Archived: Dr Elizabeth Young Also known as Allenson House Medical Centre

Updated 10 May 2016

Dr Elizabeth Young (“the Provider”) operates from the Allenson House Medical Centre, Weston Park, Crouch End, London N8 9TB.

The practice provides NHS services through a General Medical Services (GMS) contract to 2,524 patients. It is part of the NHS Haringey Clinical Commissioning Group (CCG) which is made up of 45 general practices. The practice is registered with the CQC to carry out the following regulated activities - diagnostic and screening procedures, maternity and midwifery services, treatment of disease, disorder or injury, surgical procedures.

The patient profile for the CCG area has a higher number of working age adults than the national average, with fewer older patients and younger people aged under-19. Data provided by the practice gave a breakdown of the patient list as follows: 0 - 16years, 336 patients (14% of the practice population; 16 – 65 years, 1,926 patients (76%); 65 years and over, 252 patients (10%).

The practice team is made up of the Provider with regular locum GP support and a practice nurse. The practice provides ten clinical sessions per week, with the Provider working six or seven and the remainder being covered by a locum GP. The practice nurse works part time, six sessions a week. The administrative team comprises a practice manager, an administrator and three receptionists, all of whom worked part time.

The practice’s opening hours are 9.00am to 7.00pm on Monday, Thursday and Friday; 9.00am to 8.00pm on Tuesday; and 8.30am to 7.00pm on Wednesday. Patients may contact the practice by phone between 8.00am and 7.00pm (8.00pm on Tuesday).

The morning surgery hours for booked appointments are 9.30am to 11.30am on Monday, Tuesday, Thursday and Friday and 8.30am on Wednesday. The evening surgery hours for booked appointments are 5.00pm to 6.30pm Monday, Wednesday Thursday and Friday and 5.00pm to 8pm on Tuesday. Provision is made during the booked surgery sessions for patients needing emergency consultations. Telephone consultations and home visits are also available.

Although the practice does not yet have a website, patients can register with the Patient Access service to book appointments online and to order repeat prescriptions.

The practice has opted out of providing an out-of-hours service. Patients calling the practice when it is closed are connected with the local out-of-hours service provider.

Updated 10 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 25 February 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients said it was easy to make an appointment, 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 practice was aware of and complied with the requirements of the Duty of Candour.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• There was an active patient participation group.

The areas where the practice should make improvement are:

• Arranging refresher training in relation to the Mental Capacity Act and regarding obtaining children’s consent to care and treatment.
• Formalising practice staff meetings and fully recording the discussions.
• Continuing with plans to set up a practice website.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 10 May 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.
• The practice maintained a register of 104 patients on the diabetes register, of whom 93 had received an annual eye check and a foot check.
• All 17 patients on the practice’s heart failure register had had a medication review.
• Longer appointments and home visits were available when needed.
• The flu vaccination rate for at risk patients was higher than the national average.
• All patients with long term conditions were audited monthly by the Provider.

Updated 10 May 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.
• The percentage of patients with asthma on the register who had an asthma review in the preceding 12 months was above the national average.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals. The Provider agreed to arrange suitable refresher training in relation to obtaining children’s consent to treatment.
• The rate of uptake for cervical screening tests was above the national average.
• 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, district nurses and health visitors.

Updated 10 May 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 for those with enhanced needs.
• Records showed that 271 patients, being 89% of those prescribed more than four medications, had received a structured annual review
• Records showed that 218 patients had been offered cognition testing.
• The practice maintained a register of 43 patients at risk of admission to hospital, all of whom had had their care plans reviewed.
• The flu vaccination rate for older people was above the national average.

Updated 10 May 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 reflects the needs for this age group.

Updated 10 May 2016

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

• Advanced care planning was done in relation to all of the seven
• The practice maintained a register of 31 patients with schizophrenia, bipolar affective disorder and other psychoses for whom a comprehensive, agreed care plan was documented in the record, in the preceding 12 months. This was above the national average. Twenty nine of the patients had received an annual health check; the remaining two had been invited.
• The practice regularly worked with multi-disciplinary teams in the case management of people 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.
• 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.
• Staff had a generally good understanding of how to support patients with mental health needs and dementia, although the need for refresher training was identified and agreed by the Provider.

Updated 10 May 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice maintained registers of vulnerable adults and vulnerable children. Homeless patients could register at the practice address to receive health care related correspondence.
• The practice had a register of 8 patients with learning disabilities, all of whom had had an annual assessment and care plan review.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• 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.