South Street Medical Centre

Updated 22 December 2016

South Street Medical Centre is based in a large end of terrace property converted for the sole use as a surgery. It is located in the Royal Borough of Greenwich within a predominantly residential and tourist area of Greenwich. Greenwich Clinical Commissioning Group (CCG) are responsible for commissioning health services for the locality.

The property includes a purpose-built extension on the ground floor providing four identical consulting rooms. The ground floor also includes the reception area and waiting room. Two treatment rooms, including one large room which is also used for minor surgery, are located on the first floor which can be accessed by a lift. The first floor also has a spare consultation room which is also used as an isolation or breast feeding room as required. The top floor includes three administration rooms and a large meeting room.

The practice is registered with the CQC as Primecare (a partnership of two partners) which also provides services from a second location and branch surgery located in the Royal Borough of Greenwich. This is registered with the CQC as a separate location and was therefore not included in this inspection.

Services at South Street Medical Centre are delivered under a Personal Medical Services (PMS) contract. The practice is registered with the CQC to provide the regulated activities of maternity and midwifery services; treatment of disease, disorder and injury and diagnostic and screening procedures.

The practice has 8304 registered patients. The practice age distribution is lower than the national average for the over 55 year age group and higher than the national average for the 25 to 40 year age group. The surgery is based in an area with a deprivation score of 5 (with 1 being the most deprived and 10 being the least deprived).

The 28 GP sessions provided each week are delivered by male and female GPs which include two GP partners (10 sessions per week); two salaried GPs (10 sessions per week) and three regular locums (8 sessions per week).

The clinical team also includes a Nurse Practitioner (0.85 wte); two Practice Nurses (1.68 wte) and a Phlebotomist (0.2 wte).

Administrative services are provided by a Practice Administrator (1 wte) a Reception Team Leader (0.74 wte) and eight administration/reception staff (4 wte). The Practice Manager for Primecare is based in the other Primecare location but also provides managerial support to South Street Medical Centre.

The reception and telephone lines are open between 8am and 6.30pm Monday to Friday with reception extended hours provided from 6.30pm to 7.30pm on Monday and Thursday. The surgery is closed at weekends.

Pre-booked and urgent appointments are available with a GP from 8am to 1pm and 2pm to 7.30pm on Monday; from 9am to midday and 2pm to 6pm on Tuesday and Wednesday; from 8am to 1pm and 4pm to 7.30pm on Thursday and from 9am to 1pm and 2pm to 6pm on Friday.

Pre-booked and urgent appointments are available with the Nurse Practitioner from 9am to midday and 4pm to 6pm on Tuesday and Wednesday; from 10.30am to 12.30pm and 4pm to 7.30pm on Thursday and from 9am to midday and 4pm to 6.30pm on Friday.

Pre-booked appointments are available with the Practice Nurse from 10.30am to 1.30pm and 4pm to 7.30pm on Monday; from 10am to 6pm on Tuesday; from 8.30am to midday and 2pm to 6pm on Wednesday; from 9am to midday and 4pm to 7.30pm on Thursday and from 9am to midday and 4pm to 6pm on Friday.

When the surgery is closed urgent GP services are available via NHS 111.

Updated 22 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at South Street Medical Centre on 11 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.
• The practice had identified only 34 patients as carers (0.4% of the practice list). The practice had produced a poster displayed in the waiting area encouraging patients to alert the practice if they were a carer.  
• 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.
• There was continuity of care and urgent appointments were available the same day but patients said they sometimes found it difficult to make a routine appointment. The practice were aware of the issue and were investigating possible ways to improve this.
• 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 and displayed a poster in all clinical rooms explaining the requirements to patients.

The areas where the provider should make improvement are:

• The provider should review how patients with caring responsibilities are identified and recorded on the clinical system to ensure information, advice and support is made available to all carers on the practice list.

• The provider should continue to monitor patient satisfaction rates regarding booking routine appointments and implement changes as appropriate.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 22 December 2016

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

• GPs worked closely with practice nursing staff and community specialist nurses in the management of patients with long-term conditions.
• Patients at risk of hospital admission were identified as a priority.
• The performance rate for the Quality Outcomes Framework (QOF) diabetes related indicators was below the local and national average. This had been identified by the practice as an area for improvement and action had been taken to address this.
• Longer appointments and home visits were available when needed.
• 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 GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. These patients were discussed at the quarterly multi-disciplinary team meetings.

Updated 22 December 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 who were at risk, for example, children and young people who had a high number of A&E attendances.
• Immunisation rates for all standard childhood immunisations were comparable to local and national averages.
• Children and young people were treated in an age-appropriate way and we saw evidence to confirm this. Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with the midwife who held a weekly clinic at the surgery.
• The practice provided a weekly sexual health clinic during which a phlebotomist was also on site. This service was also available for patients not registered at the practice. The service was commissioned by the local Public Health service with whom the practice held quarterly performance monitoring meetings.

Updated 22 December 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.
• Quality Outcomes Framework (QOF) performance indicators for conditions found in older people were comparable to local and national averages.
• The practice was responsive to the needs of older people and offered home visits and urgent appointments for those with enhanced needs.

Updated 22 December 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 percentage of women aged 25 to 64 years who had received a cervical screening test in the preceding five years was 96% which was higher than the local and national average of 82%.
• Extended hours appointments were available at the surgery two evenings a week.
• The practice was proactive in offering online services.
• A full range of health promotion and screening services were provided that reflects the needs for this age group.

Updated 22 December 2016

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

• 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the preceding 12 months. This was above the local average and national average of 84%.
• 94% of patients diagnosed with a mental health disorder had a comprehensive agreed care plan documented in the preceding 12 months. This was comparable to the local average of 85% and 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 advised patients experiencing poor mental health 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.

Updated 22 December 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 and annual reviews 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 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.