WF Federated GP Network Ltd

Updated 31 May 2019

Waltham Forest Federated GP Network was formed in July 2014, after GPs in Waltham Forest made the decision to ‘federate’ (work together more closely and share resources) so they could provide more services for local people.

Although people stay registered with their own GP practice, they can access enhanced services – such as weekend and evening GP appointments, through other GP practices who are also part of Waltham Forest Federated GP Network.

The remit of the federation was to share responsibility for delivering high quality, patient-focussed services for the local community as an organisational entity, working together within the local health economy. This could include developing services specifically to suit local needs and submitting bids to deliver services which are already part of primary care services, or which may be delivered in the future. It was also to meet the challenges of the wider health and care economy and more specifically the challenge being faced by local general practices.

Waltham Forest is home to an estimated 271,000 residents and 104,000 households. In January 2019 the registered list size was 314,639. There are proportionately fewer people aged over 50 living in Waltham Forest (25 per cent) compared to the UK average (36 per cent) and the borough is one of the most diverse areas in the country. Forty Eight percent of residents are from a minority ethnic background.

Waltham Forest Federated GP Network provides pre-bookable weekend and evening services at a time that’s convenient to all residents in the borough, via the General Practice Enhanced Service (GPES). Appointments have also been made available on bank holidays. This allows patients to see a GP or a nurse for routine GP appointments, health checks and treatments. People with long term health conditions such as asthma and diabetes can also access these appointments. Because the GPs can see and update patient records during the appointment, it is no different to seeing a doctor at the patient’s registered practice.

The service operates from five GP hubs, all of which offer weekend and evening services via GPES. These hubs are located at:

• Allum Medical Centre, Fairlop Road, Leytonstone, E11 1BN,
• Handsworth Medical Centre, Handsworth Avenue, Highams Park, Chingford, E4 9PD,
• Higham Hill Medical Centre, 260 Higham Hill Road, Walthamstow, E17 5RQ,
• The Grove Medical Centre, 103-105 Grove Road, Walthamstow, E17 9BU and
• Triangle House Health Centre, 2-8 Harrow Road, Leytonstone, E11 3QF

Also operating from the above locations is a nurse-led anti-coagulation service which provides advice and dose recommendation for patients taking oral anticoagulants (e.g. warfarin). Nurses provide dosing advice to patients based on the results of the latest blood test (called INR). The service includes domiciliary visits to housebound patients for testing and management of their warfarin. Referrals to the service are made via the Whipps Cross Anti-coagulation Team.

In addition to the above, Waltham Forest Federated GP Network also provides a bank of clinical staff to work in the urgent care centre (UCC) at Whipps Cross Hospital. The service itself is run by North East London NHS Foundation Trust (NELFT), including clinical supervision and monitoring of service quality. This part of the service provision was not inspected on this inspection.

The service was launched in October 2017. The extended access clinics support primary care services by enabling patients to obtain a pre-booked appointment outside of their own practice’s core opening hours. Appointments can be booked through a patient’s GP practice or the NHS 111 service.

To help people who need to be seen urgently by a local doctor, same day appointments are available every weekday evening between 6:30pm and 9:30pm and between 8am and 8pm at the weekend. The service can also be accessed between 12pm and 8pm on weekdays and between 8am and 6pm on Saturdays and Sundays for pre-bookable appointments. The service does not accommodate walk-in patients. The extended access clinic is registered to provide treatment of disease, disorder or injury and sees approximately 500 patients per week.

The service is located at 500 Larkshall Road, London, E4 9HH and the team comprises four Board Directors supported by a clinical team of four clinical leads and a bank team of approximately 50 GPs, Advanced Nurse Practitioners, Practice Nurses, Health Care Assistants and pharmacists sourced from local practices. There is also an Operational Team comprising two Service Managers supported by one Service Supervisor, four administrators, 24 call handlers and five other administrative staff.

Updated 31 May 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 WF Federated GP Network Ltd on 19 February 2019 as part of our inspection programme. For reasons outside the control of the Provider, that inspection had to be terminated due to the activation of the fire alarm and subsequent advice from the fire brigade not to re-enter the property. This inspection was carried out on 3 April 2019.

This was a first rated inspection for the service that was registered with CQC in October 2017. Our inspection included a visit to the service’s headquarters and to one of its operational locations.

At this inspection we found:

• The service had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.
• The provider routinely reviewed the effectiveness and appropriateness of the care provided.
• Care and treatment was delivered according to evidence-based guidelines.
• Staff involved and treated people with compassion, kindness, dignity and respect. The service was acutely aware of the sensitivities around patient confidentiality, and this was taken seriously, with associated policies in place.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• Leaders had an inspiring shared purpose and strove to deliver and motivate staff to succeed. There was strong collaboration, team-working, and support across all functions and a common focus on improving the quality and sustainability of care and people’s experiences.
• Feedback from patients was positive. There was a strong, visible person-centred culture. Staff were highly motivated and inspired to offer care that was kind and promoted people’s dignity.
• The service had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure at local and organisational level and staff told us they felt supported by management.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care