Archived: Dr Soe Yin Also known as Acton Lane Medical Centre

Updated 15 November 2016

Dr Soe Yin provides NHS primary medical services to around 1300 patients in the South Acton and Chiswick areas of London through a 'general medical services' contract. The service is run from one surgery.

The current practice clinical team comprises a principal GP (male), a sessional GP (female), a part-time practice nurse, and a health care assistant/phlebotomist. The practice also employs a part time practice manager and receptionists. The GPs provide nine clinical sessions a week in total, one of which is provided by the female sessional GP.

The practice is open from 8.00am until 6.30pm on Monday, Tuesday and Friday. The practice is open from 8.00am until 7.00pm on Thursday and is closed on Wednesday afternoon from 1.00pm. Appointments can be made between 9.00am and 11.00am daily and afternoon appointments run from 5.00pm until 6.00pm on Monday Tuesday and Friday. Appointments can be booked between 5.30pm and 7.00pm on Thursday.

The practice offers telephone consultations online appointment booking and an electronic prescription service. The GPs make home visits to see patients who are housebound or are too ill to visit the practice.

When the practice is closed, patients are advised to use a contracted out-of-hours primary care service if they need urgent primary medical care. The practice provides information about its opening times and how to access urgent and out-of-hours services in the practice leaflet, the website and on a recorded telephone message.

The practice has a high proportion of adults under 45 and relatively few children and patients aged over 65. Practice staff can speak a range of languages.

The practice is a teaching practice and offers placements to undergraduate medical students.

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

CQC previously inspected this practice in February 2014. We found the practice was meeting all inspected standards at that time.

Updated 15 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Soe Yin's practice on 16 June 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. The practice was aware of and complied with the requirements of the duty of candour.
• Risks to patients were assessed and well managed.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients 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 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 areas where the provider should make improvement are:

• The practice should provide staff monitoring the vaccines fridge with accessible information on the acceptable range of temperatures.
• The practice should have a system to ensure that as new patient group directions are required, these are reviewed and signed by both the nurse and a senior prescriber at the time of issue.
• The practice should ensure that the principal GP has sufficient familiarity with the electronic patient record system to provide effective oversight.
• The practice should continue its efforts to identify patients who are carers to ensure they receive appropriate support.
• The practice should improve its documentation of staff induction.
• The practice should review its website periodically to ensure patient information including links to other websites are current and useful for patients.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 15 November 2016

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

• The practice kept registers of patients with long term conditions. These patients had a named GP and a structured annual review to check their health and medicines needs were being met. The practice operated a call-recall system, for example following patients up by telephone to encourage them to attend for their review.
• The principal GP had completed further training on the management of diabetes. The practice GP and practice nurse were involved in diabetic reviews and had access to advice from a specialist diabetic consultant.
• Performance for diabetes related indicators was similar to the CCG and national averages. For example, 70% of diabetic patients had blood sugar levels that were adequately controlled compared to the CCG average of 72% and the English average of 78%.
• The practice participated in a local scheme to avoid unplanned admissions which included patients with multiple long term conditions. Patients identified as at risk were reviewed and had a personalised care plan. Cases were discussed at monthly multidisciplinary meetings with other participating practices and community and specialist health and social services professionals.
• Longer appointments and home visits were available when needed.
• The practice offered 'near patient' blood testing for patients taking higher risk medicines.  

Updated 15 November 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 standard childhood immunisations.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• 70% of patients with asthma had a review within the previous year compared to the national average of 75%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw examples of timely communication with community health services about the care of younger patients for example the local health visitors.

Updated 15 November 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.
• Patients aged over 64 were offered the seasonal flu vaccination. Eligible older patients were also offered the shingles and pneumococcal vaccinations.
• The practice maintained a palliative care register. There were no patients on this list at the time of the inspection. 

Updated 15 November 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 offered online services as well as a full range of health promotion and screening that reflects the needs for this age group. Very few patients had registered to use the online appointment booking system. Patients we spoke with said this was because it was very easy to book an appointment by telephone.
• The practice’s uptake for the cervical screening programme was 80% in 2015/16, which was in line with the national average of 82%.
• The practice offered NHS health checks to patients of working age and participated in the 'catch up' programme for students for MMR and meningitis C vaccinations.

Updated 15 November 2016

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

• The practice offered dementia screening and referral to a specialist memory clinic. All patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months.
• Twelve of 13 patients diagnosed with a psychosis had a documented care plan in their records (92%) compared to the CCG average of 91% and the English average of 88%.
• The practice regularly communicated with specialist mental health teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice had told patients experiencing poor mental health 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 or who missed appointments where they may have been experiencing poor mental health.
• The GPs had a caring approach and a good understanding of how to support patients with mental health needs in general practice. Patient records included an alert for the receptionists if the patient might need flexible or short notice appointments. 

Updated 15 November 2016

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

• The practice held registers of patients living in vulnerable circumstances including those with a learning disability. The practice encouraged patients to register regardless of their circumstances, for example patients living at a nearby homeless shelter.
• The practice offered longer appointments for patients with a learning disability and had carried out health checks with all of these patients within the last year.
• The practice coordinated with other health care professionals in the case management of vulnerable patients.
• 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.
• The practice staff had recently attended carers awareness training and were actively trying to identify patients who were also carers who might need additional support.