Portobello Medical Centre

Updated 19 August 2016

Portobello Medical Centre is a single location GP service which provides primary medical services through a General Medical Services (GMS) contract to approximately 2,600 patients in the Royal Borough of Kensington and Chelsea in West London. The practice is part of NHS West London CCG. The practice is located in a purpose built property which it shares with another GP practice. The patient population includes a cross-section of socio-economic and ethnic groups. The practice serves a relatively young population group with above average numbers in the 15 to 44 years age range and below average numbers aged 75 and over.

The practice team is made up of two GP partners (1.2 whole-time equivalent (WTE)); a maternity cover GP (0.5 WTE); a salaried GP (0.2 WTE); the practice manager (0.6 WTE); a practice nurse (0.8 WTE) and healthcare assistant (0.2 WTE); an administration manager, and three reception staff (total 2.6 WTE). There are three female GPs (including one on maternity leave) and one male GP (maternity cover), and one female practice nurse and one male healthcare assistant.

The practice is open between 7.00 am to 5.00pm Monday and Thursday; 8.00am to 5.00pm Tuesday and Friday; and 7.00am to 5.00pm Wednesday. A walk-in surgery is available from 7.00am to 10.00am Monday, Wednesday and Thursday and 8.00am to 10.00am Tuesday and Friday. Booked in advance appointments with a GP are from available on Monday, and Tuesday between 2.00pm and 5.00pm and on Wednesday and Friday between 3.00pm and 5.00pm. GP appointments can also be booked on the day on Monday between 8.00am and 10.00am. Early morning appointments are offered between 7.00am and 8.00am in walk-in clinics on Monday, Wednesday and Thursday.

There are also arrangements to ensure patients receive urgent medical assistance when the practice is closed. Out of hours services are provided by a local provider. Patients are provided with details of the number to call.

Updated 19 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Portobello Medical Centre 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.
• Clinical audits had been carried out, and one of these was a completed second cycle audit demonstrating quality improvement in patient outcomes.
• 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 were able 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:

• Continue to complete clinical audits through the full audit cycle  to further demonstrate where the improvements made are implemented and monitored to improve patient outcomes.
• Review the system for the identification of carers to ensure all carers have been identified and provided with support.
• Advertise in the reception area that translation services are available.
• Update the practice’s policy on notifiable incidents in line with 2014 regulations.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 August 2016

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

• The practice nurse had a lead role in chronic disease management and patients at risk of hospital admission were identified as a priority.
• QOF performance for long term conditions management was generally above average. Performance for diabetes related indicators was below the national average but the practice was taking action to address this.
• 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. This included close communication with district nurses and a primary care navigator.

Updated 19 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 broadly comparable to CCG averages for all standard childhood immunisations.
• The practice’s uptake for the cervical screening programme was 76%, which was comparable to the CCG average of 75% 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 and health visitors. The practice also worked with the local ‘family nurse partnership’ to secure home visiting support for first time young mothers, aged 19 years or under.

Updated 19 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 and same day access via the telephone for those with enhanced needs.
• There was close liaison with the community matron, district nurses and primary care navigator for signposting patients and relatives to access services and for management of their conditions.
• There was also close working with the local rapid response team, which included doctors and nurses to keep patients over 65 well, at home and out of hospital.
• The practice worked to the Gold Standards Framework in supporting patients on its palliative care register and made use of the Co-ordinate my Care portal to register the wishes of patients and communicate with other services in supporting those patients.

Updated 19 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 reflected the needs for this age group.
• There was early morning opening for walk-in appointments, three days a week for working patients who could not attend during normal opening hours.
• Same day access was available via the telephone or in face-to face consultations.
• The practice provided an in-house phlebotomy service.
• The practice provided a travel vaccination clinic.

Updated 19 August 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 who had their care reviewed in a face to face meeting in the last 12 months, which is above the national average.
• QOF performance for mental health related indicators was above average.
• The practice regularly worked with multi-disciplinary teams in the case management of patients 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, including ‘Take time to talk’ for access a range of psychological therapies and support to patients who were anxious, depressed, stressed or worried.

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

Updated 19 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 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. There was close liaison with a primary care navigator for signposting patients and relatives to access services and for support in the management of their conditions.

• 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.