Honeypot Medical Centre

Updated 14 February 2018

The Honeypot Medical Centre operates from 404 Honeypot Lane, Stanmore, HA7 1JP. The practice provides NHS services through a Primary Medical Services (PMS) contract to approximately 12,000 patients. It is contracted to NHS Harrow Clinical Commissioning Group (CCG). In April 2015, the practice merged with and took over care of the patients at Charlton Medical Centre; patients are seen across both sites which are situated a few hundred yards apart. The practice premises are two converted semi-detached houses with rear and side extensions. Honeypot Medical Centre has secured funding through the Primary Care Infrastructure Fund (PCIF) for building expansion work to accommodate all patient services at the practice location. The practice is situated on a main road which allows parking, but there is also a car park which is available at the rear of the practice. There is easy access to public transport.

The practice’s clinical staff comprises of two GP partners, one female and one male GP, together with five salaried GPs and one GP registrar (female), providing a total of 47 sessions per week. Also employed are three independent prescribing pharmacists, a practice nurse, an independent prescriber nurse, a healthcare assistant and an enhanced nurse. The practice’s administrative team is made up of a business/practice manager, an assistant practice manager, a reception manager and a finance/accounts support. Also employed are six receptionists and eleven administrators. Honeypot Medical Centre is an accredited training practice for GP trainees and GP registrars.

The practice’s opening times are between 8am and 6.30pm on Monday to Friday. Extended hours are between 8.00 and10.00am or 9.00am and 11.00am on Saturday mornings. Additional extended hours are on Monday and Friday weekday evenings between 6.30pm and 7.30pm and on Tuesday, Wednesday and Thursday between 6.30pm and 7.00pm. The practice have delegated out of hours care to an out of hours provider, three local GP access clinics which have walk in appointments with a GP seven days a week from 8am to 8pm. Patients calling the practice when it is closed are connected with the local out-of-hours service provider. Information is provided on the practice website regarding the NHS 111 service.

The patient profile for the practice indicates a higher than average population of elderly people and the practice told us that there is a higher percentage of the practice population of Asian origin, compared to the local area.

Honeypot Medical Centre was inspected under our methodology on 23 December 2015 and they were rated Good overall, meeting all the standards inspected. Regulated activities the practice is registered for include surgical procedures; treatment of disease, disorder or injury; diagnostic and screening procedures and maternity and midwifery services. The branch location, Charlton Medical Centre at 223 Charlton Road, London, HA3 9HT, was not visited as part of this inspection.

Updated 14 February 2018

Letter from the Chief Inspector of General Practice

We carried out an unannounced focused inspection at Honeypot Medical Centre on 17 October 2017 in response to concerns raised directly with CQC. This related to safety systems and processes, co-ordinating patient care, access to appointments, responding to complaints and governance of the practice. This report covers our findings in relation to the inspection on 17 October 2017. As a result of this inspection, the provider’s rating remains unchanged and stays Good overall.

Our key findings were as follows:

• The practice had experienced a period of change in the last 12 months following a recent merger.
• The practice had adequate infection control procedures in place and clearly defined and embedded systems to minimise risks to patient safety.
• There were adequate recruitment arrangements in place which included the necessary checks for all staff.
• There were arrangements for planning and monitoring the number of staff and mix of staff needed to meet patients’ needs.
• Clinical audits were carried out and patients’ needs were assessed; care was planned and delivered following best practice guidance.
• Staff were aware of and provided patients’ care and treatment in line with current evidence based guidelines. They had also been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• The practice had a system in place to ensure that paper records were stored safely and securely.
• Staff demonstrated an understanding of the importance of patient confidentiality. They treated patients with dignity and respect and took care to protect their privacy and personal information at the reception desk and in the treatment rooms.
• Patients described staff as friendly, caring and helpful and specifically commented on how the practice had improved in the last six months since.
• We found that the practice had taken positive steps to improve access to appointments and patients and staff told us access to appointments had improved.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

However, there were areas of practice where the provider should make improvements.

The provider should:

• Continue to monitor and improve patient access to the service.

• Continue to review the national GP patient survey scores with the aim of improving patient satisfaction scores on GP and nurse consultations.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 8 June 2016

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

• Nursing staff and the practice pharmacist had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators was 85.1%, being 1.6% below the CCG average and 4.1% below the national average.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and the medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 8 June 2016

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

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice’s uptake for the cervical screening programme was 62%, which was comparable to the CCG average of 66% and below the national average of 74%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives and health visitors. Monthly meetings were held with the health visitor.

Updated 8 June 2016

The practice is rated as good for the care of older people.

• The practice was the pilot site for a new service that was introduced in 2015 a virtual ward. This service offered care for patients at risk of admission to hospital and in need of intensive monitoring. Patients at risk could be referred into the virtual ward; a multi-disciplinary team of specialist health and social care professionals visited, reviewed and supported patients and the GP to manage episodes of care until patients were more stable.

• Advice or recommendations for treatment by another professional was always reconfirmed and re-explained to the patient before being instigated.

• The practice worked and communicated well with local nursing homes. GPs provided regular visits and conducted ward rounds with the nursing home staff.

• The practice used mobile technology, a system that allowed them to access up to date clinical information about patients during home visits. Patient’s clinical records were updated in real-time.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 8 June 2016

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

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

• Telephone appointments were offered daily.

Updated 8 June 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

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  Performance for mental health related indicators was 94.1%, which is comparable to the national average.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 8 June 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.

The practice used a ‘carer’s passport’ that ensured carers had access in a timely manner when they needed to be seen.