Archived: Beechwood Medical Centre

Updated 2 March 2018

Beechwood Medical Centre is located in London Borough of Hackney within the NHS City and Hackney Clinical Commissioning Group. The practice address is 86-86A Dalston Lane, Hackney, London, E8 3AH. The practice is registered with the Care Quality Commission to carry on the regulated activities of treatment of disease, disorder or injury, diagnostic and screening procedures, maternity and midwifery services and family planning. The practice provides a range of services including childhood immunisations, extended hours access, dementia support, influenza and pneumococcal immunisations, learning disability support, rotavirus and shingles immunisation and unplanned admission avoidance. More information about services provided by the practice can be found on their website: www.beechwoodmci.co.uk

The practice has a patient population of 3,755. The practice serves a diverse population, 55% is White British, 23% Black, 10% Asian and 7% Mixed Race and 5% Other Background. At 47% the practice had a lower proportion of people with a long standing health conditions than the national average of 54%. At 79 years, male life expectancy was in line with the national average of 79 years. At 83 years, female life expectancy was in line with the national average of 83 years.

The practice has a higher than average percentage of patients aged 25 to 44, a lower than average percentage of patients aged 64 to 85 and a similar percentage of patients aged 24 and below when compared to the national average. The surgery is based in an area with a deprivation score of two out of ten (one being the most deprived). At 45% older people registered with the practice have a significantly higher level of income deprivation compared to the national average of 20%. Patients at this practice have a higher rate of unemployment when compared to the national average.

Updated 2 March 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection February 2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced/unannounced comprehensive/focused inspection at Beechwood Medical Centre on 19 December 2017 as part of our inspection programme of providers previously rated good.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

• National GP survey results showed patient satisfaction for nurse consultation was below the local and national averages. The practice acknowledged these results and took action by promoting the importance of patient feedback and carried out a practice based survey which demonstrated improvement.

• The practice had comprehensive systems in place for reviewing patient care including long-term conditions. Patient outcomes were significantly higher than local and national averages for several clinical indicators and the practice had a lower than average exception reporting rate.

We saw one area of outstanding practice:

The practice worked with an IT Facilitator from the NHS City and Hackney Commissioning Support Unit to improve online access for patients. Out of 43 GP practices participating in the scheme within the borough of City and Hackney the practice was the top performing in improving access to online services for quarters one, two and at the time of the inspection during quarter three. The practice was the only practice involved in the scheme that not only exceeded the monthly target but showed a steady increase month on month in patients accessing online services provided by the practice. This meant that patients registered with the practice had the best online access in the borough.

The areas where the provider should make improvements are:

• Review the times listed for the daily morning walk-in clinic to ensure they are accurately reflected in the practice leaflet.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 27 August 2015

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 that their health and medication needs were being met. For example, the practice had undertaken annual reviews for 92% of patients on the chronic obstructive pulmonary disease (COPD) register and all of the patients on the COPD register had an agreed care plan. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. The practice ran a weekly diabetic clinic.

Updated 27 August 2015

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. For example the practice vaccinated 90.3% of children with the MMR vaccination which was higher than the clinical commissioning group (CCG) average of 89%. 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, this included baby changing facilities. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 27 August 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people For example 77% of patients had received a flu vaccination. All patients had a named GP and this was recorded within their notes The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits.

Updated 27 August 2015

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 including online booking of appointments. The practice implemented a drop in clinic for emergency appointments each day and offered extended hour appointments which included Saturday morning appointments.

Updated 27 August 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Ninety percent of people experiencing poor mental health had received an annual physical health check and 72% had an agreed care plan. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia.

The practice advised patients experiencing poor mental health how to access support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) who may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs including dementia.

Updated 27 August 2015

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. It had carried out annual health checks for people with a learning disability and 90% of these patients had received a follow-up. It offered longer appointments for people with a learning disability and those who needed the support of the advocacy service at the local hospital or telephone interpreting services.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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. The GP also provided a report for the transition of young people in social services care to adult services.