Archived: Dr David Jones Also known as Broadwater Farm Medical Practice

Updated 10 October 2016

Dr David Jones (Broadwater Farm Medical Practice) is located in Haringey, North London. The practice has a patient list of approximately 2890. Fifty one percent of patients are aged under 18 (compared to the national practice average of 15%) and 8% are 65 or older (compared to the national practice average of 17%). Fifty four percent of patients have a long-standing health condition.

The Broadwater Farm Medical Practice had recently merged with the Lawrence House Group and has become the third practice within the group. Dr David Jones has become a partner within the group. The practice has regular clinical staff based at the practice. There is a central call centre where patients can ring for appointments. When they call they are made an appointment with the practice or with the closest practice to where they are located if no appointments are available. Patients can request to be seen at any of the group’s practices. This was to alleviate the volume of telephone calls handled by the receptionists within the practice.

The services provided by the practice include child health care, ante and post-natal care, immunisations, sexual health and contraception advice and management of long term conditions.

The staff team comprises a male GP partner who is based at the practice (working eight sessions a week), a regular female locum GP working six sessions per week, a locum nurse Female (working five sessions a week), a practice manager, secretarial and administrative staff. Broadwater Farm Medical Practice holds a Personal Medical Service (PMS) contract with NHS England.

The practice’s opening hours are:

• Monday and Tuesday8.00am-8:30pm

• Wednesday, Thursday and Friday8.00am – 6:30pm

Appointments are available at the following times:

• Each morning between 9.00am and 12:30pm

• Each afternoon between 2.00pm and 6:30pm

The practice offers extended hours opening at the following times:

• Monday and Tuesday 6:30pm – 8.00pm

The telephone lines are diverted to the out of hour’s provider when the practice is closed.

In addition to pre-bookable appointments that could be booked up to four weeks in advance, urgent appointments are also available for people that need them. If there are no appointments available at the practice, patients are offered an appointment at another of the practices within the group if the patient wants to be seen sooner.

The practice is registered to provide the following regulated activities which we inspected: family planning, treatment of disease, disorder or injury; diagnostic and screening procedures, surgical procedures and maternity and midwifery services.

This practice has not previously been inspected.

Updated 10 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr David Jones (Broadwater Farm Medical Practice) on 11 July 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. However a health and safety risk assessment had not been carried out on the children’s outdoor play area which was found to be in need of renewal. The practice was aware of this and advised parents to not allow their children on the equipment.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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 provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Carry out a health and safety risk assessment to take into account the children’s play area.

• Improve telephone access by completing the practice move to a central booking system.

• Produce a schedule for the regular cleaning of clinical equipment.

• To review how patients with caring responsibilities are identified and recorded on the patient record system to ensure information, advice and support is made available to all.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 10 October 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 percentage of patients whose last measured total cholesterol was 5 mmol/l or less was 82% compared to the CCG average of 77% and the national average of 80%.

• The percentage of patients with a recorded foot examination and risk classification was 96% compared to the CCG average of 85% and the national average of 88%.

• However, the percentage of patients who’s last IFCC-HbA1c was 64 mmol/mol or less was 68% compared to the CCG average of 74% and national average of 77%.The percentage of patients where the last blood pressure reading was 140/80 or less was 61% compared to the CCG average of 75% and the national average of 78%.Longer appointments and home visits were available when needed. The practice was aware of this and were providing further appointments at a local practice that belonged to the group of practices to increase availability.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. This included a dementia test or dementia review if already diagnosed.

• For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 10 October 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.

• 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.

• The practice’s uptake for the cervical screening programme was 77%, which was comparable to the CCG average of 72% and the national average of 74%.

• 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, health visitors and school nurses.

• The practice provided an outside play area for children while they waited for their appointment.

Updated 10 October 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.

• The practice had an agreement with a local pharmacist to provide dosette boxes for older patients.

• The practice had regular multi-disciplinary telephone conferences to discuss older patients.

• The practice undertook annual reviews for patients over 75. This included a dementia test or review.

Updated 10 October 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 including booking appointments and ordering repeat prescriptions.

• Telephone consultations were offered for those patients unable to attend the practice during working hours.

• The practice provided a full range of health promotion and screening that reflects the needs for this age group.

Updated 10 October 2016

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

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the records was 92% compared to the CCG average of 87% and the national average of 88%.

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption had been recorded was 95% compared to the CCG average of 89% and the national average of 89%.

• The percentage of patients diagnosed with dementia whose care had been reviewed in a face to face review was 90% compared to the CCG average of 86% and the national average of 84%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice 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.

• 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 good understanding of how to support patients with mental health needs and dementia.

Updated 10 October 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, travellers and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked 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.

• The practice had an agreement with a local pharmacist to provide a dosette box for vulnerable patients

• 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.