Streatham Common Practice

Updated 10 February 2017

Streatham Common Group Practice is a large practice based in Lambeth, south London. The practice list size is 11046. The practice population is diverse and is in an area in London of medium deprivation.

The practice has a Personal Medical Services (PMS) contract and is signed up to a number of enhanced services (enhanced services require an enhanced level of service provision above what is normally required under the core GP contract). These enhanced services include childhood vaccination, extended hours access, dementia diagnosis and support, flu and pneumococcal immunisation, learning disabilities, minor surgery, remote care monitoring, risk profiling, rotavirus and shingles immunisation, and unplanned admissions.

The practice is made up of three GP partners, one male and two female and employs five full time salaried GPs. The GPs undertake a combined total of 53 sessions per week. There are two practice nurses and one healthcare assistant. The practice team includes a practice manager and 11 managerial and administrative staff.

The practice operates from two branches; the main practice is in a renovated church building on Guildersfield Road, with a branch in a purpose built health centre on Baldry Gardens, both in Streatham. All patient facilities are wheelchair accessible and there are facilities for wheelchair users including an accessible toilet. The practice had installed hearing loops at each location.

The Guildersfield Road practice has access to 6 consultation rooms and two treatment rooms on the ground floor. Opening hours are between 8.00am and 6.30pm weekdays, with extended opening hours until 7.30pm on Tuesday and Wednesday, and from 9.00am to 1.00pm on Saturday.

The Baldry Gardens branch has access to four consultation rooms and two treatment rooms on the first floor, with lift access. Opening hours are between 8.00am and 1.00pm on weekdays.

The practice is a training practice with an active teaching programme for both undergraduate medical students and post graduate doctors pursuing higher training to gain a special interest in general practice.

Information taken from the Public Health England practice age distribution shows the population distribution of the practice was similar to that of other practices in CCG. The life expectancy of male patients was 80 years, which was higher than the CCG average of 77 years and the national average of 79 years. The female life expectancy at the practice was 84 years, which is higher than the CCG average of 82 years and the national average of 83 years.

Information published by Public Health England rates the level of deprivation within the practice population group as five on a scale of one to 10. Level one represents the highest levels of deprivation and level 10 the lowest.

Updated 10 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 13 September 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.
• The practice had a strong culture of learning and improvement, and supported staff to develop their skills and roles within the practice.
• 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 practice patient participation group was actively involved in the running and future development of the practice, as well as engaging with the patient population.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

• The practice patient participation group (PPG) was closely involved in the running of the practice, organising health promotion events and improving practice performance. In addition to monthly PPG meetings with guest speakers, annual patient surveys and regular health talks, the PPG chair had been invited to attend receptionist meetings and was given a tour of the practice staff areas to better understand how it was run. The PPG had also campaigned to win funding from the local Clinical Commissioning Group to install television screens in the practice; these screens were used to play a short film made by the PPG about its work and local health issues. A PPG newsletter was posted to patients who were being invited to attend chronic illness reviews, and also to housebound patients, in an effort to reach out to these groups of patients. The PPG, with the support of the practice had helped to establish a network of PPGs in the Lambeth area in order to discuss local issues and share information, as well as developing its own set of “gold standards”, and a toolkit which had been sent to all practices in the area.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 10 February 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. A named doctor was responsible for reviewing all hospital discharge summaries, contacting the patient and ensuring appropriate follow up action was taken.

• Performance for all diabetes related indicators was 92%, which was comparable to the Clinical Commissioning Group (CCG) average of 86% and the national average of 89%.

• 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 10 February 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 practice’s uptake for the cervical screening programme was 77%, which was comparable to the CCG average of 80% 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.

Updated 10 February 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 provided coordinated care and support to the residents of two local care homes and two local nursing homes.

Updated 10 February 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 had taken steps to improve the take up of the electronic prescribing service, following a review of repeat prescribing carried out by an external organisation.

Updated 10 February 2017

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

• The practice was participating in a community incentive scheme funded by the local Clinical Commissioning Group for patients who had a serious mental health illness, and had been discharged from the local NHS mental health trust. The scheme provided access to a named, qualified mental health liaison nurse, a link worker from the local community mental health team and hub services including peer support, psychiatric assessment, social support.

• The number of patients diagnosed with dementia whose care had been reviewed in a face-to-face review in the preceding 12 months was 87%, compared to the CCG average of 88% and the national average of 84%.

• Overall performance for mental health related indicators was 100%, which was above the CCG average of 91% and the national average of 93%.

• 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.

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

• The practice hosted sessions from an alcohol and drugs advisor on the premises.

Updated 10 February 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.