Handsworth Medical Practice

Updated 25 April 2017

The practice is located in Waltham Forest, London, E4 9PD, it is situated in a purpose built three storey building. The building is owned by a private company and leased through NHS Property Services who are also responsible for maintaining the building. They provide NHS primary medical services to approximately 14500 patients through a General Medical Services contract (a General Medical Services (GMS) contract is the contract between general practices and NHS England for delivering primary care services to local communities) in the NHS Waltham Forest CCG area.

The premises have step free access with an accessible toilet and baby changing facilities. It is located on Handsworth Avenue and is a few minutes away from Highams Park British Rail Station.

The practice staff includes eight GP partners (five male and three female), four of the male GPs work eight sessions each per week, with the other working four. The three female GP partners work seven, five and four sessions respectively. There are also two GP trainees(male) at the practice who both work eight sessions per week. There are three nurses, two working full time (male and female) and another (female) working 11.5 hours per week and a health care assistant (female) who works 20 hours per week. The practice manager works full time and there is a variety of reception and administration staff who work a total of 350 hours per week.

The practice is open from 7.30am to 6:30pm every weekday, appointments were from 8am to 11:30am every morning and 2pm to 6pm daily

The practice provides telephone consultations and home visits. The home visits are carried out between morning and evening surgery. The practice offers extended hours which are for pre-booked appointments only between 7.30am - 8am on weekdays. Early evenings and weekends are covered by the Partnership of East London Cooperatives (PELC) and this runs from 6:30pm – 8am weekdays and from 6:30pm Friday through to 8am Mondays. This is a service that offers future and on the day routine GP and nurse appointments every weekday evening and all day on weekends and bank holidays. Out of hours services are covered by the 111 service.

The practice population is largely white British with English being the first language for 74% of patients and Polish and Turkish the next at 3% each. Information published by Public Health England rates the level of deprivation within the practice population group as five on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

The practice is registered to provide the following regulated activities:

• Maternity and midwifery services

• Surgical procedures

• Diagnostic and screening procedures

• Treatment of disease, disorder or injury

• Family planning

Updated 25 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Handsworth Medical Practice on 27th October 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. 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 sometimes found it difficult access appointments, but could see 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.

Updated 25 April 2017

The practice is rated 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 with diabetes, on the register, in whom the last IFCCHbA1c

  was 64 mmol/mol or less in the preceding 12 months was 80% which was higher than the CCG average of 75% and comparable to the national average of 78%. Exception reporting for this was 22% which was more than the CCG average of 17% and the national average of 12%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. 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 25 April 2017

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 percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years was 95% which was the higher than the national average of 81%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice runs contraception clinics every two weeks.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 25 April 2017

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 participated in a Locally Enhanced Service (LES) in several care homes to improve care and reduce unplanned hospital admissions.

• The practice had monthly multi-disciplinaryteam meetings (MDT) to discuss elderly and vulnerable patients.

• All patients in this group had a named GP.

• Patients in this group were offered the Six-item Cognitive Impairment Test which is a dementia screening tool in Primary Care.

Updated 25 April 2017

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.

• Patients were able to book appointments online and have telephone consultations.

• Patients were able to register for online access and send messages to the practice via an on line messaging system.

• The practice offered early morning and evening appointments.

Updated 25 April 2017

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 have a comprehensive, agreed care plan documented in the record, in the preceding 12 months is 88% which is comparable to the CCG average of 91% and the national average of 89%.

• 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 25 April 2017

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 referred vulnerable patients to the Waltham Forests Council social prescribing service which provided support for non-medical problems.

• 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.