Archived: Shirland Medical

Updated 21 January 2016

Shirland Road Medical Centre is situated at 321 Shirland Road, London, W9 3JJ. The practice provides NHS primary care services through a General Medical Services (GMS) contract to approximately 3,800 people living in the London Borough of Kensington and Chelsea. The practice is part of the NHS West London Clinical Commissioning Group (CCG).

The practice population is multicultural including English, Caribbean or Polish. The practice population is representative of most age groups with a higher than average number of patients between the age of 30 and 60 years. The practice area is rated in the second more deprived decile of the Index of Multiple Deprivation (IMD). People living in more derived 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 and family planning.

The practice team consists of two full-time GP partners (one male, one female), three part-time practice nurses and a practice manager who is supported by a small team of reception / administration staff. The practice is open between 9.00am and 7.30pm Mondays and Fridays, 9.00am and 6.30pm Tuesdays and Wednesdays and between 9.00am and 1.00pm Thursdays. Appointments are from 9.00am to 1.00pm every morning and 4.00pm to 6.00pm excluding Thursday afternoons. Extended hours surgeries are offered between 6.30pm to 7.30pm Mondays and Fridays. Patients are directed to the NHS 111 service to access out of hours care.

The services provided include: childhood and travel immunisations, smoking cessation advice, chronic disease management, family planning and contraception, flu vaccinations, phlebotomy, ear syringing, cervical screening and antenatal clinics.

We carried out an inspection of Shirland Road Medical Centre on 19 May 2014 as part of our pilot phase of new approach inspections and therefore the practice was not rated. At the inspection in May 2014 the practice was found to be in breach of five regulations of the Health and Social Care Act 2008 and was required to take the following action;

• Put systems in place to protect patients from the risks associated with the unsafe use and management of medicines.

• Ensure staff are appropriately supported in relation to their responsibilities.

• Put in place effective systems to protect patients against the risks associated with the prevention and spread of infection.

• Ensure effective procedures are in place to protect patients against the risks associated with unsafe recruitment of staff.

• Ensure effective procedures are in place to safeguard patients against the risk of abuse.

Updated 21 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at 8.30am on 9 December 2015. 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 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.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day. However, patients reported that they often had to wait a long time after their appointment time to be seen.
• The practice had reasonable facilities and was equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice 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:

• Provide annual basic life support training for non-clinical staff.

• Display more prominently information in the waiting room including a chaperone notice, translation services, and support services.

• Provide nursing staff with training in conducting mental capacity assessments.

• Carry out clinical audit to demonstrate on-going quality improvement.

• Put in place measures to address over running appointments as identified by patient feedback.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 January 2016

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

• Nursing staff supported the GPs in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes was below the local / national average.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 21 January 2016

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

• Immunisation rates were comparable to the local average 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.

• The practice’s uptake for the cervical screening programme was 79.3%, which was above the CCG average.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 21 January 2016

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.

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

• There was a primary care navigator based at the practice one day a week to provide social support to patients over 55 years of age and 85 patients were receiving support at the time of our inspection.

Updated 21 January 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 provided online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 21 January 2016

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

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  There were 20 patients on the dementia register and eight had care plans / annual reviews.

• 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.

• It 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 people with mental health needs and dementia.

Updated 21 January 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 homeless people, and those with a learning disability. There were 32 patients on the homeless register and all had received health checks on registration.

• It offered longer appointments for people with a learning disability.

• The practice had carried out learning disability health checks for 16 of the 20 learning disability patients on the register.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• 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.