We carried out an announced comprehensive inspection at Belsize Priory Medical Practice on 30 January 2019 as part of our inspection programme.

The practice was previously inspected in December 2017 and rated as good overall.

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 and
• information from the provider, patients, the public and other organisations.

We rated this practice as good overall but requires improvement for providing responsive services. We rated the practice requires improvement for responsive because:

• Patient satisfaction with telephone access and making and accessing appointments was consistently lower than average compared to other GP practices. Although the practice had introduced improvements, the practice had not yet assessed the effectiveness of actions taken and could not demonstrate changes made had been fully embedded and were sustainable.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• 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.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

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

• Continue to improve the uptake for childhood immunisations to achieve the national target of 90% or above in all four indicators.
• Continue with efforts to recruit a qualified sample taker to improve cervical screening rates and to improve the uptake for cervical screening to achieve the national target of 80%.
• Follow through with plans to assess the impact of changes made to services and continue to consider where further improvements could be made with a view to improving patient satisfaction levels.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Letter from the Chief Inspector of General Practice

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

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

We carried out an announced comprehensive focused inspection at Belsize Priory Medical Practice on 4 December 2017. This inspection was carried out as part of our inspection programme. There was a new provider, Dr Nabila Muslem Abdulsahib Hanosh, who took over the running of the practice in 2016. This was the first, comprehensive inspection for the new provider.

At this inspection we found:

• The practice had clear 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 provider was aware of, and complied with, the requirements of the duty of candour.

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided.

• Care and treatment was delivered according to evidence- based guidelines.

• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.

• The leadership team were committed to service development and were working to improve the quality of the service.

• The practice proactively sought, and acted on, feedback from staff and patients.

However,

• Patients found that there were long waiting times for appointments.

• The GP Patient survey suggests had not always involved patients in their care.

• The practice had good facilities; however the lift to the first floor remains out of use.

• Staff had relevant training for the role, but the practice had not always identified and monitored where staff may need additional training, such as in the requirements of the Mental Capacity Act (2005) or in fire safety.

The areas where the provider should make improvements are:

• Implement strategies to improve cervical screening uptake among women attending the practice.

• Staff should take action to involve patients in their care and consistently treat patients with kindness and respect.

• Continue to review patient feedback and take action to improve in areas where patients indicate that they are not satisfied with the service provided.

• Take action to satisfy themselves the premises and equipment used by the service are properly maintained.

• Review actions already taken to improve waiting times to assess the impact of these, and the sustainability of any reductions in waiting times.

• Review protocols for risk assessing staff that do not require a Disclosure and Barring Service (DBS) check to carry out their role.

• Assess staff training requirements in relation to fire safety and the requirements of the Mental Capacity Act (2005).

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice