Supreme Medical Centre

Updated 20 April 2017

Supreme Medical Centre is located on Regents Park Road in North Finchley. It is well served by Finchley Central underground station and local buses. The practice is on the ground floor in a purpose built property. The building is owned by a private landlord, however the practice is responsible for the maintenance and upkeep of the premises.

The premises have step free access and an accessible toilet with baby changing facilities.

The practice provides NHS primary medical services to approximately 4351 patients through a General Medical Services (GMS) contract (a GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities) with NHS Barnet Clinical Commissioning Group (CCG). The practice provides a range of enhanced services including, child and travel vaccination, the removal of sutures and ambulatory blood pressure monitoring.

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

There are two GP partners (female) both working eight sessions per week, a salaried GP (female) working seven sessions per week and a sessional GP (male) working two sessions per week. The practice nurse (female) works three sessions per week. The clinical team are supported by a full time practice manager and three reception staff.

The practice is open from;

•  Monday: 8:30am – 6pm
•  Tuesday: 8:30am – 6pm
•  Wednesday: 8:30am – 6pm
•  Thursday: 8:30am – 1pm
•  Friday: 8:30am – 6pm

Appointments were from;

•  Monday: 9am – 11:30pm and 4pm to 6pm
•  Tuesday: 9am – 12:30pm and 3:45pm to 6pm
•  Wednesday: 9am – 11:30am and 3:45pm to 6pm
•  Thursday: 9am – 12pm
•  Friday: 9am – 11:30pm and 3pm to 5pm

Extended hours appointments were offered between 6:30pm to 7:30pm on Mondays. The practice also provides telephone consultations and home visits; the home visits are carried out between morning and evening surgery. Out of hour’s services including weekends are covered by Barndoc (who provide telephone consultations, home visits or patients can be seen at the local hospital from 6:00pm to 08:30am Monday, Tuesday, Wednesday and Friday and 1:00pm to 8:00am on Thursday) and the 111 service.

Data showed that the practice population is 47% white English and at 18% the next largest group is white other. The practice has 58% of its patient population in the working age group and 24% over 60. At 82 years for males and 86 years for females, the average life expectancy is higher than the England averages of 79 and 83 years, respectively. Information published by Public Health England rates the level of deprivation within the practice population group as eight on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

Updated 20 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Supreme Medical Centre on the 29 November 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events. However, reviews and investigations were not thorough enough.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with 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 a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider should make improvement are:

• Make arrangements to ensure appropriate security and monitoring of prescription pads.

• Improving the uptake of the Childhood Immunisation programme.

• Introduce a broader programme of clinical audits including re-audits to ensure that improvements are measurable.

Ensure significant events were investigated, analysed and learnings shared.Assess, monitor and improve the timing of appointments in view of the low national patient survey results for waiting times.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 April 2017

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.

• The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) is 140/80 mmHg or less was 85% which was better than both the CCG average of 76% and the national average of 78%.

• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.

• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.

• All these patients had a named GP and there was a system to recall patients for a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 20 April 2017

The practice is rated as good for the care of families, children and young people.

• From the sample of documented examples we reviewed we found there were systems to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of accident and emergency (A&E) attendances.

• Immunisation rates were relatively low for all standard childhood immunisations.

• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice worked with midwives, health visitors and school nurses to support this population group. For example, in the provision of ante-natal, post-natal checks for mum, and 6 weeks check for new born baby–combined triple appointments offered with a GP.

• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

Updated 20 April 2017

The practice is rated as good for the care of older people.

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.

• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.

• Where older patients had complex needs, the practice shared summary care records with local care services, such as the intermediate care team, district nurses and the rapid response team.

• All the patients in this group have a named GP.

Updated 20 April 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, extended opening hours and Saturday appointments.

• Telephone consultations during lunch time hours from 1 to 2 pm.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

• The practice offered temporary registration or immediate and necessary registration to students.

• Pre-bookable and opportunistic NHS Health Checks appointments.

• Extended hour’s appointments with 2 GPs on Mondays for 1 hour/week from 6:30pm to 7:30pm (totalling 12 appointments).

Updated 20 April 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The practice carried out advance care planning for patients living with dementia.

• The practice specifically considered the physical health needs of patients with poor mental health and dementia, for example those with mental health issues had annual health check and reviews of blood pressure, alcohol intake, and smears tests for women.

• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption has been recorded in the preceding 12 months was 90% which was comparable to the CCG average of 91% and the national average of 89%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.

• Patients at risk of dementia were identified and offered an assessment.

• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 20 April 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability.

• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.

• For patients who had complex care needs such as; physical, social, psychiatric they were referred to Network-led Community Mental Health Services or Complex Care Team, Medical Foundation for Victim of Torture.

• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.