Archived: Eltham Palace PMS

Updated 31 March 2015

Eltham Palace PMS also known as Eltham Practice Surgery is based in the London Borough of Greenwich. The practice provides primary care services to 4800 patients.

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

The practice is located in an area that has high deprivation as well as pockets of affluence The practice serves a culturally diverse population, including British, African, Caribbean, White Other, Indian and Chinese patients. According to the practice they have a high number of young and elderly patients.

 The practice has two GP partners, female and male , plus one salaried male GP. The practice employs one practice nurse and one advanced  nurse practitioner. A healthcare assistant is also available for 35 hours per week and eight administrative staff and the practice manager.

The practice holds a Personal Medical Services (PMS) contract for the delivery of general medical services. Personal Medical Services (PMS) agreements are locally agreed contracts between NHS England and a GP practice. PMS contracts offer local flexibility compared to the nationally negotiated General Medical Services (GMS) contracts by offering variation in the range of services which may be provided by the practice, the financial arrangements for those services and the provider structure (who can hold a contract).

Appointments were available from 08:00 am to 18:30 pm on weekdays. Extended hours were offered on Tuesdays & Wednesday mornings  07:00- 08:00am and Tuesday evening 18:30-19:30pm.

The practice has opted out of providing out-of-hours services to their own patients. A local out of hours service, 111, is used to cover emergencies.

Updated 31 March 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Eltham Palace PMS on 11 December 2014. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing, well-led, effective, caring and responsive services. The practice is rated as requires improvement for providing safe services. While staff understood and fulfilled their responsibilities to raise concerns, and report incidents and near misses, clinical staff had not undertaken relevant child protection training.

It was also good for providing services for older people; people in the working age populations and those recently retired and people experiencing poor mental health. We found that requirements were required for families, children and young people and people whose circumstances may make them vulnerable

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.

• Risks to patients were assessed and well managed.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• 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.

• 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.

However, there are also area(s) where the provider must make improvements

• Ensure that all staff have undertaken relevant child protection training.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 March 2015

The practice is rated as good for the population group of people with long term conditions. Emergency processes were in place and referrals made for patients in this group that had a sudden deterioration in health. When needed longer appointments and home visits were available. All these patients had a named GP and structured annual reviews to check their health and medication 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.

Updated 31 March 2015

The practice is rated as requires improvement for the population group of families, children and young people. Systems were in place for identifying and following-up children living in disadvantaged circumstances and who were at risk, such as those, who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations. Patients told us and we saw evidence that children and young people were treated in an age appropriate way and recognised as individuals. Appointments were available outside of school hours and the premises were suitable for children and babies. There were baby change facilities, space for prams and buggies and a play area. We were provided with good examples of joint working with midwives, health visitors and school nurses. Emergency processes were in place and urgent referrals made for children and pregnant women who had a sudden deterioration in health. However a member of the medical team had not completed role specific child protection training.

Updated 31 March 2015

The practice is rated as good for the care of older people. Nationally reported data showed the practice had good outcomes for conditions commonly found amongst older people. All patients aged 75 and over had a named GP. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of direct enhanced services that were designed to reduce hospital admissions. The practice was responsive to the needs of older people, including offering home visits and rapid access appointments for those with enhanced needs. The GPs followed up all patients discharged from hospital within 24 hours to check they had all the medicines required.

Updated 31 March 2015

The practice is rated as good for the population group of the 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 offer continuity of care. The practice was proactive in offering online services as well as a full range of health promotion and screening which reflects the needs for this age group.

Updated 31 March 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). 62% of people experiencing poor mental health had received an annual physical health check. The practice told us they had scored slightly low in this area due to the number of patients moving addresses and not notifying them. 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 in place advance care planning for patients with dementia.

The practice offered these patients opportunistic cervical smear checks, flu vaccinations and other health and well-being checks.

The practice had sign-posted patients experiencing poor mental health to various support groups and third sector organisations including MIND and SANE. The practice had a system in place to follow up on patients who had attended accident and emergency where there may have been mental health needs. Staff had received training on how to care for patients with mental health needs and patients with dementia.

Updated 31 March 2015

The practice is rated as requires improvement for the population group of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and this included patients with learning disabilities. The practice had carried out annual health checks for people with learning disabilities and 100% of these patients had received a follow-up. The practice offered longer appointments for people with learning disabilities.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. The practice had sign-posted vulnerable patients to various support groups and third sector organisations. Staff knew how to recognise signs of abuse in vulnerable adults. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in and out of hours.