The Belmont Medical Centre

Updated 20 December 2016

The Belmont Medical Centre is a well-established GP practice situated within the London Borough of Hillingdon. The practice lies within the administrative boundaries of NHS Hillingdon Clinical Commissioning Group (CCG) and is one of eight member GP practices of the Wellcare Health Network in the Uxbridge and West Drayton locality. The practice is an accredited training practice for GP trainees and a teaching practice for undergraduate medical students.

The practice provides primary medical services to approximately 7,468 patients living in Uxbridge and some areas within Hillingdon. The practice holds a General Medical Services Contract (GMS) and Directed Enhanced Services Contracts. The practice is located at 53-57 Belmont Road, Uxbridge, with good transport links by bus and rail services.

The practice operates from converted premises leased from a private landlord and managed by the GP Partners. The practice has occupied the premises for 20 years and shares the premises with a community health care organisation. The building is set over three floors with stair and lift access. There are three consultation rooms on the ground floor and five on the first floor, administration offices are located on the third floor. The reception and waiting area are on the ground floor and the main waiting area on the second floor. There is wheelchair access to the entrance of the building and two toilet facilities for people with disabilities one on the ground floor and one on the second floor. There are payable car parking facilities in the roads surrounding the practice.

The practice population is ethnically diverse and has a higher than the national average number of male and female patients between 0 and 4 years of age and between 25 and 39 years of age. There is a higher than average number of male patients 40 to 44 years of age and a comparable average of male and female patients 55 years plus. The practice area is rated in the fourth less deprived decile of the national Index of Multiple Deprivation (IMD). People living in more deprived areas tend to have greater need for health services. Data from Public Health England 2014/15 shows that the practice has a lower percentage of patients with a long-standing condition compared to CCG and England averages (53%, 50%, and 54% respectively).

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

The practice team comprises of one male and three female GP partners, one male salaried GP and a female GP registrar who all collectively work a total of 35 clinical sessions per week. They are supported by three part time practice nurses, a practice manager and ten administration staff.

The practice opening hours are 8.30am to 6.30pm Monday to Friday. Consultation times in the morning are from 9.00am to 11.15am Monday, 8.30am to 12.30pm Tuesday, 8.30am to 11.10am Wednesday, Thursday and 8.30am to 11.50am on Friday. Consultation times in the afternoon are from 2.30pm to 6.00pm Monday, 3.00pm to 6.00pm Tuesday, 2.00pm to 6.00pm Wednesday, Friday and 2.00 to 5.50 pm on Thursday. Extended hour appointments are offered form 6.30pm to 7.20pm Monday and Tuesday, 7.30am to 8.00am Thursday and Friday and 8.10am to 11.00am one Saturday a month. The out of hours services are provided by an alternative provider. The details of the out-of-hours service are communicated in a recorded message accessed by calling the practice when it is closed and on the practice website.

The practice provides a wide range of services including chronic disease management, minor surgery and health checks for patients 40 years plus. The practice also provides health promotion services including, cervical screening, childhood immunisations, contraception and family planning.

Updated 20 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Belmont Medical Centre on 29 July 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 generally 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 felt the practice offered an excellent service and staff were professional, helpful, friendly and caring and treated them with dignity and respect.
• 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 patient participation group was very well engaged and influenced practice development.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Revise the incident reporting form so that it supports the recording of notifiable incidents under the duty of candour.
• Optimise the security of the repeat prescription request box held in reception.
• Review the provision of a mercury spill kit to ensure one is available for use in the event of accidental damage to mercury blood pressure equipment.
• In accordance with published guidance ensure all non-clinical staff receive annual basic life support training.
• Review the need for clinical staff to receive formal MCA training.
• Display notices in the reception areas informing patients that translation services are available.
• Install a hearing loop to assist people with hearing loss.
• Review options to restrict queues forming too close to the reception desk.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 December 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. Patients with long term conditions were invited for annual health checks including medication reviews.

• Longer appointments and home visits were available when needed.

• The practice identified patients with long term conditions at risk of hospital admission and invited them in for review to create integrated care plans aimed at reducing the risk. Cases of unplanned admission were discussed at the clinical meeting to review and update care plans.

• Monthly multi-disciplinary team meetings were held with members of the district nurses, mental health team, well-being officer and community matron to discuss patients with complex medical needs.

• The practice made referrals to the well-being officer attached to the surgery whose role was to support patients over the age of 55 years to access community services.

• A community respiratory care nurse attended the practice once a week to help manage and give advice on patients with asthma and Chronic Obstructive Pulmonary Disease (COPD).

Updated 20 December 2016

The practice is rated as good for the care of families, children and young people.

• There was a named lead for safeguarding children, staff had received role appropriate safeguarding training and were aware of their responsibilities to raise concerns.

• 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.

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

• The practice had good links with child health team and held regular multi-disciplinary team meetings attended by the health visitor and community matron.

• Childhood immunisations were offered in line with national guidelines and uptake rates were similar to local averages for 2014/15.

• The practice offered routine ante-natal and post-natal care, expectant mothers were given an antenatal pack and routine mother baby six week checks were offered postnatally.

Updated 20 December 2016

The practice is rated as good for the care of older people.

• The practice had a named lead for safeguarding vulnerable adults and staff were aware of their responsibilities to raise concerns.

• Home visits were available for patients unable to attend the surgery due to illness or immobility.

• The practice identified older patients at risk of hospital admission and invited them in for review to create integrated care plans aimed at reducing that risk. Cases of unplanned admission were discussed at the clinical meeting to review and update care plans.

• Monthly multi-disciplinary team meetings were held with members of the district nurses, mental health team, well-being officer and community matron to discuss older patients with complex medical needs.

• The practice made referrals to the well-being officer attached to the surgery whose role was to support patients over the age of 55 years to access community services.  

Updated 20 December 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The practice offered extended hour appointments two mornings and two evenings a week in addition to Saturday appointments once a month to support patients unable to attend the practice in normal working hours to access the service. Telephone consultations were also available.

• There was the facility to book appointments, request repeat prescriptions online and access care record viewer if they had subscribed to do so.

• New patients and NHS health checks for patients aged 40–74 were offered with appropriate follow-ups for the outcomes of health assessments where abnormalities or risk factors were identified.

• Patients were able to receive travel vaccinations available on the NHS as well as those only available privately.

Updated 20 December 2016

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

• QOF data 2014/15 for performance indicators relating to mental health were similar to local and national averages.

• The practice maintained a register of patients experiencing poor mental health and these patients were invited for annual health checks.

• 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.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

• The practice had access and encouraged self-referral to the talking therapies counselling services based at the premises.

Updated 20 December 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• There was a named GP lead for safeguard vulnerable adults. 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 held a register of patients living in vulnerable circumstances including homeless people and those with a learning disability.

• Annual health checks with extended appointments were offered to patients with learning disabilities and these patients were given a health action plan to keep at home. The uptake rate for these annual health checks was 96% in the last year.

• 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.