The Corfton Road Surgery

Updated 20 March 2017

The Corfton Road Surgery provides NHS primary medical services to around 7000 patients in Ealing. The service is provided through a general medical services contract.

The current practice clinical team comprises two GP partners and two salaried GPs. Patients have the choice of seeing a male or female GP. The GPs have a range of special interests including paediatrics and the management of particular long term conditions. The GPs typically provide around 20-24 sessions in total each week.

The practice also employs two practice nurses (one of whom is an independent prescriber), a health care assistant, a phlebotomist, a practice manager and receptionists and administrative staff.

The practice opening hours vary daily:

• Monday: 8am-6pm
• Tuesday: 8am-6.30pm (extended surgery 6.30pm-8pm)
• Wednesday: 8am-6.30pm (extended surgery 6.30pm-8pm)
• Thursday: 8am-2pm
• Friday: 8am-6pm

The telephone lines close between 1pm and 2.30pm and also 30 minutes before the practice closes on Monday and Friday. The practice is also normally closed over the weekend.

Same day appointments are available for patients with complex or more urgent needs. The practice offers online appointment booking and an electronic prescription service. The GPs make home visits to see patients who are housebound or are too ill to visit the practice.

When the practice is closed, patients are advised to use the local out-of-hours primary care service if they need urgent primary medical care. The practice provides information about its opening times and how to access urgent and out-of-hours services in the practice leaflet, on its website and on a recorded telephone message.

The general practice population is characterised by higher life expectancy than the national average and lower than average levels of income deprivation and unemployment. The practice also serves patients in nearby hostel and residential accommodation. The practice has a relatively young population and is ethnically diverse.

The practice is a training practice offering training posts to newly qualified doctors.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures; treatment of disease, disorder and injury; and maternity and midwifery services.

Updated 20 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Corfton Road Surgery on 20 December 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. The provider was aware of and complied with the requirements of the duty of candour.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments 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 areas where the provider should make improvement are:

• The practice should ensure that it receives and acts on relevant non-clinical safety alerts (for example to assess the risk posed by looped blind cords).
• The practice should make greater use of two-cycle clinical audit within its quality improvement programme to ensure that observed improvements are sustained in practice.
• The practice had relatively high exception reporting rates for some Quality and Outcome Framework indicators (for example, on diabetes). The practice should investigate these areas of practice to ensure it is fully meeting patients' needs.
• The practice should consider ways to understand and improve standardised measures of patient feedback with its nursing service.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 20 March 2017

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 kept registers of patients with long term conditions. These patients had a structured annual review to check their health and medicines needs were being met. The practice operated a call-recall system to encourage patients to attend for their review.
• Practice performance for diabetes was above average. In 2015/16, the percentage of diabetic patients whose blood sugar levels were adequately controlled was 96% compared to the clinical commissioning group (CCG) and national averages of 78%.
• The practice participated in schemes to avoid unplanned admissions which included patients with complex or multiple long term conditions. The top 4% of patients identified as at risk were reviewed and had a personalised care plan. Cases were discussed at regular multidisciplinary meetings. These patients' cases were allocated between the GPs to promote continuity.

Updated 20 March 2017

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.
• The practice achieved immunisation targets (90%) for all standard childhood immunisations and boosters and offered child developmental checks.
• Children and young people were treated in an age-appropriate way and were recognised as individuals. The premises were suitable for children and babies.
• Appointments were available outside of school hours.
• We saw positive examples of timely communication and referral to health visitors and other community health services.
• One of the GPs had a paediatric specialism and this was utilised within the practice to provide second opinions as well as pre-referral advice and reviews of patients. The practice told us this helped reduce onward hospital clinic referrals and provide effective care closer to patients’ homes.
• The practice provided paediatric phlebotomy (for two to five year olds) from the premises. This service was also available to patients from other practices in Ealing.

Updated 20 March 2017

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, for example offering care planning to patients aged over 75.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice provided the seasonal flu vaccination for patients over 65 and the shingles and pneumococcal vaccinations for eligible older patients. The practice ensured that housebound patients received these vaccinations.

• The practice had been instrumental in setting up a care coordinator scheme covering local practices. The assigned care coordinators visited patients in their own homes and regularly liaised with the practice, for example on care planning and case management.

Updated 20 March 2017

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 and flexible.
• The practice offered additional evening sessions from 6.30pm to 8pm on Tuesday and Wednesday and opened on Saturday morning from January to March.
• The practice offered a range of ways to access services, for example, daily telephone consultations with a GP, online appointment booking and an electronic prescription service. The practice used a messaging service to communicate with patients and send appointment reminders.
• The practice offered a full range of health promotion and screening services reflecting the needs for this age group including NHS health checks.

• In 2014/15, 87% of eligible women registered with the practice had a recorded cervical smear result in the last five years compared to the CCG average of 79%.

Updated 20 March 2017

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

• 100% (of 24) patients with dementia had attended a face to face review of their care in the last year compared to the CCG average of 86%.
• The practice screened patients at risk of dementia, and, if applicable, they were referred onwards to memory clinics for further assessment.
• 97% (of 33) patients diagnosed with psychosis had a comprehensive care plan in their records compared to the CCG average of 92%. The practice regularly liaised with the mental health specialist teams and took over the management of patients with stable conditions. These patients were able to meet the primary care mental health support worker and obtain specialist mental health smoking cessation advice at the practice.
• The practice was able to advise patients experiencing poor mental health and their carers 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.

Updated 20 March 2017

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

• The practice was open to all eligible patients regardless of their circumstances. For example, the practice encouraged people living on probation or in secure or long term hospital accommodation to register with the practice.
• The practice held a register of patients living in vulnerable circumstances including people with a learning disability.
• The practice offered longer and same day appointments for patients with a learning disability.
• The practice maintained a register of patients who were also carers and had a designated 'carers champion'. Carers were offered regular reviews and flu vaccination and signposted to further support.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• 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.