Background to this inspection
Updated
3 October 2014
Harrow Road Health Centre is a GP practice situated within the geographical area of NHS West London Clinical Commissioning Group (CCG). The practice is located in West London in the North East part of the London Borough of Westminster. The Paddington and Westbourne Green area has a cosmopolitan population and has a number of distinct characteristics that are reflected in the practice population profile:
As of February 2014, approximately 4,500 patients were registered at the practice, of these 24 percent of patients are aged 0-16, 52 percent aged 25-54 and 2.5 percent aged over 75 years.
The practice team included one male GP partner, three salaried female GPs, two non-prescribing practice nurses, a practice manager, assistant practice manager, reception and administrative staff. A further non-practicing GP provided support for clinical organisation. The practice opened Monday to Friday from 09:00–13:00 and from 14:00–18:00, with the exception of Thursday afternoon when the practice was closed.
The practice operated from converted premises spread over three floors, with nine consultation rooms. Access to the building was suitable for people who used a wheelchair and a lift was available to access upper floor consultation rooms. A children’s play area was located on the ground floor reception area, baby changing facilities and a parent and baby room was available for use.
Updated
3 October 2014
Harrow Road Health Centre is a general medical practice providing the regulated activities: diagnostics and screening procedures; maternity and midwifery; treatment of disease disorder or injury and surgical procedures to approximately 4500 patients in the North East part of the London Borough of Westminster.
We carried out an announced inspection of the service on the 21 May 2014. During our inspection we spoke with a range of staff including GPs, nurses, and management and reception staff. We also spoke with patients and a representative from the practice’s patient reference group (PRG).
The premises were suitable and appropriate health and safety checks had been completed. There was a recruitment policy in place and staff had received up-to-date training appropriate to their role. There were clear procedures for safe guarding children and vulnerable adults from harm. Staff were trained in dealing with medical emergencies and appropriate emergency equipment was available, although not all rooms were equipped with an emergency alarm pull cord. Medicines and vaccinations were in-date and stored safely.
There were regular clinical meetings and audits to promote and maintain best practice. Staff received appropriate induction and attended regular appraisal to identify training needs. The practice worked collaboratively with other allied health professionals to provide integrated care pathways for their patients. There was a pro-active approach to health promotion and prevention.
Staff were observed to be courteous and approachable when dealing with patients. Consultation rooms were equipped to maintain privacy and dignity. Patients felt they received compassionate care and were supported to be involved in decisions about their care and treatment.
The practice provided a wide range of services and clinics to support the varied needs of their patient population. They provided email and telephone access for patients to contact their usual GP and same day emergency appointments were also available. There was an effective complaints procedure for patients to raise concerns about the service.
There was a clear strategy for the practice and leadership was visible and supportive. The practice engaged in regular clinical audit and performance checks to ensure the service they provided was monitored and improved to deliver high quality care. Patient feedback about the service was gained from the patient reference group (PRG) established at the practice and from local annual patient surveys. Staff feedback was encouraged in regular team practice meetings. There were systems in place to record and learn from any significant incidents and complaints.
The practice provided and had access to a range of services to support the needs of the different patient population groups attending the practice. These included rapid referral to secondary care for frail elderly patients, health visitor clinics for babies and young children and on site access to staff with skills in supporting people with drug misuse problems and people experiencing poor mental health. The practice operated an open access for all policy so that vulnerable people could receive accessible health care without negative attitudes.
People with long term conditions
Updated
3 October 2014
The practice had measures in place to support and meet the needs of people with long-term conditions in their practice population.
Patients with a chronic condition had a named GP as a clear point of contact for the management of their medical needs. The practice held monthly multi-disciplinary team meetings with a range of allied health professionals to plan integrated care pathways for patients with chronic and complex needs. A rolling programme of call and recall was maintained for influenza vaccination uptake.
Families, children and young people
Updated
3 October 2014
The practice had measures in place to support and meet the needs of mothers, babies, children and young people.
The practice ran a weekly child health and immunisation clinic provided jointly by a GP, practice nurse and health visitor to support the needs of families with babies and young children. A monthly specialist child health clinic with a paediatric consultant was also held, which other local practices could refer to. There was a child and baby emergency walk in service daily to ensure access to urgent care if required.
The practice ran health promotion clinics for mothers and young people including family planning, ante-natal and post-natal care and smear testing.
Updated
3 October 2014
The practice had measures in place to support the needs of older patients in their practice population. All patients over the age of 75 years had a named GP.
They had access to a wide range of services including older person’s rapid access clinic (OPRAC) with same or next day assessment for frail elderly patients by secondary care and access to memory service assessments.
The practice had access to a Primary Care Navigator (PCN) who could support older patients in accessing health, social care and voluntary sector services in the community.
Working age people (including those recently retired and students)
Updated
3 October 2014
The practice head measures in place to support and meet the needs of working age people in their practice population.
The practice had a range of methods for patients to contact their usual GP without attending the practice, including email and telephone advice, to ensure health care was accessible to patients of working age. There were no face-to-face GP appointments for patients to access outside of normal working day time hours.
People experiencing poor mental health (including people with dementia)
Updated
3 October 2014
The practice had measures in place to support and meet the needs of people experiencing poor mental health in their practice population.
The practice had on-site access to a community psychiatric nurse and an on-site counselling service was available. The practice maintained a rolling programme of cervical screening call and recall for female patients in this population group.
People whose circumstances may make them vulnerable
Updated
3 October 2014
The practice had measures in place to support and meet the needs of people in vulnerable circumstances.
The practice had a long standing open access arrangement to treat people in vulnerable circumstances and ensure they did not encounter any negative attitudes.
The practice ran specific clinics to support patients in vulnerable circumstances including joint clinics for patients with learning difficulties and their primary carer. The practice had integrated extended on site services to support the needs of people with drug misuse problems.