26 July 2018
The Wembley Practice is a GP practice located at the Westmore Unit, Wembley Centre for Health and Care, Wembley, London. The practice lies within the administrative boundaries of Brent Clinical Commissioning Group (CCG) and provides primary medical services to approximately 10,744 patients and holds an Alternative Provider Medical Services (APMS) contract.
The Wembley Practice is managed by the provider organisation AT Medics Limited. The management contract commenced in January 2017, following the relocation of Brent GP Access walk-in centre to a different wing of the centre. AT Medics Limited is run by six GP directors who are all practicing GPs and they manage over 30 GP locations across London.
The surgery is situated on the ground floor, a wing of the large, modern, purpose-built health centre where the previous Brent GP access walk-in centre was situated. It consists of nine clinical rooms, a dedicated reception and back office and a range of offices. The centre comprises four other GP practices, a pharmacy, a dental clinic and other community services. It is located in a residential area, near the busy A404 Wembley High Road. The health centre building is owned and managed by NHS Property Services. Accessible facilities are available throughout the building. There is a public pay and display car parking facility.
The practice population is ethnically diverse with a large proportion (68%) from an Asian background. Less than 2% of the population are aged over 65. The practice area is rated in the fifth most deprived decile of the national Index of Multiple Deprivation (IMD). People living in more deprived areas tend to have a greater need for health services.
The practice team comprises of how two female and two male GPs who collectively work a total of 22 sessions a week. Also employed are two physician associates (physician associates support doctors in the diagnosis and management of patients), a clinical pharmacist, one full-time practice nurse, two full-time healthcare assistants, a phlebotomist, a practice manger and 10 reception and administration staff. They were supported by a AT Medics clinical director and a director of operations and business development.
The practice opening hours are between 8am and 6.30pm Monday to Friday and extended hours are offered on Saturday between 9am and 1pm. Pre-bookable appointments can be booked up to four months in advance. When the practice is closed, patients are advised to contact NHS 111 or the GP access hub located in the health centre. The details of the out-of-hours service are communicated in a recorded message accessed by calling the practice when it is closed and on the practice website.
The practice provides a wide range of services including chronic disease management, flu immunisations, childhood immunisations, child health surveillance, cervical screening, phlebotomy, maternity services and health checks for patients 40 years plus. The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening services; family planning; surgical procedures, maternity and midwifery services and treatment of disease, disorder or injury.
The practice has not previously been inspected by the CQC.
26 July 2018
This practice is rated as Good overall. (No previous inspection)
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
We carried out an announced comprehensive inspection at The Wembley Practice as part of our inspection programme.
At this inspection we found:
- The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
- There was a strong focus on continuous learning and improvement at all levels of the organisation. The practice used innovative and proactive methods to assure effective communications across the organisation. For example, the provider had initiated an online networking tool to share learning, information, ideas including social events and peer support. The provider was using this online tool to monitor the performance and utilising the resources, such as managing staffing levels when the demand increased for appointments.
- The provider sent monthly staff newsletters. This provided them with any information about the practice including clinical updates, staffing matters, training opportunities and any changes within the practice group.
- Staff had access to a suite of bespoke training materials to cover the scope of their work and meet their learning needs. This included access to a corporate learning and development portfolio featuring face-to-face, web-based and blended training programs tailored for each staff role. For example, fortnightly web-based training for healthcare assistants and nurses’ development support, bi-monthly development for practice management, fortnightly consultant led development program for clinicians and monthly face-to-face training for the physician associate and pharmacist.
- The practice used innovative and proactive methods to improve patient outcomes and worked with other local and national healthcare providers to share best practice. This included arranged events such as a health and wellness day and a diabetes prevention week.
- An interactive online messaging system, ‘message my GP’ was available for patients to direct non-urgent queries to a GP, with a response turnaround of up to 48 hours.
- The practice used information technology systems to monitor and improve the quality of care. The electronic dashboard used across the provider group was an effective tool for understanding the practice’s comparative performance across a range of clinical indicators and had provided access to bespoke searches relevant to medicines management and effective care. This enabled the practice to readily identify when follow up tests and screening were due in the management of patients with long term conditions and those experiencing poor mental health.
- The practice had strong visible and clinical managerial leadership and governance arrangements.
We saw an area of outstanding practice:
- The provider worked in collaboration with a social enterprise and set up a website facility called ‘Talking from the heart’, which was aimed at patients from ethnic minorities suffering from mental health conditions. This was set up due to the stigma surrounding mental health and communication problems in some communities, which often meant patients did not seek support. In collaboration with several ethnic minority groups and mental health professionals, they developed four short films in three spoken languages, which could be used by primary care practitioners with their patients or with community groups. The films combined medical and religious advice and addressed stigma.
The areas where the provider should make improvements are:
- Take action to ensure the practice safeguarding leads are recorded clearly in all the safeguarding policies.
- Monitor and continuously review the system in place for checking vaccine fridge temperatures.
- Continue to monitor and improve on child immunisation uptake.
- Continue to monitor and improve the uptake for cervical, bowel and breast cancer screening.
- Review exception reporting and take appropriate action where progress is not achieved as expected.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice