Green Cedars Medical Services Also known as Green Cedars Medical Centre

Updated 31 August 2017

The Green Cedar Medical Centre practice is located in Edmonton, North London within the NHS Enfield Clinical Commissioning Group. The practice holds a General Medical Services contract (an agreement between NHS England and general practices for delivering primary care services to local communities). The practice provides a full range of enhanced services including childhood vaccination and immunisation, improving patient online access, influenza and pneumococcal, minor surgery, risk profiling and case management, and rotavirus and shingles immunisation.

The practice population is in the second most deprived decile in England. The practice population has a greater than average percentage of working age people between the ages of 25-39 years, with a lower than average population of people aged 60 years or older. The practice had surveyed the ethnicity of the practice population and had determined that 5% of patients identified themselves as having Black British ethnicity, 5% White British, 4% Other British, 18% Turkish, 30% Other White, 14% African, 5% Other Black and 19% as having mixed or other ethnicity.

The practice is registered with the Care Quality Commission to carry on the regulated activities of family planning, surgical procedures, treatment of disease, disorder or injury, and maternity and midwifery services, diagnostic and screening procedures. The practice had a patient list size of 6,369 at the time of our inspection. The staff team at the practice included one Principal GP (male), one salaried GP (female) and two regular locum GPs (one female, one male) one practice nurse (female), one healthcare assistant (female) and one practice manager. The practice had five administrative staff and one security guard. There were 19 GP sessions and five nurse sessions available per week.

The practices opening hours are Monday to Friday from 9.00am to 6.00pm (with the exception of first Thursday of each month when the practice closes at 1.00pm for staff training). Outside of these times patients are seen by a local out of hours provider.

Appointments with GPs are available at the following times:

• Monday to Friday from 9.00am to 1.00pm and 3.00pm to 6.00pm (with the exception of the first Thursday of each month when appointments are available from 9.00am to 1.00pm)

The practice telephone lines are open:

• Monday to Friday from 8.30am to 1.00pm and 2.00pm to 6.30pm

To assist patients in accessing the service there is an online booking system, and a text message reminder service for scheduled appointments. Urgent appointments are available daily and GPs also complete telephone consultations for patients.

Updated 31 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Green Cedars Medical Services on 16 August 2016. The overall rating for the practice was good, however the effective domain was rated as requires improvement. The full comprehensive report on the August 2016 inspection can be found by selecting the ‘all reports’ link for Green Cedars Medical Services on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 3 August, 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulation that we identified in our previous inspection on 16 August, 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice rating remains as good, the practice is now rated good for providing effective services.

Our key findings were as follows:

• Exception reporting rates had decreased significantly since the inspection on 16 August 2016.Exception reporting is the removal of patients from quality and outcomes framework (QOF) calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects.

• Clinical audits were used to drive improvement in patient outcomes.

• All staff at the practice completed fire safety training.

• All screens used in clinical rooms were visibly clean and were included on the daily cleaning schedule.

• Prescription pads were kept in a secure area and all serial numbers were recorded on a log maintained by the practice manager.

• Comprehensive infection control audits were completed two to three times per year.

• Carers were identified through new patient registration forms, posters in reception and clinical consultations. The number of carers identified was less than one percent of patients registered at the practice. The practice told us this was in relation to their young patient population. For example, the number of patients at the practice aged 60 years or older is significantly lower than the national average.

At our previous inspection on 16 August 2016, we rated the practice as requires improvement for providing effective services as exception reporting was much higher than local and national averages. At this inspection we found that the exception reporting rate had decreased significantly. The practice is now rated as good for providing effective services.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 31 August 2017

The practice is rated as good for the care of people with long term conditions. As the practice was found to be providing good services overall, this did not affect the rating for the population groups we inspect against.

Updated 31 August 2017

The practice is rated as good for the care of families, children and young people. As the practice was found to be providing good services overall, this did not affect the rating for the population groups we inspect against.

Updated 31 August 2017

The practice is rated as good for the care of older people. As the practice was found to be providing good services overall, this did not affect the rating for the population groups we inspect against.

Updated 31 August 2017

The practice is rated as good for the care of working age people (including those recently retired and students). As the practice was found to be providing good services overall, this did not affect the rating for the population groups we inspect against.

Updated 31 August 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). As the practice was found to be providing good services overall, this did not affect the rating for the population groups we inspect against.

Updated 31 August 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable. As the practice was found to be providing good services overall, this did not affect the rating for the population groups we inspect against.