The Care Quality Commission
  • Doctor
  • GP practice

The Health Centre Also known as Runnymede Medical Practice

Overall: Good read more about inspection ratings

Bond Street, Englefield Green, Egham, Surrey, TW20 0PF (01784) 437671

Provided and run by:
Runnymede Medical Practice

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about The Health Centre on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about The Health Centre, you can give feedback on this service.

25 March 2020

During an annual regulatory review

We reviewed the information available to us about The Health Centre on 25 March 2020. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

11 April 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Health Centre (Runnymede Medical Practice) on 11 April 2017. We carried out this inspection to check that the practice was meeting the regulations and to consider whether sufficient improvements had been made.

Our previous announced comprehensive inspection in August 2016 found breaches of regulations relating to the safe, effective, caring and well-led delivery of services. Specifically, the practice was rated inadequate for safe and well-led domains, requires improvement in effective and caring domains and good in responsive. The overall rating of the practice in August 2016 was inadequate and the practice was placed into special measures for six months. Following the inspection, we received an action plan which set out what actions were to be taken to achieve compliance.

At the inspection in April 2017, we found the practice had made significant improvements. Specifically, we found the practice good for the provision of safe, effective, caring, responsive and well-led services. Overall, the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • The practice had strong and visible clinical and managerial leadership and governance arrangements and they demonstrated significant improvements since the previous inspection.
  • The practice had a clear vision which had quality and safety as its top priority.
  • The practice had implemented effective monitoring system and all the areas of concerns from the previous inspection had been resolved.
  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
  • Risks to patients were assessed and well-managed.
  • The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. There was a clear leadership structure. The practice had provided effective leadership and support to the nursing team.
  • We found that completed clinical audit cycles were driving positive outcomes for patients.
  • Data showed the practice had demonstrated improvements in patient’s outcomes.
  • The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs.
  • The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group (PPG). For example, the practice had organised health education and awareness workshops in consultation with PPG delivered by practitioners, to support patients self managing their long term conditions.
  • Staff feedback had been considered and the practice had increased staffing levels.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
  • The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
  • The provider was aware of and complied with the requirements of the duty of candour.

We saw areas of outstanding practice including:

  • There was a proactive approach to understanding the needs of different groups of patients and to deliver care in a way that meets these needs. Specifically the practice was able to demonstrate how they promoted quality improvements and how their approach improved patient outcomes for health and well-being. This included patients who were in vulnerable circumstances or who had complex needs. For example,
  • The practice had responded to the needs of a higher than average older patients list size by developing a ‘pro-active care scheme’ during the winter time, which included combination of health and social care support. This scheme had been evaluated and recognised by Health Education England. This scheme had identified more than 2000 patients with frail characteristics and the practice was planning a targeted approach to deliver the services to meet their needs.
  • The practice had secured the funding and launched a project ‘you care, we care’ to identify carers to enable them to access the support available via the practice and external agencies. The practice had taken a number of positive steps and the register of patients who were carers had increased from 76 (0.63%) patients to 299 patients (2.5% of the practice patient population list size).

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

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

3 August 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Health Centre (also known locally as Runnymede Medical Practice) on 3 August 2016. Overall the practice is rated as inadequate.

Specifically, we found concerns and regulatory breaches relating to the management and leadership of the practice and rated the practice inadequate in the safe and well led domains. We found the practice to require improvement for the provision of effective and caring services. It was good for providing responsive service. The concerns which led to these ratings apply to all population groups using the practice.

Our key findings across all the areas we inspected were as follows:

  • On the day of inspection we identified that one staff members professional registration had expired and they had not been registered with an appropriate professional body since January 2016. We also found that the member of staff had continued to perform in their registered capacity until the 3 August 2016.
  • There was a leadership structure and most staff felt supported by management. However, we observed the nursing team lacked effective leadership, monitoring and the management support.
  • There were inconsistent arrangements in how risks were assessed and managed. For example during the inspection we found risks relating to infection control procedures, management of legionella, monitoring of fridge temperature checks and the management of blank prescription forms for use in printers and handwritten pads had not been monitored.
  • Data showed care planning and health checks for patients experiencing poor mental health and childhood immunisation (under five year olds) required a review to improve patient outcomes.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment. However, two clinical staff we spoke with on the day of inspection did not understand the relevant consent and decision-making requirements of legislation and guidance, including the Mental Capacity Act 2005.
  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. The majority of information about safety was recorded, monitored and reviewed.
  • We found that completed clinical audit cycles were driving positive outcomes for patients.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
  • Results from the national GP patient survey showed the majority of patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment when compared to the local and national averages. The majority of patients we spoke with on the day of inspection confirmed this.
  • Information about services and how to complain were available and easy to understand.
  • Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was an anti-coagulation clinic (an anti-coagulant is a medicine that stops blood from clotting) offered onsite, resulting in 112 patients who required this service not having to travel to local hospitals.
  • The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the Duty of Candour.
  • There was a leadership structure and most staff felt supported by management. However, we observed the nursing team lacked effective leadership, monitoring and the management support.

The areas where the provider must make improvements are:

  • Review and improve the systems in place to effectively monitor care plans and health checks for patients experiencing poor mental health, childhood immunisation rates for the vaccines given to under five years old and promote the benefits of smoking cessation and bowel screening in order to increase patient uptake.
  • Ensure all staff understand the relevant consent and decision-making requirements of legislation and guidance, including the Mental Capacity Act 2005.
  • Provide effective leadership, support and monitoring of the nursing team. This includes the checking of appropriate registrations with the Nursing and Midwifery Council (NMC) and consistent record keeping of appraisal documents.
  • Improve the governance arrangements in place to ensure the delivery of safe and effective services. This includes the effective monitoring of infection control procedures, fridge temperature checks, the management of legionella and the handling of blank prescription forms is in accordance with national guidance.

The areas where the provider should make improvements are:

  • Ensure to carry out a formal fire safety risk assessment at the branch practice (Newton Court Medical Centre).
  • Review the process of identifying carers to enable them to access the support available via the practice and external agencies.
  • Review patient feedback and address the concerns raised during the recent national GP patient survey regarding nurses involving patients in decisions, explaining tests and treatments and treating them with care and concern during consultations.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice