Eltham Medical Practice

Updated 20 October 2022

Eltham Medical Practice operates from three sites in Eltham, its main site in Eltham Community Hospital Passey Place London SE9 5DQ and its branch sites 180 Well Hall Road Eltham SE9 6SR and 46 Westmount Road Eltham SE9 1JE. The Practice is open Monday to Friday 8am to 6.30pm, with extended hours on a Tuesday until 8:15pm and opens 7am to 8:15pm on a Thursday.

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

The practice is situated within the Greenwich South East London integrated care systems and delivers General Medical Services (GMS) to a patient population of about 24,500. This is part of a contract held with NHS England.

The practice is part of the wider network of GP practices Eltham (PCN).

The practice had increased its patient population significantly over the last two years in January 2020 the practice went from 16,000 to 24,500, by taking over two other practices in the area.

Information published by Public Health England shows that deprivation within the practice population group is in the fifth decile (5 of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 83% White, 6% Asian, 6% Black, 4% Mixed, and 1% Other.

Local enhanced services provided by the practice included Direct Oral Anticoagulant Initiation, Management of oral anticoagulation therapy (Warfarin) and Safeguarding Children, Young People, Children Looked After and Safeguarding Adults at Risk.

Eltham Medical Practice is an accredited training practice, the practice has two male GP partners They employ 10 salaried GPs eight female and two males. Three female nurse practitioners, three female nurses, two female healthcare assistants, one female paramedic, four managers and 35 receptionists and administrators.

Extended access is provided locally Eltham Health Primary Care Network Hub for late evening and weekend appointments. Out of hours services are provided by 111.

Updated 20 October 2022

We carried out an announced inspection at Eltham Medical Practice between 12 and15 September 2022. Overall, the practice is rated as Good.

Set out the ratings for each key question

Safe –Good.

Effective - Good.

Caring - Good

Responsive – Good.

Well-led - Good.

Following our previous inspection on 17 May 2017, the practice was rated Good overall and for all key questions.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for at Eltham Medical Practice on our website at www.cqc.org.uk

This inspection was a comprehensive inspection part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach which involved a site visit: We looked at the Safe, Effective, Caring, Responsive and Well-led key questions.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider.
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A short site visit.

Our findings

We based our judgement of the quality of care at this service on a combination of:

• What we found when we inspected.
• Information from our ongoing monitoring of data about services.
• Information from the provider, patients, the public and other organisations.

We have rated this practice as Good overall

We found that:

• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

The areas where the provider should make improvements are:

• Continue to take action to improve childhood immunisation.
• Continue to review and monitor patients on high risk medicines.
• Continue to review and work on coding issue.
• Review process for checking non-clinical staff immnuisaton status.
• Continue to implement fire exit procedures ensuring they are inclusive of partial hearing/deaf patients.
• Review text messaging system to ensure correct information is sent out.
• Undertake a practice patient survey.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services