Drs Patel and Partner Also known as Vassall Medical Centre

Updated 7 January 2016

Dr Patel and Partner (also known as Vassall Medical Centre) is in Oval in the London Borough of Lambeth. The practice has two partners (one of the GPs and the practice manager) who manage the practice which is based at a single site. The practice is based in a purpose built building.

The practice provides primary medical services to approximately 7,600 patients. The practice also employs three salaried GPs. There are also two nurse practitioners, one further practice nurse and a healthcare assistant . The practice has a practice manager, and a deputy practice manager. There is a lead receptionist and six other receptionists and administrators at the practice.

The practice is contracted to provide Personal Medical Services (PMS) and is registered with the CQC for the following regulated activities: treatment of disease, disorder or injury, maternity and midwifery services, family planning, and diagnostic and screening procedures at one location.

The practice provides a number of enhanced services, including childhood immunisation, extended opening hours, learning disabilities, patient participation and rotavirus and shingles immunisations.

The practice is open from 7:00am until 6:30pm Monday to Friday. Outside of normal opening hours the practice uses a locally based out of hours provider.

Updated 7 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Patel and Partner’s practice on 13 October 2015. Overall the practice is rated as good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

• 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 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.

• Patients said they found it easy to make an appointment with a named GP and that 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.

We saw a number of areas of outstanding practice:

• The practice had been involved in a research study to develop software to identify patients with a high risk of frailty. The practice had written a business case to be involved in the operational testing of the risk study which had been funded by a charity.

• The practice team was forward thinking and part of local pilot schemes to improve outcomes for patients in the area. For example the practice was one of the ten pilot sites for the Local Care Record. They had also started worked with Age UK to better deliver  care and services to housebound patients. This involved doctors proactively offering locally provided social services from which older patients might benefit on home visits. This had a positive impact for these patients as they would be advised about social services about which they might be unaware, and would be able to access both health and social services in a single appointment.

However there were areas of practice where the provider should make improvements:

• The practice had completed a risk assessment because a defibrillator was not in place. However, the practice should have a defibrillator on site.
• The practice should consider whether Disclosure and Barring Service (DBS) checks should be repeated every three years.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 January 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.
• Performance for diabetes related indicators was better than the CCG and national average. For example the number of patients who had received relevant reviews (such as foot examination, dietary advice and flu vaccination) was higher than the national and CCG averages across each of these domains.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 7 January 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 82%, which was comparable to the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 7 January 2016

The practice is rated as outstanding for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice was undertaking a pilot project in conjunction with Age UK to provide integrated health and social care for patients whenever patients were consulted. . This involved doctors proactively offering services to locally provided social services from which older patients might benefit on home visits. This had a positive impact for these patients as they would be advised about social services about which they might be unaware, and would be able to access both health and social services in a single appointment.
• The practice had been involved in a research study to develop software to identify patients with a high risk of frailty. The practice had written a business case to be involved in the operational testing of the risk study which had been funded by a charity.

Updated 7 January 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 7 January 2016

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

• 90% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.
• 83% of patients on the mental health register had received a health check in the last year.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• It 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.
• It 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 people with mental health needs and dementia

Updated 7 January 2016

The practice is rated as good for the care of people whose circumstances may make themvulnerable.

• The practice held a register of patients living in vulnerable circumstances including homeless people and those with a learning disability.
• It offered longer appointments for people with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• It had told 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.