Clapham Park Group Practice

Updated 10 January 2017

Clapham Park Group Practice is a large practice based in Clapham. The practice list size is approximately 16,700. Average life expectancy for males in the practice patient population is 79 years and for females 84 years. Both of these are in line with the Lambeth Clinical Commissioning Group (CCG) and national averages for life expectancy. The practice has a higher than average number of male and female patients aged between 20- 44 years. The practice has a lower than average number of male and female patients aged 45-85 years.

The practice facilities include 10 GP consultation rooms, two treatment rooms and a patient waiting room. The consultation rooms are all on the ground floor. The premises is wheelchair accessible and there are facilities for wheelchair users including an accessible toilet. There is a hearing loop for patients with hearing impairments.

The staff team compromises of eleven GPs in total, with six GP partners (two male and four female). There are five salaried GPs (two male and three female). They do a total of fifty seven sessions per week. The practice is a training practice and had one registrar who works seven sessions per week. Other staff included three practice nurses (all female), a health care assistant (male), nine receptionists, seven administration staff, and one practice manager.

The practice is open between 8am to 6.30pm Monday to Friday. They offer extended hours from 7.30am to 8pm on Wednesday and 8.30am to 10.30am Saturday. Appointments are available to patients from 8.00am to 6.30pm. When the practice is closed patients are directed (through a recorded message on the practice answer machine) to contact the local out of hour’s service. Information relating to out of hour’s services is also available on the practice website.

The practice is registered as a partnership with the Care Quality Commission (CQC) to provide the regulated activities of treatment of disease, disorder or injury; diagnostic and screening; family planning; maternity and midwifery services and surgical procedures.

Updated 10 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Clapham Park Group Practice on 4 October 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. However not all staff had their employment history in their files.
• 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 on the practice website but not visible in the practice. 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:

• Consider reviewing information about services and how to complain displayed within the practice.

• Consider reviewing the recruitment process to ensure all staff have their employment history on file.

• Consider reviewing training for staff to ensure the effective use and monitoring of on-line training.

• Review performances for mental health patients, ensuring annual reviews are conducted.

• Ensure staff are aware of the practice mission statement.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 10 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.

• The percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) was 5 mmol/l or less was 76%, which was 4% below the CCG average and 4% below the national average. The exception rate for the practice was 5%, CCG was 9% and national was 12%.

• The practice devised an annual health report for patients with long term conditions to complement care plans.

• Longer appointments and home visits were available when needed.

• 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.

• Longer appointments were offered for patients on ten or more medications.

• The practice participated in in virtual clinics for heart failure, hypertension, atrial fibrillation, diabetes and asthma and chronic obstructive pulmonary disease (COPD).

Updated 10 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 had a high number of Accident and Emergency (A&E) attendances.

• Immunisation rates were relatively high 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.

• 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.

• Same day appointments were always offered to children.

• There was a family planning service including long acting reversible contraception (LARC), the practice fitted 223 coils and implants in 2015/16.

• Postnatal and six week checks were conducted.

Updated 10 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.

• All older people had a named GP. The named GP was responsible for repeat prescribing, dealing with paperwork and leading on home visits for all their allocated patients.

• The practice participated in the unplanned admissions direct enhanced service and 200 older patients had a current care plan in place.

Updated 10 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.

• Phone or face to face appointments were bookable up to 6 weeks in advance.

• Online access for registration, repeat prescriptions, appointment booking, and results.

• Extended hours above those contracted; with early, late and weekend including (healthcare assistant) HCA, nurse and doctor appointments were available.

Updated 10 January 2017

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

• 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.

• Since April 2016 there was an alert put on patients records, promoting reception to book double appointments for patients who have not had their annual review.

Updated 10 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 homeless people, travellers and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability. The practice had 43 patients with a learning disability, eight had received an annual review in the last year which was 19%. The practice had recently started a structured recall system for these patients inviting them in for an appointment with a nurse and then followed up by a GP appointment.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• 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.

• Housebound patients all have a named GP who was responsible for ensuring annual reviews were completed.