Dr Rozewicz & Partners Also known as Simpson House Medical Centre

Updated 24 March 2017

Dr Rozewicz and Partners (also known as The Simpson House Medical Centre) is a GP partnership located in Harrow, London. They hold a general medical services contract and their services are commissioned by Harrow clinical commissioning group. Dr Rozewicz and Partners are registered with the Care Quality Commission to provide the regulated activities of family planning, treatment of disease, disorder or injury, diagnostic and screening procedures, surgical procedures and maternity and midwifery services.

The practice is staffed by two female and three male GP partners who provide a combination of 39 sessions a week. There is a salaried female GP who provides six sessions a week. One of the GPs has a special interest in musculoskeletal medicine, and another is qualified to perform minor surgery. The practice also employs a full time practice manager, an enhanced nurse who works 35 hours a week, two practice nurses who work a combination of 22 hours a week, and a healthcare assistant who works 34 hours a week.

Other staff include a reception manager, an information technology and Quality and Outcomes Framework manager, a secretary and seven reception and administration staff. The practice is an established training practice for the local hospital and currently has two GP registrars and one Foundation Year 2 trainee on placement who work a combination of 19 sessions a week.

The practice is open between 8.30am and 6.30pm on Monday to Thursday and between 8.30am and 5pm on Friday. The practice is closed between 1pm and 2pm on Wednesday for administration and staff training. Extended hours surgeries are offered by a GP on Monday morning between 8am and 8.30am, on Monday evening between 6.30pm and 8pm, and on Saturday morning between 8.30am and 11.15am. Outside of these hours, patients are redirected to  the NHS 111 service.

The practice has a list size of 11,500 patients which includes 32 patients that live in a local residential care home. They provide a wide range of services including a heart and stroke clinic, minor surgery, electrocardiogram monitoring, immunisations, vaccinations, screening, mental health management, chronic disease management, audiology and lifestyle management.

The practice is located in an area with high social deprivation and the majority of the population is under 18 years of age. There is a high rate of elderly patients with 16% of the practice population aged 65 years and above, and there is a diverse mix of ethnic groups.

Updated 24 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Rozewicz and Partners (also known as Simpson House Medical Centre) on 21 July 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• The governance framework supported the delivery of the strategy and good quality care, although arrangements to monitor and improve quality of services needed to be strengthened in areas.

• Although there were translation services provided, there were no notices displayed in the practice informing patients this service was available. This was quickly addressed.

• The arrangements for managing medicines, including emergency medicines and vaccines, in the practice kept patients safe. Prescription pads had not been stored securely but this was quickly addressed.

• Patients said they were treated with compassion, dignity and respect, but some said they were not always able to get appointments when they needed them.

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.

• There were effective systems in place to safeguard vulnerable adults and children. Two of the management staff had received level 4 child safeguarding training.

• The practice had a system in place to identify carers. There was effective joint working with the patient participation group (PPG) and an external organisation to undertake carers' events such as hosting a monthly coffee morning.

• 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.

• The practice’s Simpson Spectator quarterly newsletter, developed by the PPG together with the practice, was available in easy read format.

• There was a staff recognition programme in place which allowed practice staff and patients to nominate and recognise an individual staff member for their achievements.

• The provider was aware of and complied with the requirements of the duty of candour.

In addition, the provider should:

• Monitor the new prescriptions security policy to ensure all staff are aware of it, and that it is being adhered to.

• Monitor and improve patient satisfaction regarding access to appointments and contacting the practice by telephone.

• Monitor and improve performance, specifically patient outcomes in relation to the Quality and Outcomes Framework and cervical screening.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 24 March 2017

The provider is rated as good for the care of people with long-term conditions.

• The data for diabetes performance showed the practice was mostly below local and national averages; however, they were proactive in improving care for this group. For example, they had implemented a diabetes plan for the coming year and recently hosted diabetes events which targeted patients identified as being at risk of diabetes.

• In some areas of diabetes performance was comparable to the local clinical commissioning group (CCG) and national averages. For example, the percentage of patients with diabetes, on the register, whose cholesterol was within the normal range was 82%, compared to the CCG average of 80% and national average of 81%.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• The practice’s enhanced nurse was responsible for chronic disease management for patients at home.

• Longer appointments and home visits were available when needed.

Updated 24 March 2017

The provider 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 attendances to accident & emergency services.

• 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 provided monthly paediatric clinics in partnership with paediatricians from the local hospital. This was effective in reducing the number of referrals to secondary care and allowed patients to see a consultant promptly within the community.

• The percentage of women aged 25-64 who had received cervical screening test in 2014/2015 was 73%, compared to the clinical commissioning group average of 77% and national average of 82%. This figure had declined to 67% in 2015/2016 (CCG average 77%, national average81%). The practice acknowledged that this area required further monitoring and had implemented a new process to make improvements.

• 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 and health visitors.

Updated 24 March 2017

The provider 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.

• Annual health checks were available to all patients aged over 65 regardless of need.

• The practice held weekly clinics at a local care home.

Updated 24 March 2017

The provider 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 reflected the needs for this age group. For example, they interacted with the younger population and offered health promotion through social media.

• The practice implemented their own age-specific practice questionnaire for 18-30 year olds to establish their needs and to improve engagement with them.

Updated 24 March 2017

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

• The exception reporting rate for mental health in 2014/2015 was 60%, higher than the local clinical commissioning group (CCG) average of 10% and the national average of 13%. An audit carried out by the practice shortly after our inspection revealed a more accurate rate of 15%

• Data for 2014/2015 showed that 98% of patients on the mental health register had a comprehensive, agreed care plan documented in their notes, and this was above the CCG average of 91% and national average of 88%. This figure had increased to 95% in 2015/2016 (CCG average 95%, national average 89%).

• 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 held monthly drug and alcohol support clinics in collaboration with an external organisation as part of a drug programme. An in-house counsellor also held twice weekly cognitive behaviour therapy sessions at the practice.

• The practice had a system in place to follow up patients who had attended accident and emergency services 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. Annual health assessments were available for this group.

Updated 24 March 2017

The provider 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 those experiencing domestic violence, homeless people, and those with a learning disability.

• The practice worked closely with external organisations to provide food bank vouchers for those in need.

• 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.

• Although the practice provided translation services, there were no notices displayed in the practice informing patients this service was available. This was quickly addressed.

• 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 during and outside of normal working hours.