Archived: Islip Manor Medical Centre

Updated 25 September 2017

Islip Manor Medical Centre is a GP practice situated within the London Borough of Ealing. The practice lies within the administrative boundaries of Ealing Clinical Commissioning Group (CCG) and is a member of the North North Ealing GP network.

The practice provides primary medical services to approximately 3,600 patients living in Northolt and holds a core General Medical Services Contract. Since the development of two new local housing developments in the local area there has recently been an increase in the number of new patient registrations. The practice provides a wide range of services including chronic disease management and antenatal and postnatal care. The practice also provides health promotion services including, cervical screening, childhood immunisations, contraception and family planning.

The practice is currently located at 45 Islip Manor Road, Northolt, UB5 5DX with good transport links by bus and rail services. The practice operates from a converted semi-detached house. There is one consultation room on the ground floor of the premises and a treatment room and another consultation room on the first floor with stair access only. The reception and waiting area are on the ground floor with wheelchair access to the entrance of the building. There are accessible facilities but there is no public car parking on site with the exception of two parking bays for disabled people to the front of the building. Non-payable off site car parking is available in the surrounding residential areas.

The practice has recently secured agreement from NHS England to re-locate to new premises in close proximity to the current practice. An application submitted to expand the new premises has been approved by the local council and building work is due for completion by December 2017. It is the intention of the practice to extend the services provided after relocation facilitated through larger and improved facilities, which the current premises does not permit. The practice has recently contracted an independent management consultant company to assist with the development of the practice.

The practice population is ethnically diverse and has a higher than the national average number of patients under 14 years of age and between 30 to 39 years of age. There is a lower than the national average number of patients 55 years plus. The practice area is rated in the third more deprived decile of the national Index of Multiple Deprivation (IMD). People living in more deprived areas tend to have greater need for health services.

The practice registered with CQC as a sole provider on 22 July 2016 following dissolution of the previous GP partnership which the current provider was one of the partners. The practice is registered to provide the regulated activities of maternity & midwifery services and treatment of disease disorder & injury.

The practice is staffed by a male principal GP covering eight clinical sessions per week and a female locum GP covering one clinical session on Wednesday morning. They are supported by two part time female practice nurses, one working Wednesday afternoon and the other all day Friday. The nursing team is supported by a healthcare assistant covering a dual role as assistant practice manager working in total 37.5 hours per week. The practice manager who has responsibilities at other GP locations works five hours a week, with the whole team supported by four part time reception/administration staff.

The opening hours are 8am to 6.30pm Monday, Tuesday, Wednesday and Friday and from 8am to 1.30pm on Thursday. Appointments in the morning are available from 9.30am to 11.50am Monday, Wednesday and Thursday and from 9am to 11.50am Tuesday and Friday. Appointments in the afternoon are available from 4pm to 5.50pm Monday, Tuesday, Wednesday and Friday. Extended hours appointments are offered from 6.30pm to 7.30pm on Wednesday for pre booked appointments. Routine appointments can be booked up to two weeks in advance. The out of hours services are provided by an alternative provider. The details of the out-of-hours service are communicated in a recorded message accessed by calling the practice when it is closed and on the practice website.

The practice was previously inspected under the new methodology on 8 March 2016 and achieved an overall rating of requires improvement.

Updated 25 September 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Islip Manor Medical Centre on 8 March 2016. The overall rating for the practice was requires improvement. The practice was rated requires improvement for providing safe, effective, responsive and well-led services and good for providing caring services. This was specifically in relation to aspects of medicines management, staff recruitment processes, risk management, complaints and systems to improve the quality of care. The full comprehensive report on the 8 March 2016 inspection can be found by selecting the ‘all reports’ link for Islip Manor Medical Centre on our website at www.cqc.org.uk.

An announced comprehensive inspection was undertaken on 7 August 2017. Overall the practice is now rated as good

Our key findings were as follows:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.

• The practice had clearly defined and embedded systems to minimise risks to patient safety.

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.

• Patient satisfaction survey information we reviewed showed patients felt the practice offered a good service and staff were helpful, friendly, attentive and polite and treated them with dignity and respect.

• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.

• Patients we spoke with 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 accessible facilities and was equipped to treat patients and meet their needs, but the premises required renovation. The practice was due to move to new premises with improved facilities in the next four months.

• There was a 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• Review the effectiveness of storing emergency equipment and medicines in two separate locations.

• Continue to monitor and improve Quality and Outcomes Framework (QOF) performance.

• Continue to encourage the uptake of childhood immunisations.

• Continue to review how carers are identified to ensure information, advice and support is made available to them.

• Develop a comprehensive program of quality improvement including clinical audit that is independently driven.

• Review the process for submission of Friends and Family Test (FFT) feedback information to the national information resource.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 September 2017

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

• Unpublished data showed improved performance for diabetes related indicators with an overall achievement rate of 75% in 2016/17, compared to 57% in 2015/16.

• All patients had a named GP and there was a system to recall patients for a structured annual review to check their health and medicines needs were being met.

• The practice nurse and health care assistant were trained in monitoring patients with chronic disease with support from the principal GP who was the lead for long-term disease management.

• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.

• Regular multi-disciplinary team meetings attended by district nurses, the care navigator and social workers were held to discuss and manage the needs of patients with complex medical conditions.

• The practice used rescue pack medication in appropriate patients to reduce risk of unplanned hospital admission.

• In-house smoking cessation was provided by the health care assistant.

• The practice encouraged self-management in patients with long-term conditions and proactively referred them to support services such as the expert patient programme.

Updated 25 September 2017

The practice is rated as good for the care of families, children and young people.

• The practice had safeguarding procedures and policies in place. Information on safeguarding children was displayed in all consulting rooms and it was a standing agenda item at the practice team meeting. Staff had received role appropriate training and were aware of their responsibilities to raise concerns and who to contact.

• Alerts were placed on electronic patient records of vulnerable children and their families to flag this information to relevant staff, for example children subject to child protection of child in need plans.

• Immunisation rates 2015/16 were relatively high for all standard childhood immunisations, but fell below the 90% national expected coverage of immunisations given to children up to two years of age.

• Appointments were available outside of school hours.

• The practice offered routine ante-natal and post-natal care as well family planning and contraceptive services.

• The practice worked with midwives, health visitors and school nurses to support this population group.

• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

Updated 25 September 2017

The practice is rated as good for the care of older people.

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

• All older patients had a named GP to promote continuity of care. Patients were invited to annual care planning appointments as part of the unplanned admission avoidance scheme. Older patients were reviewed and care plans updated after any unplanned admission.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• The practice had a care navigator who visited the practice weekly and helped older patients to access community services.

• Regular multi-disciplinary team meetings attended by district nurses, the care navigator and social workers were held to discuss and manage the needs of older patients with complex medical care.

Updated 25 September 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• Extended hour appointments were available for patients unable to attend the practice in normal working hours. Telephone consultations were also available.

• There was the facility to book appointments and request repeat prescriptions online.

• The practice offered NHS health checks for patients aged 40 to 74 years of age.

Updated 25 September 2017

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

• Unpublished data 2016/17 showed that 78% of patients’ diagnosed with dementia on the practice list, had their care reviewed in a face to face meeting in the last 12 months; compared to 67% in 2015/16.

• All patients diagnosed with common complex mental health problems and those diagnosed with serious mental health problems were invited to annual health checks and medication review with the GP.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia. The practice had a mental health nurse provided by the CCG who attended weekly to support and manage patients experiencing poor mental health.

• Patients at risk of dementia were identified and offered an assessment.

• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

Updated 25 September 2017

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, patients with a history of drug and alcohol misuse and those with a learning disability.

• The practice provided the homelessness locally enhanced service that offered homeless patients health review including physical examination, lifestyle questions, infection screening and mental health screening.

• The practice offered annual health checks and medication review with the GP and health care assistant for patients with a learning disability. Ten out of the 12 patients on the register had received annual health checks so far this year.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.

• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.