Archived: Dr Simon Edoman Also known as The Medical Centre

Updated 24 February 2017

Dr Simon Edoman’s practice operates at The Medical Centre, 140 Holloway Road, Islington, London N7 8DD. The premises are owned by Dr Edoman and have good transport links nearby, being close to Holloway Road and Drayton Park stations.

The practice provides NHS services through a Personal Medical Services (GMS) contract to approximately 4,700 patients. It is part of the NHS Islington Clinical Commissioning Group (CCG), which is made up of 38 general practices. Dr Edoman (“the provider”) is registered with the Care Quality Commission to carry out the following regulated activities - Treatment of disease, disorder or injury; Family Planning; Maternity and midwifery services; Surgical procedures; and Diagnostic and screening procedures. The patient profile has an above average population of teenage children and working age patients, between 25 and 49, with fewer than average older patients aged over 54. The deprivation score for the practice population is in third “more deprived decile”, indicating a higher than average deprivation level among the patient population.

The practice has a clinical team comprising the provider (working four clinical sessions and four administrative sessions per week) and two salaried male GPs (one working eight clinical sessions and the other working four); a female nurse practitioner (five clinical sessions; one administrative), two female nurses (each working two clinical sessions); and a female health care assistant. The administrative team is made up of a practice manager, secretary, administrator and two receptionists. The health care assistant also spends some time on reception duty.

The practice reception operates the following hours -

Monday 9:00 am to 7:30 pm

Tuesday 8:00 am to 8:00 pm

Wednesday 9:00 am to 7:30 pm

Thursday 9:00 am to 8:00 pm

Friday 8:00 am to 7:30 pm

Clinical sessions operate between 9:00 am to 1:00 pm and 2:00 pm to 7:15 pm, Monday to Friday.

In addition, early morning appointments can be booked on Tuesday and Friday between 8:00 am and 9:00 am.

The consultations can be by booked appointment, while walk-in patients are triaged by the duty GP. Routine consultations are 10 minutes long, but longer appointments may be booked if patients have more than one issue to discuss. Home visits are available for patients who may be house bound, with requests being triaged by a GP or nurse. The GPs are also available for telephone consultations between 12:30 pm and 1:30 pm, Monday to Friday. Routine appointments may be booked online by patients who have previously registered to use the system. It can also be used to request repeat prescriptions.

The practice has opted out of providing an out-of-hours service. Patients calling the practice when it is closed are connected with the local out-of-hours service provider. In addition, the CCG provides the “IHub” service, operating until 8:00 pm on weekdays and between 8:00 am and 8:00 pm at weekends at three sites across the borough. Appointments can be booked by patients contacting their own general practice. There is also a walk in service available to all patients at three sites. Information about the out-of-hours provider, NHS 111 service and the IHub service is given on the practice website. It also gives the address of two nearby Accident and Emergency departments, together with contact details of the out of hours urgent dental service and local mental health services.

Updated 24 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 3 November 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 found it easy to make an appointment and there was good continuity of care, with urgent appointments available the same day.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• 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.

We noted an area of outstanding practice: -

The practice was currently the only one in the Islington and neighbouring CCGs which sees patients who had been removed from their previous GP’s lists for threatening behaviour. These patients were seen outside normal surgery hours. The provider had up to eight patients who had been referred under a Directed Enhanced Service, commissioned originally by the Primary Care Trust. We saw positive comments from service commissioners, including the provider and staff being commended for their approach. It was stated that it was preferable for patients to remain with the practice, rather than returning to their original GPs, as the practice was able to offer the patients stability and continuity of care they would otherwise not receive.

However, there was an area of practice where the provider should make improvements:

• The practice should continue with plans to appoint a female GP to provide an appropriate and full healthcare service for female patients.
• It should continue to monitor the patient survey results relating to GP consultations and take appropriate steps should there be no significant improvement, compared with local and national averages.

Professor Steve Field

CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 24 February 2017

The practice is rated as good for the care of people with long-term conditions.

• The practice’s performance relating to patients with long term conditions was above local and national averages.
• The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) is 140/80 mmHg or less (01/04/2015 to 31/03/2016) was 85.14%, compared with the national average of 77.58%.
• The practice maintained a register of 294 patients with diabetes. Of these, 211 (71%) had had an annual foot check and 270 (92%) had had a retinal check.
• The percentage of patients with asthma, on the register, who have had an asthma review in the preceding 12 months that includes an assessment of asthma control using the 3 RCP questions (01/04/2015 to 31/03/2016) was 88.84%, compared with the national average of 75.55%
• The percentage of patients with COPD who had a review undertaken including an assessment of breathlessness using the Medical Research Council dyspnoea scale in the preceding 12 months (01/04/2015 to 31/03/2016) was 94.38%, compared with the national average of 89.59%
• All 27 patients on the heart failure register had had a medicines review.
• Longer appointments and home visits were available when needed.

Updated 24 February 2017

The practice is rated as good for the care of families, children and young people.

• The practice worked closely with health visitors, 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 and maintained a register of vulnerable children.
• Take up rates for standard childhood immunisations were above local and national averages.
• 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.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with health visitors and of regular MDT meetings.

Updated 24 February 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, with home visits and longer appointments were available for those with enhanced needs.
• The practice maintained a case management register of patients at high risk of admission to hospital. There were 84 patients currently on the register, and 81 had had their care plans reviewed.
• Data showed that 666 patients aged over-65 were prescribed ten or more medicines; of whom 521 (78%) had had an annual structured medication review in the half year since April 2016.
• Thirty-one patients identified as being at risk of developing dementia had received a cognition test or memory assessment in the year.

Updated 24 February 2017

The practice is rated as good for the care of working-age people (including those recently retired and students).

• 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.
• Early morning and evening appointments were available throughout the week for patients unable to attend during normal working hours.
• Telephone consultations with GPs were available each day.
• The practice’s uptake for the cervical screening programme was comparable with the local and national average.

Updated 24 February 2017

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

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record, in the preceding 12 months (01/04/2015 to 31/03/2016) was 94.67%, compared with the national average of 88.77%.
• The percentage of patients diagnosed with dementia whose care plan has been reviewed in a face-to-face review in the preceding 12 months (01/04/2015 to 31/03/2016) was 93.75%, compared with the national average of 83.77%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients 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.
• Staff had a good understanding of how to support patients with mental health needs and dementia. All staff had completed online training relating to the Mental Capacity Act.

Updated 24 February 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held registers of patients living in vulnerable circumstances, including a register of homeless patients, who could register at the practice address to receive healthcare-related correspondence.
• It maintained a learning disability register of 29 patients, of whom 26 (90%) had received an annual follow up in the half year since April 2016.
• Appointments for patients with learning disabilities were 30 minutes long.
• 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.