Background to this inspection
Updated
6 April 2016
Dr Neeta Ghosh-Chowdhury also known as Hilltop Medical Practice is situated at 150 Hilltop Avenue, Harlesden, London, NW10 8RY. The practice is based in a primary care centre which it shares with three GP practices and other community services. The practice provides NHS primary care services through a General Medical Services (GMS) contract to approximately 2,984 people living in the London Borough of Brent. The practice is part of the NHS Brent Clinical Commissioning Group (CCG) and within the CCG one of a local network of 21 GP practices.
The practice population is ethnically diverse and has a much higher than average number of children under five years old and above average number of patients in the 20-50 age range. The practice area is rated in the most deprived decile of the Index of Multiple Deprivation (IMD). People living in more deprived areas tend to have greater need for health services.
The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures; treatment of disease, disorder or injury; maternity and midwifery services, surgical procedures [BR1]and family planning.
The practice team consists of a full time female principal GP, three regular locum GPs (11 sessions/week in total), a locum nurse (12 hours/week), two full time reception staff and two part time reception staff. The principal GP also acts as the practice manager and is currently trying to recruit more staff, including a practice manager, practice nurse and another permanent GP.
The practice is open between 9.00am and 7.00pm Monday, Tuesday, Thursday and Friday and 9.00am to 2.00pm Wednesdays. Appointments are from 9.30am to 11.30am every morning and 4.30pm to 6.30pm daily (not Wednesdays). The practice is closed at weekends. To access out of hours care patients are directed to LCW (London Central and West, Urgent Care Collaborative) the local Out Of Hours (OOH) service. In addition patients can access appointments including at the weekend through the locality Hub service (A GP practice offering appointments to all patients in the locality). There is also a local walk-in centre open 8.00am to 8.00pm seven days a week.
Services provided by the practice include chronic disease management, cervical screening, family planning, childhood immunisations, travel advice and vaccinations and health screening. Phlebotomy and minor surgery are not provided by the practice however these services are available through the other practices in the primary care centre through the network.
Updated
6 April 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at 8.30am on 23 February 2016. Overall the practice is rated as good.
Our key findings across all the areas we inspected were as follows:
- 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 and complied with the requirements of the Duty of Candour.
The areas where the provider should make improvements are:
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
6 April 2016
The practice is rated as good for the care of people with long-term conditions.
Families, children and young people
Updated
6 April 2016
The practice is rated as good for the care of families, children and young people.
-
Immunisation rates were relatively high for all standard childhood immunisations.
-
The percentage of patients diagnosed with asthma, on the register, who had an asthma review in the last 12 months was 76%, which was in line with local / national averages.
-
Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.
-
The practice’s uptake for the cervical screening programme was 90%, which was above the national average of 82%.
-
The premises were suitable for children and babies.
-
We saw positive examples of joint working with district nurses and health visitors.
- Staff sent congratulation letters out to all new parents and encouraged them to register their new baby with the practice.
Updated
6 April 2016
The practice is rated as good for the care of older people.
Working age people (including those recently retired and students)
Updated
6 April 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.
- 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.
People experiencing poor mental health (including people with dementia)
Updated
6 April 2016
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
-
92% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was above the national average of 84%.
-
100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record in the preceding 12 months, which was above the national average of 88%.
-
The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
-
The practice had told patients experiencing poor mental health about 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.
-
Staff had a good understanding of how to support patients with mental health needs and dementia.
- The practice had 14 patients on the dementia register all of which had received an annual health check.
People whose circumstances may make them vulnerable
Updated
6 April 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.