Shoreditch Park Surgery

Updated 6 February 2017

The practice is located opposite Shoreditch Park in London N1 5DR, it’s situated in a purpose built two storey building. The building is owned by City and Hackney CCG and maintained by NHS Property Services. They provide NHS primary medical services to approximately 8000 patients through a General Medical Services contract (a General Medical Services (GMS) contract is the contract between general practices and NHS England for delivering primary care services to local communities).

The premises have step free access with an accessible toilet and has parking spaces for disabled patients. It’s located just off the busy New North road and is well served by local bus routes.

The practice staff includes three GP partners (two male, one female) working five and half sessions each, two salaried GPs, one working six sessions (male) and the other working three sessions (female). There is a nurse practitioner working 30 hours per week, a practice nurse working full time and a health care assistant working 28 hours (all female). The practice manager and reception manager both work 36 hours and there is a variety of reception, secretarial and IT staff.

The practice has been a teaching practice since 2009 and had two registrars at the time of our inspection.

The practice is open from;

• Monday: 8:30am – 6:00pm
• Tuesday: 8:30am – 6:00pm
• Wednesday: 8:30am – 6:00pm
• Thursday: 8:15am – 6:00pm
• Friday: 8:30am – 6:00pm

The practice also provides telephone consultations and home visits, the home visits are carried out between morning and evening surgery. The practice does not offer extended hours, however out of hour’s services and weekends are covered by the locally agreed out of hours provider who provide telephone consultations, home visits or patients can be seen at the local Homerton University hospital.

The practice serves a diverse population and for many patients English is not their first language. The main local community language is Turkish. The practice does not have a large older population (7%), the largest group (29%) are aged between 25 to 34. The practice population is 46% non-white minority ethnic groups. Information published by Public Health England rates the level of deprivation within the practice population group as three on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

Updated 6 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Shoreditch Park Surgery on 19 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.
• 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.

We saw one area of outstanding practice:

• The practice has developed a vulnerable patients list where high risk patients would have up to four home visits per year and had a vulnerable patient coordinator (VPC) who would coordinate the visits and medicine reviews.

The areas where the provider should make improvement are:

• Review how patients with caring responsibilities are identified and recorded on the clinical system to ensure information, advice and support is available to them.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 6 February 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.

• The percentage of patients with hypertension in whom the last blood pressure reading measured in the preceding 12 months is 150/90mmHg or less was 85% compared to the national average of 84%.

• 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 6 February 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 percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years was 82% which was the same as the national average.

• 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 6 February 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.

• The practice had monthly Mutli Disciplinary meetings (MDTs) to discuss elderly and vulnerable patients.

• The practice participated in the Coordinate My Care (CMC) initiative which shares personalised care plans between healthcare providers.

• The practice has developed a vulnerable patients list where high risk patients would have up to four home visits per year .

Updated 6 February 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 appointment booking and prescription requests were available.

• Telephone consultations with clinicians were available to meet the needs of this population group. Patients aged 40–74 had access to appropriate health assessments and checks that were followed up where abnormalities or risk factors were identified.

• The practice did not offer extended hours but the practice was a part of the local HUB which provided appointments on weekday evenings and weekends.

Updated 6 February 2017

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

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption has been recorded in the preceding 12 months was 84% which is comparable to the national average of 90%.

• 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 6 February 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.

• The practice has a dedicated administrator who ensured that every patient on the vulnerable patient list had visits by their named GP appropriate to their needs.

• The practice had a large Turkish patient group and held clinics twice a week with a Turkish speaking advocate.