The Surgery - Cranwich Road

Updated 19 January 2017

The Surgery Cranwich Road is located in a converted house in a residential area with good transport links and free parking. The practice is a part of City and Hackney Clinical Commissioning Group.

There are 7223 patients registered at the practice, which increased from 6100 patients in 2015. 85% of the practice population are Jewish Orthodox, 49% of patients are under 18 years of age, 31% of which are under the age of ten and 4% are aged over 65. During 2015 there were 268 births registered at the practice.

The practice has two male and one female GP partners and a sessional female GP carrying out a total of 20 sessions per week, and one male and one female practice nurse completing a total of 12 sessions per week. The practice has a health care assistant, a practice manager and four reception/administration staff members.

The practice is a teaching practice for medical students.

The practice operates under a General Medical Services (GMS) contract (a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract).

The practice is open Monday to Friday between 8:30am to 6:30pm and the phone lines are open from 8:30am. Appointment times are as follows:

• Monday 8:30am to 1:00pm and 1:30pm to 7:10pm

• Tuesday 8:30am to 1:00pm and 1:30pm to 7:10pm

• Wednesday 8:30am to 1:00pm and 1:30pm to 7:10pm

• Thursday 8:30am to 1:00pm and 1:30pm to 5pm

• Friday 9:30am to 1:00pm and 2:30pm to 3:30pm

The locally agreed out of hours provider covers calls made to the practice whilst it is closed.

The Surgery Cranwich Road operates regulated activities from one location and is registered with the Care Quality Commission to provide diagnostic and screening procedures, maternity and midwifery services, surgical procedures, family planning and treatment of disease, disorder or injury.

Updated 19 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Surgery Cranwich Road on 9 November 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 comments.
• Patients said they found it easy to make an appointment with a 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 practice designed health promotion leaflets in other languages.

The areas where the provider should make improvement are:

• Continue work to improve childhood immunisation rates.

• Consider to encourage involvement from patients to establish an active patient participation group to involve patients in practice services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 January 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 percentage of patients on the diabetes register who had a record of a foot examination and risk register recorded in the notes in the preceding 12 months was 99% compared with the national average of 88%.

• A diabetes specialist nurse clinic was available once a week and a diabetes dietician once a month.

• 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 19 January 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.

• 70% of women aged 25 to 64 notes recorded a cervical screening test had been performed in the preceding five years compared to the CCG average of 81% and the national average of 82%.

• The practice employed a nurse to focus on childhood immunisations and cytology.

• 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.

Updated 19 January 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 worked with a local charity that provided massages for these patients in the practice.

• The practice participated in the admissions avoidance initiative, which aims to keep older patients out of hospital.

Updated 19 January 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.

• Extended hours evening appointments were available three evenings a week.

Updated 19 January 2017

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

• 71% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is lower than the national average of 84%.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption had been recorded in the preceding 12 months was 91% compared with the national average of 90%.

• 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.

• A consultant psychiatrist held regular clinics in the practice.

Updated 19 January 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.

• 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.

• Benefits advice clinics were regularly held at the practice.