JS Adler & F Rosenberg- The Surgery

Updated 26 July 2016

The JS Adler & F Rosenberg Practice is located in Barnet, North London within the NHS Barnet Clinical Commissioning Group. The practice holds a General Medical Services contract (an agreement between NHS England and general practices for delivering primary care services to local communities). The practice provides a full range of enhanced services including alcohol support, childhood vaccination and immunisations, extended hours, dementia support, learning disabilities, minor surgery, patient participation, rotavirus and shingles immunisation and unplanned admissions.

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

The practice has a patient list size of approximately 4,700 at the time of our inspection.

The staff team at the practice included two GP partners (male), two salaried GP (one male and one female), one practice manager and two practice nurses (females). The practice have six administrative staff.

The practices opening hours are:

• Monday to Thursday: 8.30am to 6.30pm

• Friday: 8.30am to 5.00pm

• Extended hours opening times are available Monday and Thursday from 6.30pm to 7.30pm

Appointments are available at the following times:

• Monday and Thursday: 10.00am to 12.30pm and 4.30pm to 7.30pm

• Tuesday and Wednesday: 10.00am to 12.30am and 4.30pm to 6.30pm

• Friday: 9.30am to 11.30am

Outside of these times cover is provided by an out of hours provider.

To assist patients in accessing the service there is an online booking system, and a text message reminder service for scheduled appointments. Urgent appointments are available daily and GPs also complete telephone consultations for patients. Weekly there are a total of 20 GP sessions and 10 nurse sessions available to patients.

Updated 26 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at JS Adler and F Rosenberg on 2 March, 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 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.

• Patients said they found it easy to make an appointment with a named GP and that 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.

The areas where the provider should make improvement are:

• Review how they inform and educate patients about the importance of the cervical smear screening programme and childhood vaccines to increase uptake.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 26 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.

• The percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) is 5mmol/l or less was 91% compared to the national average of 80%.

• 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 26 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. Immunisation rates were low for most standard childhood immunisations.

• The percentage of patients with asthma, on the register, who have had an asthma review in the preceding 12 months that includes an assessment of asthma control using three Royal College of Physicians questions was 70% compared to the national average of 75%.

• 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 percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years was 57% compared to a national average of 82%.

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

• There is a daily paediatric clinic from 1.30pm to 2.30pm.

Updated 26 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.

• Guaranteed same day appointments were available for older patients.

• Longer appointments and home visits were available when needed.

Updated 26 July 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.

• Telephone consultations available and online booking for appointments.

• Extended hours were available at the practice two days a week.

• E-mail consultations were available to enable patients to receive clinical advice without taking time out of work.

Updated 26 July 2016

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

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption has been recorded in the preceding 12 months was 100% above the national average of 90%.

• The practice regularly worked with multi-disciplinary teams in the case management of people 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 26 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, travellers and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• 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.