The Surgery - Dr Mangwana and Partners Also known as Palace Surgery

Updated 29 March 2022

The Surgery - Dr Mangwana and Partners, known locally as Palace Surgery, is located at 510 Fulham Palace Road, London, SW6 6JD.

The practice has around 5300 registered patients. It is part of a local network of practices, known as the South Fulham Primary Care Network, and falls within the North West London Clinical Commissioning Group area and the London borough of Hammersmith and Fulham.

The practice is situated in a converted older building which is managed by NHS Property Services. The clinical and public areas are located over the ground and first floors and are accessible to people with disabilities.

The practice is run by a GP partnership of two GPs, one of whom has recently joined the partnership. The provider employs one salaried GP and part-time sessional locum GPs; a part-time practice nurse; a practice manager; a healthcare assistant and a team of administrators and receptionists. One of the reception team is a trained smoking cessation advisor. Patients have the choice of a male or female GP.

The practice is open weekdays from 8am to 6.30pm with extended hours appointments available in the early evening between 6.30pm and 7pm on Monday, Tuesday, Wednesday and Friday. Due to the enhanced infection prevention and control measures put in place since the COVID-19 pandemic and in line with national guidance, a proportion of GP appointments are currently provided as telephone consultations. Patients are offered face-to-face appointments if this is clinically appropriate.

Extended access is provided locally by the primary care network, with evening and weekend appointments are available. Out of hours services are provided by 111 and London Central and West. Information about how to access out of hours services is provided on the practice website and via a recorded telephone message when the practice is closed.

The local population is relatively affluent as measured by socio-economic indicators of income deprivation, life expectancy and rates of employment. The population is relatively young and the prevalence of long-term health conditions in the population is lower than average with the exception of rates of mental illness.

The practice is registered with the Care Quality Commission to carry out the following regulated activities:

• diagnostic and screening procedures
• treatment of disease, disorder or injury, and
• maternity and midwifery services.

Updated 29 March 2022

We carried out an announced inspection at Palace Surgery from 9 March to 11 March 2022. Overall, the practice is rated as good.

Safe - Good

Effective - Good

Well-led - Good

The ratings for the caring and responsive key questions are carried forward from the previous inspection which was carried out on 18 December 2020.

At our previous inspection, the practice was rated requires improvement overall and for the key questions of safe, effective and well-led. It was rated as good for the key questions of caring and responsive.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for: The Surgery – Dr Mangwana and Partners, on our website at www.cqc.org.uk

Why we carried out this inspection

This inspection was a focused inspection to follow up on:

• The safe, effective and well-led key questions
• A breach of regulations (Regulation 9: Person-centred care)
• Areas identified for improvement at the previous inspection

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

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:

• Completing clinical searches on the practice’s patient records system and discussing findings with the provider
• Reviewing patient records to identify issues and clarify actions taken by the provider
• Requesting evidence from the provider
• Conducting staff interviews using video conferencing
• A short site visit

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

We have rated this practice as good overall.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
• The practice had sustained the improvements noted at the previous inspection.

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

• Continue work to improve cervical screening coverage particularly among the younger age cohort.
• Ensure that DNACPR forms can be accessed in the patient electronic medical records.

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