Honor Oak Group Practice is a general practice (GP) surgery that operates from a single premises located in Brockley, within the Lewisham Clinical Commissioning Group (CCG) area. Lewisham CCG is a membership organisation of 44 local GP practices and is responsible for commissioning health services for the local population. Census data shows an increasing population and a higher than average proportion of Black and Minority Ethnic residents in Lewisham. Life expectancy is 6.8 years lower for men and 4.6 years lower for women in the most deprived areas of Lewisham than in the least deprived areas. The number of people between 20 and 39 and children under ten is significantly higher than the England average.
The service is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures, maternity and midwifery services, surgical procedures and treatment of disease, disorder and or injury. The practice currently has 9246 patients on its list.
We carried out an announced inspection on 09 July 2014. The inspection took place over one day and was led by a lead inspector, a GP advisor, a practice manager and an expert by experience.
All the patients we talked with were happy with the care they received. We received 40 comment cards and spoke with 16 patients. Almost all had very positive comments about the care and service provided by the surgery. The majority of the participants of the 2013/2014 patient survey undertaken by the practice were satisfied with their last consultation, had felt involved in the decision involving their care and had rated their experience of making an appointment as ‘very good’ or ‘fairly good’.
We spoke with all the staff members available on the day of our visit. These included three GPs, the practice manager, counsellor, a clinical nurse and five members of the reception and administration team.
The GP partners provided a visible leadership, there were appropriate governance arrangements and staff we spoke with told us the GP partners and practice manager were very supportive of them. The practice was responsive to the needs of the vulnerable patients and homeless people, and there was a strong focus on caring for patients and on the provision of a patient-centred care, especially for those with disabilities. Staff were very clear of their roles in regards to monitoring and reporting of incidents, safeguarding vulnerable people and children, and infection prevention and control.
The practice worked with the community teams and charities to provide effective care for people with mental health issues and the homeless and vulnerable people, and had the highest percentage in the Lewisham CCG area for people receiving NHS health checks.
Overall we found that the practice provided an effective and caring service which was safe, well-led and responsive to people’s needs. There were systems in place to monitor and manage outcomes to help provide improved care, and staff shared best practice via internal arrangements and meetings. The practice was well-led, staff were supported appropriately and patients’ safety was maintained as systems were in place for reporting, recording and monitoring significant events.
We noted areas of good practice including in management of patients with complex conditions, safeguarding of children, and management of obesity. The various population groups including older people, people with long term conditions, mothers, babies, children and young people, the working age populations and those recently retired, people in vulnerable circumstances and people experiencing poor mental health received a care that was effective, caring, safe, responsive and well-led.