Dr Curran and Partners

Updated 8 August 2016

Dr Curran and Partners practice is based in the London Borough of Lambeth. The practice is run by five partners. The practice is based in a purpose built building which it shares with another practice. All of the clinical areas in the practice are based on the ground floor. The address of the practice is Manor Health Centre, 86 Clapham Manor Street, Clapham, London, SW4 6EB.

The practice has approximately 9,600 registered patients. The surgery is based in an area with a deprivation score of 5 out of 10 (10 being the least deprived). Like much of the borough of Lambeth, the practice population demographic is not in line with national averages The number of patients over the age of 50 was less than half of what would be expected nationally. The age group 20-35 made up more than 40% of the practice population, significantly above the national average.

The practice employs two further GPs. In total there are four male and three female GPs working to an equivalent of 3.9 whole time equivalent GPs. At the time of the inspection the practice were looking to recruit to a further seven clinical sessions. There are three practice nurses, working the equivalent of 2.5 whole time equivalent and a health care assistant (0.4 whole time equivalent). There is a practice manager and an assistant practice manager and eight other administrative staff. The practice is a training practice and both undergraduate and postgraduate trainees worked at the practice.

The practice is contracted to provide Personal Medical Services (PMS) and is registered with the CQC for the following regulated activities: treatment of disease, disorder or injury, family planning, maternity and midwifery, surgical procedures and diagnostic and screening procedures at one location.

The practice is open Monday to Friday 8:00am to 6:30pm. There are extended hours from 6:30pm to 8:00pm on Mondays and Tuesdays, and 6:30pm to 7:00pm on Wednesdays, Thursdays and Fridays.

The practice had not previously been inspected by the CQC.

Updated 8 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Curran and Partners on 12 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 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.

The areas where the provider should make improvement are:

• The practice should ensure that all equipment in doctors bags is calibrated.

• The practice should ensure that audits undertaken are completed in two cycles to demonstrate that care is improving over time.

The practice should consider reviewing clinical coding within the practice to ensure that all records are accurate.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 8 August 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.

• Performance for diabetes related indicators was similar to the national average. The practice had scored 79% for diabetes related indicators in the last QOF, similar to the national average of 89%. The percentage of patients with diabetes, on the register, in whom the last IFCCHbA1c was 64 mmol/mol or less (a measure of well controlled diabetes) in the preceding 12 months was 70%, compared to a national average of 77%.

• 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 8 August 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.

• 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 practice’s uptake for the cervical screening programme was 84%, which was comparable to the CCG average of 83% and the 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, health visitors and school nurses.

Updated 8 August 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.

• Named GPs were available for patients over the age of 75 to ensure continuity of care.

• The practice undertook holistic healthcare assessments for older patients who were at high risk. Referrals to the safe and independent living (SAIL) team were also available.

Updated 8 August 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.

• The practice offered extended hours five days per week for those patients who could not attend during normal working hours. Appointments were available with both GPs and nurses during extended hours.

Updated 8 August 2016

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

• 79% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average.

• Performance for mental health related indicators was lower than the national average. The practice had scored 78% for mental health related indicators in the last QOF, which was below the national average of 93%. The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 57%, lower than the national average of 88%. The practice had highlighted this as an area for improvement

• 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.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 8 August 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. Registration systems were flexible to those patients who did not have a fixed permanent address.

• 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.