Woodcote Medical

Updated 1 August 2016

Woodcote Medical provides primary medical services in Purley and Coulsdon to approximately 15000 patients and is one of 59 practices in Croydon Clinical Commissioning Group (CCG). The practice population is in the second least deprived decile in England.

The practice population has a lower than CCG and national average representation of income deprived children and older people. The practice population of children is lower than the CCG and in line with national average and the practice population of working age people is lower than the CCG and in line with national average; the practice population of older people is lower than the local average and in line with national average. Of patients registered with the practice for whom the ethnicity data was recorded 25% are white British, 2% are other white and 2% are Indian.

The practice operates from two branches one in Purley and one in Coulsdon. The Purley surgery operate in purpose built premises; the Coulsdon branch operate in converted premises. Patient facilities are wheelchair accessible on the ground floor on both the practices; GPs and nurses see patients on the ground floor if they have mobility issues. The Purley practice has access to seven doctors’ consultation rooms, one phlebotomist/healthcare assistant consultation room on the ground floor and two nurses’ consultation rooms on the lower ground floor one of which is used for minor surgery. The Coulsdon practice has access to two nurses’ consultation rooms on the ground floor and three doctors’ consultation rooms on the first floor.

The clinical team at the surgery is made up of two full-time GPs (one male and one female) who are partners and three part-time GPs (two male and one female) who are partners, three full-time salaried GPs (one male and two female), one part-time female nurse practitioner, two full-time and three part-time female practice nurses and one full-time male healthcare assistant and one part-time female healthcare assistant. The non-clinical practice team consists of business manager, practice manager, deputy practice manager, admin manager, and 24 administrative and reception staff members. The practice provides a total of 56 GP sessions per week.

The practice operates under a Personal Medical Services (PMS) contract, and is signed up to a number of local and national enhanced services (enhanced services require an enhanced level of service provision above what is normally required under the core GP contract). The practice is a training practice for trainee GPs, physician associates and medical students.

The practice reception and telephone lines are open from 8:00am till 6:30pm Monday to Friday. Appointments are available from 8:00am to 12:30pm and 2:00pm to 6:00pm every day. Extended hours surgeries are offered on Wednesdays from 6:30pm to 8:00pm and on Saturdays from 9:00am to 11:30am.

The practice has opted out of providing out-of-hours (OOH) services to their own patients between 6:30pm and 8am and directs patients to the out-of-hours provider for Croydon CCG.

The practice is registered as a partnership with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury.

Updated 1 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Woodcote Medical on 28 June 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 mostly assessed and well 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 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.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day. However some of the patients we spoke to reported issues in getting appointments.
• 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.

There were areas of practice where the provider should make improvements:

• Review practice procedures for reading and reviewing patient letters so they are safe and decisions are made by clinical staff.
• Ensure systems are in place for all staff to have annual basic life support training.
• Ensure that the recommendations in the legionella risk assessment are actioned.
• Review the practice procedures to monitor prescriptions which are not collected.
• Ensure the refrigerator temperatures are recorded consistently on days the practice is open and that the cold chain policy is accessible.
• Ensure that the business continuity plan is accessible at the branch practice in the event of an emergency.
• Review systems in place to ensure that patients with a learning disability are regularly reviewed.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 1 August 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.
• The national Quality and Outcomes Framework (QOF) data showed that 79% of patients had well-controlled diabetes, indicated by specific blood test results, compared to the Clinical Commissioning Group (CCG) average of 72% and the national average of 78%. The number of patients who had received an annual review for diabetes was 89% which was above the CCG average of 86% and in line with the national average of 88%.
• The national QOF data showed that 84% of patients with asthma in the register had an annual review, compared to the CCG average of 75% and the national average of 75%.
• Longer appointments and home visits were available for people with complex long term conditions when needed.
• All these patients had a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• The practice provided a phlebotomy service, electrocardiography and spirometry to improve monitoring of patients with long term conditions.
• The practice used a risk stratification tool that analysed medicine interactions and blood result anomalies; this was monitored and actioned by the in-house pharmacist.

Updated 1 August 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 urgent care and Accident and Emergency (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 81%, which was in line with the Clinical Commissioning Group (CCG) average of 82% and the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 1 August 2016

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 GPs provided care for 26 local care/nursing/residential homes supporting the needs of 222 residents.
• The practice had a dedicated phone number for all patients on the unplanned admissions register to avoid having to come through reception. The carers of these patients were also invited for the appointments regardless of whether they were registered patients of the surgery.

Updated 1 August 2016

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.

Updated 1 August 2016

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

• The number of patients with dementia who had received annual reviews was 81% which was below the Clinical Commissioning Group (CCG) average of 85% and national average of 84%.
• 91% of 136 patients with severe mental health conditions had a comprehensive agreed care plan in the last 12 months which was above the CCG average 85% and national average of 88%.
• The practice regularly worked with multi-disciplinary teams in the case management of people 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.
• The practice ran a regular GP clinic at a local mental health NHS trust supporting the needs of the patients.
• The practice had access to a counsellor who provided regular sessions at the surgery where necessary supporting the needs of patients with depression and anxiety disorders. The practice patients who used this service had a 70% recovery rate.  

Updated 1 August 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, carers, travellers and those with a learning disability.
• The practice offered longer appointments and extended annual reviews for patients with a learning disability; only 20% (19 patients) out of 97 patients with learning disability had received a health check in the last year. The practice had developed an action plan to improve the number of patients who had this check which included specific training for all practice staff from the learning disability nurse.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• 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.
• The practice had a dedicated phone number for all patients on the unplanned admissions register to avoid having to come through reception. The carers of these patients were also invited for the appointments regardless of whether they were registered patients of the surgery.