The Grove Medical Centre

Updated 31 January 2017

The Grove Medical Centre provides a range of primary medical services to the residents of Borehamwood. The practice has been in existence since 1948 and has operated from its current location of Borehamwood Shopping Park, Borehamwood, Hertfordshire, WD6 4PR since 2006.

The practice population is ethnically diverse with a higher than average 0 to 9 year age range and 25 to 44 year age range. National data indicates the area to be one of lower deprivation. The practice has approximately 12,600 patients with services provided under a General Medical Services (GMS) contract, a nationally agreed contract with NHS England.

The practice is led by three GP partners, one male and two female and employs five salaried GPs, one male and four female. The nursing team consists of two practice nurses and a health care assistant, all female. There are a team of eleven administrative staff all led by a practice manager.

The practice is open from 8am to 6.30pm Monday to Friday. They close for lunch from 12.30pm to 1.30pm daily but patients can still access the practice via an emergency telephone number during this time. The practice offers extended opening hours from 6.30pm to 9.30pm on Mondays and from 8.30am to 11.30am on one Saturday per month.

When the practice is closed, out-of-hours services are provided by Herts Urgent Care and can be accessed via the NHS 111 service.

Updated 31 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Grove Medical Centre on 14 December 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.
• The practice had monthly governance meetings
• 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 felt listened to and supported by staff and had sufficient time during consultations to make an informed decision about the choice of treatment available to them.
• 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.
• Succession planning was in place.
• 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 all staff receive essential training for example infection control training.
• Consider using written consent for minor procedures.
• Continue to identify and support patients who are also carers.
• Continue to encourage patients to attend cancer screening programmes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 January 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 comparable to the local and national averages. The practice achieved 96% of available QOF points, with 16% exception reporting, compared to the CCG average of 90%, with 11% exception reporting, and the national average of 90%, with 12% exception reporting.
• 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 31 January 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.
• The practice’s uptake for the cervical screening programme was 79%, which was comparable to the CCG average of 83% and the national average of 82%.
• Opportunistic chlamydia screening was offered to patients aged 16 to 24 years of age.
• 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 31 January 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.
• Weekly visits were made to three local care homes in addition to ad hoc visits to four others in the area.
• Annual health checks and flu vaccinations were available to patients over the age of 75 years.

Updated 31 January 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 offered extended opening hours two evenings a week and on one Saturday a month.
• 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 also encouraged its patients to attend national screening programmes for bowel and breast cancer screening. For example, 66% of females, aged 50-70 years, were screened for breast cancer in last 36 months compared to the CCG average of 71% and the national average of 72%. 

Updated 31 January 2017

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

• 81% of patients diagnosed with dementia who had their care reviewed in a face-to-face meeting in the last 12 months, which was comparable to the CCG and national averages.
• Performance for mental health related indicators was comparable to the CCG and national averages. The practice achieved 99% of available QOF points, with 12% exception reporting, compared to the CCG average of 95%, with 9% exception reporting, and the national average of 93%, with 11% exception reporting.
• 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 support groups and voluntary organisations.
• The practice had a system in place to follow up patients who had attended A&E 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 31 January 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 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 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 had identified 133 patients as carers which was approximately 1% of the practice list. These patients were offered flexible appointment booking, annual health checks and flu vaccinations.