St Philips Medical Centre was registered with the Care Quality Commission as a new partnership on 10 November 2017. The partnership was formed as part of an improvement plan to address concerns of continuing non-compliance with regulations identified at CQC inspections of the St Philips Medical Centre location when it was registered under a previous provider, Dr Rajan Olof Magnus Naidoo. The new partnership was formed by the addition of two new GP partners to the practice from a neighbouring practice, Holborn Medical Centre, to join Dr Naidoo, as a third partner. Although the new partnership was registered in November 2017, the new partners have been carrying on regulated activities at St Philips Medical Centre since July 2017 in the implementation of the improvement plan.

The full comprehensive reports on inspections of the practice under the previous provider in November 2015, August 2016 and April 2017 can be found by selecting the ‘all reports’ link under the archived section for St Philips Medical Centre on our website at www.cqc.org.uk.

This inspection, carried out on 23 November 2017, was an announced comprehensive inspection to review in detail the actions taken by the new partnership practice since our April 2017 inspection of the previous provider to improve the quality of care and to confirm that the provider was now meeting legal requirements.

Overall the practice is rated as good.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) – Good

Our key findings were as follows:

• The new partnership had made significant progress in implementing an improvement plan in response to our inspection of the practice under the previous provider on 20 April 2017. Concerns we identified had been or were in the process of being addressed.
• There was an open and transparent approach to safety and a system in place for reporting and recording significant events. Lessons learned were communicated effectively throughout the practice.
• There were systems, processes and practices to keep patients safe and minimise the risk of harm.
• Action had been taken to improve recruitment processes, especially in relation to pre-employment checks.
• Staff had the skills, knowledge and experience to carry out their roles.
• The practice could demonstrate that it used information about its performance to monitor and improve the quality of care. For example, the practice now fully participated in the Quality and Outcomes Framework (QOF) but recognised there was further work to be done to achieve its aim of high scores in all QOF indicators.
• There was evidence of a regular multidisciplinary approach to patient care and treatment.
• The practice carried out clinical audit and there was evidence of completion of the full audit cycle to show improved patient outcomes.
• The practice promoted good health and prevention and provided patients with advice and guidance. The practice had initiated care plans for older people (aged 75+) and at risk groups such as those with chronic mental health issues.
• Patients were positive about their interactions with staff and said they were treated with compassion, dignity and respect.
• An independent survey commissioned by the practice identified the need for action to improve patient confidence in clinical staff and an action plan was in place for this.
• The practice had an effective system for proactively identifying patients who were carers to offer them additional support.
• There was an effective complaints system in place and there was documentary evidence that learning from complaints had been shared with staff.
• Leaders had the capacity and skills and a clear vision and credible strategy to deliver high-quality, sustainable care and promote good outcomes for patients.
• Structures, processes and systems to support good governance and management were clearly set out, understood and effective.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• Continue action to improve QOF performance in all areas.
• Monitor and review action taken to improve patient screening under NHS Health checks.
• Keep under review action to address lower than average results from independent patient surveys.
• Continue to review the system for the identification of carers to ensure all carers have been identified and provided with support.
• Continue action to improve uptake of childhood immunisations and cervical screening.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice