Leander Family Practice

Updated 5 December 2017

Leander Family Practice is a medium sized practice based in Croydon. The practice list size is 7500. The practice population is very diverse. The practice is in an area in London of medium deprivation. There is a higher than average percentage of younger patients (aged between 5-24) and also a higher than average number of single parents. The practice had a General Medical Services (GMS) contract.

The practice facilities include seven consulting rooms, one treatment room, one patient waiting room and one administration office. The premises are wheelchair accessible and there are facilities for wheelchair users including an accessible toilet and the practice has a hearing loop.

The staff team comprises two male GP partners, one female salaried GP and two locum GPs providing a total of 25 GP sessions per week. There are two female practice nurses, a female associate practitioner, a practice manager and an assistant practice manager. Other practice staff include a reception manager, five receptionists (four female and one male) and three administrators.

The practice is open between 8am and 6.30pm Monday to Friday for appointments and offers extended opening on Tuesday from 7am to 8am and Wednesday from 6.30pm to 7.30pm. When the practice is closed, patients are directed (through a recorded message on the practice answer phone) to call NHS Direct on 111, or go to the nearby Croydon walk-in centre which is open 7 days a week from 8.00am to 8.00pm. This information is also available on their website.

The practice is registered as a partnership with the Care Quality Commission (CQC) to provide the regulated activities of; treatment of disease, disorder and injury; diagnostic and screening procedures; family planning; maternity and midwifery services and surgical procedures. These regulated activities are provided at one location.

Updated 5 December 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Leander Family Practice on 3 May 2016. The overall rating for the practice was Good. No breaches of legal requirements were found, however the practice was rated as requires improvement for providing responsive services. This was due to its low patient satisfaction scores with accessing the service.

An announced focussed desk-based inspection was carried out on 12 May 2017. The practice was still rated as requires improvement for responsive services. Patient satisfaction with making appointments had improved since the previous inspection; however they remained lower than local and national averages. The full comprehensive report and desk-based focussed inspection report can be found by selecting the ‘all reports’ link for Leander Family Practice on our website at www.cqc.org.uk.

This inspection was an announced focused desk-based inspection carried out on 8 November 2017 to review the improvements made in addressing patient satisfaction with accessing appointments.

Overall the practice is rated as good. Specifically the practice was now found to be good for providing responsive services.

Our key findings were as follows:

• Data from the National GP Patient Survey in July 2017 showed improvements in most areas of patient satisfaction with access to appointments.

• The practice had improved access to appointments by recruiting additional clinical and reception staff.

• The organisation of the appointment system had been changed from September 2017 so that there was more availability for telephone consultations and emergency appointments.

• There was more choice for patients requiring extended hours appointments.

• The practice website had been improved and online appointments were promoted.

• The practice had not conducted their own patient satisfaction survey.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• Monitor and evaluate patient feedback and satisfaction, considering telephone access and access to appointments.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 15 November 2016

The provider 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.

• Performance for diabetes related indicators were lower than the national average. The practice had taken steps to improve performance in this area which included providing an information session for patients from the diabetes specialist nurse and a dietician

• 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. These care plans were also monitored quarterly by the deputy practice manager.

Updated 15 November 2016

The provider 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 in line with or above national averages 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 national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies. The practice had recently introduced a mother and baby clinic.

Updated 15 November 2016

The provider 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 had introduced regular multidisciplinary team meetings to review care plans for patients who required home visits and patients with a diagnosis of dementia.

• The practice carried out weekly visits to a local care home.

Updated 15 November 2016

The provider 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 reflected the needs for this age group.

Updated 15 November 2016

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

• Performance for mental health related performance indicators was similarto the CCG 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 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 15 November 2016

The provider 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 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.