Background to this inspection
Updated
20 April 2020
The practice is registered with the CQC to carry out the following regulated activities - diagnostic and screening procedures, surgical procedures, family planning, maternity and midwifery services and treatment of disease, disorder or injury.
The practice has a contract with the Lambeth Clinical Commissioning Group (CCG) which is made up of 41 general practices. The practice had an Alternative Provider Medical Services (APMS) contract.
When the practice is closed, out of hours cover for emergencies is provided by SELDOC. The practice is part of AT Medics Streatham Primary Care Network (PCN). At the time of our inspection there were 18,925 patients on the practice list.
The practice has five male GPs, three female GPs, two female practice nurses, one female healthcare assistant, one male healthcare assistant, one male practice pharmacist, two female practice pharmacists, one female physician associate, a practice manager, an assistant practice manager and a reception and administrative team. The practice is an accredited training practice and trains F2 doctors and ST doctors, along with final year and year 4 students.
Streatham High Surgery is in a moderately deprived area of Lambeth. The practice scored four on the deprivation measurement scale; the deprivation scale goes from one to 10, with one being the most deprived. People living in more deprived areas tend to have greater need for health services. National General Practice Profile describes the practice ethnicity as being 57.0% white, 10.3% Asian, 22.8% black, and 7.6% mixed and 2.3% other ethnicities. The practice demographics show a below average percentage of people in the 75+ year age group. Average life expectancy is 80 years for men and 84 years for women compared to the national average of 79 and 83 years respectively. The general practice profile shows that 32% of patients registered at the practice have a long-standing health condition, compared to 41% locally and 51% nationally.
Updated
20 April 2020
We carried out an announced focussed inspection of Streatham High Surgery on 7 February 2020 following our annual review of the information available to us including information provided by the practice. Our review indicated that there may have been a significant change to the quality of care provided since the last inspection.
This inspection focused on the key questions effective, responsive and well-led.
Because of the assurance received from our review of information we carried forward the ratings for the key questions safe and caring.
We rated the practice as good overall with the following key question ratings:
Effective – good
Responsive– good
Well-led – outstanding
The practice had previously been inspected on 12 November 2014 and had been rated as outstanding overall: safe, effective and caring were rated good and responsive and well led were rated outstanding.
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations.
We have rated this practice as Good overall.
We rated the practice as good for providing effective services because:
- Patients received effective care and treatment that met their needs.
We rated the practice as good for providing responsive services because:
- Services were tailored to meet the needs of individual patients. They were delivered in a flexible way that ensured choice and continuity of care, particularly for working age people.
- There were innovative approaches to providing integrated person-centred care.
- Appointments were available at Streatham High Surgery from 8am to 8.30pm on Mondays to Thursdays, 8am to 6.30pm on Fridays, and 9.30am to 12 noon on Saturdays. The practice also offered appointments with the nurse until 7.30 on Wednesdays, and on Saturdays and Sundays for cervical screening.
- Clinicians had ‘catch up’ slots during their sessions to help ensure appointments ran on time.
- The practice has signed up to the Safe Surgeries Initiative to help reduce barriers to registration.
We rated the practice as outstanding for providing well-led services because:
- The culture of the practice, and the way it was led and managed, drove the delivery and improvement of high-quality, person-centred care.
- The practice has launched a Diabetes Improvement Project. We saw evidence that this project was replicated across the Lambeth CCG and led to improvements in care delivered by 41 practices.
- The practice has implemented a Bowel Cancer Screening Improvement Project. We saw evidence that the project led to an increase in screening. The project was implemented across several other practices, who also reported an increase in uptake.
- There were excellent examples of how the practice’s vision and ethos were implemented by the staff team working together to maintain high standards, deliver positive health outcomes for patients and foster a supportive work environment.
- The practice has used an inhouse analytical tool to improve the prevalence of patients with learning disabilities on the diabetes and hypertension registers. This has been shared with CCGs, who use the tool to identify patients who could be added to the hypertension registers for 60 other practices.
Whilst we found no breaches of regulations, the provider should:
- Continue to take action to monitor and improve uptake of childhood immunisations and cervical screening.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care