Archived: Philip Lane Surgery - Siva

Updated 27 April 2016

The Philip Lane Surgery is located in the London Borough of Haringey. The practice is part of the NHS Haringey Clinical Commissioning Group (CCG). The practice currently holds a Personal Medical Service (PMS) contract (a contract between NHS England and general practices for delivering personal medical services. This contract allows the flexibility to offer local services within the contract) to 2730 patients.

The Philip Lane Surgery serves a diverse population and for many patients, English is not their first language. The practice has a mixed patient population age demographic with 37% under the age of 18 and 15% over the age of 65. The Philip Lane Surgery is situated within a converted house with clinical rooms on the ground floor and administration offices on the upper floor. All consulting rooms are easily accessible through wide corridors. There are currently two full time GP partners (both male) the GP Principal undertakes eight sessions per week and the remaining partner undertakes seven sessions per week, one long term locum GP (female ) who carries out two sessions per week. The practice does not have a permanent practice nurse but relies on two long term locum nurses (both female) who carry out six hours and seven hours respectively on separate days. The staffing team also included a practice manager, administration and reception staff.

The practice is open between 8am and 6.30pm on a Monday and 7.30am and 6.30pm Tuesday to Friday. Appointments are from 7.30am (8am on a Monday) to 11am (11.30am on a Monday) every morning and 3pm (1pm on a Monday) to 6pm daily. The practice runs an extended hour’s surgery between 7.30am and 8am on a Tuesday to Friday. In addition to pre-bookable appointments that could be booked up to six weeks in advance, urgent appointments are also available for people that needed them.

The practice opted out of out of hours care and directs patients to a local out of hour’s provider.

The service is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures and the treatment of disease, disorder or injury.

The practice provides a range of services including child health and immunisation, minor illness clinic, smoking cessation clinics and clinics for patients with long term conditions. The practice also provides health advice and blood pressure monitoring.

Updated 27 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Philip Lane Surgery on 29 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 generally well managed. However nurses had not signed the Patient Group Directions (PGD’s).
• 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. However training records were not kept for the locum nurses.
• The practice had not obtained employment references and this was not detailed as a requirement within its recruitment policy.
• 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.
• 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:

• Ensure employee references are obtained and the collection of references is added to the recruitment policy.

• Ensure that copies of locum nurse qualifications and training details are kept on file.

• Ensure that appropriately signed PGD’s are on file for practice nurses.

• Implement a schedule for the cleaning of clinical equipment.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 27 April 2016

The practice is rated as good for the care of people with long-term conditions.

• GP and nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators was better than the national average. For example the percentage of patients on the diabetes register who had had a blood pressure reading within the last 12 months was 85% compared to the national average of 77%. The percentage of patients on the diabetes register that had received the flu immunisation was 98% compared 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.

Updated 27 April 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.

• 84%

• 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 83%, which was comparable to the national average of 81%.

• 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.

• The practice provided invitations for teenagers that had not been fully immunised with the MMR vaccination while children to receive the vaccination at special clinics.

Updated 27 April 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.

Updated 27 April 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 27 April 2016

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

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  95% of patients with a known mental health disorder had received a documented care plan, compared to the national average of 88%. One hundred percent of patients with a diagnosis of dementia had received a face to face review, compared to the national average of 84%.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those 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.

Updated 27 April 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 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.