Hackbridge Medical Centre

Updated 24 October 2016

Hackbridge Medical Centre is based in Wallington, south west London. Although parking is very limited, the area is well-served by public transport. The practice is based in the Sutton Clinical Commissioning Group (CCG) area.

The practice currently operates from a building converted from two houses, which limits the services that the practice can provide. For example, there is only one consultation room downstairs and although the practice has a GP who is trained to offer minor surgery, the premises are not currently suitable. Plans are in place for the practice to move to new, purpose-built premises later in 2016.

There are approximately 4050 patients registered with the practice. Compared to the other practices in England the practice has more children as patients (age 0 – 14), and patients aged 25 – 44; and fewer patients aged 15 – 24 and 55+. The deprivation score is six out of ten, with one being the most deprived.

The practice is open between 8am and 6.30pm Monday to Friday. Routine appointments with GPs are available from 8.30am to 12pm every week day. Appointments with nurses are available on Monday from 8.30am to 1.30pm and from 3pm to 7pm, on Wednesday from 8am to 1pm, on Thursday from 8.30am to 6.30pm, and on Friday from 8am to 5.30pm. Extended hours appointments are offered on Monday from 6.30pm to 8.30pm, and (as a pilot) on some Saturday mornings. When the practice is closed patients are directed to visit a local walk-in centre or call NHS 111 for advice and to be seen by a GP if necessary.

There are three doctors at the practice, two female and one male. One is registered with the CQC as the owner of the practice, and the other two are salaried GPs. Not all of the GPs work full-time. Full time doctors work eight sessions per week. The practice has 18 GP sessions per week.

There are three part-time practice nurses (all female). There are five nursing sessions in total.

The practice provides NHS GP services under a Personal Medical Services contract, and is registered with the CQC to provide diagnostic and screening procedures, surgical procedures, family planning, maternity and midwifery services and treatment of disease, disorder or injury.

Updated 24 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hackbridge Medical Centre on 10 August 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.
• Most risks to patients were assessed and well managed, although there was no formal fire risk assessment and the plan for managing major incidents was incomplete.
• Recruitment procedures were not operated consistently. Staff records we checked were not complete
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and 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.
• 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 practice risk assessments to ensure that all relevant fire risks are included.
• Include staff and supplier contact details in the business continuity plan and ensure it is stored off-site.
• Review the system for identifying significant events to ensure that the events can be thoroughly analysed and learning can be consistently identified, shared and monitored.
• Review how the practice manage complaints to ensure that complainants receive a written response where appropriate.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 24 October 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.
• Performance for long-term conditions, such as diabetes, was comparable to other practices nationally. The practice had a process in place to support patients with COPD, which meant that no patients had been admitted to hospital as a result of their COPD last winter.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and were offered 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.

Updated 24 October 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.
• 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 85%, which was comparable to the CCG average of 83% and 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 and school nurses.

Updated 24 October 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.
• All older people had a named GP responsible for their care.

Updated 24 October 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 24 October 2016

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

• 88% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average to the national average.
• Performance for mental health related indicators was comparable or above the national average. For example, 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan (compared to the national average of 88%).
• The practice regularly worked with multi-disciplinary teams in the case management of patients 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.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 24 October 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 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.