Archived: Wembley Park Drive Medical Centre

Updated 10 August 2017

Wembley Park Medical Centre is located in Wembley and holds a General Medical Services (GMS) contract and is commissioned by NHS England, London. The practice is registered with the Care Quality Commission to provide the regulated activities of family planning, treatment of disease, disorder or injury, maternity and midwifery services, surgical procedures and diagnostic and screening procedures.

The practice is staffed by a senior GP female partner who provides two sessions a week and a male GP partner who provides nine sessions a week. The practice employs six female salaried GPs who provide 32 sessions a week. The practice is also staffed by a practice manager who works 36 hours a week and a part time assistant manager who works 32.5 hours a week. Also employed is a practice nurse and an advanced nurse practitioner who work 37.5 hours a week, one part time healthcare assistant (HCA), one part time phlebotomist, one office assistant, a clinical coder, a scanner and six reception and administration staff.

The practice is open between 9.00am and 6.30pm on Monday, Tuesday, Thursday and Friday and between 9.00am and 1.00pm on Wednesday. Outside of these hours, the answerphone advises patients of the number of their out of hours provider. An extended hours surgery is offered on Tuesday between 6.30pm and 8.00pm. The practice is a part of the Harness group of 26 practices that also provide a GP access hub service which offers extended access clinics between 6.00pm and 9.00pm on Monday to Friday and between 9.00am and 3.00pm on Saturday and Sunday.

The practice has a list size of 10,467 patients and provides a wide range of services including acupuncture, cryotherapy, joint injections, phlebotomy, wound clinic, chronic disease management and antenatal and postnatal care. The practice also offers public health services including family planning, sexual health screening, travel vaccinations and a well women’s clinic for cervical screening.

In 1994, the building was located at number 21 Wembley Park Drive which had back and side extensions built to create additional consulting rooms and in 1997, the provider purchased number 19 Wembley Park Drive which includes extra consulting rooms and a second reception and waiting area for the patients.

The practice is also located in a mixed demographic area where 132 different languages are spoken. The majority of the population is relatively young and aged between 20 to 39 years of age.

Updated 10 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wembley Park Drive Medical Centre on 30 March 2016. The overall rating for the practice was good, however the practice was rated requires improvement for safe. The full comprehensive report on the March 2016 inspection can be found by selecting the ‘all reports’ link for Wembley Park Drive Medical Centre on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 11 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 30 March 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall, the practice remains rated as good. At our previous inspection on 30 March 2016, we rated the practice as requires improvement for providing safe services as the practice did not have effective monitoring processes in place to ensure there were no gaps in mandatory staff training, as not all staff had received fire safety training and safeguarding training. We also found the practice did not have effective processes in place to ensure that there were no gaps in recruitment records for newly employed staff. Additionally, the practice did not ensure that all smart cards were securely stored when staff left their rooms. The practice is now rated as good for providing safe services.

Our key findings were as follows:

• Risks to patients were assessed and managed with the exception of recruitment checks, keeping medical records secure and mandatory training.

In addition, at the previous inspection we identified a number of areas where improvements should be made. These were as follows:

• Review the national GP patient survey scores with the aim of improving patient satisfaction scores on nurse’s involvement in care.

• Ensure all staff have an understanding of the practice mission statement.

• Ensure all staff have an understanding of the duty of candour policy.

At this inspection we found improvements had been made:

• All staff had completed fire safety and safeguarding training since the previous inspection.

• Smart card notices had been applied to all computers to alert the staff to remove their cards from their computer when not in use.

• The practice had recruited a new practice nurse and the two of the practice nurses were undergoing extensive training to improve their knowledge and skills.

• The practice had incorporated their mission statement as part of their New Staff Welcome Pack

• The practice had introduced a duty of candour training module into their annual mandatory training schedule.

• Although some improvements had been made to ensure there were no gaps in recruitment records, we still found that one newly recruited clinical member of staff only had one reference requested instead of two as per the practice recruitment policy.

In addition to addressing the breaches of regulation which impacted on safety, the practice had taken additional action on the basis of our last report:

• They had carried out improvement work to the patient toilets.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider should:

• Review staff recruitment files and ensure they are in accordance with policy.

• Continue to review the national GP patient survey results with the aim of improving patient satisfaction for nurse’s involvement in care.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 26 October 2016

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

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

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and there was an effective recall system in place that ensured a structured annual review to check their health and medicines needs were being met.

• We saw evidence that multi-disciplinary team meetings took place on a monthly basis with regular representation from other health and social care services such as the complex patient management group (CPMG) which met with the practice weekly to discuss all patients and sharing of significant events.

• We saw that discussions and joint clinics with doctors and nurses with specialist knowledge of long term conditions took place to understand and meet the range and complexity of people’s needs and to assess and plan ongoing care and treatment.

• One of the GPs had a special interest in acupuncture and provided this service within the practice as an alternative to medicines and other therapies.

Updated 26 October 2016

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

• There were systems in place 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 A&E attendances.

• Immunisation rates were relatively high for all standard childhood immunisations. There was an effective immunisation recall system in place. The practice had a high Romanian population and had set up an immunisation open day to promote immunisations aimed at the Romanian population.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice had a smear lead administrator who was responsible for ensuring women attending their screening tests.

• The practice offered quick access to contraceptive services such as coil fitting and implants.

• Postnatal mothers were screened for anxiety and depression.

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

• We saw positive examples of joint working with midwives, health visitors and school nurses including direct mobile access when required.

Updated 26 October 2016

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population including end of life care.

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

• The practice sent letters to patients over 75 to inform them of their named GP and they were screened for dementia as well as for anxiety and depression. Patients requiring care plans were called prior to their appointment to remind them.

• Immunisations such as shingles and flu were offered to patients at home, who could not attend the surgery.

• The practice supported patients who were eligible for transport to community or hospital services.

• Systems were in place to identify and assess patients who were at high risk of admission to hospital and the practice would call them after discharge to ensure they were receiving appropriate follow up care.

• The practice ensured an emergency bypass number was available for care homes and out of hours services.

Updated 26 October 2016

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

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• 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 was selected to register all new students, including international students attending the football university and as a result, the practice participated in the fresher’s fair held at the university for the last two academic years. This enabled them to register between 150-200 students each year and work in partnership with other external organisations to drive health promotion and sexual health screening within this population group.

Updated 26 October 2016

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

• Unverified data provided by the practice showed 91% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was higher than the national target of 40%.

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

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

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

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

• Staff had a good understanding of how to support patients with mental health needs and dementia and patients who did not attend their counselling appointment were followed up.

Updated 26 October 2016

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

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

• 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 informed vulnerable patients about how to access various support groups and voluntary organisations.

• The practice was responsive to homeless patients. They had no restrictions on registration and patients were offered food bank vouchers. Patients were also offered the option to register with a local homeless practice.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff 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.