Elizabeth Avenue Group Practice

Updated 2 March 2017

The practice is located Islington in London N1 3BS, it’s situated in a purpose built two storey building. The building is owned by the original partners and the current partners are responsible for maintaining the building. They provide NHS primary medical services to approximately 7400 patients through a General Medical Services contract (a General Medical Services (GMS) contract is the contract between general practices and NHS England for delivering primary care services to local communities) in the NHS Islington CCG area.

The premises have step free access with an accessible toilet and has baby changing facilities. It’s located on Elizabeth avenue just off the busy New North Road and is well served by local buses.

The practice staff includes four GP partners (two male two female) working six sessions each, two salaried GPs one working four sessions (male) and the other working five sessions (female).They have two practice nurses both working full time and a health care assistant working 36 hours (all female). The practice manager works full time and there is a variety of reception and administration staff who work a total of 208 hours per week.

The practice is a training practice and currently has two registrars.

The practice is open from;

Monday 08:00-13:30 14:00-18:30

Tuesday 07:30-13:30 14:00-19:30

Wednesday 08:00-13:30 14:00-18:30

Thursday 07:30-12:30 CLOSED

Friday 08:00-13:30 14:00-18:30

The practice also provides telephone consultations and home visits. The home visits are carried out between morning and evening surgery. The practice offers extended hours which are for pre-booked appointments only between 7.30am - 8.00am and 6.30pm - 7.30pm on Tuesdays. Early evenings and weekends are covered by the Islington GP hub (I:HUB 06:30pm to 8:00pm Mondays to Friday and 08:00am to 8:00pm at weekends) which is a service run by Islington GPs that offers future and on the day routine GP and nurse appointments every weekday evening and all day on weekends and bank holidays. Out of hours services are covered by the 111 service.

The practice population is largely white British (83%) with 4% coming from European Union (EU) countries and 10% coming from non EU countries. Information published by Public Health England rates the level of deprivation within the practice population group as three on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

Updated 2 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Elizabeth Avenue Group Practice on 29 September 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 2 March 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 percentage of patients with hypertension in whom the last blood pressure reading measured in the preceding 12 months is 150/90mmHg or less was 81% compared to the national average of 83%.

• For the management of long term conditions the practice had developed a reminder system which printed the reminder for health checks on the patient’s prescriptions and coded on their computer system.

• 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.

• The practice participated in the Year of Care project, this was CCG led and funded approach to holistic care for patients with long term conditions.

Updated 2 March 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 percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years was 82% which was the same as the national average of 82%.

• The practice held a baby clinic every two weeks with the health Visitor.

• 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.

Updated 2 March 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.

• Housebound patients were highlighted on the practices computer system and had a nominated GP, who arranged routine visits 2-3 times per year.

• The practice provided GP services to two local nursing homes.

• The practice had dedicated pharmacist who reviewed medication for elderly patients and nursing home patients.

Updated 2 March 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.

• Patients were able to book appointments online and have telephone consultations.

• Patients were able to register for online access and send messages to their GP/ practice via an on line messaging system.

• The practice offered early morning and evening appointments.

Updated 2 March 2017

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

• 78% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which was lower than the CCG average of 83% and the national average of 84%.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption has been recorded in the preceding 12 months was 92% which was higher than the CCG average of 86% and the National average of 89%.
• 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 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 2 March 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, travellers 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 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.

• Patients could self-refer to an alcohol counsellor who held sessions once a week at the practice.