The Ridgeway Surgery

Updated 15 November 2016

The Ridgeway Surgery is located in a converted house within a residential area of East London and is a part of Waltham Forest Clinical Commissioning Group.

There are 7700 patients registered at the practice 22% of which are aged over 65 years compared to a CCG average of 15%.

The practice has three GP partners (two male and one female) carrying out 17 sessions per week, there are regular locums carrying out 11 sessions per week and one practice nurse. The practice has a health care assistant, a practice manager and 11 administration/reception staff members. The practice is a training practice for third year medical students.

The Ridgeway Surgery operates under a General Medical Service Contract (GMS) (a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract).

The practice is open Monday to Friday from 8:20am to 6:30pm; the phone lines are open from 8:00am. Appointment times are as follows:

• Monday 8:30am to 12:30pm and 2:00pm to 6:00pm

• Tuesday 8:30am to 12:30am and 2:00pm to 7:30pm

• Wednesday 8:30am to 12:30pm and 2:00pm to 5:30pm

• Thursday 8:30am to 12:30pm and 4:00pm to 7:30pm

• Friday 8:30am to 1:00pm and 3:30pm to 6:00pm

The out of hours provider covers calls made whilst the practice is closed.

The Ridgeway Surgery operates regulated activities from one location and is registered with the Care Quality Commission to provide treatment of disease, disorder and injury, family planning, maternity and midwifery and diagnostic and screening procedures.

Updated 15 November 2016

We carried out an announced comprehensive inspection at The Ridgeway Surgery on 24 May 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.
• 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 practice carried out International Normalized Ratio (INR) testing for their own patients as well as patients from local practices.

The areas where the provider should make improvement are:

• Review systems for identifying carers to ensure appropriate support is provided to them.

Letter from the Chief Inspector of General Practice

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 15 November 2016

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

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

• Leaflets were available in different languages to give further information to patients about their condition.

• The practice carried out International Normalized Ratio (INR) testing on the premises.

• The percentage of patients on the diabetes register with a record of a foot examination and risk classificationin the preceding 12 months was 77% compared with a 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 15 November 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.

• 77% of women aged 25 to 64 had a record of a cervical screening test documented in their record in the preceding five years compared to a 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 15 November 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, telephone consultations and urgent appointments for those with enhanced needs.

• The practice was a part of the Everyone Counts Scheme, which focusses on patients aged over 75 years old.

Updated 15 November 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.

• The practice offered extended hours twice a week for patients who were unable to attend the practice during normal working hours.

Updated 15 November 2016

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

• 77% 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 of 84%.

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychosis who had a comprehensive agreed care plan documented in the record was 89% compared with 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.

• 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.

• The practice offered longer appointments for patients with dementia.

Updated 15 November 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 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.

• The practice held a register of carers of patients who were vulnerable.

• 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.