Archived: Northcote Medical Centre

Updated 13 December 2017

Northcote Medical Centre is located in Southall in the London Borough of Ealing. The practice provides care to approximately 1600 patients. According to the practice 90% of their population are of Asian ethnic origin. The practice area is rated in the fifth less deprived decile of the Index of Multiple Deprivation (IMD). People living in more deprived areas tend to have a greater need for health services.

The practice is registered as a sole provider with the Care Quality Commission (CQC) to provide the regulated activities of: treatment of disease, disorder or injury; diagnostic and screening procedures; family planning services and maternity and midwifery services.

The practice has a General Medical Services (GMS) contract (this is a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract) and provides a range of essential, additional and enhanced services including maternity services, child and adult immunisations, family planning and sexual health services.

The practice has one male principal GP working a total of three sessions and employs two long term locum GPs (a male and female) working two and four sessions respectively, giving a total of nine. The rest of the practice team consists of one part time practice nurse and three administrative staff consisting of medical secretaries and reception staff and a part time practice manager who works across two other sites that are owned by the principal GP.

The opening hours were 8:30am to 6:30 Monday- Friday, Except on Wednesdays when the practice closes at 1pm. Appointments were available from 8.30am to 11am each week day morning and from 3pm to 6pm on Monday, Tuesday, Thursday and Friday.The out of hours services were provided by an alternative provider. The details of the out-of-hours service were communicated in a recorded message accessed by calling the practice when it is closed and on the practice website.

Updated 13 December 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Northcote Medical Centre Health Centre on 8 November 2016. The overall rating for the practice was inadequate and the practice was placed in special measures for a period of six months. The full comprehensive report can be found by selecting the Northcote Medical Centre ‘all reports’ link for on our website at www.cqc.org.uk.

This inspection was undertaken following the period of special measures and was an announced comprehensive inspection on 12 September 2017. Overall the practice is now rated as requires improvement.

Our key findings were as follows:

• Improvements had been made since our last inspection there had been some improvements. There was an open and transparent approach to safety and a system in place for reporting and recording significant events. However we are still concerned about the lack of consistent clinical leadership at the practice.

• The practice had clearly defined and embedded systems to minimise risks to patient safety, this was an area of improvement since our previous inspection.

• Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.

• However the practices patient quality outcomes were still low.

• 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.

• Patients we spoke with said they found it easy to make an appointment with urgent appointments available the same day.

• The practice had good facilities and was equipped to treat patients and meet their needs. However, we saw that chairs in the waiting room were not comfortable particularly for elderly patients and this was also reported by some patients we spoke with.

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

Importantly, the provider must:

• The provider must ensure they provide sufficient clinical leadership.

• Ensure that all patients’ needs are identified and care and treatment met their needs.

In addition the provider should:

• Sustain the improvements that have been achieved from the GP national patient survey results survey and also make further improvements in areas that are still low.

• Continue efforts to recruit a fully established patient participation group (PPG) at the practice

• Consider providing chairs that are more comfortable in the patient waiting area.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 December 2017

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

• Data showed patient outcomes were low compared to the national average. Unpublished data for 2016/17 provided by the practice showed the practice had only achieved 52 %( 50/86) points in diabetes care. The principal GP told us they were aware of the low performance and will be working to make improvements.

• 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 13 December 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 high 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, health visitors and school nurses to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.
• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

Updated 13 December 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 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.

Updated 13 December 2017

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

• The needs of these populations had not been fully identified. The practice did not offer extended hours for this population group.

Updated 13 December 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.

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

• 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 13 December 2017

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

• 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.