Archived: Parliament Hill Medical Centre

Updated 25 August 2016

Parliament Hill Medical Centre is located in the London Borough of Camden. The practice has a patient list of approximately 6,667. Thirty one percent of patients are aged under 18 (compared to the national practice average of 15%) and 16% are 65 or older (compared to the national practice average of 17%). Forty three percent of patients have a long-standing health condition.

The services provided by the practice include child health care, ante and post-natal care, immunisations, sexual health and contraception advice and management of long term conditions.

The staff team comprises three GP partners (two male and one female, working 0.7 whole time equivalent (WTE), 0.6 WTE and one working 0.4 WTE), two salaried GP’s (one female working 0.5 WTE and on male working 0.7 WTE), four female GP registrar (all working 1 WTE), a female practice nurse (0.6 WTE), and an administrator/HCA (working 0.8 WTE). The practice also consisted of a practice manager, office manager, secretarial and administrative staff. Parliament Hill Medical Practice holds a General Medical Service (PMS) contract with NHS England.

The practice’s opening hours are:

• Monday – 9am – 1pm and 2pm to-6:30pm

• Tuesday 9am – 1pm and 2pm to 8pm

• Wednesday 9am – 1pm

• Thursday 9am to 1pm and 2pm to 6:30pm

• Friday 9am to 1pm and 2pm to 6pm

Appointments are available at the following times:

• Monday :9:30am-12:30pm and 3:30pm -6:30pm

• Tuesday: 9:30am-12.30pm and 3:30pm-8pm

• Wednesday 9:30 - 12:30pm

• Thursday 9:30am-12:30pmand 3:30pm to 6:30pm

• Friday: 9am-12:30pm and 3:30pm-6:00pm

The practice telephone lines are answered from 9am each week day. Outside of these times, the telephones are diverted to an out of hour’s provider.

In addition to pre-bookable appointments that could be booked up to six weeks in advance, urgent appointments were also available for people that needed them. A daily walk in service was available where patients could wait and see the duty doctor.

The practice is registered to provide the following regulated activities which we inspected: family planning, treatment of disease, disorder or injury; diagnostic and screening procedures, surgical procedures and maternity and midwifery services.

Updated 25 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Parliament Hill Medical Centre on 23 June 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.
• The practice shared key staff, for example IT support, with local practices to ensure that key skills were available to the practice.
• 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 with a named GP 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:

• Consider increasing the frequency of the patient participation group meetings.

Review systems to identify and support patients who are also carers.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 25 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 comparable to the national average. The percentage of patients in whom the last IFCC-HbA1c was 64 mmol/mol or less was 82% compared the CCG average of 77% and the national average of 77%.

• The percentage of patients that had a foot examination and risk classification recorded was 94% compared to the CCG average of 89% and national average of 88%.

• Longer appointments and home visits were available when needed.

• Regular multidisciplinary team meetings were held to discuss those on the long term conditions registers.

• 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 25 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 72% and the national average of 81%.

• 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.

• The practice provided educational talks in local primary schools explaining what happens at the practice.

Updated 25 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 urgent appointments for those with enhanced needs.

• The practice provided home visits to patients unable to visit the surgery and for those patients that were housebound, an extended home visit lasting up to one hour was provided.

• The practice had an active frailty register and those on the register were regularly reviewed and received a care plan.

Updated 25 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 a full range of health promotion and screening that reflects the needs for this age group.

• The practice offered a full range of online services including booking appointments, requesting repeat prescriptions and viewing medical records.

• A daily walk in service was available for patients who could only attend at specific times of the day. These patients would be seen by the duty doctor.

Updated 25 August 2016

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

• Performance for mental health related indicators was comparable to the CCG and the national average. The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in their record was 90% compared to the CCG average of 87% and the national average of 88%.

• The percentage of patients with dementia who had received a face to face review was 88% compared to the CCG average of 83% and the national average of 84%.

• 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.

• The practice had the service of an onsite psychological wellbeing practitioner that was available to patients of the practice.

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

Updated 25 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.