Updated 15 July 2019
Essex Lodge Surgery operates under the provider Essex Lodge I-health Ltd within the premises of Essex Lodge (a GP Practice) and was formed in 2009 to facilitate clinical care delivery from a community based setting. It is situated in a three storey premises which it shares with a GP surgery called Essex Lodge. The Essex Lodge GP practice was granted planning permission to extend the premises. This work was underway at the time of the previous inspection in 2018 and has now been completed. All treatment and consultations provided by Essex Lodge Surgery are undertaken in rooms on the ground floor.
Essex Lodge I-health Ltd is part of a consortium of providers (Barts Health, Homerton Hospital, BMI, Essex Lodge I-health Ltd, East London Foundation Trust, and Patient First Ltd) to deliver specialist musculoskeletal (MSK) care and chronic pain management to patients that belong to NHS Newham Clinical Commissioning Group (CCG). The services are provided under an NHS contract and include physiotherapy, acupuncture, steroid injections, spinal injections that are administered off site in a hospital setting, and chronic pain management including associated counselling and psychotherapy such as cognitive behaviour therapy (CBT).
Essex Lodge I-health Ltd also provides a private slimming service from the Essex Lodge (GP Practice) premises, outside of NHS time weekly on Friday afternoons, and once a month on Saturday and Sunday mornings. This is a private service where patients pay for their treatment. The slimming clinic staff team includes four non-clinical administrators (all with a range of part time hours), one GP and one director of operations. Patients are all welcomed and checked in by slimming clinic staff.
The service is registered with the Care Quality Commission to carry on the regulated activities of maternity and midwifery services, treatment of disease, disorder or injury, surgical procedures, slimming clinics, and diagnostic and screening procedures. This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of regulated activities and services and these are set out in and of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Essex Lodge Surgery provides a range of non-surgical cosmetic interventions, for example botulinum toxin injection which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.
Dr Hardip Nandra is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The specialist musculoskeletal (MSK) and Pain clinic service provides a variable amount of appointments ranging from 100 to 200 per month depending on factors such as the time of year, number of referrals from GPs within the local CCG area. The staff team are employed by either: Barts Health NHS Trust, Essex Lodge I-Health Ltd or East London Foundation Trust. The team includes four GPs (three male and one female) including the lead specialist GP who is the Director of Essex Lodge I-health Ltd. The GPs have a range of special interests in areas applicable to MSK care and chronic pain in areas including rheumatology, orthopaedics, and chronic pain management. In addition, there are two consultant anaesthetists, a Cognitive Behaviour Therapist, four physiotherapists and a physiotherapy team leader. Non clinical staff are a full time director of operations and four administrators that work a range of part time hours.
Service opening hours are Monday to Friday from 9am to 6pm, Saturday 9am to 1pm and once a month Sunday 9am to 12pm.
Approximately five to ten MSK clinical sessions run per week, according to patient need such as the number of patient referrals. On an average week there are likely to be a combination of 10 sessions from:
Musculoskeletal (MSK) and Pain Clinics:
- Monday 2:20pm to 5pm - Consultant anaesthetists’ appointments.
- Monday 9am to 2pm – Pain CBT
- Tuesday 9am to 2pm – Pain CBT & Group Sessions
- Tuesday 4pm to 6pm – Physiotherapy
- Wednesday 9am to 3pm – Pain CBT and Group Session
- Wednesday 10am to 1pm & 2pm to 5pm – Chronic pain clinic with a specialist GP.
- Thursday 2pm to 4pm - Chronic pain clinic with a specialist GP.
- Thursday 9am to 12pm - Physiotherapy clinic.
- Thursday 9am to 5pm - Consultant anaesthetists’ appointments.
- Thursday 9am to 4pm - Pain CBT
- Friday Alternate Fridays 2pm to 5pm - Specialist GP Orthopaedic appointments alternating with Specialist GP Chronic pain relief and musculoskeletal clinics.
- Saturday 9am to 12pm - Physiotherapy clinic.
- Saturday 9.30am to 12.30pm - Specialist GP clinic.
- Rheumatology clinics run every first and third Saturday morning of the month.
Slimming Service:
- Friday afternoons – 12:30pm to 3:15pm and 5:30pm to 6pm
- Once a month Saturday Morning – 9am to 12pm
- Once a month Sunday Morning – 9am to 12pm
How we inspected this service
During the inspection visit we:
- Spoke with clinical and non-clinical staff including the lead doctor and service manager and reception and administrative staff.
- Reviewed a sample of patient treatment records and documents and policies for the service.
- Reviewed comment cards in which patients shared their views and experiences of the service.
To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:
- Is it safe?
- Is it effective?
- Is it caring?
- Is it responsive to people’s needs?
- Is it well-led?
These questions therefore formed the framework for the areas we looked at during the inspection.