Fordbridge Medical Centre

Updated 3 May 2016

Fordbridge Medical Centre is located in a residential area of Ashford and provides primary medical services to approximately 6,734 patients.

There are three GP partners and one salaried GP (one male, three female). 21 sessions are delivered each week by the GPs collectively. The practice is supported by an ex-partner GP who works as a locum as required and one other regular locum GP. The GPs are supported by three female practice nurses, one healthcare assistant, a team of receptionists, administrative staff and a practice manager.

Data available to the Care Quality Commission (CQC) shows the practice serves a higher than average number of patients who are aged 15-19 years and between 45-54 years of age when compared to the national average. The number of patients aged 20 to 39 is slightly lower than average. The number of registered patients suffering income deprivation (affecting both adults and children) is below the national average.

The practice is open on Monday, Tuesday, Thursday and Friday between 8am and 6pm and on Wednesday between 8am and 1pm. Extended hours appointments are offered every Tuesday and Thursday evening from 6pm to 8pm, and one Saturday morning per month between 9am and 12pm. Appointments can be booked over the telephone, online or in person at the surgery. Patients are provided information on how to access an out of hour’s service by calling the surgery or viewing the practice website.

The practice runs a number of services for its patients including; chronic disease management, new patient checks, smoking cessation, phlebotomy, 24 hour blood pressure monitoring, travel vaccines and advice.

Services are provided from one location. Fordbridge Medical Centre, 4 Fordbridge Road, Ashford, Middlesex, TW15 2SG.

The practice has a Personal Medical Services (PMS) contract with NHS England. (PMS is one of the three contracting routes that have been available to enable commissioning of primary medical services). The practice is part of NHS North West Surrey Clinical Commissioning Group. Out of hours care is provided by Care UK.

Updated 3 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Fordbridge Medical Centre on 4 February 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 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice offered a number of services to meet the needs of their patients. This included clinics for patients with a diagnosis of diabetes, asthma and coronary heart disease.
• 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 improvement are:

• Review the complaints process to ensure patients are given the information on how they can escalate the complaint if they remain dissatisfied.
• Review the opening times in line with patient feedback in respect of access to the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 May 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.
• Data showed that the percentage of patients on the diabetes register, who had received an influenza immunisation for 2014/15, was 92%. This was comparable to the national average of 94%.
• 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. Multidisciplinary care team meetings were held every six weeks.
• The practice used the computer system to actively search for patients who were at risk of chronic diseases. For example, screening patients with family history, lifestyle and obesity risk factors for diabetes and smokers at risk of chronic obstructive pulmonary disease (COPD).
• The practice offered a range of enhanced services to people with long term conditions. This included clinics for patients with asthma, diabetes, coronary heart disease and chronic obstructive pulmonary disease.

Updated 3 May 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 A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.
• Data showed that 72% of patients on the asthma register who had received an asthma review within the previous 12 months for 2014/15 compared to the national average of 75%.
• 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.
• Data for 2014/15 showed that 80% of eligible women aged between 25 and 64 years of age had a cervical screening test performed in the preceding five years compared to 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. The practice had initiated regular meetings with the local children’s centre and the health visiting team to discuss any children that may be at risk.
• The practice held children’s flu clinics on a Saturday morning to allow parents to attend without having to take time off work or school.
• The practice held weekly community midwife led clinics to allow continuity of ante natal care.

Updated 3 May 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 offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services. These included services such as; dementia identification and reducing unplanned hospital admissions. Those patients at risk had personalised care plans to meet their complex care needs.
• The practice was actively involved in referring patients to the Spelthorne Healthy home project –this included a free home assessment for vulnerable patients, who were at risk of a cold home.
• The practice provided an information pack for ambulance staff attending older patients to assist in reducing unplanned admissions and providing them with care pathway information.

Updated 3 May 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.
• The practice offered telephone consultations where appropriate so as to allow patients to receive consultations whilst still working.
• The practice offered extended hours appointments between 6pm and 8pm every Tuesday and Thursday evening. There were also appointments available on one Saturday morning per month between 9am and 12pm.
• Electronic Prescribing was available which enabled patients to order their medicine on line and to collect it from a pharmacy of their choice.

Updated 3 May 2016

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

• 89% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months. This was better than the national average of 84%.
• Data showed that the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had received a comprehensive, agreed care plan, in the preceding 12 months for 2014/15 was 80%. This was lower than the 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 had an identified lead GP with extensive experience and training in caring for patients with poor mental health.
• The practice operated a duty GP system. Any patient presenting with self-harm thoughts or suicidal ideation were provided immediate contact with the duty GP.

Updated 3 May 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, travellers and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• 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.
• Any patient that was listed as vulnerable was offered a same day appointments regardless of the nature of their illness.
• Vulnerable patients that did not attend for three appointments had a welfare visit performed by the local community police support officers to ensure that they were safe.