Archived: Cranford Medical Centre

Updated 6 November 2017

Cranford Medical Centre provides NHS primary medical services to approximately 5,100 patients living in the surrounding areas of Cranford and Heston, in the London Borough of Hounslow. The practice has a General Medical Services (GMS) contract (GMS is one of the three contracting routes that have been available to enable commissioning of primary medical services). The practice is part of NHS Hounslow Clinical Commissioning Group (CCG) and the Great West Road locality (comprised of ten practices).

The practice is led by a GP principal (female) who provides nine clinical sessions per week. The GP principal is supported by two regular GP locums (male) who collectively provide 10 sessions; a practice nurse (19.5 hours); a student practice nurse / district nurse (37.5 hours); a phlebotomist / administrator (25 hours); a practice manager (35 hours); an office manager (25 hours) and four receptionists / administrators.

The practice operates from one site. The surgery is a purpose built medical building over two floors. On the ground floor there is step and ramp access to the waiting area, reception desk and five consulting rooms. The first floor comprises practice management facilities including staff room, meeting room and offices.

The practice is open from 8.15am to 6.30pm every weekday except Wednesday when it closes at 5.30pm. The telephone lines open at 9am every weekday. Pre-booked appointments are from 8.30am to 1pm and 2pm to 6.30pm on Monday, Tuesday, Thursday and Friday. On Wednesday appointments are from 9am to 1pm and 1.30pm to 5.30pm. Same day appointments are available for patients with complex or more urgent needs. When the practice is closed, patients are advised to use the local out-of-hours provider.

The practice population is characterised by average levels of income deprivation and lower employment rates when compared to the English average. The practice has a higher percentage of female patients aged 25 to 39 and male patients aged 25 to 49 compared to the English average. The population is ethnically diverse.

The practice service is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures; treatment of disease, disorder and injury; surgical procedures; and maternity and midwifery services.

Updated 6 November 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cranford Medical Centre on 8 November 2016. The practice was rated as good overall and requires improvement for providing effective services. This was specifically in relation to data from the Quality and Outcomes Framework (QOF) which showed patient outcomes were below local and national averages for diabetes and mental health. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Cranford Medical Centre on our website at www.cqc.org.uk.

This inspection was a desk-based focused inspection carried out on 10 October 2017 to confirm that the practice had addressed the concerns that we identified at our previous inspection on 8 November 2016. This report covers our findings in relation to those recommendations made since our last inspection. The practice is now rated good for providing effective services and the overall rating remains as good.

Our key findings were as follows:

• The practice provided evidence that they had reviewed their performance for the QOF over the last year and achieved improved outcomes for patients with diabetes and mental health conditions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 6 March 2017

The practice is rated as requires improvement 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.

• 67% of patients diagnosed with asthma had an asthma review in the last 12 months; this was below the local average of 75% and national average of 75%.

• Performance for diabetes related indicators was below the local and national average, for instance:

• 54% of patients with diabetes on the register had their blood sugar recorded as well controlled (local average 67%, national average 77%).
• 56% of patients with diabetes on the register had their cholesterol measured as well controlled (local average 73%, national average 78%).
• 78% of patients with diabetes on the register had a recorded foot examination and risk classification (local average 85%, national average 88%).
• 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 6 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.

• 81% of women aged 25-64 had it recorded on their notes that a cervical screening test has been performed in the preceding five years; this was comparable to the local average of 77% and 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 and health visitors.

Updated 6 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.

• These patients had a named GP and were offered an 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 6 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.

Updated 6 March 2017

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

Performance for mental health related indicators was the local and national average:

• 64% of patients diagnosed with dementia had a recorded review in a face to face meeting in the last 12 months (local average 83%, national average 84%).

• 77% of patients with schizophrenia, bipolar affective disorder and other psychoses had their alcohol consumption recorded in the preceding 12 months (local average 91%, national average 90%).

• 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 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 6 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.