Elmbank Surgery

Updated 24 May 2017

Elmbank Surgery is located in the London Borough of Ealing, and provides a general practice service to around 3200 patients from a converted house. The practice is registered as a partnership with the Care Quality Commission (CQC) to provide the regulated activities of: treatment of disease, disorder or injury; diagnostic and screening procedures and maternity and midwifery services at one location. The practice has one female GP partner, a male GP partner and a female long term locum GP working total of thirteen sessions amongst them.

The practice has a part time practice manager, a full time assistant practice manager. The rest of the practice team consists of one part time locum practice nurse, one part time nurse practitioner, one part time locum health care assistant and three administrative staff consisting of medical secretaries, reception staff, clerks and typist.

The practice is currently open five days a week from 08:30- 18:30hrs on Mondays and from 08:30-19:00hrs on Tuesday/ Wednesday and Fridays. On Thursday the practice opens until 13:00hrs. Consultation times are 08:30 until 13:00 and from 15:00hrs in the afternoons. When the practice is

closed, the telephone answering service directs patients to contact the out of hours provider.

Updated 24 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Elmbank Surgery on 28 June 2016. The overall rating for the practice was good. However, within the key question safe an area was identified as ‘requires improvement’, as the practice was not meeting the legislation Safe care and treatment.

The practice was issued a requirement notice under Regulation 12, Safe care and treatment. The full comprehensive on 28 June 2016 can be found by selecting the ‘all reports’ link for the Elmbank Surgery on our website at www.cqc.org.uk.

This inspection was a focused desk based review carried out on 31 March 2017 to confirm the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations we identified in our previous inspection on 28 June 2016. This report covers our findings in relation to those requirements and also any additional improvements made since our last inspection.

Overall, the practice is rated as good.

Our key findings were as follows:

• The practice had ensured that health care assistants only worked to Patient Specific Directives to deliver care safely.

The practice supplied an action plan and a range of documents which demonstrated they are now meeting the requirements of Regulation. Regulation 12 Health & Social Care Act 2008 (Regulated Activities) Regulations 2014 Safe care and treatment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 August 2016

The practice is rated as good for the care of people with long-term conditions.

• GPs had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for patients with diabetes, on the register, in whom the last blood test was 62 mmol/mol or less in the preceding 12 months, was higher than the national average. (practice 87%; national 78%).

• 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 31 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 81%, which was comparable to the CCG average of 79% 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 31 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.

• Systems were in place to identify and assess patients who were at high risk of admission to hospital and the practice would call them after discharge to ensure they were receiving appropriate follow up care.

Updated 31 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.

Updated 31 August 2016

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

• The dementia diagnosis rate was comparable to the national average (practice 75%; national 84%).The practice had thirteen patients who were eligible for the screening.

• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption has been recorded in the preceding 12 months (01/04/2014 to 31/03/2015).This was higher than the national average of 90%.

• 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.

• 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 31 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.

• 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.