Archived: The Practice Heart of Hounslow

Updated 13 January 2017

The Practice Heart of Hounslow is situated at Heart of Hounslow Centre for Health, 92 Bath Road, Hounslow, Middlesex, TW3 3LN. The practice shares the health centre with three other GP practices.The practice provides NHS primary care services through a Personal Medical Services (PMS) contract to approximatey 15,000 patients living in the London Borough of Hounslow. The practice is part of the NHS Hounslow Clinical Commissioning Group (CCG). The practice belongs to The Practice Group PLC which comprises 40 GP practices including three walk-in centres across England.

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

The practice serves a very transient population of which an extremely high proportion of the registered patients are working age adults and young children and a very low proportion of middle aged and elderly patients. The practice has a 30% turnover of patients annually. The ethnicity estimate is 58% Asian, 6% Black, 3% mixed and 4% other non-white ethnic groups. There is an average level of deprivation.

The practice team consists of two female salaried GPs, four male and one female long-term locum GPs (43 clinical sessions in total), four nurse practitioners (25 clinical sessions in total), two practice nurses, four healthcare assistants, a practice manager, two assistant managers supported by ten non-clinical staff. There are also three clinical pharmacists employed by the practice.

The practice is open between 8am and 8pm Monday to Friday. Appointments are available throughout the opening hours. Extended hours appointments are also offered on Saturday mornings from 8am.

Services provided include the management of long-term conditions, immunisations, antenatal care, contraceptive services, joint injections and cryotherapy.

Updated 13 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Practice Heart of Hounslow on 29 November 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.
• Data showed that cervical screening and childhood immunisation rates were below average. However, despite serving a very challenging population the practice were striving to improve outcomes for them.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment although national GP survey performance was generally below average for caring aspects of the service.
• 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 did not always find it easy to make an appointment with a preferred GP and therefore continuity of care was sometimes an issue. However, the practice were taking action to address 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.

The areas where the provider should make improvement are:

• Consider ways to improve QOF exception reporting to bring in line with local and national averages.
• Continue to improve cervical screening uptake and childhood immunisation rates to bring in line with local and national averages.
• Improve national GP survey performance in relation to the caring aspects of the service.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 13 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 for support from the nurses.
• Performance for diabetes related indicators was 81% compared to the CCG average of 85% and the national average of 90%.
• 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 13 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 generally below local and national averages. The practice had started to hold practice nurse and healthcare assistant clinics on a Saturday morning to improve uptake.
• 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 70%, which was below the CCG average of 78% and the national average of 82%. In addition, exception reporting was high at 17% compared to the CCG average of 9% and the national average of 7%. However, the practice had a very challenging population with a 30% turnover of patients per year. Despite this, they were striving to reduce exception reporting.
• Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 13 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 provided weekly home visits to 55 patients across two care homes and there was a dedicated phone line to the practice for acute and chronic issues.

Updated 13 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 13 January 2017

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

• 91% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months compared to the CCG average of 86% and the national average of 84%.
• Performance for mental health related indicators was 86% compared to the CCG average of 91% and the national average of 93%.
• 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.
• In 2015 the practice achieved 213% of the CCG target for dementia screening which was the best performance in the locality.

Updated 13 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.
• 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.