Brocklebank Group Practice

Updated 17 February 2017

Brocklebank Group Practice provides primary medical services in Wandsworth to approximately 17,000 patients and is one of 44 member practices in the NHS Wandsworth Clinical Commissioning Group (CCG). The practice operates under a Personal Medical Services (PMS) contract and provides a number of local and national enhanced services (enhanced services require an increased level of service provision above that which is normally required under the core GP contract).

Wandsworth has 50% more 20 to 40 year olds, but 33% fewer older people than other south west London boroughs, reflected in the patient demographics for the practice with 7% of patients aged 65 or over, 70% of patients aged 18-65 years old and 23% aged 18 or younger.

The practice population is in the fourth less deprived decile, with income deprivation affecting children and adults comparable to local and national averages.

The practice operates from a purpose built facility, the Brocklebank Health Centre, which is shared with a wide range of community services including ante-natal, post-natal and community midwifery services, audiology, dentistry, physiotherapy and psychiatry services, and an out of hours GP service.

Practice patient facilities are on the ground floor which is wheelchair accessible throughout. There are nine consultation rooms, six treatment rooms, a meeting room, practice management offices and a shared reception and waiting area. There are shared staff facilities and shared accessible facilities for patients with baby changing and breast feeding areas available.

The practice team at the surgery is made up of eight part time GP partners, seven part time salaried GPs, one part time regular locum GP and one part time GP registrar. Eight of the GPs are male and nine GPs are female. Together the GPs provide 89 clinical sessions per week. The practice employs three full time and three part time female practice nurses, one part time female health care assistant, and two full time female phlebotomists. The non-clinical team consists of one business manager, one practice manager and fourteen administrative and clerical staff.

The practice opens between 8.10am and 6.30pm Monday to Friday. Telephone lines are operational between the hours of 8.10am and 6.30pm Monday to Friday. Appointments are available during three sessions daily. Extended hours are available on Monday, Tuesday and Thursday evenings from 6.30pm until 8.00pm and on a Wednesday and Friday evening from 6.30pm until 7.00pm. The practice also opens on Saturday mornings between 8.30am and 11.30pm for pre booked appointments.

The provider has opted out of providing out-of-hours (OOH) services to their own patients between 6.30pm and 8.10am when the practice directs patients to seek assistance from the locally agreed out of hours provider.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of surgical procedures, treatment of disease, disorder or injury, maternity and midwifery services, family planning and diagnostic and screening procedures.

The practice has not previously been inspected by CQC.

Updated 17 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Brocklebank Group Practice on 6 October 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.

We saw one area of outstanding practice;

• The practice had policies and procedures in place to monitor patients who had appointments in the acute and emergency care system and followed up missed appointments. This included following up patients who had not attended outpatient appointments, guiding patients through their patient journey when faced with cancer diagnosis, and the following up of patients not attending appointments for their dementia care.

The areas where the provider should make improvement are:

• Review how patients with caring responsibilities are identified and recorded on the clinical system to ensure information, advice and support is made available to them.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 17 February 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 clinical commissioning group (CCG) average and the national average.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review of their health, medicine and social care needs, managed under the clinical commissioning group (CCG) planning all care together (PACT) scheme.

• 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 17 February 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 comparable to other practice locally and nationally for all standard childhood immunisations offered.

• 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 82%, which was comparable to the CCG average of 81% 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 other agencies including health visitors and school nurses.

Updated 17 February 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.

• All older people had a named GP responsible for their care.

• Older people who met the criteria had their health and social care needs managed under the clinical commissioning group (CCG) planning all care together (PACT) scheme.

• Older patients discharged from hospital were followed up by their GP within 24 hours of the practice receiving notification.

Updated 17 February 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.

• Online services included electronic consultations and telephone consultations were also available.

Updated 17 February 2017

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 to the local clinical commissioning group (CCG) average and the national average.

• 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, with dementia patients being guided through the care system, including following up on missed appointments and rebooking missed appointments.

• 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 17 February 2017

The practice is rated as outstanding 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 recently released from the prison system.

• The practice offered longer appointments for patients with a learning disability, with patients at risk of developing disease or hospital admission managed under the clinical commissioning group (CCG) planning all care together (PACT) scheme.

• 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.

• The practice had policies and procedures in place to monitor patients who had appointments in the acute and emergency care system. This included following up patients who had not attended outpatient appointments, guiding patients through their patient journey when faced with cancer diagnosis, and the following up of patients not attending appointments for their dementia care.

• 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.