Archived: Dr Simon Woolf Also known as Mitchley Avenue Surgery

Updated 14 July 2016

Dr Simon Woolf (also known as Mitchley Avenue Surgery) operates from a single location in Sanderstead, Croydon. It is one of 49 GP practices in the Croydon Clinical Commissioning Group (CCG) area. There were 3629 patients registered at the practice at the time of our inspection.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of treatment of disease, disorder or injury, and diagnostic and screening procedures. The practice is not currently registered for the regulated activity of surgical procedures, but is approved to carry out the minor surgeries direct enhanced service (DES). Under the DES the practice provides joint injections only.

The practice has a personal medical services (PMS) contract with the NHS and is signed up to a number of enhanced services (enhanced services require an enhanced level of service provision above what is normally required under the core GP contract). These enhanced services include childhood vaccination and immunisation, flu and pneumococcal immunisations, risk profiling and case management, and extended opening hours.

The practice clinical team is made up of the lead GP and a salaried GP (both male), and a female practice nurse. The clinical team is supported by a practice manager, a team of 4 reception and administrative staff members, and a cleaner.

The practice is open between 8am to 1pm, then 3pm to 6.30pm on Mondays, Wednesdays and Fridays. On Tuesdays and Thursdays the practice is open from 7.30am to 1pm. On Tuesdays and Thursdays, the GPs are on call in the afternoon, and the practice phone lines are manned by a local GP practice.

The practice has opted out of providing out-of-hours (OOH) services and directs their patients to a contracted out-of-hours service.

Updated 14 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Simon Woolf (also known as Mitchley avenue surgery) on 17 December 2015. 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 a system in place for reporting and recording significant events. However we noted that improvements could be made in the capturing of significant events.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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.
• Patients said they found it easy to make an appointment with a named GP and that 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:

• The practice should ensure its significant events management process is improved to capture the full range of relevant events

• Ensure a patient participation group is made available in the practice for the patient population

• Ensure revision histories of its policies and procedures are well documented so authorising person(s), review and revision dates are included.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 14 July 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.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• Patients with long term conditions were managed according to the various national guidelines for these conditions. The GPs and nurse had additional training and specialisations in the management of certain long term conditions, including diabetes and chronic obstructive pulmonary disease (COPD).

• Patients with chronic disease as well as elderly patients who may have poor health and increased health needs were enrolled (with their consent) into the practice’s Avoidance of Unplanned Admissions scheme. Patients have care plans included in their records and these plans were reviewed each time the patient was seen and updated if there was a change of medication and/or diagnosis.

Updated 14 July 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.

• The practice offered the full range of recommended childhood immunisations. Immunisation rates were relatively high for all standard childhood immunisations.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice provided a number of ‘book on the day’ and urgent appointments specifically for families, children and young people

• The practice reception staff was trained to prioritise ill children to be seen immediately regardless of the overall state of appointments on any day.

• We saw good examples of joint working with midwives and health visitors. The practice provided antenatal clinics and baby checks

• The practice did not have its own website, but online services were available in the practice through the patient access website

• The practice participated in health promotion programmes aimed at reducing sexual health risks including contraception and safe sex advice and screening for sexually transmitted diseases.

• The practice provided all forms of contraceptive advice, but referred those requesting intrauterine devices (IUDs) / intrauterine systems (IUSs) or contraceptive implants to the local sexual health clinics.

Updated 14 July 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.

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

• The practice liaised with the District Nursing team for appropriate visits for house bound patients.

• The GPs visit the elderly to give flu jabs. Patients over the age of 65 were routinely invited for flu clinics and they were opportunistically inoculated during consultations with consent. Flu vaccination rates for the over 65s in the practice was 73%, which was in line with the national averages.

• The practice had adopted a number of measures aimed at helping elderly patients and those with sensory problems. For example, they had all their signage regularly reviewed to ensure that it was clear and large enough.

• The practice had informed all their elderly patients of their registered GP and recorded information about their next of kin and any carer information.

Updated 14 July 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 provided extended hours GP and nurse appointments on Tuesday and Thursday mornings (7.30 -8.00am).

• The practice provided telephone feedback, consultations and advice to patients who cannot come to the surgery.

• The practice provided online access services for patients of working age including booking and cancelling appointments, requesting repeat prescriptions, viewing test results and other investigations, amending patient details, and sending messages to the surgery particularly regarding prescriptions.

Updated 14 July 2016

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

• 83% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice worked closely with the local mental health services and followed the relative guidelines and referral protocols.

• The practice participated in all the shared care protocols including shared care prescribing guidelines.

• It 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.

• It had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support people with mental health needs and dementia. The practice participates in regular updates and training regarding mental health issues. The lead GP had recently attended a teaching session on making your Practice dementia friendly.

Updated 14 July 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.

• It offered longer appointments for people with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• It had told 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.

• The practice had safeguarding leads and all staff had undertaken safeguarding training. There were a number of layers of alerts regarding people who may be vulnerable and these alerts appeared on patients’ records. They included children in care or on the Child protection register. They also included vulnerable adults. The practice ensured that their diagnosis and their needs are fully recorded in their records as well as details of their carer, other responsible adult or next of kin / closest relative.