Background to this inspection
Updated
15 November 2021
Dr Jefferies and Partners provides primary medical services from a main site at: 292 Munster Road, Fulham, London, SW6 6BQ and at a nearby branch surgery at 286 Munster Road, Fulham. London, SW6 6BQ. During the Covid-19 pandemic the practice has rationalised the way it uses the sites to maintain social distancing. There is a centralised telephone call centre which processes patient telephone calls for both sites.
The practice is located in the London borough of Hammersmith and Fulham and within the North West London Clinical Commissioning Group (CCG) area. It is part of a primary care network with another GP provider.
The practice provides services to around 15,000 patients. The practice also delivers a specially commissioned service for patients in the borough who are restricted from registering with a local general practice.
The practice has two GP partners and a business partner and the management team also includes a clinical director. The practice additionally employs salaried GPs, clinical pharmacists, a practice nurse, health care assistants and a team of technical, administrative and reception staff. The practice has contracted with a locum practice nurse to provide sessions on Saturday, a physiotherapist and patients have access to a social prescriber.
The practice opening hours are 8am to 6.30pm Monday to Friday. Extended opening hours are available on some evenings and on Saturday 8am to 5pm. Patients can access appointments via telephone, in person or online. Patients can also access ‘e-consults’ and digital appointments with a GP if they wish. During the Covid-19 pandemic the practice has reviewed and triaged patients to remote consultations where appropriate to reduce the risk of cross-infection.
There are higher than average number of patients between the age of 15 and 44 and fewer patients aged over 65 than the national average. The National General Practice Profile states that around three quarters of the practice population is from a white background with the remainder of originating from black, mixed or other non-white ethnic groups. The practice population has average levels of income deprivation. Life expectancy for both males and females is slightly higher than average.
The provider is registered with CQC to deliver the regulated activities: diagnostic and screening
procedures; maternity and midwifery services; treatment of disease, disorder or injury; family planning and surgical procedures.
Updated
15 November 2021
We carried out an announced inspection at Dr Jefferies and Partners from 6-8 September 2021. Overall, the practice is rated as good.
Safe - Good
Effective - Good
Well-led - Good
Following our previous inspection on 24 January 2019, the practice was rated good overall and for all key questions and population groups.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Dr Jefferies and Partners on our website at www.cqc.org.uk
Why we carried out this inspection
This inspection was a focused inspection to follow up:
- Information of concern received by CQC about the safety of the service
- The inspection focused on the key questions for: safe, effective and well-led. The ratings for the key questions: caring and responsive will be carried forward from the previous inspection.
We also followed up on some specific issues identified for improvement from the previous inspection. These were:
- low uptake of childhood immunisations and cervical screening
- the lack of a proactive approach to monitoring and reviewing vulnerable patients
- the need to strengthen links with health visitors in relation to safeguarding
- the high rate of Quality and Outcomes Framework (QOF) personalised care adjustments (exception reporting)
- the need to develop quality improvement activity
- the need to identify and support patients who are carers.
How we carried out the inspection
Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.
This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.
This included:
- Conducting staff interviews using video conferencing
- Completing clinical searches on the practice’s patient records system and discussing findings with the provider
- Reviewing patient records to identify issues and clarify actions taken by the provider
- Requesting evidence from the provider
- A short site visit
Our findings
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations.
We have rated this practice as good overall and for all population groups.
We found that:
- Prior to the inspection, CQC received concerning information about specific aspects of safety at the practice. The inspection showed that these concerns were unfounded.
- The practice had effective systems in place to manage most risks.
- Patients received effective care and treatment that met their needs.
- The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic.
- The way the practice was led and managed promoted the delivery of high-quality, person-centred care.
- The practice had addressed or was in the process of addressing the areas identified at the previous inspection for improvement.
While we found no breaches, the provider should:
- Ensure that clinical records clearly reflect the clinical rationale in cases where prescribing falls outside of practice policy or national guidelines.
- Continue work to improve the uptake of childhood immunisations and cervical screening.
- Review the demand and supply of practice nursing appointments.
- Continue work to ensure comprehensive clinical coding of diabetes.
- Record the immune status of staff in line with national guidelines.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care