Glenlyn Medical Centre

Updated 10 January 2017

Glenlyn Medical Centre offers personal medical services to the population of East Molesey and Thames Ditton, Surrey and surrounding areas. There are approximately 23,200 registered patients to both the main practice of Glenlyn Medical Centre and the branch surgery of Giggs Hill. Patients can access care and services at either practice location. GPs, nursing staff and some reception and administrative staff work within both locations. Glenlyn Medical Centre is also a training practice for registrar GPs.

Giggs Hill is also the urgent care centre for the practice. Any patient calling for an urgent on the day appointment will be asked to attend Giggs Hill, Thames Ditton, Surrey. Patients are given a morning or afternoon sit and wait slot. Patients are seen by Advanced Nurse Practitioners who are able to prescribe and if necessary can refer to a GP. Patients are able to see GPs at both locations for routine appointments as well as appointments for nurses and healthcare assistants.

An Advanced Nurse Practitioner is a registered nurse who has acquired an expert knowledge base by undertaken extra training in clinical assessment, (including history-taking and physical examinations), in order to safely manage patients presenting with undifferentiated and undiagnosed conditions.

Services are provided from:

Glenlyn Medical Centre - 115 Molesey Park Road, East Molesey, Surrey, KT8 0JX

Opening Time

Monday to Friday 8am to 6.30pm

Extended hours

Monday to Friday 6.30pm – 7.30pm

Saturday 7.30am 11.30am

And

Giggs Hill, 14 Raphael Drive, Thames Ditton, Surrey, KT7 0EB

Opening Time

Monday to Friday 8am to 6.30pm

Glenlyn Medical Centre is run by two partners (both male). The two locations are also supported by four associate GPs, four salaried GPs, three advanced nurse practitioners, five practice nurses, six health care assistants, a team of administrative staff and managerial staff.

The practices run a number of services for their patients including asthma clinics,child immunisation clinics, diabetes clinics, new patient checks and holiday vaccines and advice.

At both locations there is disabled access with seated waiting areas. At Giggs Hill all of the GP consulting rooms and treatment rooms are located on the ground floor. At Glenlyn there are clinical rooms on the first floor which can be accessed by lift or stairs. There are accessible toilets for all patients and baby changing facilities.

When the practice is closed arrangements have been made for patients to access care from an Out of Hours provider.

The Information published by Public Health England rates the level of deprivation within the practice population group as ten on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. The practice area has a lower percentage of people over 10-29 years of age and a higher number of patients aged 30-44, 65-69 and 85+ years of age when compared with the local clinical commissioning group and the national averages. The average male and female life expectancy for the practice is 82 years for males (compared to 79 years nationally), and 85 years for females (compared to 83 years nationally). Locally held demographic data showed that less than 10% of patients do not have English as their first language.

Updated 10 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on May 2015 and a focused inspection in January 2016. During both inspections we found the same breach of legal requirement and the provider was rated as requires improvement under the safe domain. The practice sent to us an action plan detailing what they would do to meet the legal requirements in relation to the following:-

• Ensuring that all recruitment checks are carried out and recorded as part of the staff recruitment process, including a risk assessment as to which staff required a criminal records check with the disclosure and barring service (DBS).

We undertook this announced focused inspection on 8 December 2016 to check that the provider had followed their action plan and to confirm that they now met legal requirements. The provider was now meeting all requirements and is rated as good under the safe domain.

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

• The practice had reviewed their processes for the employment of staff and ensured that recruitment checks were carried out and all required information was recorded. This included, proof of identification including photo identification, references, full works history, signed confidentially forms and where required disclosure and barring checks (DBS). We saw that risk assessment had also taken place to review whether a DBS check was required for individual staff members.

We also received concerns raised by patients in relation to access to GPs. We spoke with the two GP partners about this. They were able to explain they had difficulties in recruiting and retaining GPs, this was partly due to many GPs not wishing to work full time. In response to this the GPs had come up with several initiatives to ensure that extra GPs had been recruited and that patients had timely access to emergency appointments and GP appointments.

Initiatives included:-

• Creating an on the day urgent care centre at Giggs Hill. Patients who required an on the day emergency appointment were given a two hour sit and wait time slot either in the morning or afternoon to see the Advanced Nurse Practitioners (who had support from the duty GP). The practice had plans to ensure that urgent care would also be provided from Glenlyn each morning, Monday to Friday after acting on comments from the patient participation group (PPG).
• Having a daily Administration GP assigned, which covered both Glenlyn and Giggs Hill. This role meant that all prescriptions, test results, calling patients for reviews etc. and administrative duties for all GPs were covered by a single GP. This ensured that any administration duties for GPs would not be delayed and the practice had been able to employ more GPs including those who wished to work part time. Patient prescription requests were completed in a timely fashion and the Administration GP had more time to review test results and decide on next actions to take for patients.
• Having a Duty GP which covered both Glenlyn and Giggs Hill. The duty GP had a slightly lighter patient list for the day to be able to support the advanced nurse practitioners and to take urgent phone appointments and could be called upon to help with enquiries from staff or other GPs.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Glenlyn medical Centre on our website at www.cqc.org.uk.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 July 2015

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. Longer appointments and home visits were available when needed. All these patients had a structured annual review to check that their health and medicine needs were being met. The GPs followed national guidance for reviewing all aspects of a patient’s long term health. 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. The practice nurses were trained and experienced to support patients with managing their conditions and preventing deterioration in their health. The local clinical commissioning group had funded a specialist diabetic nurse to offer support and training to the practice to increase clinician’s knowledge. Diabetic patients were supported by the practice in managing their condition and were encouraged to monitor their own condition and set health goals. The practice had a specialist respiratory nurse who managed all asthma and chronic obstructive pulmonary disease (COPD) patients. Flu vaccinations were routinely offered to patients with long term conditions to help protect them against the virus and associated illness.

Updated 23 July 2015

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. Monthly meeting were held with health visitors to discuss any children of concern. Immunisation rates were average for the local clinical commissioning group (CCG) area. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives and health visitors. Practice staff had received safeguarding training relevant to their role and knew how to respond if they suspected abuse. Safeguarding policies and procedures were readily available to staff. The practice ensured that children needing emergency appointments would be seen on the day.

Updated 23 July 2015

The practice is rated as good for the care of older people. Patients had a named GP which allowed for continuity of care. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older patients. The practice offered proactive, personalised care to meet the needs of the older patients in its population and had a range of enhanced services, for example, in dementia and end of life care. Elderly patients with complex care needs all had personalised care plans that were shared with local organisations to facilitate the continuity of care. The practice was responsive to the needs of older patients, and offered home visits and rapid access appointments for those with enhanced needs. Patients were able to speak with or see a GP when needed and the practice was accessible for patients with mobility issues. The practice had a safeguarding lead for vulnerable adults. The practice had good relationships with a range of support groups for older patients. There were arrangements in place to provide flu and pneumococcal immunisation to this group of patients. Clinics included diabetic reviews and blood tests. Blood pressure monitoring was also available.

Updated 23 July 2015

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 and flexible. For example, the practice was open Monday to Friday 8am to 8pm and offered Saturday morning appointments. 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 advice on diet and weight reduction. Nurses were trained to offer smoking cessation advice and patients could request routine travel immunisations.

Updated 23 July 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Patients with severe and enduring mental health needs had care plans and received annual physical health check. New cases had rapid access to community mental health teams. The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. The practice participated in the Dementia Direct Enhanced Service which ensures early diagnosis of Dementia. Patients were referred to a dementia nurse for consultation following a blood test and could then be referred to the local elderly mental health team. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

Updated 23 July 2015

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 for example those who were housebound or with complex health needs. The practice ensured that patients classed as vulnerable had annual health checks. It offered longer appointments for patients when required. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients. It had told 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. Translation services were available for patients who did not use English as a first language. The practice could accommodate those patients with limited mobility or who used wheelchairs. Carers and those patients who had carers were flagged on the practice computer system. A member of staff was a carer’s support link worker who worked closely with Surrey Carer Support Programme and could provide information or signpost carers to local support teams and networks.