Archived: Well Court Practice

Updated 2 March 2017

Well Court Practice, is an established GP practice situated within the London Borough of Sutton and NHS Sutton Clinical Commissioning Group (CCG).

The practice provides primary medical services to approximately 2200 patients living within its catchment area in North Cheam, Sutton. The practice holds a Personal Medical Services (PMS) Contract and is a teaching practice with regular medical student teaching, affiliated with several London medical schools. The practice is located at 6 Well Court, Sutton, SM3 9BX and is served with relatively good transport links by bus and rail services. The nearest station is West Sutton and the surgery is accessible by bus route 413. The building comprises of two adjoining maisonettes which have been converted into a single premises. The practice has four clinical rooms with all the consulting rooms being on the ground floor, which provide disabled access, together with the reception waiting area and two toilets which also provide disabled access. There is a ramp at the front of the practice which provides step free and wheelchair access to the entrance of the building, reception and waiting area. There is restricted parking on site for general use and disabled patients. An induction loop system is available for deaf and hearing impaired people who use the service.

The practice population, although ethnically diverse, is predominantly white English 74% with those from Asian backgrounds, mostly Tamil, accounting for approximately 13% of the community. The area has no significant deprivation with an Indices of Multiple Deprivation (IMD) score of 10 (least deprived decile). The demographics appear to show nothing of any particularly significance with the population group being reflective of both the CCG and National average across the population groups. The percentage of patients with a long standing health condition appears slightly lower but generally comparable to both the CCG and national average.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic & screening procedures, treatment of disease disorder or Injury and maternity & midwifery services. Some directed enhanced services are also provided at this practice which includes extended hours, facilitating timely diagnosis and support for people with dementia and influenza and pneumococcal immunisations.

The practice team comprises of one male and one female partner GP’s, one part time salaried GP, and one locum GP providing three hours per week. The partners provide six clinical sessions and share on call duties between them, with the salaried GP providing a further four clinical sessions. They are supported by two part time practice nurses, one full time practice manager, one part time administrative manager and four part time reception/administration staff.

The opening hours are Monday to Friday, 8am to 6..30pm. There is an extended clinic provided on a Wednesday & Friday 6.30pm to 7pm (for pre booked and emergency appointments).

Out-of-hours services are communicated by calling the practice when it is closed, calls are signposted to the out of hours or by calling 111. There are two walk in centres to support patients when the practice is closed, which are approximately within a one to three mile radius of the surgery. Information is provided on the practice telephone line, the website and on the practice notice board.

The practice provides a full range of general medical services including chronic disease management, minor surgery, GP triage and NHS health checks. The practice also provides health promotion services including, cervical screening, childhood immunisations, shared antenatal care, contraception (including intrauterine device (IUD) fitting) and family planning.

Updated 2 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Well Court Practice on 27 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.
• 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:

• The practice should ensure that any fire escape doors are fully accessible for emergency evacuation.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 2 March 2017

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 practice used the information in the Quality and Outcomes Framework (QOF) to monitor outcomes for patients (QOF is a system intended to improve the quality of general practice and reward good practice). Data from 2014/2015 showed that performance for diabetes related indicators was 82% which was comparable to the CCG average of 81% and national average of 84%.

• 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.

• Diabetic patients are signposted to appropriate support services, for example the livewell service and the Desmond programme for patients newly diagnosed with diabetes to support them with diet and lifestyle information and required changes.

Updated 2 March 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.

• The practice uptake for the cervical screening programme was 70% which was comparable with the CCG average of 71% and the national average of 74%. The practice had a policy to offer telephone reminders for patients who did not attend for their cervical screening tests. Patient notes recorded those who had a cervical screening test in the preceding 5 years was 85% compared to the CCG average of 83% and the national average of 82%.

• 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.

• We saw that the practice offered chlamydia screening for patients and the promotion of sexual health when relevant.

Updated 2 March 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 offered health checks for patients aged over 75.

• The practice contacted all patients after their discharge from hospital to address any concerns and to assess if the patient required any GP involvement at that time.

• The practice referred older people to other services in order to more effectively meet their needs, for example the falls prevention service.

Updated 2 March 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.

• The practice encouraged its patients to attend national screening programmes for bowel and breast cancer screening. The practice uptake for patients aged 60-69, screened for bowel cancer in the last 30 months was 60%; this was slightly higher than the CCG average of 56% and the national average of 58%. The practice uptake for female patients screened for breast cancer in the last 36 months was 76%, which was higher than the CCG average of 66% and comparable with the national average of 72%.

• The practice proactively used the HbA1c criteria to identify patients at risk of diabetes as a preventative tool.

Updated 2 March 2017

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

• All 12 patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was better than the CCG average of 81% and the national average of 84%. 

• All 15 patients with schizophrenia, bipolar affective disorder and other psychoses have had a comprehensive, agreed care plan documented in the record, in the last 12 months which was better than the CCG average of 87% and the national average of 88%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those 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 2 March 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 computer system alerted staff to vulnerable patients.

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

• The practice worked with other health care professionals in the case management of vulnerable patients, although they should look at strategies to improve attendance by other professionals at multidisciplinary meetings which at times were poorly attended.

• 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 were able to signpost young people under 18, or a family member/carer concerned about substance misuse in a young person, to Switch; a local drug and alcohol service for further advice and support.