We carried out an announced comprehensive inspection at Lane End Medical Group on 21 March 2019 as part of our inspection programme.

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 have rated this practice as good overall and good for all population groups.

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:

• Ensure an up to date health and safety risk assessment is completed.
• Continue to work to improve access to the practice by telephone.

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

We carried out an announced comprehensive inspection at Lane End Medical Group on 16 October 2014. The overall rating for the practice was requires improvement. The full comprehensive report on the 16 October 2014 inspection can be found by selecting the ‘all reports’ link for Lane End Medical Group on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 9 February 2017 to confirm that the practice had carried out their plan to improve the areas of the service we identified in October 2014. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• The practice had improved telephone access by working with the patient participation group.
• A dedicated telephone management rota was introduced to enhance access at peak times.
• The practice maintained a detailed record of complaint investigations and lessons learned from them.
• Significant events were investigated appropriately and learning outcomes shared with appropriate staff and stakeholders.
• An audit timetable was in place and staff used this to structure an annual programme that contributed to the quality of clinical care and patient outcomes.
• A recruitment policy had been updated in April 2016 that included the need for pre-employment checks before a member of staff took up their post.
• All staff trained to provide chaperone duties had an up to date background check with the Disclosure Barring Service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lane End Medical Group on 16 October 2014. Overall the practice is rated as requires improvement.

Specifically, we found the practice to be good for providing effective, caring and well led services. We rated the practice as requires improvement for providing services for older people, families, children and young people, working age people (including those recently retired and students), people living in vulnerable circumstances, people experiencing poor mental health (including people with dementia) and for people with long term conditions. It required also improvement for providing safe and responsive services.

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

• During our inspection, we observed that reception staff treated patients with dignity and respect;

• The practice had recognised the needs of different groups in the planning of its services. For example, a receptionist outlined the steps taken to help vulnerable patients who needed additional support to understand and be involved in their care;

• Records showed the practice used significant events to improve the service and we noted that learning points were shared at team meetings. However, we also found that learning outcomes from complaints received were not always shared with staff;

• We saw evidence that clinical audits were being used to help improve patient outcomes but noted the absence of a systematic clinical audit programme;

• The practice participated in a national performance measurement tool called Quality Outcome Framework (QOF). We saw that performance was above the Barnet and England practice average in a number of clinical areas such as dementia, coronary heart disease and childhood immunisations.

• There was a strong focus on continuous learning and improvement at all levels of the organisation. This was supported by GPs’ involvement in part time undergraduate, post graduate teaching and by nurse practitioner involvement in a local practice nurse mentoring scheme.

We saw evidence of outstanding practice:

• GPs had experience of contributing to child protection hearings in person or by submitting reports.

However, there were areas of practice where improvements were needed. Importantly, the provider must:

• Carry out Disclosure and Barring (DBS) checks on all staff who undertake chaperone duties at the practice.

In addition, the provider should;

• Ensure that learning outcomes from all complaints are identified and shared;
• Introduce a timetabled policies and procedures review programme to ensure they are fit for purpose;

• Ensure that the necessary locum GP pre-employment checks have taken place and are on file (for example we noted that a record of Hepatitis B vaccination status was not on file for one of the locum GPs).

• Continue working with its Patient Participation Group to make further telephone access improvements.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice