The Whitehorse Practice

Background to this inspection

Updated 20 April 2017

The Whitehorse Practice provides primary medical services in Croydon to approximately 7,800 patients and is one of 58 member practices in the NHS Croydon Clinical Commissioning Group (CCG).

The practice population is in the second more deprived decile in England with higher than CCG and national average representation of income deprived children and older people. The practice population has lower than local and national average life expectancy. There are more children under 18 years of age than the CCG and national average and a lower percentage of patients over 65 years of age.

The practice had surveyed the ethnicity of the practice population and main languages patients spoke, 37% of patients identified as Black, 28% White, 26% Asian and 9% as having mixed or other ethnicity. There are 83 languages spoken at the practice with English, Tamil, Urdu, Polish French and Twi being the most commonly spoken first languages.

The Whitehorse Practice is a two storey modern building comprising of seven consultation rooms, four on the ground floor and three on the first floor. The practice has two separate patient waiting areas located on each floor with Reception on the ground floor. Also on the first floor are two administration offices, a staffroom, a meeting room, a staff toilet, a patient toilet and a staff kitchen. Disabled access is available to the ground floor only via the side entrance.

The practice operates under a Personal Medical Services (PMS) contract and provides a number of local and national enhanced services (enhanced services require an increased level of service provision above that which is normally required under the core GP contract).

The practice operates as a partnership with three full time female GP partners. There is one part time male salaried GP and one part time female salaried GP. The doctors provide 32 clinical sessions per week. The nursing team consists of one part time female nurse practitioner and three part time female practice nurses. The practice also employs one part time female health care assistant. There are 11 administrative and clerical staff including one full time practice manager, one part time senior receptionist and six part time receptionists, one part time senior medical secretary and two part time administrators.

The practice is open between 8.00am and 6.30pm Monday to Friday. Telephone lines are operational and appointments are available between 8.00am and 6.30pm. The practice does not open at weekends. The practice has opted out of providing out of hours (OOH) services to their own patients between 6.30pm and 8.00am and directs patients to the locally agreed OOH provider.

The Whitehorse Practice is registered as a partnership with the Care Quality Commission to provide the regulated activities of diagnostic and screening services, family planning, maternity and midwifery services, and the treatment of disease, disorder or injury.

Overall inspection

Good

Updated 20 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Whitehorse Practice on 31 March 2016. The overall rating for the practice was good, however the practice was rated as requires improvement for providing safe services. The full comprehensive report on the March 2016 inspection can be found by selecting the ‘all reports’ link for The Whitehorse Practice on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 13 February 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 31 March 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice maintains its rating of good, with the practice now rated as good for providing safe services.

Our key findings were as follows:

The practice had carried out a full risk assessment against the chaperoning service and now only provided the service using clinical staff who were trained for the role and had checks carried out through the disclosure and barring service (DBS).
The practice had carried out portable appliance testing, ensuring all electrical appliances were safe to use.
The practice had reviewed and updated their recruitment policy to include a comprehensive recruitment and induction checklist, covering areas such as proof of identity and references from previous employers.
The practice carried out monthly fire alarm checks and fire evacuation drills.
Practice policies and plans had been reviewed and updated since our last inspection.
The practice had developed a business plan and strategy for the practice, using templates from the local clinical commissioning group (CCG) Practice Development and Delivery Scheme and had submitted assurances against the template to the CCG.
The arrangements for recording and disseminating actions and outcomes from clinical meetings, including clinical standards and best practice guidelines had improved and we saw evidence of clinical meeting minutes and an alerts log used by the practice.
The practice quality improvement programme had been reviewed and updated and we saw evidence of regular clinical audits undertaken and planned for the future.
Health care assistants had been reminded of processes and procedures for escalating concerns and we saw evidence in clinical meetings that patients with abnormal blood pressures had been escalated to GPs for review.
The practice had reviewed how patients were informed of the availability of a room for private conversations if required and had produced a poster for the reception area.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice