Woodlands Practice

Updated 16 November 2016

The Woodlands Practice is based in a two storey extended semi-detached property in the London Borough of Bromley. It is located within a predominantly residential area of Chislehurst with a busy high street nearby. The property has been converted for the sole use as a surgery, undergoing a two-stage restructure of the layout and modernisation between 2013 and 2014. The property now includes 6 consulting rooms, 2 treatment rooms, reception, waiting room, administration offices and a meeting room. Bromley Clinical Commissioning Group (CCG) are responsible for commissioning health services for the locality.

The practice is registered with the CQC as a Partnership. Services are delivered under a Personal Medical Services (PMS) contract. The practice is registered with the CQC to provide the regulated activities of family planning; maternity and midwifery services; treatment of disease, disorder and injury, surgical procedures and diagnostic and screening procedures.

The practice has 9700 registered patients. The practice age distribution is similar to the national average with a slightly higher than average number of patients in the 40 to 55 year age group. The surgery is based in an area with a deprivation score of 6 (with 1 being the most deprived and 10 being the least deprived).

Clinical services are provided by four GP partners (male and female) providing 28 sessions per week; four part-time salaried GPs providing 18 sessions per week; one part-time Nurse Practitioner (0.5 wte); two part-time Practice Nurses (1.2 wte) and one part-time Health Care Assistant (0.5 wte).

Administrative services are provided by a Practice Manager (1.0 wte), Personal Assistant (0.8 wte), medical secretary (0.64 wte) and 16 administration/reception staff (6.65 wte).

The practice provides the following Directed Enhanced Services (DES): Childhood Vaccination and Immunisation Scheme; Extended Hours Access; Facilitating Timely Diagnosis and Support for People with Dementia; Improving Patient On-line Access; Influenza and Pneumococcal Immunisations; Learning Disabilities; Minor Surgery; Patient Participation; Rotavirus and Shingles Immunisation and Unplanned Admissions. (Enhanced Services are services which require an enhanced level of provision above what is expected under a core contract).

The surgery is the training site for GPs and nurses in Bromley undergoing training in the insertion of intrauterine devices (IUDs).

The surgery is open between 8am and 6.30pm Monday to Friday with extended hours provided from 6.30pm to 8pm on Monday and Tuesday. The surgery is closed at weekends.

Pre-booked and urgent appointments are available with a GP or Nurse Practitioner from 8.30am to 12.20pm and 2pm to 7.30pm on Monday; from 8.30am to 11.30am and 2pm to 7.30pm on Tuesday; from 8.30am to 11.30am and 1pm to 6pm on Wednesday; from 8.30am to 11.30am and 2pm to 6pm on Thursday and from 8.30am to 12.20pm and 1pm to 6pm on Friday.

Extended hours appointments are also provided by the local GP Alliance Hub service. These appointments are available between 6.30pm and 8pm Monday to Friday and from 9am to 1pm Saturday and Sunday. Appointments must be booked through the surgery. The service is staffed by GPs from the practices who are members of the alliance and full access to GP electronic records is available for all consultations.

Pre-booked appointments are available with the Practice Nurse from 8am to 12.45pm and 2pm to 7.45pm on Monday and Tuesday; from 8am to 12.45pm and 2pm to 5.45pm on Wednesday and Friday and from 2pm to 5.45pm on Thursday.

Pre-booked appointments are available with the Health Care Assistant from 3pm to 7.45pm on Monday; from 2pm to 6.45pm on Tuesday and from 8am to 12.45pm on Thursday.

When the surgery is closed urgent GP services are available via NHS 111.

An informative practice leaflet and practice website provide details of services provided by the surgery and within the local area.

Updated 16 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Woodlands Practice on 2 August 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.
• The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe. Blank prescription forms and pads were securely stored and there were systems in place to monitor the use of prescription pads. However, a record was not kept of batch numbers of blank prescriptions placed in printers.

• 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 did not always find it easy to book a routine appointment with a GP but there was continuity of care with urgent appointments available the same day.
• The practice had good facilities and was 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.

There were areas where the provider should make improvements.

• The provider should keep a record of batch numbers of blank prescriptions placed in printers.
• The provider should continue to monitor patient satisfaction regarding the availability of routine appointments.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 16 November 2016

The practice is rated as good for the care of people with long-term conditions.

• GPs worked closely with practice nursing staff and community specialist nurses in the management of patients with long-term conditions.
• Patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related Quality Outcomes Framework (QOF) indicators was comparable to the local and national average.
• Longer appointments and home visits were available when needed.
• 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. The management of care for these patients was discussed at the quarterly multi-disciplinary team meetings.

Updated 16 November 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 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 we saw evidence to confirm this.
• The percentage of women aged 25 to 64 years who had received a cervical screening test in the preceding five years was comparable to the local and national average.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, who held an antenatal clinic at the surgery every week, and health visitors who attended safeguarding meetings at the practice.

Updated 16 November 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 Nurse Practitioner carried out annual home visits for housebound patients for review and care planning.
• Performance for Quality Outcomes Framework (QOF) indicators for conditions found in older people were comparable to the Clinical Commissioning Group (CCG) and national average.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced need.
• The practice participated in the information sharing agreement with the local community health service to facilitate co-ordinated care for this group of patients.

Updated 16 November 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.
• Extended hours evening appointments were available at the surgery two evenings a week.
• The practice was proactive in offering online services. Patients were sent texts to encourage uptake of the service.
• A full range of health promotion and screening services were provided that reflects the needs for this age group. Evening appointments were available from the Health Care Assistant for these services.

Updated 16 November 2016

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

• 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the preceding 12 months, which was above the CCG average of 83% and national average of 84%.
• 91% of patients diagnosed with a mental health disorder had a comprehensive agreed care plan documented in the preceding 12 months, which was above the CCG average of 84% and national average of 88%.
• 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.
• A counsellor provided twice weekly clinics at the surgery.
• The practice informed patients experiencing poor mental health 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 and would alert the partners if they had concerns regarding a patient’s memory.

Updated 16 November 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 and annual reviews for patients with a learning disability. 73% of patients had attended for their annual review.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice informed vulnerable patients 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.