Newton Medical Centre

Updated 8 January 2018

Newton Medical Centre, 14-18 Newton Road, London W2 5LT: www.newtonmedical.co.uk provides primary medical services through a Personal Medical Services (PMS) contract within the London Borough of Westminster. The services are provided from a single location to around 9,400 patients. The practice has higher than average numbers of patients in the 25-39 age groups. Nine percent of registered patients are under the age of 16. Over half the practice population is white British and the rest of patients are a mix of ethnic backgrounds including Caribbean, African, Asian and Arab.

Updated 8 January 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection in January 2016– Good)

The key questions are rated as:

Are services safe – Good

Are services effective – Good

Are services caring – Good

Are services responsive – Good

Are services well-led - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Newton Medical Centre on 1 November 2017 to check that action had been taken to comply with the requirement notice we served for regulation 12 (Safe Care) and regulation 19 (Fit and Proper Person Employed) at our last inspection in January 2016.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Review processes to improve children’s immunisation uptake.
• Ensure patients with caring responsibilities are proactively identified and supported.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 March 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.
• The practice performance for the majority of 2014/15 QOF indicators for long-term conditions was above average. Performance for diabetes related indicators was below the CCG and national average but the practice had addressed this and in the current year to date was the third best performing practice within the CCG area.
• Longer appointments and home visits were available when needed.
• All these patients saw the same GP and nurse practitioner had 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.
• Flu vaccinations were offered to all eligible and at risk patients.

Updated 17 March 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.
• 79% patients with asthma, on the register, have had an asthma review in the last 12 months that includes an assessment of asthma control. This was comparable with the national average of 75%.
• The practice’s uptake for the cervical screening programme was 70%, which was comparable to the CCG average of 68% and the national average of 77%.
• 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 and health visitors. The weekly baby clinic was combined with antenatal and post-natal reviews.
• Nursing staff ran a well woman clinic twice a month on Wednesday evenings by appointment.

Updated 17 March 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.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. Flu vaccinations were provided to older people in at-risk groups.
• The practice had monthly multidisciplinary meetings which involved social services, mental health, and nursing and pharmacy staff to allow a thorough review. A community primary care navigator also attended to help co-ordinate the care for any elderly patients who needed more support.
• The practice aimed to provide as many in-house services as possible including a falls clinic.
• The practice provided continuous care for nursing home patients and had a close relationship both with them and with the staff at the homes.

Updated 17 March 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.
• If someone is too ill to work they were able to be seen on the same day if they attended the walk-in clinic available daily.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group. It was in the process of redesigning its website to further improve access.
• Services included advice on smoking cessation, weight loss and alcohol and drug advice. The practice nurse had recently won an award as one of the most successful stop smoking advisers in Central London.

Updated 17 March 2016

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

• 82% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the national average of 84%.
• Performance for QOF mental health related indicators was below the CCG and national average. However, these had been reviewed and we were told had been low primarily due to coding issues. The practice anticipated higher scores for the current year.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• There were close links with the local mental health team, including regular meetings with a local psychiatrist and discussions with local personality disorder and drug services.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. It provided an in house counsellor, cognitive behaviour therapist and a community psychiatric nurse.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 17 March 2016

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 those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• 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.