Background to this inspection
Updated
11 February 2020
Roxbourne Medical Centre is a GP practice located in South Harrow and is part of the Harrow Clinical Commissioning Group (CCG). The practice is located in purpose-built premises. A number of community health services are offered at the premises by the different providers. The practice is fully accessible and has disabled parking spaces and entrance at the rear of the building.
The practice is part of the Healthsense Primary Care Network (PCN) since July 2019.
The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services, family planning, surgical procedures and treatment of disease, disorder or injury. However, on the day of the inspection, we noted the practice’s CQC registration was non-compliance because only one of the two partners (in accordance with the provider’s CQC registration) was managing the practice as a principal GP. The practice informed us they had this arrangement in place since April 2019. After the inspection, the practice acted immediately and submitted relevant application forms to the Care Quality Commission to resolve the registration issues.
The practice provides services to 7,400 patients under the terms of a General Medical Services (GMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.
There is a principal GP, supported by two salaried GPs and a long term locum GP at the practice. Three GPs are male and one is female, who work a total of 20 GP clinical sessions per week on average. The practice employs an enhanced practice nurse (EPN), a practice nurse, a health care assistant, two phlebotomists and four community phlebotomists. The practice manager is supported by the operations manager, reception manager and a team of the administrative and reception staff.
This is a teaching practice, where they teach medical students and physician associate students. Students have access to a senior GP throughout the day for support.
The practice is approved as a GP training practice on 13 November 2019 and a GP registrar is expected to join the practice from February 2020.
The practice is registered as a yellow fever vaccination centre and it also offers travel vaccination.
Out of hours (OOH) service is provided by Care UK.
The practice population of patients aged between 5 to 14 and under 18 years old is higher than the national average and there is a lower number of patients aged above 65 years old compared to the national average.
Ethnicity based on demographics collected in the 2011 census shows the patient population is ethnically diverse and 63% of the population is composed of patients with an Asian, Black, mixed or other non-white backgrounds.
Information published by Public Health England, rates the level of deprivation within the practice population group as six, on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. Male life expectancy is 81 years compared to the national average of 79 years. Female life expectancy is 86 years compared to the national average of 83 years.
Updated
11 February 2020
We carried out an announced comprehensive inspection at Roxbourne Medical Centre on 4 December 2019 as part of our inspection programme.
At this inspection, we followed up on breaches of regulations identified at a previous inspection on 21 November 2018. We rated the practice as requires improvement overall in November 2018. Previous reports on this practice can be found on our website at: https://www.cqc.org.uk/location/1-545557983.
At this inspection, we found that the practice had demonstrated improvements.
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 and
- information from the provider, patients, the public and other organisations.
We have rated this practice as good overall and good overall for all population groups, with the exception of
working age people (including those recently retired and students) which is rated as requires improvement.
We rated the practice as good for providing safe, effective, caring, responsive and well-led services because:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided.
- Staff had received required training relevant to their role.
- Feedback from most patients reflected that they were not always able to access care and treatment in a timely way.
- The practice was encouraging patients to register for online services and 57% of patients were registered to use online Patient Access.
- Information about services and how to complain was available.
- The practice’s uptake of the national screening programme for cervical and bowel cancer screening and childhood immunisations rates were below the national averages.
- The patient participation group (PPG) become less active recently due to low attendance in the recent two PPG meetings.
- The practice was aware of and complied with the requirements of the Duty of Candour.
- There was a clear leadership structure and staff felt supported by the management.
- The practice’s Care Quality Commission registration was non-compliance since April 2019 and they submitted relevant application forms immediately after this inspection to resolve the registration issues.
We rated all population groups as good for providing responsive services. We rated all population groups as good for providing effective services, with the exception of working age people (including those recently retired and students) which is rated as requires improvement, because of low cervical cancer screening rates.
Whilst we found no breaches of regulations, the provider should:
- Continue to encourage and monitor the childhood immunisation, cervical and bowel cancer screening uptake.
- Review patients’ feedback regarding access to the service.
- Review the governance arrangements to ensure effective monitoring of blank prescription forms in line with national guidance.
- Review staff and patients’ feedback regarding the staffing levels at the practice.
- Continue to take necessary action to resolve the CQC registration issues.
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