Belmont Medical Centre

Updated 18 April 2016

Belmont Medical Centre is situated at 18-20 Western Road, Southall, UB2 5DU. The practice provides NHS primary care services through a General Medical Services (GMS) contract to approximately 6,000 people living in the London Borough of Ealing. The practice is part of the NHS Ealing Clinical Commissioning Group (CCG) and is in the South Southall GP network which comprises eight GP practices.

The practice population is ethnically diverse with a higher than average number of children under four years of age and patients between 20 and 40 years old. The practice area is rated in the third most deprived decile of the Index of Multiple Deprivation (IMD). People living in more deprived areas tend to have greater need for health services. The local area has a high incidence of diabetes with a prevalence of 8.1% in the practice population, which is above the CCG average of 5.1%.

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

The practice team consists of a male GP partner (eight sessions / week), a female GP silent partner, a female long-term locum GP (six sessions / week), a male long-term locum GP (three sessions / week) and a further nine sessions / week covered by other locum GPs. There are two practice nurses (six sessions / week in total), a healthcare assistant (37 hours / week), a practice manager and seven reception / administration staff.

The practice is open between 8.30am to 6.30pm Monday to Friday and appointments are from 8.30am to 12.30am every morning and 2.30pm to 6.30pm daily. Extended surgery hours are offered from 7.00am on Monday and Friday. When the practice is closed patients are directed to the local out of hours (OOH) service which is provided by London Central & West Unscheduled Care Collaborative (LWC).

Services provided include Phlebotomy, chronic disease management, child and travel immunisations, NHS health checks, dressings / removal of sutures, ear syringing, joint injections, smear tests, family planning, electrocardiogram (ECG), spirometry, care planning and wound management.

Updated 18 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at 8.30am on 8 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.

We found one area of outstanding practice:

• Proactive management of diabetes. The practice had 544 patients on the diabetes register. Data showed that the practice had achieved HbA1c levels below 58mmol/mol in 56% of these patients (HbA1c is a measure of blood glucose levels. National Institute for Clinical Excellence guidance recommends levels below 58mmol/mol to prevent long-term complications). The practice had also completed the nine key care processes in 58% of diabetes patients in the current year (to ensure that the risk of diabetes related complications are kept to a minimum, NICE recommends that all patients should annually receive nine crucial tests as part of their diabetes management). In addition the practice had identified through proactive screening 575 patients at high risk of developing diabetes and since July 2015 provided 204 of them with diet and lifestyle advice to reduce the risk of diabetes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 April 2016

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

• The practice provided proactive management of long-term conditions, particularly diabetes which had a high prevalence in the practice population.

• 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 18 April 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 comparable to other practices for all standard childhood immunisations.

• The percentage of patients with asthma, on the register, who have had an asthma review in the preceding 12 months was 77%, which was comparable 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.

• The practice’s uptake for the cervical screening programme was 84%, which was comparable to the CCG average of 78%, and the national average of 82%.

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

• We were given positive examples of joint working with midwives and health visitors.

Updated 18 April 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.

Updated 18 April 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 18 April 2016

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

• 100% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was above the national average of 84%.
• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, in the preceding 12 months which was above the national average of 88%.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those 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 18 April 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.