St Peter's Medical Centre

Background to this inspection

Updated 29 November 2017

St Peter’s Medical Centre provides primary medical services through a Personal Medical Services (PMS) contract within the London Borough of Harrow. The practice is part of NHS Harrow Clinical Commissioning Group. The services are provided from a single location to around 7960 patients. The practice serves a wide ethnic, cultural, demographic and socio-economic mix. It has higher than average numbers of ‘non-white UK’ patients and patients in the 25-39 age groups and lower than average numbers age 65 and over.

At the time of our inspection, there were three permanent GP partners (two male and one female). The practice also employed an advance nurse practitioner (1 whole time equivalent (WTE)), a practice manager (1 WTE), four part-time practice nurses, including an enhanced practice nurse (1.5 WTE), two healthcare assistants (0.8 WTE), a reception manager, four receptionists and a bank worker (3.2 WTE) and six administrative staff and a bank worker (2.5 WTE).

The practice is a training practice allowing for the attachment of F2 (foundation year 2) and ST3 (speciality trainee year 3) doctors to the practice. The practice also has student nurses, and medical students who come to the practice from time to time as part of their training.

The practice is open between 8am to 6.30pm Monday to Friday. Morning appointments are from 8am to 1pm Monday, Wednesday and Thursday and 8am to 12 noon Tuesday and Friday; and afternoon appointments from 2.30pm to 6.30pm Monday, and 2.30pm to 6pm Tuesday to Friday. Extended hours appointments are offered from 6.30pm to 8pm every Wednesday. In addition to pre-bookable appointments that can be booked in advance, urgent appointments are also available for people that need them. Pre-bookable telephone consultations with a GP are offered by contacting reception to arrange this.

There are also arrangements to ensure patients receive urgent medical assistance when the practice was closed. Out of hours services are provided by a local walk in and urgent care centres. Patients are provided with details of the address, opening times and numbers to call.

The practice is registered to carry on the following regulated activities:

Diagnostic and screening procedures

Family planning

Maternity and midwifery services

Surgical procedures

Treatment of disease, disorder or injury

Overall inspection

Good

Updated 29 November 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St Peter’s Medical Centre on 17 August 2016. The overall rating for the practice was good. The full comprehensive report on the August 2016 inspection can be found by selecting the ‘all reports’ link for St Peter’s Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 12 October 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 17 August 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

At the inspection on 17 August 2016, the practice was rated overall as ‘good’. However, within the key question safe, areas were identified as ‘requires improvement’, as the practice was not meeting the legislation around ensuring adequate arrangements were in place to ensure care and treatment to patients was provided in a safe way in relation to the provision of medical equipment. The practice was issued a requirement notice under Regulation 12, Safe care and treatment.

Other areas identified where the practice was advised they should make improvements within the key question of safe included:

Complete and record a risk assessment of the practice’s decision not to stock medicine excluded from the emergency medicines kit.
Review staff records to confirm pre-employment reference checks are documented for all staff.
Secure with the landlord of the premises, the implementation of action arising from the latest fire risk assessment.

At our October 2017 inspection we reviewed the practice’s action plan submitted in response to our previous inspection and a range of supporting documents which demonstrated they are now meeting the requirements of Regulation 12, Safe care and treatment, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The practice also demonstrated improvement in the other areas identified in the report from August 2016 which did not affect ratings. These improvements have been documented in the safe section, showing how the registered person has demonstrated continuous improvement since the full inspection.

Areas identified at the August 2016 inspection where the practice was advised they should make improvements within another key question of caring included:

Consider making information on display at the practice more visible to patients.
Review the arrangements for the storage of patient records to mitigate potential security risks.

At our October 2017 inspection we found significant improvements in the display and content of information to patients. Patient information leaflets, the practice leaflet and patient booklet had been updated and were available within the patient waiting room; the layout of the patient information board had been improved; the patient information screen had been updated and the practice manager trained in its use; and the practice website had been updated and its content managed at practice level to ensure information is kept accurate and current. We saw the minutes from the July 2017 PPG meeting, where members commented positively regarding changes.

The practice had also improved the security of patient records previously kept in unlocked cabinets and boxes. All such records, including confidential waste, were now stored in lockable cabinets or boxes and secure key management arrangements were in place.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice