Roxbourne Medical Centre

Updated 31 October 2023

Roxbourne Medical Centre is located in Harrow at:

37 Rayners Lane

Harrow

HA2 0UE

The practice is part of the North West London Integrated Care Board and is a member of the Healthsense Primary Care Network (PCN). The practice is located in purpose-built premises. A number of community health services are offered at the premises by different providers. The practice is fully accessible and has disabled parking spaces and an accessible entrance at the rear of the building.

The practice provides services to approximately 7300 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.

The team comprises a lead GP supported by 3 salaried GPs and GP locums. The practice employs a practice nurse, a health care assistant, a clinical pharmacist and two phlebotomists, as well as a paramedic and a physician associate. The practice manager is supported by the operations manager, reception manager and a team of the administrative and reception staff.

Roxbourne Medical Centre is a teaching practice, responsible for teaching medical students and physician associate students on temporary placements. The practice is approved as a GP training practice and at the time of the inspection was supporting 2 GP trainees.

The local population experiences levels of income deprivation in line with the national average with higher life expectancy. The age profile of the population is also similar to the England average. The population is ethnically diverse. The practice population experiences a relatively high prevalence of diabetes mellitus, mental illness and asthma.

The practice 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.

Updated 31 October 2023

We carried out an announced focused inspection at Roxbourne Medical Centre from 3-5 May 2023. Overall, the practice is rated as good.

Safe - good

Effective - good

Caring - good

Responsive – requires improvement

Well-led - good

Following our previous rated inspection in April 2022, the practice was rated requires improvement overall. It was rated inadequate for providing safe services and requires improvement for providing effective and well-led services. The practice was rated good for providing caring and responsive services at an earlier inspection in December 2019.

At the inspection in April 2022, we found that the practice was not addressing risks in the following areas: prescribing of medicines that require monitoring; medicines usage for asthma; potential missed diagnoses of diabetes; its implementation of selected national patient safety alerts; and its management of diabetes and hypothyroidism. We also found that the practice was not always managing clinical documents including letters, test results and referrals on the electronic system in a timely way.

We carried out an unrated follow-up inspection in October 2022 and found that the practice had improved and was meeting the required standards at that time.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Roxbourne Medical Centre on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection to follow-up on previous breaches of regulations and to assess whether improvements noted at the focused follow-up visit in October 2022 had been sustained. We carried out a comprehensive inspection covering all key questions.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• 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.
• Information from the provider, patients, the public and other organisations.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm. The practice had sustained the improvements to safety noted at our previous follow-up inspection.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• Patients could access care and treatment in a timely way. However, improvements to the appointment system were not yet reflected in patient feedback and the practice’s National GP Patient Survey results were below average.
• The way the practice was led and managed promoted the delivery of high-quality, person-centred care.

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

• Take action to improve the documentation of medicines reviews so these more consistently include all required information.
• Follow up patients who have been prescribed oral steroids for an acute exacerbation of asthma in line with current clinical guidelines.
• Take action to increase the participation of eligible patients in cancer screening programmes and increase uptake of childhood immunisations.
• Evaluate patient experience of the appointment system including the experience of patients without online access to identify any areas for improvement.
• Engage with the patient participation group and include them in planning future meetings and group activity.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care