Archived: Latymer Road Surgery

Updated 11 January 2019

Latymer Road Surgery is located in the London Borough of Enfield. The location address is:

2a Latymer Road

Edmonton

N9 9PU

The practice is part of the NHS Enfield Clinical Commissioning Group (CCG) which is made up of 50 practices. It currently holds a General Medical Services (GMS) contract to provide services to 4964 patients. This is a locally agreed alternative to the standard General Medical Service (GMS) contract used when services are agreed locally with a practice which may include additional services beyond the standard contract.

The practice serves a diverse population with many patients attending where English is not their first language. The practice has a mixed patient population age demographic with 37.8% under the age of 18 and 21.4% over the age of 65.

The practice operates from a purpose-built building. Consulting rooms are situated on the ground level with administrative offices on the upper floor.

There is currently one male GP partner and a second partner who is the practice manager. In addition to the clinical partner there are two salaried GPs and a long term locum. the practice offers a total of 22 clinical sessions per week. Practice staff also consists of a practice nurse (who works 24 hours a week), and an administrative team.

The practice is open between 8am and 6.30pm each week day except Thursday when the practice is open between 8am and 1pm. Appointments are from 8.30am to 12.30pm every morning and then each afternoon, except Thursday between 3pm and 6.30pm. The practice does not offer an extended hours surgery. Pre-bookable appointments can be booked up to eight weeks in advance; urgent appointments are also available for people that need them. Patients can book appointments on-line. The practice has opted out of providing an out of hour’s service and refers patients to the local out of hours provider.

The practice provides a range of services including child health and immunisation, minor illness clinic, smoking cessation clinics and clinics for patients with long term conditions. The practice also provides health advice and blood pressure monitoring.

The practice is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, family planning, maternity and midwifery services and the treatment of disease, disorder or injury.

The practice was inspected in November 2015 and rated good overall but requires improvement for providing a safe service, due to no log of emergency medicines being held. A follow up inspection in November 2016 rated the practice good for the key question of safe and overall.

A further inspection was undertaken in January 2018. The practice was rated requires improvement for providing a safe and well led service and good for providing an effective, caring and responsive service. The practice was rated requires improvement overall. The practice also received two requirement notices for Regulation 12 (safe care and treatment) and 17 (good governance) HSCA (RA) Regulations 2014. We found there had been a breakdown in the relationship between partners that had impacted on patient care. There were no clear systems for following up on referral letters and no formal policy or procedure for monitoring patients on high risk medicines. The systems around incidents and complaints needed review and the practice did not hold any minutes of team meetings or take part in multi-disciplinary team meetings.

Since the last inspection, a new clinical team has been put in place and the issues found in January 2018 have been addressed through the implementation of new clinical systems to improve governance and help improve patient outcomes.

Updated 11 January 2019

This practice is rated as good overall. (Previous rating 01 2018 – Requires improvement)

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

We carried out an announced comprehensive inspection at Latymer Road Surgery on 7 November 2018 to follow up breaches of regulation.

At our inspection on 16 January 2018 following concerns raised with the CQC, we rated the practice as requires improvement for providing a safe and well led service and good for providing an effective, caring and responsive service. The practice was rated requires improvement overall. The practice was found in breach of regulations 17 and 12 of the HSCA (RA) Regulations 2014 (good governance and safe care and treatment) as staff were unclear of policies and procedures, there was no clear system for following up on patient referral letters and no policy for monitoring patients on high risk medicines. The practice also did not participate in multidisciplinary team meetings and minutes of practice meetings were not kept. Incidents were not recorded and there was no clear system for checking pathology results. Procedures for follow up on repeat prescribing were also not sufficiently robust.

At this inspection we found a new clinical team had been in place since May 2018 and had implemented new systems to address the concerns of the previous inspection. At this inspection we found

• The clinical outcomes were still below local and national averages; however, the new clinical team were working towards improving these.
• The practice had systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported they could access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Continue to look at ways to improve patient outcomes through the QOF programme.
• Continue to look at ways to improve patient’s outcomes from childhood immunisations and the cervical screening programme.
• Ensure the current fire risk assessment is updated;
• Look at ways to further identify and respond to carers;
• Undertake its own patient survey to gauge current patient satisfaction;
• Update the practice major incident policy;
• Continue to develop clinical audit cycles.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Updated 11 January 2019

Updated 11 January 2019

Updated 11 January 2019

Updated 11 January 2019

Updated 11 January 2019

Updated 11 January 2019