Archived: Dr Ruth O'Hare Also known as Connaught Square Practice

Updated 10 September 2015

Dr Ruth O’Hare practice is a well-established GP practice within the London Borough of City of Westminster and is part of the NHS Central London Clinical Commissioning Group (CCG) which is made up of 35 GP practices. The practice provides primary medical services through a Personal Medical Services (PMS) contract and also offers enhanced services which include extended hours. There are approximately 7,400 patients registered at the practice which has a high patient turnover due to transience within the patient population. There has been a recent rapid rise in the patient list size due to the closure of two GP practices in the area.

The practice team comprises of one female GP partner, one male GP partner, three regular male GP contractors, one female nurse, two female healthcare assistants, one male phlebotomist, a psychotherapist, family therapist, a practice manager and deputy who are supported by a secretary, three administrators and four reception staff. There has recently been a high turnover of administration staff due to maternity, long term sickness and resignation. The current practice manager has been in post for four months and the practice nurse for six months.

The practice opening hours are 8.00 am to 8.00 pm Mondays to Fridays (extended hours) and is closed between 12.30 pm to 1.30 pm on Thursdays for a lunchtime meeting. The practice provides services on Saturdays and Sundays between 10.00 am and 6.00 pm and patients can see a GP or nurse either by booking a same day appointment or by walking in. Patients do not have to be registered with the practice to access the weekend service. Out of hours services are provided by a local provider. The details of the out of hours service are communicated in a recorded message accessed by calling the practice when it is closed and on the practice website.

The practice provides a wide range of services including chronic disease management, child health care, specialist psychotherapy services and travel immunisations. The practice also provides health promotion services including a flu vaccination programme, smoking cessation service and cervical screening.

The age range of patients is predominately 25-54 years and the number of 25-39 year olds is greater than the England average. There is a wide distribution of ethnic backgrounds in the practice patient population and 6% of registered patients speak Arabic only and many have Arabic as their first language.

The practice has previously been inspected in August 2014 and shortfalls were found relating to the arrangements in place for the completion of patient records.

Updated 10 September 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Ruth O’Hare also known as The Connaught Square Practice on 5 May 2015.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well- led services. It was good for providing services for older people, people with long term conditions, families, children and young people, working age people, people whose circumstances may make them vulnerable and people experiencing poor mental health.

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

• There were processes in place to report and discuss significant events and incidents and staff understood and fulfilled their responsibilities to raise concerns.
• There were processes in place to safeguard vulnerable adults and children.
• Patients’ needs were assessed and care was delivered following best practice guidance.
• Patients said they were treated with kindness, dignity and respect and were involved in decisions about their care.
• Patients were generally satisfied with the appointment system and found it easy to make an appointment.
• Staff felt supported by the practice management and they were encouraged to maintain their clinical professional development through training.
• The practice demonstrated evidence of listening to patient feedback and made improvements to service as a result of this.

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

The provider should:

• Document learning points and action plans to improve future practice for all significant events recorded and discussed.
• Document learning points and action plans to improve future practice for all complaints recorded and discussed.
• Ensure that infection control audits are completed in line with best practice guidance.
• Ensure newly appointed staff completes role appropriate training in basic life support and safe guarding vulnerable adults and children.
• Ensure that annual appraisals are completed for all administration and nursing staff to support their professional development.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 September 2015

The practice is rated as good for the care of people with long-term conditions. There were nurse led chronic disease management clinics for review and monitoring of people with long term conditions. The practice held regular multi-disciplinary team meetings to discuss and plan management of patients with complex medical needs. The practice were in the process of identifying patients with long term conditions at high risk of hospital admission and inviting them for review to create comprehensive care plans. A primary care navigator worked with practice staff to proactively find and co-ordinate health, social care and volunteer services to people with long term conditions. There was comprehensive health information on the practice website about common long term conditions, such as asthma, heart disease and diabetes, and this included information about relevant support groups.

Updated 10 September 2015

The practice is rated as good for the care of families, children and young people. Families with children under five were given priority for urgent same day appointments. The practice offered post natal services including GP led six week mother and baby reviews. The practice offered a full range of childhood immunisations in line with national guidelines. There was comprehensive health information for pregnant women and families with children, on the practice website. The practice offered nurse led family planning and cervical smear clinics. Chlamydia screening was offered to patients aged 18 to 25 years.

Updated 10 September 2015

The practice is rated as good for the care of older people. All patients over the age of 75 years had a named GP and were given priority when booking appointments with them. They had access to urgent same day telephone consultations for medical advice. Home visits were available for patients unable to attend the practice due to illness or immobility. The practice offered routine screening for dementia to all patients over 75 years with referral on to local memory services if required. The practice offered flu and shingles immunisations to older patients in line with national guidance and these could be administered at home if patients could not attend the practice. The practice held regular multi-disciplinary team meetings to discuss the needs of older patients with complex medical needs.

Updated 10 September 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). They offered daily extended hour appointments and weekend walk-in clinics for patients who could not attend the practice during normal working hours. Telephone consultations were also available and repeat prescriptions and appointments could be requested online. The practice offered NHS Health Checks for patient aged 40 to 74 years of age and these were well advertised in the waiting room.

Updated 10 September 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). They offered routine screening for dementia to all patients over 75 years with referral on to local memory services if required. There was an in house psychotherapy service available Monday to Friday to see patients with anxiety or depression. Patients could self-refer to this service. There was a system in place to follow up on patients experiencing poor mental health who did not attend for practice and secondary care appointments.

Updated 10 September 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice maintained a list of 12 patients with learning disabilities and invited them for annual review of care plans. There was an in house psychotherapy service available Monday to Friday to see patients with alcohol or drug misuse problems. Patients could self-refer to this service. There was a separate dedicated practice in Westminster that managed the medical needs of homeless patients in the area and as a result the practice did not have many on their list. Patients with no fixed address were offered immediate registration to allow them to access medical care when required.