Rydal Group Practice

Updated 3 April 2017

Rydal Group Practice provides GP primary care services to approximately 11,500 people living in Woodford Green, London Borough of Redbridge. The practice has a General Medical Services (GMS) contract for providing general practice services to the local population. General Medical Services (GMS) contract is the contract between general practices and NHS England for delivering primary care services to local communities.

Information published by Public Health England rates the level of deprivation within the practice population group as eight on a scale of one to ten. Level one represents the very highest levels of deprivation and level ten the lowest. This information also shows that Income Deprivation Affecting Older People (IDAOPI) is 14% which is lower than the CCG average of 21% and the national average of 16%. Income Deprivation Affecting Children (IDACI) is 13% (CCG average 19%, national average 20%).

There are currently five GP partners, two male and three female. The practice provides a total of 36 GP sessions per week.

The clinical team is completed by three practice nurses and a health care assistant all of whom work part time. The health care assistant is also trained as a phlebotomist (Phlebotomists are specialist healthcare assistants who take blood samples from patients for testing in laboratories). There are also a practice manager, a deputy practice manager and thirteen administrative and reception staff.

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

The practice is located in a two storey building and patients are given the option of being seen on the ground floor. Consulting rooms are located on the ground floor.

The practice opening hours for the surgery are:

Monday 7:30am to 7:00pm

Tuesday 7:30am to 6:30pm

Wednesday 7:30am to 7:00pm

Thursday 7:30am to 7:00pm

Friday 8:00am to 6:30pm

Saturday Closed

Sunday Closed

The practice is also part of a federated group of local practices which provides pre-bookable appointments on weekday evenings between 6.30pm and 10pm, between 9am and 5pm on Saturdays and 9am and 1pm on Sundays. These are available at three different GP surgeries and include appointments with nurses as well as doctors.

The practice has opted not to provide out of hours services (OOH) to patients and these were provided on the practice’s behalf by Partnership of East London Co-operatives (PELC). The details of the how to access the OOH service are communicated in a recorded message accessed by calling the practice when it is closed and details can also be found on the practice website.

Patients can book appointments in person, on-line or by telephone. Patients can access a range of appointments with the GPs and nurses. Face to face appointments are available on the day and are also bookable up to six weeks in advance. Telephone consultations are offered where advice and prescriptions, if appropriate, can be issued and a telephone triage system is in operation where a patient’s condition is assessed and clinical advice given. Home visits are offered to patients whose condition means they cannot visit the practice.

The practice provides a wide range of services including clinics for diabetes, weight control, asthma, contraception and child health care and also provides a travel vaccination clinic. The practice also provides health promotion services including a flu vaccination programme and cervical screening.

Updated 3 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Rydal Group Practice on 17 January 2017. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Refresher training around safeguarding and infection prevention was overdue for some staff although we saw confirmation from a training provider showing specific dates when this training would be provided.
• Risks to patients were assessed and well managed with the exception of fire safety risks.
• All staff who acted as chaperones had undertaken DBS checks. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• 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 all staff follow through with planned training in safeguarding and infection prevention and control.
• Ensure that risk assessments are carried out for non-clinical staff to ascertain whether DBS checks should be undertaken.

• Ensure a fire risk assessment is carried out and recommended actions are followed up promptly.

• Review how carers are identified and recorded on the clinical system to ensure information, advice and support is made available to them.
• Ensure planned improvements of arrangements to support patients with hearing impairments are implemented.
• Consider putting arrangements in place to review how patient consent forms are used at the practice.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 3 April 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.
• The practice performance rate for the Quality and Outcomes Framework (QOF) diabetes related indicators were comparable to the local and national average. For instance, 84% of patients with diabetes had well controlled blood sugar levels (CCG average of 68%, national average 78%).
• Patients who had recently been diagnosed with long term conditions but who were experiencing difficulties adjusting to their condition were offered support to develop strategies to help them feel more involved in decisions about their own care and treatment.
• 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 3 April 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’s uptake for the cervical screening programme was 80%, which was comparable to the CCG average of 78% and the national average of 81%.

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

Updated 3 April 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.
• Outcomes for conditions often associated with older people were comparable to local and national averages. For instance, 80% of patients with hypertension had well controlled blood pressure compared to the CCG average of 81% and the national average of 83%.

Updated 3 April 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 provided GP led telephone triage and telephone consultations which benefitted patients who were unable to attend during normal working hours or who were unsure if their condition required a visit in person.
• Extended opening hours were available every morning and evening between Monday and Friday.
• Patients had access to appointments at a local hub service on weekday evenings between 6.30pm and 10pm, between 9am and 5pm on Saturdays and 9am and 1pm on Sundays.

Updated 3 April 2017

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

• 91% of patients diagnosed with schizophrenia, bipolar affective disorder and other psychoses had an agreed care plan documented in the record which was comparable to 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 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 3 April 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 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.
• The practice care co-ordinator provided support to patients who had recently been bereaved or had become carers for the first time and helped these to navigate care pathways, access external support organisations and develop care plans.