Background to this inspection
Updated
3 February 2017
Chartfield Surgery provides primary medical services in Wandsworth to approximately 12,300 patients and is one of 44 member practices in the NHS Wandsworth Clinical Commissioning Group (CCG). The practice operates under a Personal Medical Services (PMS) 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). The practice is a training and teaching practice affiliated with two universities, training and teaching medical students and GP registrars.
The practice operates from a converted residential property with patient facilities on the ground floor which is wheelchair accessible throughout and the first floor. There are four consultation rooms, one treatment room, a meeting room, practice management offices and a reception and waiting area. There are staff facilities and accessible facilities for patients with baby changing and breast feeding areas available.
The practice team at the surgery is made up of four full time GP partners, five part time and one full time salaried GPs. Seven of the GPs are female and three GPs are male. Together the GPs provide 62 clinical sessions per week. The practice employs one full time female practice nurse, one part time female health care assistant, and one part time female phlebotomist. The non-clinical team consists of one practice manager, one development manager, one reception manager and fourteen administrative and clerical staff.
The practice opens between 8.00am and 6.30pm Monday to Friday. Appointments are available from 8.00am to 12.00am and 2.00pm to 6.00pm daily. Extended hours appointments are offered from 7.00am on a Monday, Thursday and Friday morning, from 6.30pm until 8.30pm on a Monday, Tuesday and Wednesday evening and from 6.30pm to 7.00pm on a Thursday evening. The practice is also open every Saturday between 7.30am and 10.30am.
The provider has opted out of providing out-of-hours (OOH) services to their own patients between 6.30pm and 8.00am 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 treatment of disease, disorder or injury, maternity and midwifery services, family planning and diagnostic and screening procedures.
The practice has not previously been inspected by CQC.
Updated
3 February 2017
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Chartfield Surgery on 13 October 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
People with long term conditions
Updated
3 February 2017
The practice is rated as good for the care of people with long-term conditions.
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Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
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Performance for diabetes related indicators was comparable to the local and national average.
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Longer appointments and home visits were available when needed.
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All these patients had a named GP and were offered 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.
Families, children and young people
Updated
3 February 2017
The practice is rated as good for the care of families, children and young people.
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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.
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Immunisation rates were relatively high for all standard childhood immunisations.
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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.
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The practice’s uptake for the cervical screening programme was 81%, which was comparable to the CCG average of 81% and the national average of 82%.
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Appointments were available outside of school hours and the premises were suitable for children and babies.
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We saw positive examples of joint working with midwives and health visitors.
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The practice carried out a survey specifically targeted to teenagers who are often an under represented group. The results of the survey were analysed and the practice put in place plans to start a clinic for teenagers and young people during after school hours where patients in this group could drop in for advice and treatment covering a range of issues including mental health and sexual health.
Updated
3 February 2017
The practice is rated as good for the care of older people.
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The practice offered proactive, personalised care to meet the needs of the older people in its population.
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The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
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All older people had a named GP responsible for their care.
Working age people (including those recently retired and students)
Updated
3 February 2017
The practice is rated as good for the care of working-age people (including those recently retired and students).
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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.
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The practice was proactive in offering online services, telephone appointment booking, and telephone consultations as well as a full range of health promotion and screening that reflects the needs for this age group.
People experiencing poor mental health (including people with dementia)
Updated
3 February 2017
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
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Performance for mental health related indicators was comparable to local and national averages.
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The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
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The practice carried out advance care planning for patients with dementia.
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The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
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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.
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Staff had a good understanding of how to support patients with mental health needs and dementia.
People whose circumstances may make them vulnerable
Updated
3 February 2017
The practice is rated as good for the care of people whose circumstances may make them vulnerable.
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The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability.
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The practice offered longer appointments for vulnerable patients.
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The practice regularly worked with other health care professionals in the case management of vulnerable patients.
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The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
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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.