Penrose Surgery

Updated 1 August 2016

Penrose Surgery provides primary medical services in Walworth to approximately 6700 patients and is one of 49 practices in Southwark Clinical Commissioning Group (CCG). The practice population is in the second most deprived decile in England.

The practice population has a higher than CCG and national average representation of income deprived children and older people. The practice population of children is lower than the CCG and national averages and the practice population of working age people is higher than the CCG and national averages; the practice population of older people is lower than the local and national averages. Of patients registered with the practice for whom the ethnicity data was recorded, 28% are British or Mixed British, 24% are Other White Background and 12% are African.

The practice operates in converted premises. All patient facilities are wheelchair accessible. The practice has access to two doctors’ consultation rooms, one nurse consultation room, one healthcare assistant consultation room and one pharmacist consultation room on the ground floor.

The clinical team at the surgery is made up of one part-time female GP who is a partner and two part-time salaried GPs (one male and one female), one full-time and one part-time female practice nurses and two part-time female healthcare assistants. The non-clinical practice team consists of practice manager who is a partner and 10 administrative and reception staff members. The practice provides a total of 21 GP sessions per week.

The practice operates under a Personal Medical Services (PMS) contract, and is signed up to a number of local and national enhanced services (enhanced services require an enhanced level of service provision above what is normally required under the core GP contract).

The practice reception and telephone lines are open from 8:00am till 6:30pm Monday to Friday. GP appointments are available from 8:30am to 12:20pm and 3:20pm to 6:00pm every day. Extended hours surgeries are offered on Saturdays from 9:00am to 12:00pm. Nurse appointments are available from 9:00am to 6:00pm every day. The practice offers additional GP appointments for patients through the extended primary care service provided by the local Clinical Commissioning Group (CCG) in Bermondsey which is open from 8:00am to 8:00pm seven days a week including bank holidays.

The practice has opted out of providing out-of-hours (OOH) services to their own patients between 6:30pm and 8am and directs patients to the out-of-hours provider for Southwark CCG.

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

Updated 1 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Penrose Surgery on 22 June 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 with the exception of patient letters initially being reviewed and coded by administrative staff instead of clinical staff.
• 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 some of the patients we spoke to indicated that they had to wait nearly two weeks to get a regular appointment.
• 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 saw one area of outstanding practice:

• The practice had an in-house pharmacist who ran regular medicines review clinics for patients with long term conditions, reviewed medicines for patients who had unplanned admissions and also checked all repeat prescriptions to ensure safe prescribing.

There were areas of practice where the provider should make improvements:

• Review the practice procedures to ensure the recording of significant events and lessons learnt are improved.
• Review practice procedures for reading and reviewing patient letters so they are safe and decisions are made by clinical staff.
• Review how they identify and record patients with caring responsibilities to ensure information, advice and support is made available to them.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 1 August 2016

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 national Quality and Outcomes Framework (QOF) data showed that 73% of patients had well-controlled diabetes, indicated by specific blood test results, compared to the Clinical Commissioning Group (CCG) average of 74% and the national average of 78%. The number of patients who had received an annual review for diabetes was 80% which was below the CCG average of 85% and national average of 88%.
• The national QOF data showed that 74% of patients with asthma in the register had an annual review, compared to the CCG average of 75% and the national average of 75%.
• Longer appointments and home visits were available for people with complex long term conditions when needed.
• All these patients had a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• The practice provided a phlebotomy service and spirometry to improve monitoring of patients with long term conditions.

Updated 1 August 2016

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 urgent care and 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.
• The practice’s uptake for the cervical screening programme was 80%, which was in line with the Clinical Commissioning Group (CCG) average of 80% and the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice provided antenatal and postnatal checks.
• They also provided a smoking cessation service and healthy living advice using healthcare assistants.

Updated 1 August 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. They had personalised care plans for patients at risk of hospital admission.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• All patients had a named GP and were informed about this.
• The practice provided a phlebotomy service which suited older patients who may have difficulty in getting to the hospital.
• The practice nurses or healthcare assistants visited the patients home to provide flu immunisations if they were unable to attend the surgery.

Updated 1 August 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 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.

Updated 1 August 2016

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

• The number of patients with dementia who had received annual reviews was 77% which was in line the Clinical Commissioning Group (CCG) average of 81% and national average of 84%.
• 94% of 66 patients with severe mental health conditions had a comprehensive agreed care plan in the last 12 months which was above the CCG average 85% and national average of 88%.
• The practice regularly worked with multi-disciplinary teams in the case management of people 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.

Updated 1 August 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, carers, travellers and those with a learning disability.
• The practice offered longer appointments and extended annual reviews for patients with a learning disability; 75% of the 8 patients with learning disability had received a health check in the last year.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• 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.