The Neaman Practice

Updated 23 January 2017

Neaman Practice provides GP primary medical services to approximately 9057 patients living in the City of London. The practice serves a relatively affluent population with pockets of socio-economic deprivation. The majority of patients are from White British or White European backgrounds. The practice serves a predominantly older population and there are small numbers of patients between the ages of five and eighteen years of age.

The practice team is made up of three GP partners, four salaried GPs and one registrar GP (providing 24 sessions per week), two nurses, one trainee nurse, five receptionists, one secretary and two practice managers.

The practice is open between 8am-8pm on Mondays; 8am-6:30pm Tuesday to Friday. Appointments are from 9am-12:50pm daily; 4pm-8pm on Mondays and 4pm-6pm Tuesday to Friday. Home visits are provided for patients who are housebound or too ill to visit the practice.

The practice has a General Medical Services (GMS) contract (GMS is one of the three contracting routes that have been available to enable the commissioning of primary medical services).The practice refers patients to the NHS ‘111’ service and CHUHSE (City and Hackney Urgent Healthcare Social Enterprise) for healthcare advice during out of hours.

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

The practice provides a range of services including maternity care, childhood immunisations, chronic disease management and travel immunisations.

Updated 23 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Neaman Practice on 3 October 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 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.

• 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 improvements are:

• Advertise the provision of the interpreting service to inform patients this service is available to them.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 January 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 for diabetes related indicators were above the national averages. For example, the percentage of patients with diabetes, on the register, whose last measured total cholesterol was 5 mmol/l or less, was 88% which was above the national average of 81%; and the percentage of patients with diabetes, on the register, who received a foot examination, was 93% which was above the national average of 88%.

• 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 23 January 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, 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.

• The practice’s uptake for the cervical screening programme was 77%, which was comparable to the CCG average of 81% 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, family support workers and child psychologists as part of the ‘Children and Families’ multidisciplinary team meetings.

Updated 23 January 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.

• The practice had developed a proactive ‘Frail Home Visiting’ service to ensure housebound and vulnerable patients who may not otherwise attend the practice were provided with additional support and care.

• The practice provided a replacement hearing aid service for patients to enable patients to change their hearing aid batteries at the practice rather than travel to the service. Double appointments were also offered for patients with hearing loss.

Updated 23 January 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.

• 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 23 January 2017

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

• Performance for some mental health related indicators were above the national averages. For example, the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan was 96% and the national average is 88%.

• The practice employed an in-house psychotherapist to increase access for patients to psychotherapy services.

• 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.

• 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 and changes had been implemented to the practice to make the premises ‘dementia friendly.’

Updated 23 January 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 those with a learning disability and homeless patients were able to register at the practice.

• 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.