Statham Grove Surgery

Updated 14 July 2017

Statham Grove Surgery provides GP primary care services to approximately 8,500 people living in Stoke Newington, London Borough of Hackney. The practice has a General Medical Services (GMS) contract for providing general practice services to the local population. A General Medical Services (GMS) contract is the contract between general practices and NHS England for delivering primary care services to local communities.

Information published by Public Health England rates the level of deprivation within the practice population group as four on a scale of one to ten. Level one represents the very highest levels of deprivation and level ten the lowest.

There are currently four GP partners, three female and one male. There are also four salaried GPs, two female and two male, all of whom work part-time. The practice provides a total of 36 GP sessions per week.

The clinical team is completed by two practice nurses and two health care assistants all of whom work full- time. The health care assistants were also trained as phlebotomists (Phlebotomists are specialist healthcare assistants who take blood samples from patients for testing in laboratories). There are also a business manager and ten administrative and reception staff.

The practice is registered to provide the regulated activities of maternity and midwifery services, diagnostic and screening procedures, family planning, treatment of disease, disorder or injury and surgical procedures.

The practice is located in a purpose built two storey building and patients are given the option of being seen on the ground floor.

The practice opening hours for the surgery are:

Monday 9am to 7:30pm

Tuesday 9am to 7:30pm

Wednesday 9am to 6:30pm

Thursday 7am to 1:00pm

Friday 9am to 6:00pm

Saturday Closed

Sunday Closed

Appointments with GPs and nurses are available every weekday morning between 9am and 11:50am, every Monday, Tuesday and Wednesday afternoon between 4pm and 6:20pm, and on Friday afternoons between 4pm and 5:50pm. Extended hours GP appointments are offered between 6:30pm and 7:30pm on Monday and Tuesday evenings and between 7am and 7:45am on Thursday mornings. Extended hours nurse appointments are offered on Monday and Tuesday evenings between 6:30pm and 7pm. In addition to pre-bookable appointments that can be booked up to six weeks in advance, urgent appointments are also available for patients that need them.

The practice has opted not to provide out of hours services (OOH) to patients and these were provided on the practice’s behalf by City & Hackney Urgent Healthcare Social Enterprise (CHUSE). The details of the how to access the OOH service are communicated in a recorded message accessed by calling the practice when it is closed and details can also be found on the practice website.

Patients can book appointments in person, on-line or by telephone. Patients can access a range of appointments with the GPs and nurses. Face to face appointments are available on the day and are also bookable up to six weeks in advance. Telephone consultations are offered where advice and prescriptions, if appropriate, can be issued and a telephone triage system is in operation where a patient’s condition is assessed and clinical advice given. Home visits are offered to patients whose condition means they cannot visit the practice.

The practice provides a wide range of services including clinics for diabetes, asthma, contraception and child health care and also provides a travel vaccination clinic. The practice also provides health promotion services including a flu vaccination programme and cervical screening.

Updated 14 July 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Statham Grove Surgery on 25 February 2015. The practice was rated good overall and requires improvement for safe. The full comprehensive report from this inspection can be found by selecting the ‘all reports’ link for Statham Grove Surgery on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection carried out on 6 June 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 25 February 2015. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

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

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with 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 a significant number of patients whose first language was Turkish and the practice had put arrangements in place to support this group. For instance, some leaflets were available in Turkish and the practice had arranged to have Turkish speaking support workers provide services at the surgery.
• 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider should make improvements:

• Continue to review infection control arrangements in those consulting rooms fitted with carpets and which had sinks and taps that did not comply with national guidelines

• Review and improve how patients with caring responsibilities are identified and recorded on the clinical system to ensure that information, advice and support is made available to them.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 14 July 2017

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

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.
• The practice provided or hosted a range of specialist clinics to support patients with long term conditions. For instance, there were weekly clinics with specialist diabetes nurses and dieticians, respiratory pharmacists and coronary heart disease nurses.
• Performance for diabetes related indicators were comparable to CCG and national averages. For instance, 85% of patients had well controlled blood sugar levels (CCG average of 78%, national average 78%).
• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.
• All these patients had a named GP and there was a system to recall patients for 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 14 July 2017

The practice is rated as good for the care of families, children and young people.

• From the sample of documented examples we reviewed we found there were systems 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 accident and emergency (A&E) attendances.
• The practice’s uptake for the cervical screening programme was 82%, which was comparable with the CCG average of 79% and the national average of 81%.
• Immunisation rates were relatively high for all standard childhood immunisations.
• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.

Appointments with GPs and nurses were available outside of school hours and the premises were suitable for children and babies.

• The practice worked with midwives, health visitors and school nurses to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.
• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

Updated 14 July 2017

The practice is rated as good for the care of older people.

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.
• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible.
• Outcomes for conditions often associated with older people were comparable to local and national averages. For instance, 90 % of patients with hypertension had well controlled blood pressure compared to the CCG average of 90% and the national average of 83%.

Updated 14 July 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, extended opening hours.
• 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 14 July 2017

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

• The practice carried out advance care planning for patients living with dementia.
• 89% 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%.
• 94% of patients diagnosed with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record compared to the CCG average of 89% and national average of 89%.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs and had recently undertaken a clinical audit of patients with learning difficulties who had been prescribed medicines to treat mental health conditions.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 14 July 2017

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. Patients who were homless could register using the practice address and could present a special card at reception to avoid potentially embarrassing conversations.
• GPs from the practice provided GP services at the Hackney Winter Night Shelter for three hours every Sunday night between November and March. This was done in a voluntary capacity and was unpaid. As well as providing GP services, doctors also supported patients through counselling, advocacy and signposting to support organisations.
• Information about support for victims of domestic violence was available in the waiting area as well as in the privacy of toilet cubicles where patients could engage with the details unobserved.
• The practice offered longer appointments for patients with a learning disability.
• The practice had a significant number of patients whose first language was Turkish and when the PPG published a patient guide to accessing the appointment system, this had also been translated into Turkish.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.