Archived: Child and Family Doctors Surgery

Updated 14 March 2017

Child and Family Doctors Surgery provides primary medical services in Barking, Essex to approximately 10450 patients and is a member of NHS Barking And Dagenham CCG Clinical Commissioning Group (CCG).

The practice has surveyed the ethnicity of the practice population and had determined that 35% of patients described themselves as white, 36% Asian, 24% black and 5% as having mixed or other ethnicity.

The practice operates from a purpose built property with all patient facilities on the ground floor which is wheelchair accessible. There are offices for administrative and management staff on the ground floor.

The practice operates under an Alternative Provider Medical Services Contract (APMS) contract.

The practice team at the surgery is made up of: three part-time female and three part-time male GPs. The GPs provide 24 clinical sessions per week. Subsequent to our inspection the practice told us that in addition to the three part-time female and three part-time male GPs, there is a full-time clinical lead GP. The nursing team consists of one part-time nurse practitioner, two part-time female practice nurses. Child and Family Doctors Surgery also employs one full-time and one part-time health care assistant. There are 10 administrative and clerical staff including: a part-time business manager clerical and reception staff.

The practice is open between 8.00am and 8.00pm Monday to Friday, and Saturday between 9.00am to 12.00pm.

Weekday appointments are from 8.00am to 8.00pm daily, with Saturday appointments available from 9.00am to 12.00pm. The practice has opted out of providing out of hours (OOH) services to their own patients when it is closed and directs patients to the OOH provider for NHS Barking And Dagenham CCG.

Child and Family Doctors Surgery is registered with the Care Quality Commission as part of Concordia Limited to provide the regulated activities of: surgical procedures; treatment of disease, disorder or injury; and diagnostic and screening procedures.

This practice has not previously been inspected by CQC.

Updated 14 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Child and Family Doctors Surgery on 9 November 2016. Overall the practice is rated as good.

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

• The practice had identified 55 carers, less than one percent of the practice population.
• The overall clinical exception rate was 15% which was above the local and national averages.
• Patients told us they had difficulty in contacting the practice by phone and in getting an appointment. The practice was aware of these issues and had taken action to improve access.
• 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 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 areas where the provider should make improvement are:

• Review how patients with caring responsibilities are identified and recorded on the patient record system to ensure information, advice and support is made available to all.

• Work to improve its overall clinical exception rate which is above local and national averages.

• Continue to improve phone access and the availability of appointments for the benefit of patients.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 14 March 2017

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 hospital admission were identified as a priority.

• 94% of patients with diabetes, on the register, had a last blood pressure reading within the acceptable range, which was comparable to the national average.

• Longer appointments and home visits were available when needed.

• 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 14 March 2017

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.

• 79% of women aged 25 or over and who have not attained the age of 65 notes’ record that a cervical screening test has been performed in the preceding 5 years, which was comparable to the 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, health visitors and school nurses.

Updated 14 March 2017

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.

• Home visits were available for patients who could not attend the practice.

Updated 14 March 2017

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.

• The practice offered appointments Monday to Friday until 8.00pm and on Saturday mornings for patients who were unable to attend the practice during normal opening hours.

Updated 14 March 2017

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

• 92% of patients with schizophrenia, bipolar affective disorder and other psychoses had had a comprehensive care plan documented in their record, in the preceding 12 months, which was above the national average.

• 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.

Updated 14 March 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, 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.