Earlsfield Practice

Updated 2 May 2017

Earlsfield Practice provides primary medical services in Wandsworth to approximately 11,000 patients and is one of 44 member practices in the NHS Wandsworth Clinical Commissioning Group (CCG). 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 population is in the third less deprived decile with income deprivation affecting children and adults lower than national averages.

The practice operates from Earlsfield Surgery located at 2-4 Steerforth Street which is a purpose built property over two floors. There is step free access to the ground floor which has two treatment rooms and seven consulting rooms, disabled access facilities, reception and the patient waiting area. The first floor comprises a counsellor’s room and administrative offices, a meeting room and staff facilities.

The practice operated a branch surgery at 280 Trinity Road which formally closed on 1 April 2017.

The practice clinical team is made up of three full time GP partners, four salaried GPs, one part time and one full time practice nurse and one part time and one full time healthcare assistant. The GPs together provide 48 clinical sessions per week. Three of the GPs are male and all other clinical staff are female. The non-clinical team consists of one practice manager and eight administrative and reception staff.

The practice opens between 8.00am and 6.30pm Monday to Friday. Telephone lines are operational between the hours of 8.00am and 6.30pm Monday to Friday. Appointments are available between 8.00am and 6.30pm. Extended hours are available Monday to Thursday mornings from 7.30am, Wednesday evenings until 7.30pm, and Saturday mornings between 8.30am and 11.30am. All extended hours appointments are pre booked.

The provider has opted out of providing out-of-hours (OOH) services to their own patients between 6.30pm and 8.00am when the practice directs patients to seek assistance from the locally agreed out of hours provider.

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

Updated 2 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Earlsfield Practice on 4 July 2016. The overall rating for the practice was good, with the rating for providing safe services requires improvement. The full comprehensive report on the 4 July 2016 inspection can be found by selecting the ‘all reports’ link for Earlsfield Practice on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 27 March 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 4 July 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The practice is now rated as good for providing safe services. The overall rating remains unchanged from our previous inspection.

Our key findings were as follows:

• The practice had reviewed and improved the arrangements for assessing the risk of, and preventing detecting and controlling the spread of infections, including those that are healthcare associated.
• The practice had conducted infection prevention and control training sessions for clinical and non-clinical staff, conducted and carried out actions identified through infection prevention and control audits and stopped providing services from their branch surgery.

We also reviewed the areas we identified where the provider should make improvement:

• The practice had reviewed and updated their induction programme to include training for temporary staff which included practice introduction, mandatory training such as infection prevention and control and role specific training and induction requirements. 

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 14 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 practice performance for diabetes care was comparable to local and national averages.  

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and were offered 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 14 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 comparable to other practices locally 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 82%, which was comparable to local and national averages.

• Appointments were available outside of school hours, there were daily walk in clinics for children under 5 years old and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives and health visitors.

Updated 14 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.

• Older people had a named GP responsible for their care.

Updated 14 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 online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 14 December 2016

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

• The practice performance for the care of people experiencing poor mental health was comparable to local and national averages.
• 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 employed four part time counsellors who provided in house counselling services and promoted a range of online modules in cognitive behavioural therapy as well as local support groups.  

• 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 14 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.

• The practice regularly engaged with the local traveller community, providing a full range of health services and signposting people to other support services.