GP EXTENDED ACCESS

Updated 5 June 2019

GP Extended Access service (GPEA) operates from University Hospital Lewisham (UHL), Lewisham High Street, London SE13 6LH. The service is co-located in the Yellow Zone within the Accident and Emergency and Urgent Care Centres. The service is provided by One Health Lewisham and is commissioned by the local Clinical Commissioning Group (CCG). The facility consists of two consultation rooms, a treatment room, reception area and an isolation room. The premises are managed by the hospital trust, Lewisham and Greenwich NHS Trust. The service is open from 8am to 8pm seven days a week.

The GP Extended Access (GPEA) service is available to any patient registered to a GP Practice in Lewisham and who consents to their medical record being shared. Appointments can be booked by the registering GP practice, Urgent Care Centre (UCC), SELDOC and NHS 111. GPEA does not offer a walk-in service and all appointments must be pre-booked. GP practices in Lewisham can directly book an appointment for their registered patients to be seen at the service including same day appointments. Nurse appointments are also available.

The service is commissioned to provide 29,916 appointments per annum of which 28% (8,928) could be carried out by nurses and the remaining 20,988 (72%) by GP’s.

The clinical team at GP Extended Access is made up of one part time clinical lead GP, 17 sessional GPs, nine part time nurse practitioners and six part time reception staff. The non-clinical service team consists of an operations service manager, an assistant service manager and 6 part time reception staff members.

The provider has centralised governance for GPEA’s services which are co-ordinated by the One Health Lewisham’s board of directors. The provider is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, family planning, treatment of disease, disorder or injury and surgical procedures.

Updated 5 June 2019

This service is rated as Good overall.

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 GP Extended Access on 27 March 2019 as part of our inspection programme. This was the first inspection of this service. The service was registered by CQC on 7 April 2017 is registered to provide three regulated activities: Diagnostic and screening procedures, family planning, treatment of disease, disorder or injury.

At this inspection we found:

• Whilst safety alerts had been managed appropriately, there was no formal safety alert protocol to notify staff who were prescribers or who administered medicines. There was no system in place to ensure oversight that appropriate actions had been completed.
• The service 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 people with compassion, kindness, dignity and respect.
• Patients were able to access care and treatment from the service and reported that they were able to access care when they needed it.

The areas where the provider should make improvements are:

• Review the system for managing safety alerts.
• Continue to implement a quality improvement programme to demonstrate improved clinical outcomes for patients.
• Review the need to have a system to periodically check that risk management activities are being undertaken and retain records of recommended actions and monitor progress on these.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care