distribution of the practice population broadly follows the local and national averages.

The clinical team at the practice includes 5 GP partners, 14 salaried GPs, 4 practice nurses, an assistant nurse practitioner and healthcare assistants.

Non-clinical staff include a team of reception and administration staff. The practice manager, operations manager, reception managers and systems manager provide managerial oversight and are supported by an assistant manager.

Attenborough Surgery also forms the Attenborough and Tudor Primary Care Network (PCN). The PCN employs a variety of staff who support patients of Attenborough Surgery. These staff include care coordinators, clinical pharmacists, a pharmacy technician, a dietician, a mental health practitioner, paramedics, physiotherapists and a social prescriber.

The practice’s main site, Bushey Medical Centre, is open between 8am and 8pm on Mondays, 7.30am and 8pm on Tuesdays to Fridays and 9am and 5pm on Saturdays. The practice’s branch sites at Carpenders Park and Holywell Surgery are open from 8am to 6pm on Mondays to Fridays. Appointments are available at Tudor Surgery between 8am and 6.30pm on Mondays to Fridays. Patients are offered appointments and can access services at any of the 4 sites.

When the practice is closed, patients are directed to access support, treatment and advice from the NHS 111 service or Hertfordshire Urgent Care services.

Patients can book appointments online, or by telephoning or visiting the practice.

The practice offers a range of appointment types including face-to-face, telephone, home visits and online consultations.

The practice offers urgent, or ‘same day’, face-to-face or telephone appointments, including home visits.

Patients can also pre-book routine appointments, with a clinician of their choice, up to 7 days in advance.

Patients can ask for prescriptions online, or by visiting or emailing the practice.

Updated 19 June 2023

We carried out an announced focused inspection at Attenborough Surgery on 18 and 19 January 2023. Overall, the practice is rated as good.

The ratings for each key question are:

Safe - requires improvement

Effective - good

Caring – not inspected, the rating of good is carried forward from our previous inspection

Responsive – good

Well-led – good.

Following our previous inspection on 19 November 2019, the practice was rated good overall and for the provision of effective and well-led services. The practice was rated requires improvement for the safe key question.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Attenborough Surgery on our website at www.cqc.org.uk.

Why we carried out this inspection

We inspected Attenborough Surgery as part of our regulatory functions under the Health and Social Care Act 2008.

We served a requirement notice following our previous inspection as we found there were breaches in regulation 12 (safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We carried out this inspection to follow up on the concerns identified in the safe key question, the breaches of regulation and the areas identified where the provider should make improvements.

We looked at the safe, effective, responsive and well-led key questions for this inspection.

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 was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• conducting staff interviews using video conferencing facilities

• completing clinical searches and reviewing patient records on the practice’s patient records system to identify issues and clarify actions taken by the provider

• requesting evidence from the provider

• a site visit to Attenborough Surgery including all 4 of the practice’s sites

• requesting and reviewing feedback from staff and patients who work at or use the service.

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

• information from the provider, patients, the public and other organisations.

We found that:

• The practice had made improvements to provide care in ways that kept patients and staff protected from avoidable harm, for example in processes to ensure emergency medicines and equipment were always safe and available to use.

• Staff worked together and with patients and other organisations to deliver effective care and treatment and help patients to live healthier lives.

• The practice organised and delivered services that met patients’ needs.

• There was effective leadership and a positive culture in the practice.

• The practice sought and responded to feedback from patients and staff to continue to make improvements.

• There was a strong learning environment and a desire to continue to improve the quality of the service and apply innovative ways of working to support patients and staff.

We also saw an area of outstanding practice in how the practice worked with other services to to provide coordinated and responsive care for patients with complex mental health needs.

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

• Continue to take actions to check all staff continue to be suitable for their roles, including, but not limited to, checks that staff have appropriate and up-to-date Disclosure and Barring Services checks, appraisals and that staff have completed all required training, for example in basic life support.

• Continue to develop systems to maintain health and safety requirements at all of the practice’s sites, for example fire drills, checks of the fire alarm systems and water testing for legionella bacteria.

• Continue to monitor and take actions to improve attendance for cervical screening.

• Monitor and review all patients who have medicines or long-term conditions in line with national guidance and to protect patients affected by safety alerts from harm.

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 Hospitals and Interim Chief Inspector of Primary Medical Services