• Doctor
  • GP practice

Willow Tree Family Doctors

Overall: Good

343 Stag Lane, London, NW9 9AD (020) 8204 6464

Provided and run by:
Willow Tree Family Doctors

This service was previously registered at a different address - see old profile

Latest inspection summary

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Background to this inspection

Updated 29 March 2017

Willow Tree Family Doctors provides primary medical services in Brent to approximately 12,000 patients and is part of Brent Clinical Commissioning Group (CCG).

The practice population is in the sixth most deprived decile in England. The percentage of children registered at the practice who are living in income deprived households is 18%, which is lower than the CCG average of 27%. The percentage of older people registered at the practice who live in income deprived households is 26%, which is the similar to the CCG average of 27%. The practice has a higher than average proportion of patients aged between 25 and 39 years.

The practice team at the surgery is made up of three male GPs and five female GPs who are partners, one male salaried GP and one female salaried GP. In total 56 GP sessions are provided per week. The practice has two full time female nurses and a full time female healthcare assistant. The practice team also consists of a practice manager, assistant practice manager, administrator, two clinical coders, a reception manager and 10 receptionists.

The practice operates under a Personal Medical Services (GMS) contract, and is signed up to a number of local and national enhanced services (enhanced services require an enhanced level of service provision above what is normally required under the core GP contract).

The practice is open between 8:30am and 6:30pm Monday to Friday. Appointments are from 9am to 12pm and then from 3:30pm to 6pm daily. Extended hours appointments are offered from 6:30pm to 8pm on Mondays. In addition to appointments that can be booked in advance, urgent appointments are also available for people who needed them.

When the practice is closed patients are directed to the local out-of-hours service.

The practice is registered as a partnership with the Care Quality Commission to provide the regulated activities of diagnostic and screening services; maternity and midwifery services; treatment of disease, disorder or injury; surgical procedures; and family planning.

Overall inspection

Good

Updated 29 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Willow Tree Family Doctors on 24 November 2016. Overall the practice is rated as good.

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

  • 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.
  • Outcomes for patients were comparable to local and national averages with the exception of the uptake of childhood vaccinations, which were comparable to local averages but significantly below national averages for some vaccinations.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment; however, members of the Patient Participation Group had said that it could be difficult to read the information displayed on the television display screen in the waiting room, and there were no information posters displayed in the area.
  • 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 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 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.

We saw one area of outstanding practice:

The practice had been working closely with staff from the supported living home situated next door in order to improve outcomes for residents with long-term conditions. They met regularly with staff from the home to discuss patients’ conditions and provide training on managing long-term conditions. We saw data which showed a positive impact for patients of this joint approach. For the five month period prior to the practice starting this joint working (November 2014-April 2015) there had been 80 ambulance call-outs and 23 unplanned admissions to hospital for these patients. Work with the home started in April 2015 and data showed that for the five month period following the work commencing (May to September 2015) there were 17 ambulance call-outs for these patients (a 78% reduction) and eight unplanned admissions to hospital (a 65% reduction).

The areas where the provider should make improvement are:

  • They should review the way that information is displayed in the waiting area to ensure that it is accessible to all patients.
  • They should consider what further action they can take to improve their uptake of childhood vaccinations.
  • They should ensure that waste bins are labelled to indicate the type of waste they are for.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

People with long term conditions

Good

Updated 29 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.
  • Performance for diabetes related indicators were better than local and national averages. Overall the practice achieved 100% of the total QOF points available for diabetes indicators, compared with an average of 89% locally and 90% nationally.
  • Longer appointments and home visits were available when needed.
  • The practice offered care plans to patients with long-term conditions, and had completed 188 during the 2015/16 reporting year.
  • All these patients had 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.

Families, children and young people

Good

Updated 29 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 comparable to local averages, for all standard childhood immunisations, but in some areas were significantly below national averages.
  • 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 82%, which was comparable to the CCG average of 77% and the national average of 81%.
  • Appointments were available outside of school hours and the premises were suitable for children and babies.
  • We saw positive examples of joint working with health visitors.

Older people

Good

Updated 29 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.
  • The practice identified patients who were at high risk of unplanned admission to hospital and worked closely with these patients to ensure that these patients had priority access to a GP.
  • All patients aged 75 years and over had a named GP.
  • The practice’s performance in relation to conditions commonly found in older people was comparable to local and national averages. For example, The percentage of patients with hypertension who had well controlled blood pressure was 91% compared to a CCG and national average of 83%.

Working age people (including those recently retired and students)

Good

Updated 29 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 and text message reminders, as well as a full range of health promotion and screening that reflects the needs for this age group.

People experiencing poor mental health (including people with dementia)

Good

Updated 29 March 2017

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

  • Performance for mental health related indicators was comparable to local and national averages. The practice had 67 patients diagnosed with dementia and 89% of these patients had had their care reviewed in a face to face meeting in the last 12 months, compared to the CCG average of 86% and national average of 84%. The practice’s exception reporting rate for this indicator was 10% compared to the CCG and national average of 7%.
  • The practice had 116 patients diagnosed with schizophrenia, bipolar affective disorder and other psychoses and 95% of these patients had had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the CCG average of 91% and national average of 89%. The practice’s exception reporting rate for this indicator was 3% compared to the CCG average of 7% and national average of 13%.
  • The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
  • The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. The practice hosted counsellors on site as part of the Improving Access to Psychological Therapies (IAPT) initiative. Patients could be referred to this service by a GP or could self-refer.
  • 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.

People whose circumstances may make them vulnerable

Good

Updated 29 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 and those with a learning disability. The practice had 85 patients on their learning disability register and on the day of the inspection, they had completed annual reviews for 47 of these patients since 1 April 2016.
  • 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.
  • The practice was situated next door to an assisted living home, and had been meeting regularly with staff from the home to discuss patients’ conditions and provide training on managing long-term conditions. We saw data which showed that since starting this joint-working pilot there had been a reduction in the number of unplanned admissions to hospital for these patients.
  • 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.