Kingshead Medical Practice

Updated 20 January 2017

Kingshead Medical Practice is located in Chingford, North London. It is part of the Waltham Forest Clinical Commissioning Group (CCG). The practice has a patient list of approximately 3400. Thirty three percent of patients are aged under 18 (compared to the national practice average of 44%) and 39% are 65 or older (compared to the national practice average of 20%). Forty nine percent of patients have a long-standing health condition.

The services provided by the practice include child health care, ante and post-natal care, immunisations, sexual health and contraception advice and management of long term conditions.

The staff team comprises two male GP partners (both working 9 sessions a week), a female long term locum (working eight sessions a week), a female practice nurse (working twenty hours a week), a part time practice manager secretarial and reception staff. Kingshead Medical Practice holds a Personal Medical Service (PMS) contract with NHS England.

The practice’s opening hours are:

• Monday, Tuesday, Wednesday and Friday 8:00am-6:30pm
• Thursday 8:00am to 1pm
• Tuesday 6:30pm-8:15pm (extended hours)

Appointments are available at the following times:

• Monday, Tuesday, Wednesday and Friday 8:30am – 11:30am and 3:00pm – 6:00pm
• Thursday – 8:30am – 11:30am
• Each week day appointments were available with the nurse from 7:30am

In addition to pre-bookable appointments that can be booked up to four weeks in advance, urgent appointments are also available for people that need them. When the practice is closed, patients are directed to a local out of hour’s provider.

The practice is registered to provide the following regulated activities which we inspected: treatment of disease, disorder or injury; diagnostic and screening procedures, and maternity and midwifery services.

The practice had not been inspected previously.

Updated 20 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kingshead Medical Centre on 1 December 2016. Overall the practice is rated as good.

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

• At our inspection the practice did not have access to a defibrillator (AED- a portable electronic device that analyses life threatening irregularities of the heart) nor had risk assessed the need for one on the premises. Shortly after the inspection, the practice carried out a full risk assessment and purchased a defibrillator.
• 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 improvements are:

• Ensure carers are identified and correctly coded on the computer system and that systems are put in place to support them.

• Develop a practice website.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 20 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.

• Diabetes related performance indicators were comparable to the local and national averages.

• In house smoking cessation advice was available.

• 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 20 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.

• The practice’s uptake for the cervical screening programme was 85%, which was comparable to the CCG average of 81% and the national average of 81%.

• 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 and health visitors.

Updated 20 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.

• Nurse led clinics such as ear syringing were provided by the practice nurse.

Updated 20 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 including booking appointments and ordering repeat prescriptions.

• Text message appointment reminders were sent to patients.

• Temporary registration was offered to students returning home during the holiday periods.

• Extended hour appointments were available on a Tuesday evening until 8:15pm and nurse appointments were available each weekday from 7:30am.

• A full range of health promotion and screening that reflects the needs for this age group was available.

Updated 20 January 2017

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

• The percentage of patients diagnosed with dementia whose care had been reviewed in a face to face review was 95%, compared to the CCG average of 81% and the national average of 84%.

• Mental health performance indicators were comparable to the local and national averages.

• 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.

Updated 20 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 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.