Park Road Surgery

Updated 27 July 2016

• The Park Road Surgery - Brockbank, also known as The Park Road Surgery, is located in the London Borough of Richmond Upon Thames. The building is situated on a main road. The practice is located on the ground and first floor of a converted residential property. There are eight consulting rooms and a room for baby consultations. There are two toilets; one for patients with disabled access and another for staff . Access to the surgery is via the main front entrance of the building on level flooring and side entrance with automatic doors for wheelchair access, patients with mobility issues were offered an appointment on the ground floor.
• The service is registered with the Care Quality Commission to provide regulated activities of; diagnostics and screening services, treatment of disease, disorder or injury, surgical procedures, maternity and midwifery services and family planning
• Five GP partners (two female and three male) run the practice. The partners are supported by; two salaried GP’s and two permanent GP locums, two nurses, one healthcare assistant (HCA), one practice manager and reception staff.

• The GP’s at the practice collectively provided 52 clinical sessions a week.

• The practice is open between 08:30am – 6:30pm Monday – Friday. Appointments are available from 8:30am – 6:30pm.

• Extended surgery hours are offered from:

• 6:30pm – 8:00pm every Monday.

• 7:00am - 8:00am – Wednesday and Friday

• When the practice is closed patients can call NHS 111 in an emergency or a local out of hour’s service.

• The practice has a patient list size of approximately 13,100 patients. The practice is situated in an area which is classified as the tenth least deprived decile. The majority of the patients within the practice are either young or of working age. A small percentage of patients are aged between 65 and 85.

Updated 27 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Park Road Surgery - Brockbank, also known as The Park Road Surgery on 5 May 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.

• 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 when interviewed 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.

• Risks to patients were assessed and well managed, except for some medical equipment had not been calibrated within the past twelve months.

• There was no instant messaging system on the computers in all the consultation and treatment rooms, which alerted staff to any emergency.

• 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.

• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from patients and staff, which it acted on.

• The provider was aware of and complied with the requirements of the Duty of Candour.

The area where the provider should make an improvement is to:

• Ensure that equipment used at the practice is calibrated at regular intervals, in accordance with the practice policy.

• Ensure that adequate arrangements are in place to respond to emergencies and major incidents.

• Ensure the practice improves performance identified in the GP Patient survey (January 2016), relating to access to care and treatment.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 27 July 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 were comparable to the local and national average, for instance:

• 76% of patients with diabetes on the register had their blood sugar recorded as well controlled (CCG average 77%, national average of 77%).

• 81% of patients with diabetes on the register had a recorded foot examination and risk classification (CCG average 91%, national average of 88%).

• 72% of patients with diabetes on the register had their cholesterol measured was well controlled (CCG 79%, national average 81%).

• 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 27 July 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.

• 71% of patients diagnosed with asthma had an asthma review in the last 12 months this was lower than the CCG average of 74% and national average of 75%.

• 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.

• 90% of women aged 25-64 had it recorded on their notes that a cervical screening test had been performed in the preceding 5 years; this was higher than the CCG average of 83% and national average of 82%.

• 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 27 July 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.

• 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 27 July 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.

• The practice offered extended opening hours on Monday evenings and Wednesday and Friday mornings.

Updated 27 July 2016

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

• Performance for mental health related indicators was comparable or lower than the local and national average:

• 86% of patients diagnosed with dementia had a recorded review in a face to face meeting in the last 12 months (CCG average 86%, national average 84%).

• 78% of patients with schizophrenia, bipolar affective disorder and other psychoses had their alcohol consumption recorded in the preceding 12 months, this was much lower than the CCG average of 92% and the national average of 90%.

• 94% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan recorded in the last 12 months (CCG average 94%, national average 88%).

• The practice regularly worked with multi-disciplinary teams in the case management of people 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 27 July 2016

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

• The practice was piloting the Rapid Access Team (RAT), a mobile GP service working alongside the dedicated multidisciplinary community team to offer a rapid assessment of, and rapid treatment for, acutely unwell housebound patients.

• 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 multi-disciplinary teams in the case management of vulnerable people.

• 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.