Queenstown Road Medical Practice

Updated 15 March 2017

Queenstown Road Medical Practice is based in Battersea, in the borough of Wandsworth. The practice list size is approximately 8000. Life expectancy for males in the practice is 76 years and for females 83 years. Both of these are in line with the CCG and national averages. The practice has a higher than average number of male and female patients aged between 25-49 years. The practice has lower than average numbers of both male and female patients aged 0-19 years old. The practice is in the fifth most deprived decile.

The basement of the practice had recently been flooded; this has been sectioned off and the running of the practice had not been affected. Consequently the practice was now operating over one floor instead of two. Facilities included five consultation, two treatment rooms and a patient waiting room. The consultation rooms are now all on the ground floor. The premises are wheelchair accessible and there are facilities for wheelchair users including a lift and disabled toilet. There is a hearing loop for patients with hearing impairments. There is an electronic sign-in system that can translate into 18 different languages.

The staff team compromises of three male GP partners. One of the male partners works eight sessions a week, the other two male partners work six sessions a week. There are four salaried GPs one male and three female. Three of the salaried GPs worked four sessions per week, one worked eight sessions. Other staff included two female practice nurses and a female health care assistant, seven receptionists, one administration staff, one medical secretary, an assistant manager and a practice manager.

The practice is open between 8.00am to 6.30pm Monday to Friday. They offer extended hours from 6.30pm to 8.00pm on Mondays, Tuesdays and Thursdays and from 8:30am to 11:30am on Saturdays. Appointments are available to patients from 8.30am to 12.30pm and from 1.30pm to 6.30pm Monday to Friday. Appointments are also available during the extended hours from 6.30pm to 8.00pm. When the practice is closed patients are directed (through a recorded message on the practice answer machine) to contact the local out of hours service. Information relating to out of hours services is also available on the practice website. The practice holds a Personal Medical Services (PMS) contract and is registered as a partnership with the Care Quality Commission (CQC) to provide the regulated activities of surgical procedures, diagnostic and screening procedures, family planning, treatment of disease, disorder or injury and maternity and midwifery services.

Updated 15 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Queenstown Road Medical Practice on 20 July 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 but were not always well managed, we found evidence that blood results were left unchecked for up to four days.
• 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.

The areas where the provider should make improvement are:

• Ensure that there are adequate systems in place for checking blood results when GPs are away from practice.

• Review practice procedures to ensure discussions from meetings are adequately documented and actions are followed up.

• Ensure recruitment process is effective, ensuring interview summary are recorded, and keeping a copy of contract signed by staff members.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 15 March 2017

The practice is rated as requires improvement 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 comparable to Clinical Commissioning Group (CCG) and national averages. For example, 81% of patients had well-controlled diabetes, indicated by specific blood test results, comparable to the Clinical Commissioning Group (CCG) average of 75% and the national average of 78%.

• 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 care professionals to deliver a multidisciplinary package of care.

Updated 15 March 2017

The practice is rated as requires improvement 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 Accident and Emergency (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 81%, which was high compared to the Clinical Commissioning Group (CCG) average of 72% and the national average of 74%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 15 March 2017

The practice is rated as requires improvement 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 older patients were allocated a named accountable GP.

• The practice offered a designated service called Planning All Care Together (PACT). This was a Clinical Commissioning Group initiative which was specially aimed at older patients to enhance their care, and to help aid in admission prevention. Patients on PACT, would be reviewed twice a year, appointments given to them were minimum 20 minutes long, annual medical notes reviewed, care plans prepared. Patients on the PACT register, were given a rapid response visiting arrangement whereby patients requiring a visit were triaged within 15 minutes and seen within 2 hours if felt to be at high admission risk.

Updated 15 March 2017

The practice is rated as requires improvement 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.

• They offer extended hours from 6.30pm to 8.00pm on Mondays, Tuesdays and Thursdays and from 8:30am to 11:30am on Saturdays.

Updated 15 March 2017

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

• 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 15 March 2017

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

• The practice held a register of patients living in vulnerable circumstances for example travellers and those with a learning disability, however homeless people were not allowed to be registered, but GPs would still see them, as they would be recorded as a temporary patient.

• 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 offered a designated service called Planning All Care Together (PACT), this was also aimed at vulnerable patients to enhance their care. Patients on PACT would be reviewed twice a year, appointments given to them were minimum 20 minutes long, annual medical notes reviewed, and care plans prepared.