West Hampstead Medical Centre

Updated 2 December 2016

The West Hampstead Medical Centre is located in Camden, North London. The practice has a patient list of approximately 11050. Twenty eight percent of patients are aged under 18 (compared to the national practice average of 15%) and 14% are 65 or older (compared to the national practice average of 17%). Forty percent of patients have a long-standing health condition.

The services provided by the practice include child health care, ante and post-natal care, immunisations, sexual health and contraception advice and management of long term conditions.

The staff team comprises three GP partners (two male, one female) who work a total of 23 sessions a week, seven sessional GP’s (three male, four female) working a total of 32 sessions per week and two medical students who work a total of 12 sessions per week. The practice offers a total of 67 clinical sessions per week. The practice also includes two female practice nurses (providing a total of 12 sessions per week), a female healthcare assistant (providing five sessions per week) a practice manager, assistant practice manager, office manager and administrative staff. The West Hampstead Medical Centre holds a Personal Medical Service (PMS) contract with NHS England and is a training practice.

The practice’s opening hours are:

• Monday –Friday 8:20am-6:30pm
• Monday 7:30am-8:30am (extended hours)

• Tuesday - Friday 6:30pm-7:10pm (extended hours)

• Saturday (as needed) 9.00am1.00pm (service provided by Haverstock Health)

Appointments are available at the following times:

• Monday 7:30am – 12:30pm and 2:30pm – 6:30pm
• Tuesday 8:30am – 12:30pm and 3:30pm – 6:30pm
• Wednesday 8:30am to 12:00pm and 2:30pm – 7:10pm
• Thursday 8:30am – 12:30pm and 3:30pm – 7:10pm
• Friday 8:30am – 12:30pm and 3:30pm – 6:30pm
• Saturday 9.00am – 1.00pm

In addition to pre-bookable appointments that could be booked up to four weeks in advance, urgent appointments are also available for people that needed them.

Outside of these times, cover is provided by an out of hour’s provider.

The practice is registered to provide the following regulated activities which we inspected: family planning, treatment of disease, disorder or injury; diagnostic and screening procedures, surgical procedures and maternity and midwifery services.

This practice has not previously been inspected.

Updated 2 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at West Hampstead Medical Centre on 22 September 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 were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice worked as part of a federation which provided further services to patients, including a Saturday morning surgery.
• Information about services and how to complain was available and easy to understand. 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:

• Ensure a cleaning log is maintained for clinical equipment.

• To review how patients with caring responsibilities are identified and recorded on the patient record system to ensure information, advice and support is made available to all.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 2 December 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 percentage of patients with diabetes in whom the last IFCC-HbA1c was 64 mmol/mol or less was 84% (compared to the CCG average of 78% and the national average of 78%), with an exception figure of 7% (CCG average of 7%, national average of 12%).
• The percentage of patients with diabetes in whom the last blood pressure reading was 140/80 or less was 87% (compared to the CCG average of 78% and the national average of 78%), with an exception figure of 8% (CCG average of 7%, national average of 8%).

• The percentage of patients on the diabetes register with a recorded foot examination and risk classification was 95% (compared to the CCG average of 89% and the national average of 88%), with an exception figure of 7% (CCG average of 5% and national average of 8%).

• 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.

Updated 2 December 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 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 67%, which was comparable to the CCG average of 59% and the national average of 82%. The practice was aware that results for the cervical screening programme were lower than the national average and were conscious of the need to ensure letters were sent to those who were due a test and the use of telephone reminders for patients who did not attend for their cervical screening test. 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 and school nurses.

Updated 2 December 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.

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

• The practice are part of the Camden Federation which provided an over 75 visiting service for housebound patients who become unwell and can be seen by an on call doctor from the service. The service was in place for patients of the practice.
• Patients over the age of 75 who call for an appointment are seen the same day.
• The practice worked closely with an Age UK care navigator who helps with patients where there is social isolation and accompanies patients to their appointments. The care navigator also attends clinical meetings.

Updated 2 December 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 a full range of health promotion and screening that reflects the needs for this age group.

• The practice hosted a Camden federation Saturday clinic which was available to all patients of the practice.
• Technology is used to enable patients to keep in contact with the practice. This included a 24 hour booking and cancelling of appointment telephone system, the use of text messaging to update health status and an online asthma review for patients who had their condition under control and would not benefit from a face to face annual review.
• Patients could make appointments and order repeat prescriptions online.
• The practice provided out of hours smoking cessation appointments.

Updated 2 December 2016

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

• Performance for mental health related indicators was comparable to the CCG and national average. For example;

  • The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in their record was 94% (compared to the CCG average of 87% and the national average of 88%, with an exception figure of 1% (CCG average 7% and national average 12%).

  • The percentage of patients diagnosed with dementia whose care had been reviewed in a face-to-face review was 73% (compared to the CCG average of 83% and the national average of 84%). The practice did not exception report any of the 26 patients on its dementia register.

• 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 hosted cognitive behavioural therapists and psychotherapists who were available to see patients with poor mental health.

• 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 2 December 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, travellers and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• 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.