Background to this inspection
Updated
19 January 2017
Dr Chanh Tran is located in a purpose built 1970s building which has recently had an extension with one other practice. The practice is a part of Havering Clinical Commissioning Group.
There are 5200 patients registered at the practice where 1% of the working age population are unemployed, which is lower than the local average of 4.3% and the national average of 5.4%.
The practice has one principal male GP, one salaried female GP and a regular locum completing a total of 19 sessions per week and one female nurse prescriber carrying out seven sessions per week. There is a practice manager and six reception/administration staff members.
The practice is a training practice for fifth year medical students.
The practice operates under a Personal Medical Services (PMS) contract (a locally agreed alternative to the standard GMS contract used when services are agreed locally with a practice which may include additional services beyond the standard contract).
The practice is open Monday to Friday between 8:00am and 6:30pm and once a month on a Saturday between 9:00am and 1:00pm. Phone lines are answered from 8:30am and appointment times are as follows:
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Monday 8:30am to 12:00pm and 2:00pm to 8:00pm
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Tuesday 9:00am to 12:00pm and 2:00pm to 5:00pm
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Wednesday 8:30am to 12:30pm and 3:00pm to 6:00pm
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Thursday 8:30am to 12:30pm and 2:00pm to 6:00pm
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Friday 8:30am to 12:00pm and 1:45pm to 6:00pm
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Saturday (once a month) 9:00am to 1:00pm
The locally agreed out of hours provider covers calls made to the practice whilst it is closed.
Dr Chanh Tran operates regulated activities from one location and is registered with the Care Quality Commission to provide treatment of disease, disorder or injury, surgical procedures and diagnostic and screening procedures.
Updated
19 January 2017
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Dr Chanh Tran on 13 September 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.
- The practice carried out a large number of clinical audits and could demonstrate quality improvement.
- 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.
- The practice worked with local charities to provide in-house support to older patients, carers and patients with dementia or a memory impairment.
- 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.
- There was a continuous focus on learning and improvement in the practice,
We saw an area of outstanding practice:
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
19 January 2017
The practice is rated as good for the care of people with long-term conditions.
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Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
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The percentage of patients on the diabetes register with a record of a foot examination and risk classification in the preceding 12 months was 97% compared with the national average of 88%.
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Longer appointments and home visits were available when needed.
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All these patients 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.
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The practice carried out a rolling cancer audit since 2009 looking at the patient journey when referred under the two week wait, as a result of the last audit the practice identified a cancer diagnosis that was missed by secondary care.
Families, children and young people
Updated
19 January 2017
The practice is rated as good for the care of families, children and young people.
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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. Immunisation rates were relatively high for all standard childhood immunisations.
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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.
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82% of women aged 25 to 64 had a record of a cervical screening test documented in their record in the preceding five years, which was the same as the CCG and national average.
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Appointments were available outside of school hours and the premises were suitable for children and babies.
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We saw positive examples of joint working with midwives, health visitors and school nurses.
Updated
19 January 2017
The practice is rated as good for the care of older people.
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The practice offered proactive, personalised care to meet the needs of the older people in its population.
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The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
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Patients were offered an annual appointment with a nurse and age concern to review their clinical and non-clinical needs.
Working age people (including those recently retired and students)
Updated
19 January 2017
The practice is rated as good for the care of working-age people (including those recently retired and students).
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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.
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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.
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The practice offered extended hours one evening a week and on one Saturday a month for patients who were unable to attend the practice during normal working hours.
People experiencing poor mental health (including people with dementia)
Updated
19 January 2017
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
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97% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is above the CCG average of 86% and the national average of 84%.
- The percentage of patients with schizophrenia, bipolar affective disorder and other psychosis who had an agreed comprehensive care plan documented in the record was 100% compared with a national average of 88%.
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The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
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The practice carried out advance care planning for patients with dementia.
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The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
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The practice worked with a local charity to provide in-house support to patients.
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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.
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Staff had a good understanding of how to support patients with mental health needs and dementia.
People whose circumstances may make them vulnerable
Updated
19 January 2017
The practice is rated as good for the care of people whose circumstances may make them vulnerable.
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The practice held a register of patients living in vulnerable circumstances including those with a learning disability.
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The practice offered longer appointments for patients with a learning disability.
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The practice regularly worked with other health care professionals in the case management of vulnerable patients.
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The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
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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.