Archived: Dr Christopher Anthony Grainger Stern Also known as Carepoint Practice

Updated 27 August 2015

Dr Christopher Anthony Grainger Stern, also known as Carepoint Practice, provides primary medical services for patients in the Hillingdon and Uxbridge area within the London Borough of Hillingdon. It is part of the NHS Hillingdon Clinical Commissioning Group (CCG) which is made up of 48 GP practices. The practice holds a core General Medical Services (GMS) contract and provides primary medical services to approximately 5,000 registered patients. The practice is currently managing an additional 3,000 patients due to the recent closure of a GP practice operating from the same premises until a formal merger is overseen by NHS England.

The practice team comprises of one male GP partner, one male salaried GP, two part-time female locum GPs, one part time male locum GP, two female practice nurses, one female health care assistant, two pharmacists, a practice manager, a secretary and six receptionists. One of the practice nurses is a registered nurse prescriber.

The practice opening hours are 7.30 am to 6.30 pm on Mondays, Tuesdays and Fridays; 8.00am to 6.30 on Wednesdays; and 7.30am to 4.30pm on Thursdays. Appointments are available from 7.30am to 8.00am; 8.30am to 12.10pm and 3.00pm to 6.00pm on Mondays, Tuesdays and Fridays; 8.30am to 12.10pm and 3.00pm to 6.00pm on Wednesdays; 7.30am to 8.00am and 8.30am to 12.10pm on Thursdays.

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 checks for diabetes, asthma review, family planning services, minor surgery and child health care. The practice also provides health promotion services including a flu vaccination programme, smoking cessation clinic and cervical screening.

The age range of patients is predominately 25-64 years and the number of 25-39 year olds is greater than the England average. There is a wide distribution of social and ethnic backgrounds in the practice patient population.

The practice has previously been inspected during our pilot phase in September 2014 and shortfalls were found relating to the arrangements in place for managing complaints and with the storage of patient’s paper based records.

Updated 27 August 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Christopher Anthony Grainger Stern also known as Carepoint Practice on 7 April 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:

• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses.
• There were processes in place to safeguard vulnerable adults and children.
• Patients’ needs were assessed and care was delivered following best practice guidance.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned through personal development plans.
• Patients said they were treated with kindness, care and respect and they were involved in decisions about their care and treatment.
• Patients were generally satisfied with the appointment system and found it easy to make an appointment.
• Staff felt that the practice was very supportive of training and that they had staff away days where guest speakers and trainers attended.
• The practice learned from patient experiences, concerns and complaints to improve the quality of care.

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

The provider should:

• Review the refrigerator temperature monitoring record log to ensure that all relevant data is captured and that dates of checks are recorded.
• Review the child protection policy to ensure that the information is up to date.
• Ensure that information about the practice opening hours is consistent in the literature available to patients.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 27 August 2015

The practice is rated as good for the care of people with long-term conditions. Patients with long term conditions were invited to annual nurse-led medical reviews and there was a system in place to alert staff when these reviews were due. Reminder letters were sent to patients inviting them to attend for annual review. Regular searches were performed to identify patients that required improvements to their long term conditions. The practice used risk stratification tools to identify patients at risk of hospital admission and they had a programme to create integrated care plans to help manage and meet these patients’ needs. The practice offered flu immunisation to at risk groups of patients in line with national guidance and uptake rates were high.

Updated 27 August 2015

The practice is rated as good for the care of families, children and young people. There was a named lead for safeguarding and safeguarding alerts were placed on patient’s electronic records to alert staff to any child protection plans in place when they attended appointments. The practice offered the full range of childhood immunisations and uptake rates were at or better than the CCG average for the local area. There was a system to follow up patients who did not attend immunisation appointments. There were nurse-led women’s health clinics providing cervical smears, family planning and sexual health advice. All women were encouraged to attend for regular cervical smear testing and the practice had a reminder system for patients who did not attend. A well-baby clinic and developmental check led by community health visitors was held at the practice weekly.

Updated 27 August 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 to co-ordinate their care and they were invited to annual health checks. Health checks were conducted during home visits if patients were unable to attend the practice due to illness or immobility. The practice used a risk stratification tool to identify patients over 75 years at risk of an unplanned hospital admission and invited them to receive personalised care planning to improve their health and well-being. The practice held monthly multidisciplinary meetings to discuss patients with complex needs including elderly and frail patients and those with end of life care needs. The practice offered a full range of immunisations in line with national guidance and flu immunisation in patients over 65 years of age was high.

Updated 27 August 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). Extended hour opening was available for bookable appointments from 7.30am on Mondays, Tuesdays, Thursdays and Fridays for patients unable to attend the practice during normal working hours. The practice offered same day emergency appointments and telephone consultations with GPs could also be requested on the same day. Repeat prescriptions and appointments could be made online for those who found it difficult to attend the practice. The practice offered NHS Health Checks to patients aged 40 -75 years. The practice identified the smoking status of patients over the age of 16 and offered a nurse led smoking cessation service.

Updated 27 August 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Patients experiencing poor mental health were offered annual health checks with a care plan review. The practice offered screening for memory problems during routine consultations and referred on to memory services if required. The practice had an experienced clinical lead for dementia. They had a register of patients diagnosed with dementia and arranged annual health reviews of these patients.

Updated 27 August 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. There were alerts added to patient notes to make staff aware of any specific requirements and extended appointments could be offered to patients who required translation services. The practice kept a register of patients with learning disabilities and offered them annual health checks including medication review and blood tests. One of the lead GPs had received training in managing patients with drug and alcohol misuse problems and these patients were referred to local hospital drug and alcohol teams for continued support when needed. Patients could be referred to see a counsellor on site for advice on alcohol and drug-related problems.