Chatfield Health Care

Updated 11 April 2016

Chatfield Health Care is based in the London Borough of Wandsworth. The practice has five partners (three female and two male) who manage the practice. The practice is based in a purpose built building and the practice rooms were spread across four floors which can all be accessed by lift. The address of the practice is 50 Chatfield Road, Battersea, London, SW11 3UJ.

The practice is based in an area of mixed demographics , its catchment area including a large area of relatively high depravation as well as some areas of very low deprivation. The practice population included a relatively high level of patients (12% of the list size) of patients for whom English was not their first language.

The practice has a list size of approximately 10,500 patients. The practice employs five salaried GPs, and as a teaching practice at any given time there could also be two GP registrars at the site. Not including appointments available through the on call doctor, there were 470 GP led appointments available per week. There is a nurse manager plus two further practice nurses and two health care assistants. A management team of a practice manager and two assistant practice managers share leadership responsibilities in the practice. The practice employs a receptionist manager and a deputy reception manager who managed a total of nine receptionists. The practice also employs three administrators.

The practice is contracted to provide Personal Medical Services (PMS) and is registered with the CQC for the following regulated activities: treatment of disease, disorder or injury, maternity and midwifery services, family planning, surgical procedures, and diagnostic and screening procedures at one location.

The practice is open Monday to Friday 8:00am to 6:30pm. There are extended hours from 6:30pm to 8:00pm on Mondays, Tuesdays and Thursday, as well as Saturday mornings from 9:00am until 12:00pm.

The practice had not been inspected prior to this inspection.

Updated 11 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Chatfield Health Care on 18 February 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 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.

• Patients said they found it easy to make an appointment with a named GP and that 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 provider should consider the following:

• The practice should consider using a hearing loop on the reception desk.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 11 April 2016

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 similar to the CCG and national average. The practice had scored 88% of available Quality and Outcomes Framework (QOF) points with a total achievement of 76 of 86 points. For example, the percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) was 140/80 mmHg or less, was 73%, compared to 78% nationally.

• Longer appointments and home visits were available when needed.

• All these patients had a “usual” 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 usual GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• The practice offered in house ECGs, twenty four hour blood pressure monitoring, phlebotomy and spirometry.

Updated 11 April 2016

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 83%, which was comparable to the national average of 82%. There was a policy to offer telephone reminders for patients who did not attend for their cervical screening test.

• 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 school nurses.

• The practice had a minors policy which allowed children to be seen alone.

Updated 11 April 2016

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.

• Planning All Care Together (PACT) assessments were available for older patients with multiple health concerns which included individualised care plans.

Updated 11 April 2016

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 was open later three nights a week and on Saturday mornings for the benefit of patients who could not attend during core hours due to work.

• Telephone appointments were offered daily.

Updated 11 April 2016

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

• 92% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average.

• Performance for mental health related indicators was similar to the CCG and national average with a total QOF achievement of 99%. The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the preceding 12 months was 93%, compared to a national average of 88%.

• The practice regularly worked with multi-disciplinary teams in the case management of people 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 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 11 April 2016

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 multi-disciplinary teams in the case management of vulnerable people.

• 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.