Bethnal Green Health Centre

Updated 12 April 2017

The Bethnal Green Health Centre is located in Tower Hamlets, East London within the NHS Tower Hamlets Clinical Commissioning Group. The practice holds a General Medical Services contract (an agreement between NHS England and general practices for delivering primary care services to local communities). The practice provides a full range of enhanced services including childhood immunisation and vaccination, dementia support, influenza and pneumococcal immunisations, rotavirus and shingles immunisation and unplanned admissions avoidance.

The practice is registered with the Care Quality Commission to carry on the regulated activities of family planning, maternity and midwifery services, treatment of disease, disorder or injury, diagnostic and screening procedures and surgical procedures.

The practice had a patient list size of 8,300 at the time of our inspection. The practice had a lower proportion of people with a long standing health conditions than average (40% compared to the CCG average of 45% and the national average of 54%). The practice serves a diverse community: 31% White British, 30% Asian, 27% African and 12% White other. At 75 years, male life expectancy is lower than the CCG average of 77 years and the England average of 79 years. At 83 years, female life expectancy is in line with the CCG average of 82 years and the England average of 83 years.

The practice has fewer patients aged 60 years of age and older compared to an average GP practice in England. The percentage of patients under the age of 40 years of age is higher than the average GP practice in England. The surgery is based in an area with a deprivation score of two out of ten (one being the most deprived). Children and older people registered with the practice have a higher level of income deprivation compared to the local and national averages. Compared to the average GP practice in England, patients at this practice have a higher rate of unemployment.

The staff team at the practice included five female GP partners, two salaried female GPs, two female practice nurses, three psychologists (two male, one female), one female and one male healthcare assistant (both healthcare assistants have dual roles, one is also an interpreter and the other is also a phlebotomist). A phlebotomist is a health care professional that collects blood samples from patients. The practice had one practice manager and eight administrative staff. There were 42 GP sessions and eight nurse sessions available per week.

The practice is open between 8.30am and 6.30pm Monday to Friday, with the exception of Thursday when the practice is open between 8.30am and 1.00pm. GP appointments are available between 9.00am and 12.00pm and between 3.30pm and 6.00pm Monday to Friday (with the Exception of Thursday afternoon). Extended hours appointments are available every Friday between 7.00am and 8.00am. The surgery is closed on Saturdays, Sundays and bank holidays. Urgent appointments are available each day and GPs also provide telephone consultations for patients. An out of hours service is provided for patients when the practice is closed. Patients may also access one of two local walk-in centres and one hub location. Information about the out of hours service is provided to patients through posters in the waiting area, on the practice website and the practice leaflet. Patients are automatically transferred to the out of hours provider when they ring the surgery if it is closed.

Updated 12 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bethnal Green Health Centre on 11 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.

• 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.
• 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. Patient satisfaction was consistently positive.
• 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 areas where the provider should make improvement are:

• Implement audit systems in relation to the monitoring of prescription pads in accordance with national NHS guidelines.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 12 April 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.
• Performance for diabetes related indicators was in line with the CCG average and the national average. The percentage of patients with diabetes, on the register, in whom the last IFCC-HbA1c is 64 mmol/mol or less in the preceding 12 months was 90% compared to the CCG average of 93% and the national average of 91%.
• 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 12 April 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 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 comparable to the CCG average of 79% and the national average of 82%.
• 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. For example, the monthly antenatal meetings and monthly child safeguarding meeting.

Updated 12 April 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.
• GPs at the practice regularly worked with relevant health and care professionals to deliver a multidisciplinary package of care for those patients with the most complex needs.

Updated 12 April 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.
• Online services were available including booking appointments and ordering repeat prescriptions.

Updated 12 April 2017

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

• Performance for dementia related indicators was above the national average. The percentage of patients diagnosed with dementia whose care has been reviewed in a face-to-face review in the preceding 12 months was 86% compared to the CCG average of 87% and the national average of 84%.
• 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.

Updated 12 April 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 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.