Minet Green Health Practice

Updated 5 July 2016

The Minet Green Health Practice is locted between Brixton and Camberwell in the London Borough of Lambeth. The practice serves approximately 12,100 people living in the local area. The local area is diverse. People living in the area speak a range of different languages and express a range of cultural needs. The practice is situated in a relatively deprived area, compared to the national average.

The practice operates from a single site. It is situated on the first floor of the purpose-built Akerman Health Centre, which also houses a range of other health and social care services. There are twelve consulting rooms and three treatment rooms on the first floor. The premises are fully wheelchair accessible with level access at the entrance and a lift up to the first floor. There are also disabled toilets on site.

There are five GP partners (three female, two male) as well as five salaried GPs, two practice nurses and a healthcare assistant. Overall the practice provides 59 GP sessions each week. The practice also employs a range of non-clinical support staff comprising a business manager, operations manager, two practice administrators and six patient services officers.

The practice provides mentored placements for doctors undertaking their foundation and speciality general practice training, as well as hosting other postgraduate and undergraduate medical students. The practice also supports academic research programmes in general practice with one of the GP partners and one of the salaried GPs linked to university research teams.

The practice offers appointments on the day and books appointments up to four weeks in advance. The practice has appointments from 8.00am to 6.30pm Monday to Friday and is also open on Saturdays from 8.30am to 12:30pm. Patients who need attention outside of these times are directed to call the 111 service for advice and onward referral to other GP out-of-hours services. The practice runs a sexual health clinic which is open from 4.00pm to 7.00pm on Tuesdays and from 9.30am to 12.30pm on Saturdays.

The Minet Green Health Practice is contracted by NHS England to provide Personal Medical Services (PMS). They are registered with the Care Quality Commission (CQC) to carry out the following regulated activities: Maternity and midwifery services; Family planning; Diagnostic and screening procedures; Treatment of disease, disorder or injury.

Updated 5 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Minet Green Health Practice on 5 May 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• 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 had good access to named GPs 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 was aware of and complied with the requirements of the duty of candour.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example two of the GP partners held academic research posts with local universities which supported the development of innovative practice in primary care.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw one area of outstanding practice:

• The practice had made a strong commitment to treating people with dignity and respect. This included ensuring that people using the service were not discriminated against in any way. For example, the practice had been awarded a Gold ‘Pride in Practice’ award by the LGBT Foundation for providing inclusive services for patients regardless of their sexual orientation. Staff had received additional training in this area. This was in recognition of the needs of the local population.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 July 2016

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

• Nursing staff, salaried GPs, and GP partners 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 patients with long-term conditions 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 practice had a higher than average number of people registered at the practice requiring diabetes care. The practice had recognised the need to improve diabetes care and had a plan in place to implement a range of monitoring and education systems with a view to improving outcomes for these patients in the coming year. An audit system was in place to monitor the effectiveness of these programs.

• The practice had an innovative program for identifying and monitoring patients with  prediabetes with a view to preventing an escalation to a full diabetes diagnosis. Yearly audits, carried out since 2012, were being used to assess the effectiveness of this strategy.

Updated 5 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, 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 were recognised as individuals, and we saw evidence to confirm this.

• The practice’s uptake for the cervical screening programme was 76%, which was comparable to the CCG average of 71% and the national average of 74%. 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 and health visitors, for example at multi-disciplinary team meetings where higher-risk cases were reviewed.

Updated 5 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.

• The practice prioritised calls from care homes or care agencies in order to provide prompt response to any immediate concerns.

• GPs attended monthly multidisciplinary meetings with a geriatrician to review complex cases.

• Onward referrals were made by clinicians to a local charitable agency that supported older people to access services which enabled safe and independent living.

Updated 5 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 as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 5 July 2016

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

• 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.

• The practice monitored its performance in relation to mental health care. Data for the year 2014/15 showed that 94% of patients with a serious mental health condition had had a care plan review within the past 12 months. Data from the Quality Outcomes Framework (QOF) for 2015/16 showed that the practice had achieved the maximum number of QOF points in this area, indicating that the practice had continued to perform well in this area.

Updated 5 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 homeless people, travellers and 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.