Eastwick Park Medical Practice

Updated 31 January 2017

Eastwick Park Medical Practice provides general medical services to approximately 7,400 registered patients. The practice delivers services to a higher number of patients who are aged 65 years and over, when compared with the national average. Care is provided to patients living in residential and nursing home facilities and a local hospice. Data available to the Care Quality Commission (CQC) shows the number of registered patients suffering income deprivation is lower than the national average.

Care and treatment is delivered by four GP partners and three salaried GPs. Five of the GPs are female and two are male. The practice employs a team of two practice nurses and two healthcare assistants. GPs and nurses are supported by the practice manager and a team of reception and administration staff.

The practice is a GP training practice and supports undergraduates and new registrar doctors in training. The practice is open from 8.30am to 6.30pm on weekdays.

Services are provided from: Eastwick Park Avenue, Bookham, Leatherhead, Surrey, KT23 3ND.

The practice has opted out of providing out of hours services to its own patients and uses the services of a local out of hours service.

Updated 31 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Eastwick Park Medical Practice on 10 September 2015. The practice was rated as Good for providing caring and responsive services. However, Requires Improvement for safe, effective and well-led services. Following the comprehensive inspection, the practice wrote to us to tell us what they would do to meet the legal requirements in relation to the breaches. We undertook an announced focused inspection on 3 May 2016 to check the provider had followed their action plan and to confirm they met the legal requirements. The practice was rated as Good for providing caring, effective, responsive and well-led services. However, remained Requires Improvement for providing safe services. Following the focused inspection, the practice sent to us an action plan detailing what they would do to meet the legal requirements in relation to the following:-

• Mitigating risks associated with infection control by ensuring that privacy curtains within the practice were regularly laundered and that a clear record of this was kept.

We undertook this announced desk based inspection on 13 December 2016 to check that the provider had followed their action plan and to confirm that they now met legal requirements. The provider was now meeting all requirements and is rated as Good for providing safe services.

This report only covers our findings in relation to those requirements.

• The practice had created a clear record outlining the regular laundering of the privacy curtains and in some instances replaced existing fabric curtains with disposable.

This report should be read in conjunction with the previous reports. You can read the reports, by selecting the 'all reports' link on our website at www.cqc.org.uk

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 January 2017

The provider had resolved the concerns found during our inspection on 10 September 2015 . Concerns found were for safety, effective and well-led domains which applied to everyone using this practice, including this population group. The population group ratings have been updated to good to reflect this.

• Nursing staff had lead roles in chronic disease management such as diabetes and respiratory conditions and patients at risk of hospital admission were identified as a priority.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check that their health and medicine 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.

• All patients were routinely collected from the waiting room by their GP. GPs told us this provided the GP with the opportunity to begin their assessment of each patient’s condition prior to their arrival in the consulting room.  

Updated 31 January 2017

The provider had resolved the concerns found during our inspection on 10 September 2015 . Concerns found were for safety, effective and well-led domains which applied to everyone using this practice, including this population group. The population group ratings have been updated to good to reflect this.

• The practice offered continuity of care with a named GP.

• 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 and those who were carers.

• Immunisation rates were good 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.

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

• We saw good examples of joint working with midwives and health visitors.

Updated 31 January 2017

The provider had resolved the concerns found during our inspection on 10 September 2015. Concerns found were for safety, effective and well-led domains which applied to everyone using this practice, including this population group. The population group ratings have been updated to good to reflect this.

• Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people.

• The practice offered continuity of care with a named GP.

• Elderly patients with complex care needs and those at risk of all had personalised care plans that were shared with local organisations to facilitate the continuity of care.

• The practice was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

• The practice supported residents within three residential and nursing homes including a home which was located next to the practice. The practice nominated a lead GP for each care home who provided weekly ward rounds within the homes.

• The practice organised a voluntary car service for patients who required transport in order to attend the practice.

• Following the death of a patient the practice sent a condolence card inviting the carer to attend the practice in order that on-going support could be provided.

Updated 31 January 2017

The provider had resolved the concerns found during our inspection on 10 September 2015 . Concerns found were for safety, effective and well-led domains which applied to everyone using this practice, including this population group. The population group ratings have been updated to good to reflect this.

• The practice provided services to meet the needs of the working age population, those recently retired and students.

• The practice had recently increased the availability of urgent and pre-bookable appointments by recruiting an additional GP partner.

• The practice was proactive in offering online services and patients were able to opt to have their prescriptions delivered using the electronic prescription service to a pharmacy of their choice.

• Installation of an improved telephone system meant that patients were able to cancel appointments using an automated system.

• The practice provided temporary residents status for students returning from university.

• Practice staff carried out NHS health checks for patients between the ages of 40 and 74 years.

Updated 31 January 2017

The provider had resolved the concerns found during our inspection on 10 September 2015 . Concerns found were for safety, effective and well-led domains which applied to everyone using this practice, including this population group. The population group ratings have been updated to good to reflect this.

• The practice held a register of patients experiencing poor mental health and offered continuity of care with a named GP.

• Patients with severe mental health needs were supported by care plans and received annual .

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

• The practice undertook dementia screening of patients and ensured early referral to memory assessment services.

• The practice held regular meetings with a consultant psychiatrist to review those patients receiving secondary care and those in primary care whose treatment outcomes could be improved by the input of specialist advice.

• The practice provided information to patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• It had a system in place to follow up patients who had been discharged from secondary care where they had been experiencing poor mental health.

Updated 31 January 2017

The provider had resolved the concerns found during our inspection on 10 September 2015 . Concerns found were for safety, effective and well-led domains which applied to everyone using this practice, including this population group. The population group ratings have been updated to good to reflect this.

• The practice offered continuity of care with a named GP.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• It offered longer appointments and carried out annual health checks for people with a learning disability.

• Care was provided to patients with a learning disability living within one residential facility and to those living independently who received support from that facility.

• The lead GP partner provided flu vaccination clinics within the facility and worked closely with the staff team to carry out medicine reviews.

• The practice regularly worked with multi-disciplinary teams in the case management of other vulnerable patients.

• Information was provided to support vulnerable patients in accessing support groups and voluntary organisations.

• 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.