Background to this inspection
Updated
8 March 2018
The Glen Road Medical Centre is one of 51 practices situated within NHS Newham Clinical Commissioning Group (CCG). The practice provides services to approximately 6,400 patients under a Personal Medical Services (PMS) contract. PMS agreements are locally agreed contracts between NHS England and a GP practice, and are designed to offer local flexibility compared to the nationally negotiated General Medical Services contract.
The practice provides a full range of enhanced services including Diabetes Management, NHS health checks and minor surgery. The practice is registered with CQC to provide the following requlated activities;
- Diagnostic and screening procedures
- Family planning services
- Midwifery and maternity
- Surgical procedures
- Treatment of disease, disorder and injury
The staff team at the practice included two GP partners (one part time female working six to eight sessions per week and one full time male working six sessions per week), and one regular female locum GP working six sessions per week. There is a female diabetes specialist nurse practitioner working thirty four hours per week, a full time female health care assistant, a practice manager, and a team of reception and administrative staff.
The practice premises are purpose built. It is open 8am to 6:30pm every weekday except Mondays and Tuesdays when it closes for lunch between 1pm to 2pm. There are extended hours every weekday evening until 7pm and on Saturdays from 9am to 1pm. Appointments are available all day except Mondays and Tuesdays when it closes for lunch, including home visits and telephone consultations.
Appointments can be booked online, some being available the next day. Urgent appointments are also available for patients who need them. The practice has opted out of providing an out-of-hours service. Patients telephoning when the practice is closed are transferred automatically to the local out-of-hours service provider.
The practice had a lower percentage of patients aged over 65 years than the national average (6% compared to 17%), a comparable percentage of unemployed patients (5%) and a slightly lower percentage of patients with a long standing health condition (50% compared to 54%).
The registered practice population are predominantly Black, Asian and Minority Ethnic (65.5%) and are ranked in the third most deprived decile with income deprivation which is higher than the national average.
A GP Partner is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Updated
8 March 2018
Letter from the Chief Inspector of General Practice
This practice is rated as Good overall.
(Previous inspection January 2016 – Good)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:
Older People – Good
People with long-term conditions – Good
Families, children and young people – Good
Working age people (including those recently retired and students – Good
People whose circumstances may make them vulnerable – Good
People experiencing poor mental health (including people with dementia) - Good
We carried out an announced comprehensive inspection at Glen Road Medical Centre on 4 January 2018 as part of our inspection programme.
At this inspection we found:
- The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
- Clinicians followed national guidelines and protocols available to them in the identification and management of severe infections such as sepsis.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
The areas where the provider should make improvements are:
- Consider introducing a system to record the actions and outcomes of MHRA alerts.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
24 March 2016
The practice is rated as good for the care of people with long-term conditions.
- 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.
- Nursing staff had lead roles in chronic disease management, identified patients at risk of hospital admission as a priority and were generally well trained.
- The practice aimed to review care for people with long term conditions at least twice per year. A spot check showed that 99% of patients with long term conditions had an up to date care plan following a review by either the GP or Nurse Practitioner.
Families, children and young people
Updated
24 March 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 relatively high for all standard childhood immunisations.
- Eighty per cent of patients diagnosed with asthma, on the register had an asthma review in the last 12 months compared to 75% nationally.
- 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.
- Eighty-one per cent of women aged 25-64 had a cervical screening test within the last five years compared to 82% nationally.
- 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, health visitors and school nurses.
Updated
24 March 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.
- It held a list of its older patients who were more at risk and had identified one hundred and eighty nine patients who were offered regular reviews.
- The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
Working age people (including those recently retired and students)
Updated
24 March 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.
People experiencing poor mental health (including people with dementia)
Updated
24 March 2016
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
- Ninety-three per cent of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was better than the national average of 84%.
- Overall performance for mental health related indicators was similar to CCG and the national averages at 89% (CCG average 87%, national average 93%).
- 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.
People whose circumstances may make them vulnerable
Updated
24 March 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.
- 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.