Archived: The Sorsby Medical Practice

Updated 25 October 2017

The Sorsby Medical Practice is in Hackney, east London. It is one of the 43 member GP practices in NHS City and Hackney Clinical Commissioning Group (CCG).

The practice is located in the most deprived decile of areas in England. At 79 years, male life expectancy is the same as the England average. At 83 years, female life expectancy is the same as the England average. The provider tells us the practice serves a diverse population made up of 50% African / Caribbean / Black British; 30% White British / White Other; 10% Turkish; and 10% South Asian people.

The practice has approximately 4,500 registered patients. Its age distribution is similar to the England average, and the practice has the third highest proportion of patients aged 75+ years in the CCG.

Services are provided by The Sorsby Medical Practice under an Alternative Provider Medical Services (APMS) contract with NHS England.

The practice is in purpose-built premises. There is wheelchair access to the practice including automatic doors, a disabled toilet and a lift to the patient areas on the upper floor. There are five clinical rooms.

There are four GP partners and seven salaried GPs working at the practice, nine female and two male. There are also four practice nurses, two healthcare assistants, and a clinical pharmacist. The clinical staff are supported by a practice co-ordinator, secretarial and receptionist staff, headed up by a business manager and an assistant business manager.

The practice’s opening times are:

• 8.00am to 8.00pm on Monday (includes extended hours appointments between 6.30pm and 7.30pm).

• 7.00am to 7.00pm on Tuesday (includes extended hours appointments between 7.00am and 8.00am).

• 8.00am to 7.00 pm on Wednesday, Thursday and Friday.

Patients are directed to an out of hours GP service outside these times.

The Sorsby Medical Practice is registered with the Care Quality Commission to carry on the following regulated activities at 3 Mandeville Street, London E5 0DH: Diagnostic and screening procedures, Family planning, Maternity and midwifery services, Surgical procedures, and Treatment of disease, disorder or injury.

Updated 25 October 2017

Letter from the Chief Inspector of General Practice

We carried out an announced, comprehensive inspection at The Sorsby Medical Practice on 29 November 2016. The overall rating for the practice was ‘good’ overall but was rated ‘requires improvement’ for providing caring services. The full comprehensive report on 29 November 2016 inspection can be found by selecting the ‘all reports’ link for The Sorsby Medical Practice on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 13 September 2017 to confirm that the practice had carried out their plan to make improvements to their service in relation to the concerns that we identified in our previous inspection on 29 November 2016. This report covers our findings in relation to those additional improvements made since our last inspection.

Overall the practice is now rated as ‘good’ overall and ‘good’ for providing caring services.

Our key findings were as follows:

• The practice had monitored patients’ experience of the service and made changes to improve patients’ experiences.

• The changes made had resulted in some improved results in the National GP Survey; we were satisfied that the practice was committed to on going improvements that should increase patient satisfaction over the longer term.

However, there was also one area of practice where the provider needs to make improvements.

The provider should:

• Continue to monitor the appointments system to drive improvement in the quality of access for patients and communicate effectively with patients around changes to the appointments system.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 April 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.

• Performance against clinical targets for patients with diabetes was comparable to national averages. A diabetic specialist nurse was based at the practice once a week.

• The practice performed well in respect of the CCG’s local long terms conditions (LTCs) contract, and the CCG’s performance in respect of LTCs was the highest in the country.

• Longer appointments and home visits were available when needed.

• The practice was participating in the time to talk (T2T) scheme. This scheme allowed for a 30 minute GP appointment for patients with multiple long term conditions or for those newly diagnosed with a long term condition to give the patient and doctor time to understand the condition as it affected the patient, consider treatment options, and to make decisions together about the care plan.

• All these patients had a named GP, and structured and specialist reviews 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 3 April 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. Immunisation rates were relatively high for all standard childhood immunisations.

• The percentage of eligible women having the cervical screening test was comparable to national averages.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with health visitors and with children and young people’s services, for example CHYPS Plus (sexual and mental health service for young people).

Updated 3 April 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.

• Home visits were made proactively as well, for example 3.5 visits per year on average to each housebound patient aged over 75 years to ensure their needs were being met, and specialist pharmacist visits to housebound people to review medicines.

• There were targeted services to avoid unplanned hospital admissions and to enable people to remain in their home. The practice worked with other health and care providers to achieve these aims.

• The practice used the Coordinate my Care NHS clinical service so that patients' wishes and their urgent care plans could be shared with healthcare providers at all times.

Updated 3 April 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, for example periodic Saturday clinics for flu vaccination and cervical smear tests and in house phlebotomy.

• The practice offered a full range of health promotion and screening that reflects the needs for this age group.

• It was proactive in offering online services and had recently launched an online GP consultation service.

Updated 3 April 2017

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 their care reviewed in a face to face meeting in the last 12 months, which was comparable to the national average of 84%.
• Performance against mental health indicators was comparable to 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.

• A psychiatry liaison and mental health worker was based at the practice once a month.

• 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.

Updated 3 April 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, those with a learning disability and migrants.

• The practice offered longer appointments for patients with a learning disability.

• The practice was contacting all patients over the age of 75 years that it had not seen in the last two years to check their needs were being met.

• 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.