Dr Abdel Aziz Abu-Nijaila Also known as Old Kent Road Surgery

Updated 23 January 2017

Old Kent Road Surgery is based at 182–184 Old Kent Road, Southwark, London SE1 5TY. The premises has direct pavement access from Old Kent Road, a busy main road. The practice is accessible for people with limited mobility and those who use a wheelchair with an access ramp at the front entrance automatic double front doors, an accessible toilet, wide corridors, ground floor facilities and a reception desk that can be accessed by wheelchair users. The waiting room has space to accommodate wheelchairs and mobility scooters. The practice is served by a number of local bus routes. There are no disabled parking facilities.

Old Kent Road Surgery has a sole partner who is the lead GP, one salaried GP and three long term locum GPs (one female and four male) providing a total of 22 sessions per week. There are three practice nurses, two female and one male who provide 12 sessions per week. The practice employs a full time practice manager and four receptionists/administrators, two of whom also work as primary care navigators. The practice is registered to provide diagnostic and screening procedures, treatment of disease, disorder or injury and maternity and midwifery services.

The practice is open between 8.00am and 7.45pm Monday and Thursday and from 8.00am and 6.45pm Tuesday, Wednesday and Friday. It is closed Saturday and Sunday. Appointments are from 9.00am to 12.20pm and from 2.40pm to 6.00pm. Extended hours appointments are available on Monday and Thursday from 6.30pm to 7.30pm. Appointments can be booked up to six months in advance with a male or female doctor, urgent same day appointments, telephone appointments and home visits are available. Appointments can be booked by phone, online or by visiting the surgery. The practice also arranges appointments at a local health service hub where a GP is available from 12.00pm to 8.00pm on a Monday and from 8.00am to 8.00pm Tuesday to Sunday.

When the practice is closed arrangements are in place for patients to access medical care via a local out of hours provider. The telephone number for the out of hours provider is found on the front page of the practice leaflet, on the practice website and is also recorded as a message on the practice telephone system.

The practice has a list size of 7000 patients. It serves an area with a high level of deprivation and has a diverse multi ethnic diverse population. The main groups of patients are black African, black Caribbean, white English and Arabic, with a fast growing population of South Americans. The main languages spoken are English, Spanish and Arabic. There is a higher than average number of working age patients and children under ten years of age registered at the practice when compared to national averages. There is a significantly lower number of registered patients over the age of 55. There is a 20% annual turnover of patients each year indicating a very mobile population group.

Old Kent Road Surgery has not been previously inspected by the CQC.

Updated 23 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Old Kent Road Surgery on 22 June 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.
• 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 provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Ensure all clinical waste bags are tied, labelled and stored in an appropriate area for collection.

• Ensure all sharps bins are labelled and signed when assembled.

• Ensure that patients on the learning disability register have a care plan and have an annual health review.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 23 January 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.

• Eighty-six per cent of patients with diabetes had a total cholesterol of 5 mmol/l or less in the preceding 12 months, which is above local and national figures.

• Ninety-three per cent of patients with diabetes had received a foot examination and risk classification in the preceding 12 months, which was above local and national figures.

• Longer appointments and home visits were available when needed.

• All patients with long term conditions had a named GP and 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.

• The practice selected, referred and encouraged patients with long term conditions to attend a six week self management course commissioned by the local Clinical Commissioning Group.

• Key performance indicators from the local federation were used to improve the outcomes of long term conditions. For example smoking cessation and pre-diabetes screening.

• Seven per cent of the practice population were on a pre-diabetes register. They were offered advice on lifestyle and an annual blood test to check their diabetes status.

• The practice nurse provided smoking cessation advice and an ambulatory blood pressure monitoring service.

• Patients with diabetes were referred to the local DESMOND education programme. This is a national self management group education programme for people with, or at risk of type 2 Diabetes.

Updated 23 January 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 were on the at risk register.

• Immunisation rates were comparable to local and national levels for all standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• Seventy-eight per cent of women aged 25 – 64 were recorded as having had a cervical screening test in the preceding five years. This was comparable to the national and local average.

• 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, health visitors and school nurses. For example the ante-natal and post-natal service was run in liaison with the community midwifery team.

• To help families with children aged 0-5 years the practice had negotiated for an Early Start clinic to be available at the surgery. The first session was booked for the beginning of August 2016 and will cover problems such as fussy eating, toilet training, behavioural and sleep problems. The GPs and health visitor will refer directly to this service.

• The practice offered a sexual health clinic and routinely offered Chlamydia testing.

Updated 23 January 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.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice carried out holistic health assessments on patients who were either over 80 years of age, over 65 and housebound or those over 65 who had not seen the GP for over 16 months. The holistic health assessment was carried out by a nurse either at the practice or in the patient’s home and included topics such as continence, eyesight, hearing, dementia, mobility and falls. At the time of the inspection 15% of patients (49) in the target group (326) had received an assessment in the last 15 months.

• Two receptionists had been trained to act as primary care navigators for patients over 65 years of age as part of a Clinical Commissioning Group pilot scheme.

• The practice hosted educational events for patients groups for example a talk by a local carers charity.

Updated 23 January 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, 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.

• Telephone appointments were offered to improve access for working age people.

• Text messages were sent to patients to remind them of their appointment and to promote and encourage the uptake of services such as cervical cytology.

• The practice offered Human Immunodeficiency Virus screening as part of the new patient health check.

• The practice had completed 258 health checks for patients aged 40-74 in the last 15 months, this is 17% of the target group.

Updated 23 January 2017

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

• Ninety-five per cent of patients diagnosed with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan documented in the last 12 months, which was above the national average.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients 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.

• A clinical psychologist from the local mental health service provided a service once a week offering cognitive behavioural therapy in the practice setting

Updated 23 January 2017

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. Homeless people are registered at the practice as temporary patients.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients. For example multidisciplinary team meetings were held with the health visitor, palliative care team from the local hospital and the district nurses.

• 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.

• Safeguarding cases were regularly discussed at practice meetings with the whole team.

• The practice provided an on site drug and alcohol service in liaison with health workers from the Clinical Commissioning Group service for alcohol and substance misuse. The practice stated that having a service based at the practice reduced the stigma associated with attending the hospital based service and therefore improved attendance rates.

• The practice had identified the top 2% of patients at risk of unplanned admission and had completed a care plan for each of these patients.