Archived: The Randolph Surgery

Updated 22 August 2018

• The Randolph Surgery is a GP practice located in the London Borough of Westminster and is part of the NHS Central London Clinical Commissioning Group (CCG).
• Services are provided from: The Randolph Surgery, 235a Elgin Avenue, Maida Vale, London, W9 1NH.
• Online services can be accessed from the practice website: www.randolphsurgery.org
• Out of hours (OOH) service is provided by the Care UK.
• There are two GP partners but they do not offer any GP sessions at the practice. There are three salaried GPs and three locum GPs. Five GPs are female and one male, who work a total of 27 to 28 sessions per week. The practice employs two practice nurses and two health care assistants (HCAs). The service manager is supported by an assistant service manager, a head of reception and a team of administrative and reception staff.
• The partnership has a contractual relationship with Virgin Care Services Limited to provide back office functions.
• The practice provides primary medical services through a Primary Medical Services (PMS) contract to approximately 8,200 patients in the local area (PMS is one of the three contracting routes that have been made available to enable commissioning of primary medical services).
• The practice population of patients aged over 65 years old is lower than the national average.
• Ethnicity based on demographics collected in the 2011 census shows the patient population is ethnically diverse and 36% of the population is composed of patients with an Asian, Black, mixed or other non-white background.
• The service is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, treatment of disease, disorder or injury, family planning and maternity and midwifery services.

Updated 22 August 2018

This practice is rated as requires improvement overall.

(At the previous inspection in December 2014 the practice was rated as good overall).

The key questions are rated as:

Are services safe? - Good

Are services effective? - Requires improvement

Are services caring? - Requires improvement

Are services responsive? - Requires improvement

Are services well-led? - Requires improvement

We carried out an announced comprehensive inspection at The Randolph Surgery on 12 July 2018. We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether The Randolph Surgery was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

At this inspection we found:

• There was a lack of local clinical leadership and governance.
• Risks to patients were assessed and well managed in some areas, with the exception of those relating to calibration of medical equipment, childhood immunisations and management of blank prescription forms.
• There was limited evidence of quality improvement activity in some areas to review the effectiveness and appropriateness of the care provided.
• According to unverified and unpublished data there was a significant reduction in the Quality Outcomes Framework (QOF) results for the year 2017/18 compared to the previously published QOF results for 2016/17.
• The practice’s uptake of the national screening programme for breast cancer screening and childhood immunisations rates were below the national averages.
• There were ineffective arrangements in place for planning and monitoring the number of staff needed to meet patients’ needs.
• Patients feedback highlighted concerns about the appointment booking system, availability of appointments with the GPs and the continuity of care.
• Feedback suggested that patients felt they were not always involved in making decisions about their care and treatment and they did not have sufficient time during consultations to make an informed decision about the choice of treatment available to them.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Staff had received up to date training relevant to their role. Staff appraisals had been completed in a timely manner.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Information about services and how to complain were available and easy to understand.
• The practice was aware of and complied with the requirements of the Duty of Candour.
• Staff we spoke with informed us the management was approachable but they reported lack of responsiveness and support from the head office, and they did not have confidence that their concerns would be addressed in a timely manner.

The areas where the provider must make improvements are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

• Review the system in place to improve the management of blank prescription forms, to ensure this is in accordance with national guidance.
• Review and improve the systems in place to effectively monitor care plans and health checks for patients with learning disabilities and patients experiencing poor mental health.
• Review the system in place to promote the benefits of childhood immunisation and breast cancer screening in order to increase patient uptake.
• Ensure information about a translation service is displayed in the reception area informing patients this service is available. Ensure information posters and leaflets are available in multiple languages.
• Ensure written information is available for carers to enable them to access the support available via the external agencies.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Updated 22 August 2018

Updated 22 August 2018

Updated 22 August 2018

Updated 22 August 2018

Updated 22 August 2018

Updated 22 August 2018