On the day of our inspection we spoke with two doctors, three members of staff and five patients. After our inspection, we spoke by telephone with one patient who was a member of the patient participation group (PPG).

All patients we spoke with were satisfied with the surgery. This included the appointment system. When necessary patients were given an appointment for the same day. All patients said they could easily get through to the surgery by telephone. One said: “I never have to wait long if I need an appointment and if I need one the same day, it’s always arranged with no difficulty.”

We saw patients’ views and experiences were taken into account in the way the service was provided and that they were treated with dignity and respect. When patients received care or treatment they were asked for their consent and their wishes were listened to.

The practice is located in a modern building. It is fully accessible for people with disabilities. There are disabled parking spaces close to the building in the car park.

We found the practice to be clean and well organised. Processes were in place to minimise the risk of infection. There were also processes in place for monitoring the quality of service provision. There was an established system for regularly obtaining opinions from patients about the standard of the service they received.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Highgate Medical Centre on 15 February 2017. Overall the practice is rated as good.

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

• There was an effective system in place for reporting and recording significant events, and improvements were made as a result of learning outcomes. Staff had access to the electronic incident reporting system on the practice computer system, which is linked with the National Reporting and Learning System (NRLS) to contribute to wider improvements in primary care.
• Safeguarding arrangements protected children and vulnerable adults from abuse. These met with local requirements and current legislation.
• Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were similar to or higher than CCG and national averages. The most recent published results (for 2015/2016) showed the practice had achieved 99% of the total number of points available, compared with the Clinical Commissioning Group (CCG) average of 97% and the national average of 95%.
• There was evidence of quality improvement including clinical audit. The practice also participated in benchmarking and best practice sharing with other local GPs.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• We observed that staff members were helpful to patients and treated them with dignity and respect.
• Results from the National GP Patient Survey showed that most patients felt they were treated with compassion, dignity and respect, but the practice was lower than average for some of its satisfaction scores on consultations with GPs and nurses. The practice had created an action plan to improve patient satisfaction.
• The practice had reviewed the needs of its local population and adopted measures to improve patient experience. For example staff spoke a number of different languages to accommodate the diverse local population. One of the GP partners was also a qualified yoga instructor and had piloted yoga lessons for patients held in the surgery. This was used to specifically target patients who experienced low moods.
• Information was available to help patients understand the complaints system. A copy of the practice’s complaints policy was displayed in the waiting area to assist patients in understanding the complaints system. Details of how to complain were also included in the practice leaflet and on the website. The practice was aware of the requirements of the duty of candour and systems were in place to ensure compliance with this.
• The practice had clear aims and staff worked in a way that supported these. The GP partners recognised the challenges the practice faced and had created a detailed plan for the future.
• Staff we spoke with understood their roles and responsibilities, and there was a clearly defined structure to ensure everyone knew who the lead members of staff were and how to report a range of situations.
• The practice was committed to continuous improvement and innovation, and proactively sought feedback from staff and patients.

We saw two areas of outstanding practice:

• One of the GP partners offered free yoga lessons for patients one evening every week. This was used to specifically target patients who experienced low moods. There had been a strong uptake with up to 25 patients attending, and patients had the opportunity to discuss any concerns. Feedback had been positive with patients particularly commenting that their sleep had improved and that they had felt positive following yoga.
• The practice had incorporated healthy living lectures with its Patient Participation Group (PPG) meetings to educate patients and empower them to improve their lifestyles. For example the practice had invited dieticians to demonstrate how to cook a healthy meal with few ingredients, and this was specifically aimed at the practice’s large Asian population. The PPG advertised the healthy living lectures to patients and also gave a presentation or held a patient quiz on the topic of the education session to help engage patients. These sessions were attended by approximately ten to 20 patients.

The areas where the practice should make improvements are:

• Continue to review and encourage patient uptake of cervical and bowel cancer screening.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice