Broad Street Medical Practice

Updated 29 January 2018

The practice is located on Morland Road, Dagenham RM10 9HU in the purpose built Broad Street Centre on two floors. The building is shared with another GP practice. The practice is managed by Prime Practice Partnership. The building is leased from Community Health Partnership who also carries out the maintenance.

The practice provides NHS primary medical services to approximately 5,500 patients through an Alternative Provider Medical Services (APMS) contract (an APMS contract is a locally negotiated contract open to both NHS practices and voluntary sector or private providers for example. many walk-in centres). The practice is commissioned by NHS Barking and Dagenham Clinical Commissioning Group.

The premises have a lift and step free access with an accessible toilet and disabled car parking spaces.

The practice consists of two male GPs one providing eight clinical sessions and two non-clinical sessions per week and the other providing three sessions. A female GP providing eight clinical sessions and advanced nurse practitioner doing 16 hours per week, a nurse doing 20 hours, and a health care assistant (HCA) doing 30 hours (all female). They have an operations manager working 20 hours per week, a full time manager and 11 administration and receptions staff working a variety of full and part time hours.

The practice is open from;

Monday 8am – 8pm

Tuesday 8am – 8pm

Wednesday 8am – 8pm

Thursday 8am – 8pm

Friday 8am – 8pm

Saturday 10am – 2pm

The practice does not close for lunch and appointments run throughout the day. Out of hours appointments are available until 10pm from a local hub and from the 111 service from 10pm till 8am.

Twenty four percent of the practice population is over 65 and 45% of the population is aged between 25 to 34. The largest ethnic group in the practice population is white at 60% with the next largest being black African at 21%. Information published by Public Health England rates the level of deprivation within the practice population group as two on a scale of one to ten. Level one 

Updated 29 January 2018

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Broad Street Medical Practice on 6 January 2017. The overall rating for the practice was good, the practice was rated requires improvement for providing caring services. The full comprehensive report on the 6 January 2017 inspection can be found by selecting the ‘all reports’ link for Broad Street Medical Practice on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 19 December 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 6 January 2017. 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:

• 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 showed patients were treated with compassion, dignity and respect and felt 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.
• 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.

At our previous inspection on 6 January 2017, we rated the practice as requires improvement for providing caring services as the patient satisfaction scores were lower than local and national averages. At this inspection we found that the patient satisfaction scores had considerably improved. Consequently, the practice is now rated as good for providing caring services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 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 89% which was higher than both the Clinical commissioning group (CCG) average of 79% 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 28 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. For example the practice had appointments on Saturday mornings from 10am to 2pm.

• The practice worked with midwives, health visitors and school nurses to support this population group.

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

Updated 28 April 2017

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

• Staff was 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 held monthly meetings with the palliative care team.

• 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.

• One of the GPs at the practice is the named GP at a local care home and visits every two weeks.

• 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 28 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.

• The practice offered early morning and evening appointments.

• 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 were able to book appointments online and have telephone consultations.

• Patients were able to register for online access and send messages to their GP/ practice via an on line messaging system.

Updated 28 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.

• 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 97% which comparable to the CCG average of 94% 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 28 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.

• End of life patients were reviewed on a monthly basis.

• 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.

• 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.