Morden Hall Medical Centre

Updated 4 February 2016

The practice operates from Morden Hall Medical Centre. They have similar to the local and national average number of children under 18 years of age and above local and national average numbers of people aged over 65 and in line or lower than local and national averages of people aged over 75 and 85 years. Fifty five per cent of patients have long-standing health conditions, which is in line with local and national averages. Fifteen per cent of patients have a caring responsibility, in line with local and national averages. Sixty per cent of patients are in paid work or full time education, which is below the local and in line with the national average. It is in the fourth least deprived area of England. The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of: treatment of disease, disorder or injury, maternity and midwifery services, diagnostics and screening procedures, family planning services and surgical procedures.

The practice provides primary medical services through a Personal Medical Services (PMS) contract. A PMS contract is the contract between general practices and NHS England for delivering primary care services to local communities. The practice provides a range of services including long-term condition management, services to support healthy lifestyles including smoking cessation, sexual health, weight loss and alcohol advice, family planning, travel clinic, and child and adult immunisations to 13,700 patients in the Morden area of Merton.

The practice is a member of Merton Clinical Commissioning Group (CCG) and is one of 25 practices. It comprises of five partner GPs (three male and two female), four female salaried GPs (equivalent to 3.6 full time posts), seven part time practice nurses and one part time health care assistant. There is a full time practice manager, office manager, a compliance officer, clinical auditor, part time project manager and 12 administrative and reception staff. The practice is a training practice for trainee GPs, a teaching practice for third year medical students and there is a nurse trainer.

The practice is open from 8.00am to 6.30pm Monday to Friday. Extended hours surgeries are provided between 6.30pm and 9.00pm on Monday.

The practice has opted out of providing out-of-hours services to their own patients and these services are provided by the locally agreed out-of-hours provider for the CCG.

Updated 4 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Morden Hall Medical Centre on 5 November 2015. Overall the practice is rated as good.

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

• The practice operated an open and transparent approach to safety and had effective systems in place for reporting and recording significant events.
• Risks to patients were assessed and managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with kindness and compassion, their privacy and dignity was respected and they were involved in their care and decisions about their treatment.
• Information about the services provided including how to complain was available and easy to understand.
• Patient’s we spoke with had mixed experience of making an appointment with some finding it easy and others experiencing a wait. Urgent appointments were available the same day.
• The practice had good facilities and was equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by the partners and management.
• The practice sought feedback from patients and staff, 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:

• Develop systems to monitor the use of prescription pads.

• Ensure recruitment practice includes two written references being sought with gaps in employment explored.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 4 February 2016

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.

• Nationally reported data showed outcomes for patients with diabetes was in line with national averages.

• They provided longer appointments and home visits when needed.

• All these patients had a structured annual review to check that their care and treatment plans remained appropriate.

• They worked with other health and care professionals to deliver multidisciplinary care.

• They provided these patients with an alternative contact number to enable fast access to the practice.

Updated 4 February 2016

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. One of the GPs was the safeguarding lead.

• Immunisation rates were in line or above local and national averages for all standard childhood immunisations.

• Data showed the rates for cervical smears were in line with national averages.

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

• The practice worked with midwives and health visitors.

Updated 4 February 2016

The practice is rated as good for the care of older people.

• The practice provided a named GP for patients over 75 years of age.

• They offered proactive, personalised care to meet the needs of older patients.

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

• They provided a range of enhanced services including working with patients to prevent unplanned admissions.

• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• They worked with other health and social care professionals to provide joined up care.

Updated 4 February 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The age profile of patients at the practice contains those of working age, students and the recently retired, services available were largely reflective of the needs of this group. The practice offered online services as well as a full range of health promotion and screening that reflected the needs for this age group. The practice offered extended opening hours for appointments on Mondays from 6.30-9pm.

• The practice had recently launched a twitter feed in order to engage more effectively with this demographic.

Updated 4 February 2016

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

• 78% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.

• One of the nurses was a dementia specialist nurse.

• Nationally reported data identified outcomes for patients experiencing poor mental health were above local and national averages.

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

• They 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 and a counselling service was provided at the practice.

• There were systems in place to follow up patients who had attended accident and emergency departments where they may have been experiencing poor mental health.

• Staff demonstrated a good understanding of how to support people with mental health needs and dementia.

Updated 4 February 2016

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 and those with a learning disability.

• They offered longer appointments for people with a learning disability and 33% of these patients had received an annual review of their health needs so far this year. All had an annual review last year.

• One of the nurses completed additional training in how to meet the health needs of patients with learning disabilities.

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

• It had told vulnerable patients about how to access various support groups and voluntary 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 normal working hours and out of hours.

• They had access to telephone and on line translation services and staff spoke a number of the languages of the local population.

• The patient record identified if a patient was a carer and staff signposted to relevant local support services.