Triveni PMS

Updated 27 March 2017

Triveni PMS, is an established GP practice situated, in Woolwich within the London Borough of Greenwich and lies within the administrative boundaries of NHS Greenwich Clinical Commissioning Group (CCG).

The practice provides primary medical services to approximately 7350 patients living within its catchment area. The practice holds a Personal Medical Services (PMS) Contract with NHS England. The practice has its main surgery located in Escreet Grove, Woolwich, SE18 5TE with a branch surgery, approximately one mile away, at 34 Plumstead Common Road, SE18 3TL. We visited both locations as part of our inspection process. Both are served by relatively good transport links by both bus and rail services. Both have step free and wheelchair access to the entrance of the respective buildings, reception and waiting area. Parking is available on site for general and disabled parking at Escreet Grove.

The practice population is ethnically diverse and the area has significant deprivation with a deprivation score of three out of 10 (1 being the most deprived). People living in more deprived areas tend to have greater need for health services. An area itself is not deprived: it is the circumstances and lifestyles of the people living there that affect its deprivation score.

The demographics show that the composition of the population groups varies from the national average with significantly higher numbers of children and young people and lower than average numbers of older people. The percentage of patients with a long standing health condition appears generally comparable to both the CCG and National average.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic & screening procedures, treatment of disease disorder or Injury, surgical procedures, family planning and maternity & midwifery services. Some directed enhanced services are provided at this practice which includes facilitating timely diagnosis and support for people with dementia, influenza and pneumococcal immunisations, learning disabilities, risk profiling and case management.

The practice team comprises of one female and one male partner GP’s, one full time and one part time salaried GP. They are supported by two part time practice nurses, two part time health care assistants, one part time practice manager, one part time reception team leader, and six part time receptionists (includes one vacancy).

The reception opening hours are Monday to Friday, 8am to 6.30pm (except Thursdays, 8.30am to 1pm). Morning consultations are provided from 9am to 11.30am, except Wednesday which is 8.30am to 11am. On call and telephone consultations are from 12.30pm to 4pm and afternoon consultations are from 3.50pm to 5.50pm. There is an extended clinic provided on a Monday from 6.30pm to 8pm for prebooked appointments only. The branch at 34 Plumstead Common Road is open Monday to Friday from 8.30am to 6.30pm.

Out-of-hours services are contacted by calling the practice when it is closed, calls are signposted to the out of hours or by calling 111. Information is provided on the practice telephone line, the website and on the practice notice board.

The practice provides a full range of general medical services including chronic disease management and NHS health checks. The practice also provides health promotion services including, cervical screening, childhood immunisations, antenatal and postnatal care, and contraception.

Updated 27 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Triveni PMS on 10 August 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 and well managed.
• 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:

• Take action to improve the identification of patients with caring responsibilities to be able to provide appropriate support and signposting.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 27 March 2017

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.

• 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.

• Smoking cessation clinics were available to support people with long term conditions.

Updated 27 March 2017

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 uptake for the cervical screening programme was 82%, which was comparable to the CCG and the 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, health visitors and child protection teams.

• The practice provided antenatal and postnatal reviews and child health checks.

Updated 27 March 2017

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.

• The practice offered health checks to patients aged over 75

• The practice contacted patients after their discharge from hospital to address any concerns and assess if the patient needed GP involvement at that time.

Updated 27 March 2017

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 hours every Monday evening from 6.30pm to 8pm.

• The practice had a Facebook account which displayed practice information and self-help advice.

Updated 27 March 2017

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

• 93% of patients experiencing poor mental health had a comprehensive care plan documented in the last 12 months, which was higher than the CCG average of 85% and national average of 88%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those 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 March 2017

The practice 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 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 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.