Tattenham Health Centre

Updated 25 October 2016

Tattenham Health Centre offers personal medical services to the population of Epsom and the surrounding area. There are approximately 6,500 registered patients.

Tattenham Health Centres purpose built and has disabled access. There is a seated waiting area situated away from the booking in desk. All of the GP consulting rooms and nurse treatment rooms are located on the ground floor. There is a toilet for patients with disabilities which has baby changing facilities. Staff offices and facilities are also located on the ground floor.

Tattenham Health Centre is run by three female partner GPs. The practice is also supported by two salaried GPs and a locum GP, a practice nurse and two healthcare assistants. The practice also has a team of receptionists, administrative and a practice manager.

Tattenham Health Centre is a training practice for FY2 doctors. (FY2 doctors are newly qualified doctors who are placed within a practice for four months and will have their own surgery where they see patients).

The practice runs a number of services for its patients including asthma reviews,child immunisation, diabetes reviews, new patient checks and holiday vaccines and advice.

Services are provided from:-

Tattenham Crescent, Epsom, Surrey, KT18 5NU

Opening Times

Monday to Friday 8:30am to 6.30pm with the duty GP being available from 8am.

Extended hours appointments were offered at the practice on Tuesdays and Wednesdays until 7pm

The practice was part of a group of GP practices offering evening appointments until 9pm and weekend appointments. Appointments were available from two locations in Epsom and Leatherhead.

During the times when the practice is closed, the practice has arrangements for patients to access care from an Out of Hours provider.

The practice population has a higher number of patients aged between 5–9, 50-64 and over 85 years of age than the national and local clinical commissioning group (CCG) average. The practice population shows a lower number of patients aged 20 to 39 years of age than the national and local clinical commissioning group (CCG) average. The percentage of registered patients suffering deprivation (affecting both adults and children) is lower than the average for England. Less than 10% of patients do not have English as their first language.

Updated 25 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Tattenham Health Centre on21 September 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 usually found it easy to make an appointment 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 participated in the hospital admission avoidance scheme and maintained a register of patients who were at high risk of a hospital admission.
• The practice encouraged and valued feedback from patients, the public and staff.
• The practice was part of a group of GP practices offering evening appointments until 9pm as well as weekend appointments, from two locations in Epsom and Leatherhead.
• Extended hours appointments were offered at the practice on Tuesdays and Wednesdays until 7pm.
• Results from the national GP patient survey showed patients felt they were treated with compassion, dignity and respect. The practice was above average for its satisfaction scores on consultations with GPs and nurses.
• Clinical staff were trained in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguard (DOLS). The practice had developed their own mental capacity review template.

Areas where the provider should make improvements are:

• Continue with the planned programme of appraisals.
• Ensure the new system for the tracking and storage of prescriptions used in printers is maintained.
• Ensure staff are aware of the procedures to follow in the event of a fire at the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 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.
• 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.
• A specialist diabetic nurses visited the practice every month for those patients who needed additional support.

• The practice offered diabetic foot screening. CQC data indicated that the practice achieved 90% for annual foot checks in patients with diabetes compared to the national average of 88%.

• 95% of patients with chronic obstructive pulmonary disease (COPD) had a review undertaken including an assessment of breathlessness, which was the same as the national average of 90%
• Patients were supported to self manage their long-term condition by using agreed plans of care and were encouraged to attend self-help groups

Updated 25 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.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice ensured that children needing emergency appointments would be seen on the same day.
• We saw positive examples of joint working with midwives, health visitors and school nurses.
• 78% of women aged 25-64 were recorded as having had a cervical screening test in the preceding 5 years. This compared to a CCG average of 81% and a national average of 82%.
• 72% of patients with asthma had an asthma review in the last 12 months that included an assessment of asthma control. This compared to a CCG average of 74% and a national average of 75%.
• GPs and nurses carried out family planning and contraceptive services which included coil and contraceptive implant fitting.
• Practice staff had received safeguarding training relevant to their role and knew how to respond if they suspected abuse. Safeguarding policies and procedures were readily available to staff.
• Appointments were available at the practice with the GP until 6.30pm and on two afternoons a week until 7pm.

Updated 25 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.
• Older patients with complex care needs and those at risk of hospital admission all had personalised care plans that were appropriately shared with local organisations to facilitate communication and the continuity of care.
• The practice worked with the community assessment diagnostic unit (CADU) to help older patients avoid hospital admissions.
• The practice was working to the Gold Standards Framework for those patients with end of life care needs. (The Gold Standards Framework is a framework to enable an expected standard of care for all people nearing the end of their lives. The aim of the Gold Standards Framework is to develop a locally-based system to improve and optimise the organisation and quality of care for patients and their carers in the last year of life).
• The practice supported patients who lived in nursing and residential homes by undertaking home visits when needed and providing advice over the telephone.
• The practice offered flu, pneumonia and shingles vaccination programmes.

Updated 25 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.
• The practice was part of a group of GP practices offering evening appointments until 9pm as well as weekend appointments, from two locations in Epsom and Leatherhead.
• Extended hours appointments were offered at the practice on Tuesdays and Wednesdays until 7pm.
• Telephone consultations were available during working hours.
• Electronic Prescription Services (EPS) and a repeat dispensing service helped patients to get their prescriptions easily.
• Travel health and vaccination appointments were available.
• The practice offered Saturday flu clinic appointments to fit in around working patients.

Updated 25 October 2016

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

• Patients were monitored as part of the Quality and Outcomes Framework (QOF) to check that they had an up-to-date care plans. 85% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, in the preceding 12 months. This compared well to a CCG average of 89% and a national average of 88%.
• 92% of patients diagnosed with dementia had their care reviewed in a face-to-face review in the preceding 12 months. This was higher than the national average of 84%.
• 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.
• Clinical staff were trained in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguard (DOLS). The practice had developed their own mental capacity review template.

Updated 25 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 invulnerable circumstances including homeless people, travellers 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.
• 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.
• Patients with a learning disability or other significant disability were known to the practice. This meant staff could quickly identify when dealing with a patient, if they required additional assistance.
• The practice could accommodate those patients with limited mobility or who used wheelchairs.
• Carers and those patients, who had carers, were flagged on the practice computer system and were signposted to the local carers support team.