Parkside Medical Centre

Updated 15 August 2017

Parkside Medical Centre is part of Southwark Clinical Commissioning Group (CCG) serves approximately 5150 patients. The practice is registered with the CQC for the following regulated activities: treatment of disease, disorder or injury; surgical procedures; diagnostic and screening procedures.

The practice population has a slightly larger number of working age people and lower proportion of elderly people than the national average. The practice is located in an area ranked within the second most deprived decile on the index of multiple deprivation with a higher percentage of unemployment than the national average. The practice is run by Concordia Health Limited. The practice has one full time female salaried GP who supports a male registrar. One full time male GP, one female nurse practitioner and one female practice nurse and a female healthcare assistant.

The practice is a teaching practice and accepts students from the local hospital. The practice had one registrar at the time of our inspection. The GPs worked 37 hours per week, the registrar worked 40 hours per week. The nurse practitioner worked 20 hours and the practice nurse 35 hours. The practice is open from 8am Monday to Thursday and open from 7am on Friday. The practice closes at 8pm Monday and Wednesday and 6.30pm the rest of the week.

The practice offers booked and emergency appointments five days per week. Parkside Medical Centre operates from 52 Camberwell Green, London Southwark SE5 7AQ which are purpose built premises. The property is rented. Concordia Limited are responsible for the maintenance.

The service is based on a single floor and all rooms are accessible to those with mobility problems or those in wheelchairs. Practice patients are directed to contact the local out of hours provider when the surgery is closed.

The practice operates under a Personal Medical Services (PMS) contract, and is signed up to a number of local and national enhanced services (enhanced services require an enhanced level of service provision above what is normally required under the core GP contract). These are: childhood vaccination and immunisation, extended hours access, facilitating timely diagnosis and support for people with dementia, influenza and pneumococcal immunisations, learning disabilities, patient participation, rotavirus and shingles immunisation and unplanned admissions. The practice is a member of GP Federation Improving Health Limited.

Updated 15 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Parkside Medical Centre on 19 May 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the 19 May 2016 inspection can be found by selecting the ‘all reports’ link for Parkside Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection on 22 June 2017. Overall the practice is now rated as good.

Our key findings were as follows:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• 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 were below local and national standards for showing patients were treated with compassion, dignity, respect and for showing patients 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 sometimes found it difficult to make an appointment with a named GP; however, urgent appointments were 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 practice provided extended hours three times a week, Monday and Wednesday 6.30pm-8pm and Friday 7am-8am.

• The practice was in a transition stage of using a new data management system that would record, complaints, significant events, training, recruitment, minutes, and alerts.

The areas where provider should make improvements:

• Continue to review uptake of child immunisations rates.

• Monitor patient satisfaction with access and appointment availability, including improving patient satisfaction with compassion, dignity, respect and involvement in decisions on care.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 15 August 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.

• Performance for diabetes related indicators was comparable to the local and national average:

• 88% of patients with diabetes on the register had their blood sugar recorded as well controlled (local average 70%, national average of 78%). The exception reporting rate for the service was 20%, local 7% and national 13%.

• 89% of patients with diabetes on the register had their cholesterol measured as well controlled (local 81%, national average 80%). The exception reporting rate for the service was 10%, local 8% and national 13%.

• 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.

• Southwark had contractual key performance indicators for practices to work within. This covered the management of cholesterol, blood pressure and diabetes. The grades for achievement were A to F. The practice achieved five A grades and 1 C grade.

Updated 15 August 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 slightly below 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.

• The practice provided support for premature babies and their families following discharge from hospital.

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

• The practice worked with midwives, and health visitors to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics, regular meetings were held to discuss individual patients.

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

Updated 15 August 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.

• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible.

• The practice offered double appointments for older patients that required more time for their care.

• Dementia screening and reviews were carried out to ensure patients received the appropriate care and support.

Updated 15 August 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 three days a week Monday, Wednesday evening until 8pm and Friday morning from 7am.

• 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.

• Patients who reach 40 years of age were invited to have an NHS Health check.

Updated 15 August 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.

• 100% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, (local average 86%, national average 84%) which is higher than local and national average.

• The practice specifically considered the physical health needs of patients with poor mental health and dementia.

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

• 90% of patients with schizophrenia, bipolar affective disorder and other psychoses had their alcohol consumption recorded in the preceding 12 months (local average 86%, national average 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 15 August 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 had nine patients on its learning disability register, 88% had an annual review.
• 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.
• The practice had a substance misuse clinic.
• Team members had attended domestic violence training.