Archived: Clapham Junction Medical Practice

Updated 9 May 2017

Clapham Junction Medical Practice provides primary medical services in Wandsworth to approximately 3,200 patients and is one of 44 member practices in the NHS Wandsworth Clinical Commissioning Group (CCG). The practice operates under a General Medical Services (GMS) 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 10% of patients aged 65 or over, 78% of patients aged 18-65 years old and 12% aged 18 or younger.

The practice population is in the fifth more deprived decile with income deprivation affecting children and adults higher than national averages.

The practice operates from two sites, the main site is located at 263 Lavender Hill, BatterseaLondon, SW11 1JD (known to staff and patients as Lavender Hill Site or LHS) and the branch site is located at 7 Farrant House, Winstanley Road, Battersea, London SW11 2EJ (known to staff and patients as Farrant House Site or FHS).

The Lavender Hill site is a converted residential property over two floors and has two consulting rooms and one treatment room, one administration room, reception, patient waiting area, kitchen and one staff and one patient toilet. This site does not have disabled access facilities or step free access into the building or between floors. There are no baby change facilities installed or breast feeding area advertised; however, staff told us they could provide a suitable area if requested. The lavender Hill site is currently closed to patients. 

The Farrant House site is a purpose built ground floor premises within a residential block of flats. There are two consulting rooms, one treatment room, one practice manager’s room, one administration room, one reception and back office, one patient and one staff toilet and one kitchen. There are disabled access facilities with baby change facilities installed and step free access throughout.

The practice clinical team is made up of one full time and one part time GP partners one male and one female, with one female part time practice nurse. The practice offers 15 GP sessions per week. The non-clinical team consists of four administrative and reception staff.

The practice main site opens between 8.30am and 6.30pm Monday to Friday. Telephone lines are operational between the hours of 8.30am and 6.30pm Monday to Friday. Appointments are available between 9.00am and 1.00pm Monday to Friday and between 5.00pm and 6.30pm on a Monday, Tuesday and Thursday and from 4.30pm to 6.30 pm on a Wednesday and Friday. Patients are able to pre book a telephone consultation with a GP to be held between 12.00am and 12.30pm. Extended hours are available on Monday, Tuesday and Thursday evenings from 6.30pm until 8.00pm for pre booked appointments.

The provider has opted out of providing out-of-hours (OOH) services to their own patients between 6.30pm and 8.30am 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 maternity and midwifery services, family planning, diagnostic and screening procedures and treatment of disease, disorder or injury.

Updated 9 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Clapham Junction Medical Practice on 2 June 2016. The overall rating for the practice was good; however for people experiencing poor mental health (including people with dementia) and people with long term conditions, the rating in the effective domain was requires improvement. Consequently, the effective domain overall was rated requires improvement. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for Clapham Junction Medical Practice on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 23 January 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 2 June 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• Performance for diabetes related indicators had improved and was comparable to the local and national averages.

• Performance for mental health related indicators was comparable to the local and national averages and exception reporting rates had improved to below local and national averages.

We also reviewed the areas we identified where the provider should make improvement:

• The practice had undertaken infection control audits and had recorded actions taken to address identified issues including supplying a separate fridge for patient specimens that required refrigeration.

• Health and Safety risk assessments showed action had been taken to ensure cleaning chemicals were safely stored and safety information readily available for them.

• The practice provided us with evidence of fire risk assessments carried out for both sites and we saw evidence of fire alarm testing, and testing to ensure electrical appliances were safe to use.  

• The accessibility and facilities available at each site had been reviewed and signs put up advertising the availability of areas for breast feeding and private conversations. The practice had also consulted with patients and the local clinical commissioning group about the improvements required to facilities and accessibility and had decided to close their Lavender Hill site.

• The practice had reviewed and updated their business continuity plan to include staff contact details.

However, there were also areas of practice where the provider should make improvements: 

• Continue to review and develop ways of improving outcomes for patients.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 9 May 2017

The provider had resolved the concerns for effective identified at our inspection on 2 June 2016 which applied to this population group. The population group rating has been updated to reflect this.

Updated 21 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 Accident and Emergency 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 Clinical Commissioning Group 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, however baby change facilities were not available at the Lavender Hill site.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 21 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.

• All of the patients in this population group had a named GP responsible for their care.

Updated 21 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 telephone consultations for patients who could not attend during working hours.

Updated 9 May 2017

The provider had resolved the concerns for effective identified at our inspection on 2 June 2016 which applied to this population group. The population group rating has been updated to reflect this.

Updated 21 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.

• 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.