The Blithehale Medical Centre

Updated 12 July 2016

The Blithehale Medical Centre is located in Bethnal Green in east London. It is one of the 36 member GP practices in NHS Tower Hamlets CCG which are organised into eight commissioning networks. The Blithehale Medical Centre is one of the five practices making up the East End Health Network. Practices within a network work together and with other local services and providers to improve the health and wellbeing of their patients.

Tower Hamlets is ethnically diverse with around half the population comprising of Black and Minority Ethnic groups. The largest of these is the Bangladeshi community (33%). The practice is located in the second more deprived decile of areas in England. At 75 years, male life expectancy is less than the England average of 79 years. At 83 years, female life expectancy is less than the England average of 83 years.

The practice has approximately 10,900 registered patients and is growing. It has few patients aged 45 years and above compared with the England average, and very many more in the 20 to 34 years age range. Services are provided by The Blithehale Medical Centre partnership under a Personal Medical Services (PMS) contract with NHS England. The partnership is made up of three GPs and one nurse practitioner.

The practice is in purpose built health care premises managed by NHS Property Services. It occupies the ground floor of the building and the premises are Disability Discrimination Act (DDA) compliant. The practice has eight consulting rooms, four treatment rooms and three interview rooms. On street pay and display car parking is nearby.

The three GP partners together with five salaried GPs provide the equivalent of five whole time GPs. There are four female and four male GPs. There is one part time nurse practitioner (16-24 hours per week), one part time practice nurse (25-35 hours per week), and two part time health care assistants (working 25-35 hours and 16-24 hours per week). The practice is employing a phlebotomist for two half days a week. There is a team of reception and secretarial staff led by a senior receptionist, assistant practice manager and practice manager.

The practice is an accredited GP training practice and two of the GP partners are approved trainers. There were two GP in training doctors attached to the practice at the time of our visit. Some of the GPs working at the practice had completed their GP training at the practice.

The practice’s opening times are:

• 8.00am to 8.00pm Monday and Tuesday.

• 8.00am to 6.00pm Wednesday to Friday.

Telephone lines are closed between 12.30pm and 2.00pm every Tuesday and on the first Monday of the month. Calls are put through to an out of hours GP service during these times and when the practice is closed.

Appointments are available between the following times

• 9.00am to 12.00pm and 2.30pm to 8.00pm on Monday and Tuesday.

• 9.00am to 12.00pm and 2.30pm to 6.00pm on Wednesday and Thursday.

• 8.30am to 12.00pm and 2.30pm to 6.00pm on Friday.

Appointments are also available at the practice at the weekend under GP hub arrangements in Tower Hamlets.

The Blithehale Medical Centre is registered with the Care Quality Commission to carry on the following regulated activities 22 Dunbridge Street, London E2 6JA: Diagnostic and screening procedures; Family planning, Maternity and midwifery services, Surgical procedures and Treatment of disease, disorder or injury.

Updated 12 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Blithehale Medical Centre on 07 June 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 found it easy to make an appointment with a named GP and there was continuity of care, 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 had recognised shortfalls in its recruitment records and infection control systems and was addressing these as part of a review of its governance systems.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

• The practice ran an after school club with a local primary school promoting healthy lifestyles. The practice had recently won an innovation grant to build on this work and develop a health literacy curriculum with the school. The World Health Organisation defines health literacy as 'the personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health’.

The areas where the provider should make improvement are:

• Put arrangements in place to audit the practice’s infection prevention and control systems and processes on an annual basis.
• Put systems in place to make available all information required in respect of each person employed by the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 July 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 avoidable hospital admission were identified as a priority.

• Longer appointments and home visits were available when needed.

• Appointments with diabetes advisors and cardiovascular specialists were available at the practice.

• The practice ran regular anti-coagulation clinics.

• 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 12 July 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.

• Immunisation rates for children aged 12 months were high, exceeding 90%.

• The percentage of women aged 25-64 who had a cervical screening test performed in the preceding 5 years was 80%, which was similar to the England average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies. There were baby change facilities and a separate breast feeding room.

• We saw positive examples of joint working with health visitors and with a local primary school, where the practice ran a weekly after school club that focused on health promotion and education.

• The practice was ‘You’re Welcome’ accredited which means it was meeting the Department of Health quality criteria for young people friendly health services.

Updated 12 July 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.

• Continuity of care was assured by each older person and housebound person having a named GP who was the first port of call when these patients needed to be seen.

Updated 12 July 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, including non emergency GP consultations online, as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 12 July 2016

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

• 92% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average of 84%.

• The practice’s patient outcomes for mental health indicators were comparable with national averages. The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses:

  • Who have a comprehensive agreed care plan documented in the record in the preceding 12 months was 83%

  • Whose alcohol consumption has been recorded in the preceding 12 month was 95% (CCG 89%, England 90%).

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• A mental health nurse offered weekly clinics at the practice and a psychologist was on site once a week to offer initial assessments. Cognitive behavioural therapists (CBT) ran regular Managing Stress courses at the practice.

Updated 12 July 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 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.

• A benefits advisor came in to the practice once a week to assist patients.

• There were designated GP and nurse appointments where a Bengali speaking advocate was available.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations, and worked with local charities for example to provide dietary advice and exercise sessions with Bengali patients.

• An alcohol advisor from the local alcohol service ran weekly clinics at the practice.

• 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.