Archived: Kings Cross Road Surgery

Updated 23 July 2015

The Kings Cross Road Surgery is a surgery located in the London Borough of Camden. The practice is part of the NHS Camden Clinical Commissioning Group (CCG) which is made up of 40 practices. It currently holds an APMS contract and provides NHS services to 2650 patients.

The practice is provided by AT Medics which is an organisation run by six GPs. AT Medics includes 19 GP practices (including Kings Cross Road Surgery), two minor injuries centres and a walk in centre. AT Medics took over the management of the practice twelve months prior to inspection and in that time have brought in standard procedures and there has been improvements shown in the care provided. Kings Cross Road Surgery serves a diverse population with many patients attending where English is not their first language. The practice serves the general population but also a large student population and large Bengali community. The practice is situated on one level and has good access to consulting rooms for those with impaired mobility. There are currently two GPs (one male and one female), a practice nurse, healthcare assistant, six administrative staff and a practice manager.

The practice is open between 8am to 6:30pm on a Monday and Wednesday, 8am and 8pm on a Tuesday, 8am and 1pm on a Thursday and 8am and 7pm on a Friday. Appointments are available from 8:30am to 6:30pm each week day except Thursday where appointments are available to 12:30pm. Extended hours appointments are available between 6:30pm and 8pm on a Tuesday and 6:30pm to 7pm on a Friday. Telephone consultations, email enquiries and home visits are also offered. The practice opted out of providing an out of hours service and refers patients to the local out of hours provider or the ‘111’ service.

The service is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, maternity and midwifery services procedures and the treatment of disease, disorder or injury.

The practice provides a range of services including child health and immunisation, minor illness clinic, smoking cessation clinics and clinics for patients with long term conditions. The practice also provides health advice, blood pressure monitoring and a specialist diabetic clinic.

Updated 23 July 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Kings Cross Road Surgery on 3 February 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing well-led, effective, caring, safe and responsive services. It was also good for providing services for the care provided to older people, people with long term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they were treated with compassion, dignity and respect and that they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care. For example same day urgent appointments were available.
• 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.

There were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Implement a central risk register to capture all risk to patients.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 23 July 2015

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. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For example, the practice had undertaken annual reviews for 31 of the 37 patients on the chronic obstructive pulmonary disease (COPD) register and 27 patients had an agreed care plan. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 23 July 2015

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. For example the practice vaccinated 89.5% of children with the MMR vaccination which was higher than the clinical commissioning group (CCG) average of 87.5%. 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. Appointments were available outside of school hours and the premises were suitable for children and babies, this included baby changing facilities.

Updated 23 July 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. All patients had a named GP and this was recorded within their notes The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 23 July 2015

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 including online booking. The practice provided a full range of health promotion and screening that reflected the needs for this age group.

Updated 23 July 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Ninety five percent of people experiencing poor mental health had received an annual physical health check and 95% had an agreed care plan. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. The practice had the services of a psychiatrist mental health worker who met with patients on a regular basis and was involved in the management of care with the GP.

The practice advised patients experiencing poor mental health how to access support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) who may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs including dementia.

Updated 23 July 2015

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. It offered longer appointments for people with a learning disability and those who needed the support of the in house or telephone interpreting services.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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. The GP also provided a report for the transition of young people in social services care to adult services.