Lewisham Medical Centre

Background to this inspection

Updated 3 November 2017

Lewisham Medical Centre has approximately 9234 patients and is in Lewisham, south east London. The surgery is purpose built premises, on the ground floor. The area is well served by public transport.

Compared to the England average, the practice has more young children as patients (age up to five) and fewer older children (age five – 19). There are more patients aged 20 – 44, and fewer patients aged 45+ than at an average GP practice in England.

The surgery is based in an area with a deprivation score of five out of 10 (1 being the most deprived), and has a higher level of income deprivation affecting older people and children. Life expectancy in line with the national average.

Six doctors work at the practice: one male and five female. One of the doctors is a partner with the practice manager. Some of the GPs work part-time. Full time doctors work 8 sessions per week. The practice provides 32 GP sessions per week.

The (all female) nursing team is made up of two practice nurses and two health care assistants. There is also a pharmacist based in the practice, and a part-time phlebotomist.

The practice is open between 8am to 6.30pm Monday to Friday (until 8.30 pm on Wednesday) and 9am to 4pm on Saturday. Appointments with GPs are available in the morning from 9am to 12.20 on Monday, 8.30am to 12.20pm Tuesday to Thursday, 8.30am to 12pm on Friday and 9am to 4pm on Saturday. In afternoon, GP appointments are available from 2.50pm to 6pm Monday and Tuesday, 2.30pm to 6pm on Thursday and Friday and 2.50 pm to 8.30 pm on Wednesday.

The practice offers GP services under a Personal Medical Services contract in the Lewisham Clinical Commissioning Group area. The practice is registered with the CQC to provide family planning, surgical procedures, diagnostic and screening procedures, treatment of disease, disorder or injury and maternity and midwifery services.

This is the first time the CQC has inspected the practice.

Overall inspection

Good

Updated 3 November 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lewisham Medical Centre on 7 December 2016. The overall rating for the practice was requires improvement. The full comprehensive report from the 7 December 2016 inspection can be found by selecting the ‘all reports’ link for Lewisham Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 17 October 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 7 December 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

At our previous inspection undertaken on 7 December 2016, we rated the practice as requires improvement for providing safe and responsive services as:

The systems to manage the security of NHS smart card and printer prescriptions were not effective.
The practice was not undertaking periodic checks of their defibrillator to confirm that this was working.
The practice was not dealing with complaints in line with recognised guidance and contractual obligations.

In addition as to the breaches of regulation identified we also recommended that the practice should make the following improvements:

• Ensure effective security and monitoring arrangements for prescription forms.

• Monitor and act on patient feedback on waiting times after appointment time.

• Identify clear actions in all meeting minutes, so that follow-up can be checked.

Overall the practice is now rated as good for providing services that are safe and responsive:

In respect of the breaches of regulation we found that:

Systems had been put in place to manage the security of NHS smart cards.
The practice had confirmed with the manufacturer the mechanisms for testing the working status of the practice’s defibrillator and had implemented monthly visual checks to confirm the working status.
The complaints reviewed indicated that complaints were dealt in line with recognised guidance and contractual obligations.

In addition the practice had:

Improved the arrangements to monitor and ensure the security of prescriptions.
Had taken action in an effort to improve patient feedback regarding waiting times which was reflected in improved national GP Patient Survey scores including improving systems to ensure that patients were notified when clinicians were running late.
Action points from practice meetings were clearly noted on both clinical and practice meeting minutes. Though discussion of follow up action was not documented in subsequent meeting minutes.

We identified too minor areas where the provider should make improvement:

Document discussion of action points in subsequent clinical and practice meetings
Include details of organisations that patients can contact if they are unsatisfied with the practice’s complaint response.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice