Bridge Lane Group Practice

Updated 20 September 2016

The Bridge Lane Group Practice is based in Battersea in the London Borough of Wandsworth. The practice is run by seven partners (six female and one male). The practice is based in a purpose built building which is based on one floor. The address of the practice is 20 Bridge Lane, Battersea, London, SW11 3AD.

The practice has approximately 14,000 registered patients. The surgery is based in an area with a deprivation score of 6 out of 10 (10 being the least deprived). The practice is similar to much of Wandsworth in its age demographic in that the number of patients aged between 25 and 45 is higher than the national average and the number of patients aged over 55 is lower than the national average

The practice employs five further GPs. In total there are 11 female and one male GPs working to an equivalent of 9.91 whole time equivalent (WTE) GPs. The practice is also a training practice and at the time of the inspection there was a grade ST3 registrar attached to the practice on a full time basis. There are three practice nurses (2.71 WTE), and four healthcare assistants (2.02 WTE). There is a practice manager and assistant practice manager, a reception manager, a deputy reception manager and 16 other reception, administrative and secretarial staff.

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, family planning, maternity and midwifery, 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 7:00am to 8:00am and 6:30pm to 8:00pm on Tuesdays and Thursdays, and the practice is open on alternate Saturdays from 8:30am until 11:00am. Weekday morning appointments are available until 11:40am, with afternoon appointments available from 2:00pm on all days except Thursday when the afternoon session beginning at 5:00pm.

The practice had not previously been inspected by the CQC.

Updated 20 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bridge Lane Group Practice on 30 June 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 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. However, the practice had requested information and repairs from the owner of the building without success.
• 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.

There was one area of outstanding performance:

• The practice had developed and ran a primary care led alcohol service for the benefits of its own patients and to patients from other practices in the area. On piloting the clinic the waiting time for patients to receive treatment was reduced from 18 weeks to 18 days.

The areas where the provider should make improvement are:

• The practice should ensure that all clinical equipment in the practice is calibrated.

• The practice should continue to contact the owner of the building to follow up non-completed repairs and risk assessments which have yet to be provided.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 20 September 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 national average. The practice had scored 98% for diabetes related indicators in the last QOF, above the national average of 89%. The percentage of patients with diabetes, on the register, in whom the last IFCCHbA1c was 64 mmol/mol or less (a measure of well controlled diabetes) in the preceding 12 months (a measure of well controlled diabetes) was 80%, compared to a national average of 77% and a CCG average of 73%.

• 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 20 September 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 80%, 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 midwives, health visitors and school nurses.

Updated 20 September 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.

• The practice had a system in place where the patient had a known GP. To support continuity the patient would have a second named GP in case the first were unavailable.

Updated 20 September 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 offered both early morning and late evening appointments, as well as telephone consultations for the benefit of working patients.

Updated 20 September 2016

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

• 83% of patients diagnosed with dementia 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 better than the national average. The practice had scored 99% for mental health related indicators in the last QOF, which was higher than the national average of 93%. The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 95%, higher than the national average of 88%

• 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 20 September 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 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 developed and ran a primary care led alcohol service for the benefits of its own patients. On piloting the clinic the waiting time for patients to receive treatment was reduced from 18 weeks to 18 days.

• 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.