Keats Group Practice

Updated 6 July 2016

The Keats Group Practice operates from 1B Downshire Hill, Hampstead, London NW3 1NR, premises which the practice leases. It is close to Hampstead underground and Hampstead Heath overground stations with good transport links.

The practice provides NHS services through a Personal Medical Services (PMS) contract to approximately 10,800 patients. It is part of the NHS Camden Clinical Commissioning Group (CCG) which is made up of 36 general practices. The practice is registered with the CQC to carry out the following regulated activities - diagnostic and screening procedures, treatment of disease, disorder or injury, family planning, maternity and midwifery services and surgical procedures. The patient profile for the practice has a higher than average working age population, and higher than average younger children; the numbers of teenage children, younger adults and older patients are lower than the national average.

The practice has a clinical team of five partner GPs (two female and three male) and five salaried GPs (four female and one male). Two of the partner GPs work five clinical sessions per week; two of them work three sessions and the other works two sessions. One of the salaried GPs works five sessions; three others work two sessions and the remaining salaried GP works one and half sessions per week. There is a nurse practitioner, two practice nurses and a healthcare assistant. The practice also employs a counsellor. It is a training practice, with five registrars (trainee GPs) currently placed there. There is a practice manager and a patient services manager, with six receptionists. The practice team is completed by an administration and research team of four staff.

The practice’s opening hours are 8.00 am to 8.00 pm, Monday, Tuesday and Thursday; 8.00 am to 7.30 pm on Wednesday; and 8.00 am to 6.30 pm on Friday. The lunch break is between 1.00 pm and 2.00 pm. Phones are answered between 8.00 am and 7.30 pm on Monday to Thursday and from 8.00 am to 6.30 pm on Friday. After 6:30 pm, the telephone lines are for routine enquiries only; emergency calls are redirected to the out-of-hours service. The practice is closed at weekends. Morning consultation sessions are from 8.00 am to 12 noon on Monday, Tuesday, Thursday and Friday; and from 7.00 am to 12 noon on Wednesday. Afternoon / evening sessions are 3.00 pm to 8.00 pm on Monday, Tuesday and Thursday; 3.00 pm to 7.15 on Wednesday; and 3.00 pm to 6.30 pm on Friday. Walk-in and emergency appointments are available in the morning between 9.00 am and 12 noon, and in the afternoon between 3.00 pm and 6.30 pm. Consultation slots between 7.00 am to 9.00 am and 6.30 pm to 8.00 pm are reserved for pre-booked routine appointments.

Routine appointments with GPs and the nurse practitioner can be booked up to two weeks in advance. Booked appointments are 15 minutes long; walk-in and emergency appointments are 10 minutes long. Patients may book double appointments if there are a number of healthcare issues to discuss. The practice nurses provide a number of clinical services, for which a number of appointments can be booked in advance. Appointments with GPs can be booked online by patients who have previously registered to use the system, and there is a 24-hour automated telephone booking system. Patients who have provided the practice with their mobile telephone numbers are sent text reminders of their appointments. The GPs conduct telephone consultations with patients and make home visits. Patients can also seek routine advice from GPs by email, which are dealt with by the day’s duty GP.

The practice has opted out of providing an out-of-hours service. Patients calling the practice when it is closed are connected with the local out-of-hours service provider. There is information given about the out-of-hours provider and the NHS 111 service on the practice website.

Updated 6 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 10 May 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 6 July 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.
• 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.
• Data showed that the practice was performing above local and national averages in relation to diabetes care. It maintained a register of 233 patients with diabetes and had carried out annual foot checks on 215 (92%) of the patients.
• The practice maintained of register of 89 patients with heart failure, of whom 83 had had an annual medicines review.
• The percentage of patients on the practice’s asthma register, who have had a review in the preceding 12 months was above the local and national average.

Updated 6 July 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 and maintained a register of vulnerable children.
• Immunisation rates for all standard childhood immunisations were comparable with the local average.
• 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.
• 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 July 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.
• GPs made monthly visits to local sheltered accommodation.
• The practice maintained an Avoiding Unplanned Admissions register of 154 patients, all of whom had up-to-date care plans.
• The practice maintained a “Gold Standard” palliative care register of 11 patients.
• The practice had a register of 1026 patients prescribed more than four medicines and records showed that reviews had been carried out in respect of 906 (88%).

Updated 6 July 2016

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

• 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’s uptake for the cervical screening programme in 2014/15 was 85%, which was 4% above the national average.
• Data showed that 3706 patients (93% of those eligible) had undergone blood pressure checks.

Updated 6 July 2016

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

• Data showed that 65 patients (being 85% of 77 patients on the dementia register) had had their care reviewed in a face-to-face review in the preceding 12 months, above both local and national averages.
• 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.
• Continuity of care for patients experiencing poor mental health was prioritised.
• Data showed that 88 patients, being 95% of those with severe mental health problems, had an agreed care plan documented in their records.
• 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 July 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, and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability. It maintained a register of 13 patients and had carried out annual follow ups and care plan reviews in relation to their care.
• 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.