Archived: Sobell Medical Centre

Updated 14 July 2017

Sobell Medical Centre is in Holloway in north London. It is one of the member GP practices in NHS Islington Clinical Commissioning Group (CCG).

The practice is located in the second more deprived decile of areas in England. At 77 years, male life expectancy is lower than the England average of 79 years. At 82 years, female life expectancy is lower than the England average of 83 years. Data from the 2011 census shows the three largest ethnic groups in Tower Hamlets (White British, Bangladeshi and White Other) make up some 78% of the practice’s catchment area. The provider told us that the local population was growing rapidly and that its demography was changing, placing new and increasing demands on the practice.

The provider told us the practice has approximately 3,800 patients and serves an ethnically diverse patient group, with 43% of its patients being of black and minority ethnic backgrounds. This compares with 30% for Islington as a whole and 16% for London. Nine percent of the practice population is aged 65 years and above and 12% are children and young people aged under 18 years. Seventy nine percent of the practice’s patients are in the working age group (18 to 64 years), and there are high rates on unemployment in the local population. Services are provided by Sobell Medical Centre under a General Medical Services (GMS) contract with NHS England.

The practice is in purpose built premises and all patient areas are wheelchair accessible. There is lift and a disabled toilet. There is one treatment room and two consulting rooms.

The two GP partners, one male and one female, work at the practice full time, and there is one practice nurse who works 4.5 days a week (0.9 whole time equivalent). The clinical staff are supported by a team of administrative and receptionist staff and a full time a practice manager.

The practice’s opening times are:

• 9.00am to 1.30pm and 3.00pm to 6.30pm on Monday, Tuesday, Wednesday and Friday.

• 9.00am to 1.30pm on Thursday.

• Extended hours opening times are 6.30pm to 8.15pm on Tuesday.

Patients are directed to an out of hours GP service outside these times.

Weekday evening and weekend appointments are available from the I:HUB service which is run by Islington GPs.

Sobell Medical Centre is registered with the Care Quality Commission to carry on the following regulated activities at 272 Holloway Road, London, N7 6NE: Diagnostic and screening procedures, Family planning, Maternity and midwifery services, Surgical procedures and Treatment of disease, disorder or injury. It registered with the CQC on 13 December 2016. Prior to this date the practice at this address was registered with the CQC as Dr Virender Gupta. Dr Gupta entered into a Partnership with another GP in June 2016 and the new practice was registered with the CQC as Sobell Medical Centre on 13 December 2016.

We have not inspected any GP service operating at 272 Holloway Road, London, N7 6NE before.

Updated 14 July 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Sobell Medical Centre on 06 June 2017.

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 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 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 improvement are:

• Include information about the practice’s safeguarding procedures and protocols in the locum GP pack, in addition to that available on the practice computer system and on display in the consulting rooms.

• Prepare staff so that they know how the evacuation chair is used to assist a disabled person to leave the premises in an emergency if necessary.

• Review arrangements for the identification of carers amongst the practice patient list so that all carers are offered support.

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.

• Data gathered by the practice during the first six months showed that outcomes were projected to be in line with national averages.

• 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. The named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care for those patients with the most complex needs.

• The practice had signed up to the CCG Locally Commissioned Service (LCS) for long term conditions to improve early identification of patients at high risk, for example of chronic kidney disease.

• As part of the NHS Year of Care the GPs had attended care planning training and the practice adopted a care planning approach to caring for patients with diabetes and COPD (chronic obstructive pulmonary disease).

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.

• Data gathered by the practice during the first six months showed childhood immunisation rates for the vaccinations given ranged between 83% to 99%.

• 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 were available outside of school hours and the premises were suitable for children and babies.

• The practice provided antenatal and postnatal care, child health surveillance, and a range of sexual health services.

• It was concerned to improve the uptake of the and of the to improve outcomes for young people still further.

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.

• Where older patients had complex needs, the practice shared summary care records with local care services.

• The practice also identified at an early stage older patients who needed to be placed on the frailty register so that their needs would be anticipated and met.

• The practice recognised the need to develop further its procedures for following up patients when they were discharged from hospital. The practice had put a new system in place when the local enhanced service for avoiding unplanned admissions was ended.

• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible. The practice had identified areas to focus on to improve services for patients further including the uptake of the bowel cancer screening test and the shingles vaccination.

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, including extended opening hours.

• The practice offered online services and a full range of health promotion and screening that reflects the needs for this age group. The majority of pre-bookable appointments were available online.

Updated 14 July 2017

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

• Data gathered by the practice during the first six months showed that outcomes were projected to be in line with national averages.

• The practice specifically considered the physical health needs of patients with poor mental health and dementia. For example 92% to 100% of these patients had had their blood pressure checked and blood tests, and cervical smear for women. There were 57 patients on the practice’s mental health register.

• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.

• The practice regularly worked with multi-disciplinary teams in the case management of patients living with dementia.

• Patients at risk of dementia were identified and offered an assessment.

• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

• Staff 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, for example patients with dementia, patients receiving palliative care, carers, and adult safeguarding.

• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

• The practice offered longer appointments for patients where needed. They also reminded these patients about their appointments by phone, in addition to the text message reminders sent to all patients.

• 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. They had received training including domestic violence and homelessness awareness, for example.