Archived: Cassidy Medical Centre

Updated 22 January 2015

Cassidy Medical Centre operates from 651A Fulham Road, London, SW6 5PX. The practice provides NHS primary medical services through an Alternative Provider Medical Service (APMS) contract to 4800 patients in the Fulham area. The practice is part of the NHS Hammersmith and Fulham Clinical Commissioning Group (CCG) which is made up of 31 GP practices. The practice serves a young population group with patients predominantly in the 20 to 40 years age range. The practice staff comprise of a female salaried GP, a male long-term locum GP, two locum practice nurses covering the full time nurse currently on maternity leave, a practice manager and a small team of non-clinical staff. The practice partnership also runs its own bank of locum GPs to cover clinical sessions when needed. The practice is managed as part of the Hurley Clinical Partnership with over 20 practices located across London and additional support is provided to the practice by the Hurley Clinical Partnership corporate team.

The practice opening hours are 8.00am to 6.30pm Mondays and Fridays and 7.00am to 6.30pm Tuesdays, Wednesdays and Thursdays with extended hours until 7.30pm on Wednesdays. The practice is also open from 8.00am to 12.00pm on Saturdays and provides a walk-in centre between 9.00am and 4.00pm on Saturdays and Sundays for patients with minor or moderate illnesses. The practice has opted out of providing out-of-hours services to their own patients and refers patients to the ‘111’ service. The practice has an electronic prescription service and operates an online service which enables registered patients to obtain advice and consult with a GP via an interactive web form.

Updated 22 January 2015

Letter from the Chief Inspector of General Practice

The practice is rated as requires improvement

Our key findings were as follows:

• Patients were satisfied with access to the practice. There was a flexible appointment system, a weekend walk-in service and online consultations offered.
• Patients said the practice was caring and staff treated them with dignity and respect. They said clinical staff involved them in decisions about their care and treatment.
• On the day of our inspection the practice was clean, hygienic and well equipped.
• The practice had some governance arrangements in place and was supported by the providers corporate team.
• The practice actively sought patient’s feedback and acted on it.

We found areas of outstanding practice including:

• The practice offered online consultations for a range of medical conditions allowing patients to receive advice or treatment from their home.
• The practice had a close working relationship with a local charity that offered community support to patients with non-medical needs. The practice attended regular meetings with the charity to identify patients who might benefit from this form of support. The charity offered a telephone counselling service for these patients.
• A weekend walk-in service was available accessible to patients who were unregistered.

However, there were also areas of practice where the provider needs to make improvements. 

Importantly, the provider must:

• Share learning from significant events/complaints with all staff
• Disseminate safety alerts to appropriate staff and ensure they are acted on
• Hold regular clinical meetings to share best practice and learning from significant events/complaints
• Carry out clinical audit to improve outcomes for patients
• Ensure all patients with long-term conditions are reviewed appropriately
• Develop care plans for all patients with complex needs
• Ensure all patients medical records are accurate and up to date

In addition the provider should:

• Ensure all staff are aware of the practice mission statement/aims and objectives
• Proactively offer health checks for patients over 40 years old and influenza vaccinations for ‘at risk’ patients

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 January 2015

The practice is rated as requires improvement for the population group of people with long-term conditions.

The practice provided clinics for patients with a variety of long-term conditions including asthma, diabetes and chronic obstructive pulmonary disorder (COPD).  We found that some patients with long-term conditions had not had their conditions reviewed putting them at risk of avoidable complications or deterioration. We reviewed five case notes of patients with long-term conditions and found two patients had not had a review in the previous 12 months. We found that a patient with diabetes had not been regularly reviewed for their condition despite attending a recent consultation for another condition commonly associated with diabetes.

The provider was rated as requires improvement for safe, effective and well-led this includes for this population group. The concerns which led to these ratings apply to everyone using the practice, including this population group.

Updated 22 January 2015

The practice is rated as requires improvement for the population group of families, children and young people.

Services were available for this population group. The practice did not provide family planning clinics however pre and post natal support was provided by the GPs and nurse team. A wide variety of information was available on the practice website targeted at families, children and young people.

The practice referred patient’s to a specialist service for HIV testing and treatment for sexually transmitted diseases.

Child immunisation/vaccination services were available in line with national guidelines. Data showed that the practice had scored below the CCG average for most immunisations in the previous year.

The provider was rated as requires improvement for safe, effective and well-led this includes for this population group. The concerns which led to these ratings apply to everyone using the practice, including this population group.

Updated 22 January 2015

The practice is rated as requires improvement for the population group of older people.

The practice was responsive to the needs of older people including longer appointments, personalised care plans and a named GP for those patients over 75 years. Home visits were available for older patients and a dedicated phone line was in place so homebound patients could contact the practice when necessary.

The practice had safeguarding procedures in place for older people. Staff  had been trained in safeguarding vulnerable adults and were aware of the reporting procedures if they had any concerns.

Regular meetings were held to plan care and treatment for patients requiring end of life care. However we found that important decisions relating to them had not always been recorded in their case notes.

The provider was rated as requires improvement for safe, effective and well-led this includes for this population group. The concerns which led to these ratings apply to everyone using the practice, including this population group.

Updated 22 January 2015

The practice is rated as requires improvement for the working-age people (including those recently retired and students).

The practice had a flexible appointment system including extended surgery hours on Wednesdays from 6.30pm to 7.30pm and a weekend walk-in service for patients requiring an appointment outside of normal working hours. The practice offered online registration and appointments and online consultations for a variety of conditions.

The practice had information on their website on a wide range of health conditions including information specific to men’s and women’s health. Smoking cessation clinics were not provided and patients were referred to a local smoking cessation service to help them quit smoking. The practice had not monitored how many of their patients referred to this service had successfully managed to stop smoking.

The provider was rated as requires improvement for safe, effective and well-led this includes for this population group. The concerns which led to these ratings apply to everyone using the practice, including this population group.

Updated 22 January 2015

The practice is rated as requires improvement for the population group of people experiencing poor mental health (including people with dementia).

The practice offered annual physical health checks for patients experiencing poor mental health however the practice was unable to provide data on how many patients had received one. Non-attendances were followed up by staff. Staff had attended a training day covering mental health issues and reception staff knew to be flexible with patient’s adherence to appointment times when appropriate.

The practice had scored above the national average for the percentage of patients diagnosed with dementia whose care has been reviewed in the previous 15 months and the percentage of patients with physical and/or mental health conditions whose notes contain an offer of support and treatment within the preceding 15 months.

The practice had sign-posted patients experiencing poor mental health to support groups such as the local Mind team.

The practice had information on their website targeted at patients experiencing poor mental health. This included information on anxiety, depression, low mood and panic attacks. Information was also available on depression.

The provider was rated as requires improvement for safe, effective and well-led this includes for this population group. The concerns which led to these ratings apply to everyone using the practice, including this population group.

Updated 22 January 2015

The practice is rated as requires improvement for the population group of people whose circumstances may make them vulnerable.

The practice supported patients living in vulnerable circumstances. There was a weekend walk-in service accessible to unregistered patients and those who were homeless.

The practice had a register of patients with learning disabilities and these patients were offered annual health checks. The practice had developed a template written in simple English with pictures to explain the importance of health checks and inviting patients in for an appointment with the GP to encourage them to access the service.

The practice had a close working relationship with a local charity that offered community support to patients with non-medical needs. The practice attended regular meetings with the charity to identify patients who might benefit from this form of support. The charity offered a telephone counselling service for these patients. The practice also supported the food bank scheme and was a designated supplier of food vouchers.

Home visits were available for patients who were housebound.

The provider was rated as requires improvement for safe, effective and well-led this includes for this population group. The concerns which led to these ratings apply to everyone using the practice, including this population group.